Some people are stupid - really stupid. A case in point was the job I had this morning. We got called to a male with vomiting. When we got there we were given a letter explaining that he has "Idiopathic cyclic vomiting". Which, translated into English, means he has episodes of vomiting which cannot be explained by any other means. When we got there he was doing the "dry heaves", he had a temperature of 38.1C (Normal range is 36.2C-37.2C) so he was hot, and feeling terrible for it.
So obviously his family had wrapped him up in a blanket "to keep him warm". When people get a high temperature they often feel cold. The solution for this is to cool them down, and they will soon feel much better - often the trip in an ambulance will do this nicely.
I explained all this to the patient, and his wife but they insisted on bringing the blanket with them (like we don't have enough blankets in the back of our ambo). I refused to let him wear it, and lo and behold, he began to feel better as he cooled down. I explained all the above to him and his family again - that he was now feeling better because his temperature was lowering, that the blanket is the worst thing you can do, etc, etc...
We booked him in at the hospital, and as I turned around to leave, what do I see but the bloody idiot wrapped in his big thick blanket.
Well, if you are that stupid you deserve to feel like crap, and as I wasn't going to repeat myself again I left him to suffer.

I got home to find a message on my answer machine from Occupational Health asking me to ring them as soon as I can. Unfortunately I'm home too late to ring, and because Monday is a Bank holiday, I suspect that the first time I will be able to ring them is on Tuesday.
I'm hoping that the reason for the call is to remind me to get a blood test over the weekend and nothing more serious.

But I think I'm in for three days of vague worry as various scenarios rattle through my head.

One of those posts that goes nowhere.

If there is one (pointless) thing that rubs me up the wrong way, it's unpolished boots. I have to keep my boots polished - it's not a fetish, I was never in the army, and the rest of my uniform is can only be called clean in a charitable sense.
But why did I buy some another tin of polish when I had bought some a week ago and have hardly used it?

Maybe it is becoming a fetish...

Not much to do today, two chest pains - of which one was more of an abdominal pain. However he had had a heart attack and angioplasty a couple of weeks ago and his elderly wife was seriously fretting. When we told her that the nearest hospital that would see her husband was the Royal London she was mortified. Apparently the Royal London has had some increased number of Hepatitis cases (hardly surprising given the area which it services). We managed to calm her down until we got her to the hospital where she started to panic again.
We left her in the capable hands of the nurses...

Another job was opposite where I live - these jobs tend to make me paranoid for the safety of my flat. Given the area in which I live, if people know when I'm working I might find myself burgled. The job itself was a simple 18 month child who'd hit his head on a door frame.

The last job we had was the most "interesting". We got the call as "Male fitting", when we turned up he wasn't fitting but he was acting very strangely (this is normal after epileptic fits and is called "post ictal"). He was shouting, waving his hands around a threatening to shoot people if they called him a "whore".
We were a bit concerned for our safety as this fella looked as if he could handle himself and there were several tell-tale marks that led us to believe he had been in more than one street fight.
We managed to get him in the ambulance and got him seat-belted (in the UK we are not allowed to put anyone in restraints) and I drove us through a couple of red lights to get us to hospital before he turned even nastier.
The nurse who took handover was a "development" nurse - which means that she doesn't get to see patients but that she has sat some exams in "time/motion studies" and "implementing change" - all those wishy-washy nursing courses that drove me away from the nursing profession.
She then proceeded to insist that the patient had an altered GCS.

GCS is a measure of consciousness - you score the patient out of 15 depending on how orientated they are, how they open their eyes and how they respond to commands/painful stimuli. It's more complicated than that but this is an "idiots guide".

Our patient had a GCS score of 15 out of 15, he wasn't confused (he knew where he was, what date/time it was and what was happening to him) and his other markers were fine. But she insisted that it was altered.
She doesn't know I was an A&E nurse and therefore not scared of her, so I took her step by step through the scale throwing in such gems as "Inappropriate mental processes", "Maintains eye contact" and "bargaining during the scenario" (these are all buzzwords I learnt doing my psychiatry studies). I think she was a bit surprised that a "mere" Ambulance driver could do such a thorough mental assessment on a violent patient.

And she finally agreed his GCS was indeed 15.

My first "proper" day back at work, working with my new crewmate on a proper truck.
I shouldn't have mentioned that all I'm going to be seeing is little old ladies with medical problems...

The first job was a 66 year old male who had been fixing tiles on his shed roof and had fallen off the ladder, probably around 10ft. He was shut behind his front door and all I could hear through his letterbox was "I've broken my leg". The police are much better than me at getting into locked premises (last time I tried I fell on my arse in front of a crowd of 20 people) so we waited for them to arrive and use their specialised equipment (screwdriver/size 12 boot) to force open the door. Gaining access to our customer it was pretty obvious that he had fractured his femur (thighbone) as it had a new bendy section just above the knee. The pulse was good in his foot and didn't complain of pain anywhere else in his body. This brave man had crawled, with this fracture, from his garden; through his kitchen to the living room where he kept his phone. All throughout he didn't complain once. We splinted his leg and "collared and boarded" him from the house (a fall of 10ft can easily break your neck, and the pain from his leg could easily distract him from a neck injury). We could have set traction on his leg, but we were only five minutes from the hospital; so we "blued" him into Newham where he was "attacked" by the local trauma team.

The next job we got was a dinner lady at a local primary school who had dropped a knife on her foot. There was a tiny cut to the foot, and after cleaning, dressing and checking her tetanus status left her at work. What depressed us was that there were no scraps of food left we could have.

Driving back from the last job we saw three men chasing another who ducked into the local mosque - we ignored this until we got a call to the area the men had run from - apparently a man had been assaulted with a Car-lock". HEMS (our helicopter service) had been activated and were going to make their way to the scene. When we did a quick U-turn and rolled up to scene it soon became obvious that HEMS was not needed so we cancelled them down. The man had been clamping an illegally parked car when the owner and his wife returned. The owner then pulled a large aerosol can from his boot and hit our patient around the back of the neck, causing a short period of unconsciousness. His wife had also put up a fight, but the owner of the car had run (into the aforementioned mosque) leaving his wife behind. (What a gent!). At one point we thought it was going to turn into a riot as 30 youths from the mosque were adamant that the four workmen doing the chasing weren't going to set foot in the mosque.
Again, we had to collar and board him, and lift him onto our stretcher - which wasn't fun as the man weighed at least 20 stone. Subsequent treatment at hospital showed no serious injuries.

Final job (after having to get our nice, new, shiny ambulance fixed - a problem with the side-door) was a 60 year old female collapsed at a bus station with slurred speech and "not drunk". Remember that, "not drunk", it's important. What could it be? Could it be a stroke? Could it be hypoglycemia? Could it be cardiac related? So we turned up to find "Mary" having fallen over, smelling strongly of alcohol and with a 5/6ths empty bottle of whiskey in her purse.
"Not drunk" - why did the callmaker say that? It's bloody obvious she is pissed as a fart. I'd guess it was the bus station staff who wanted her gone and was afraid we wouldn't turn up if we knew she was drunk. Still it was an easy last job of the shift, even if she did keep grabbing at my balls and kissing my (thankfully) gloved hand.

This counts as a good day.

Now I'm off for some endorphin-releasing Baileys ice-cream.

My brother is a teacher, he is extremely smart and really should be blogging about the crap that he goes through - but he just can't be bothered.

His school has spent a fortune in constructing a new "eco-friendly" building - it has solar panels, efficient light-bulbs, effective insulation - that sort of thing.

However, so that people can see this new building from the street, they are cutting down the trees that block the view.

This is from the same authority that tells their teachers that they can tell Autistic children because "they are polite, shake your hand and have large foreheads"!

Is it any wonder children seem to be getting less and less interested in education?

Yes I have been mucking around with the formatting of this site - I don't know if I like this new look or not, or if I'm going to change it further. Lets just call it an experiment.

My brother, his ex-girlfriend and myself went to see The Divine Comedy at the Palladium last night. It's been years since I went to a gig that you sit down at. If there is one thing the Palladium shows us, it's that people used to be small. The seats and the spacing between them are tiny - I spent the whole night crunched up unable to move a muscle. I might be 6'1" tall but last night was the first time I really felt it. It was a good thing the music was so good, as this excused the lack of space coupled with the sweltering heat of a packed venue.
The venue was also being filmed for a forthcoming DVD release so there were a lot of cameras flying about, something I'm used to given the number of festivals that I've been to.
There was a 15 piece orchestra on stage, which gave me a chance to exercise my fetish of women who play classical instruments...
The music was excellent, Neil Hannon is a great writer and coupled with his singing skills the night was a complete success - from the most jazzed and languid "Songs of Love" to the audience participation on "National Express". Highlight of the night for me though was the cover of Queens of the Stone Age track "No-one knows" - Imagine it being played by this aforementioned 15 piece orchestra and being proceeded by a tale of leaf collecting and ancient German folk polkas...
A bloody good night - I love live music and need to make the effort to go to some more gigs.

Back to work on a "proper" truck tomorrow with my new partner "C". I'd be looking forward to it if I wasn't on the "granny run" shift. This is a daylight hours shift where you find yourself mainly picking up little old ladies who a doctor has already been to see and transporting them to hospital - plenty of lifting and very little fun at a drunken patients expense. The only bonus to this shift is that my body clock is "normal" to the rest of society.

According to Blogrunner's ranking system the most influential Bloggers are here (from Loic Le Meur). It is generated using the Pagerank system, which is based around the number and "quality" or other websites linking to them. Take a look, most of them seem to be Bloggers from traditional Media (The Washington Post, The New York Times, Guardian Unlimited) and almost all of them are American (congrats on PlasticBag on being the first non-media, British blog I see there).
There is no doubt some insightful commentary on why the traditional media have the most links - is it because most Bloggers (myself included) comment on current affairs rather than come up with original writing? Is this a good or a bad thing? Are original writing blogs "discovered" as easily as they should be? What is my favourite type of cheese?

I don't know, I'll leave it for people brighter than me.

There are two Blogmeets that I'm planning on attending in the next couple of weeks - The 12th of May, which I can definitely attend, and the 8th of May, which I want to go to, but will need some annual leave for that evening.
But...
I'm actually quite a shy person. When I'm wearing my uniform I think nothing of ordering police, firemen and the public around if it is for the best interests of my patient. In my uniform I can strip people naked and stick needles in them and they are happy for me to do this. I don't get embarrassed at nudity, bad behaviour or anything else that would make your normal person blush. I tell off-colour jokes, walk into dangerous situations and shout at idiot drivers.
But without the uniform I'm a shy little wallflower. I hate being in a large group of people I don't know, I find it hard to introduce myself, or maintain a conversation. I worry that I look like an idiot, and I'd rather wrestle a knife wielding manic than try and "chat up" someone. (Not that I'm on the pull or anything)
So these Blogmeets will make me very nervous - Full of people who seem to know each other, I know I'll feel like an outsider. Most of the folks who read this Blog are other Medics - just that they are all in America...

Then there are the problems of etiquette...
What if I've never heard of your Blog?
What if I don't recognise you from the picture of you on your Blog that I do read?
What if I get a case of Hero Worship?
What if no-one has ever heard of my Blog, will they think me a "pretender"?
What is the dress code for these things?
Will there be enough alcohol to give me "Dutch courage"?
Will I even be able to recognise other people as Bloggers?
What if they have read this Blog, and think my posts/grammar/attitude is/are crap?
Will my breath smell?
What if I can't make good on my promise of assassinating other, better authors?

As you can see this has the possibility of leaving me a quiver wreck in the corner - which would be a bad thing...

Any advice for a wallflower?

All I know is that I can't wear my uniform there, as I'd get the sack wearing it outside of work.

I told you that big things with flashing lights are invisible...

Damn that Cory Doctorow and his insight. His description of London is something that is so simple and pure - yet something I, a Londoner born and bred, would never have seen. We should all be thankful his intelligence is working for the good guys at the E.F.F.

I may have to kill him when I see him - just to stop the rest of us looking bad, other people I may have to kill include Londonmark, Diamond Geezer, Dave and Gary Turner. Go read them before I make them become "yet another statistic"

"The other side of EMS" have lost a member of their team. My sympathies go out to all concerned, his recent posts have been from the heart.

I am definitely able to go to the London Blogmeet on the 12th of May, and I'm hopeful that I'll be able to make the one on the 8th. Two social occasions in the space of five days? Makes me feel young again.

I'm still struggling with learning CSS so I can change the template of this page. But I'm a bit worried I'll just muck it up.

"Jellyman" by Autamata is soothing my fevered mind. Like Lemon Jelly, it's the sort of music I love to wind down to.

I get to see The Divine Comedy on Monday with my brother and his friend. Previous shows have been good, so I'm rather looking forward to it.

Another day spent on the Rapid Response Unit - absolutely no medical/trauma emergencies. One "frequent flyer" that I haven't seen in - oh, a month.

"Trauma" on BBC One (and Three) is about the area in which I work, some of my friends are on camera as well. Not a bad programme but it does make it out to be more interesting than the job really is. (I may be in the background of an episode, Hell I was captured opening a door and bashing a doctor in the back with it...) It's nice to watch something on telly going, "I've been there", "it's all scrotes in that area" and "That was the nurse that killed my patient"...

I think my guts are getting back to normal, as I've been farting all day - something that is not recommended when you are sharing a small car with a woman you hardly know...

Recent articles by Pixeldiva and Pete have me eyeing my "rubbish" drawer, I have too many things of no use - and so tonight I shall wade through them with the sword of pragmatism pruning the bush of detritus. (Do you think I stretched that last sentence too much?)

My "SuperMop" I bought yesterday has resulted in the cleanest bathroom floor I have ever seen*. I am most pleased.

*Well, in any property that I've lived in.