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.

Today was a bit of a bugger for no end of reasons, so I'll just list the reasons here.

1) Went down to my garage to find that it had been forced open - luckily the car was still there, and I have nothing else to steal in the garage. The vandals/thieves had gone along the row of garages breaking into them and vandalising cars.

2) Turned up on station to find that there was no work for me - so the resource centre let me go and report my crime (bless their little cotton socks) - then sent me to another station to pair up in the Rapid Response car.

3) I was told that I would be working for the next nine days (because of a discrepancy between the resource centre and my station) I went running to the station officer which has sorted it all out nicely. Now I have some actual time off where I won't be feeling sick as a dog.

4) In a lull during work I went to my council office to tell them about the damage done to my garage - they told me it would be seven days before they could fix the door.

5) On the way home I bought a new padlock for my garage door, thinking that a garage unlocked for seven days would mean me saying bye-bye to my car (it has been stolen 6 times previously). When I reached home the council had fixed my door and put a new padlock on the door. So I had to turn around and head back to the council office so I could get the keys to allow me access to my own garage. I'm now £15 ($26) out of pocket for a padlock that I won't be using.

6) I learnt that some chemical cleaning agents will actually strip the enamel off your bath.

I am tired, I am fed up and I'm on the Rapid Response car again tomorrow; but I won't be driving as I'm "not insured" - I'm insured to drive a big white deathtrap around London, but not a normal (if speedy) car. I don't understand, and I don't think I want to.

Still this has given me the final kick in the arse to ask for a transfer to a nicer bit of London - I'm getting a bit tired of workmates saying "You live _THERE?_ Why?" when they find out where I live. It'll probably take years before they move me, but it's worth a try.

As for work, all our emergency calls were quite simple and I think I spent a total of ten minutes "face-time" during the entire shift. Which is a bit dull, but is a nice warm-up to get back into the swing of working after such an extended "sickness".

The good news about my rota change is that I can definitely go to the London Blogmeet on the 12th of May, and I only need to get one day off to go to the Blogmeet on the 8th of May.

But now I just want to go to sleep.

For the past couple of months I've been teamed up with a regular crewmate, working a regular rota. This is a good thing as it provides stability, enables you to get, for want of a better word, a "bond" with your crewmate (rather than working with a different person every shift) and a chance to plan around your off-days some time in advance.
While I have been away from work, my crewmate has been "third manning" with someone who has just come off long term illness; third manning is where someone who might not be 100% fit joins a regular crew so as to ease themselves back into work - it's a good idea and works well. So my crewmate and various reliefs have been working with this return-to-work person.
Last night I got a phone call from one of my managers.
(Can you guess it didn't go well?)
Apparently I am being moved from my regular crewmate to someone else - while my crewmate is being teamed up with the fella returning to work. This means that my place on the rota will change - throwing all my plans for the next few months into disarray, meaning I get to work all of next week where I should have had a week off, and making us get used to working with new partners.
The other problem with this is that the return-to-work fella has thrown his back out quite seriously, so my old crewmate will be working with a different person every shift, until the fella with the injured back is better.

My manager was phoning me because he'd forgotten to tell me any of this in advance...

Consequently my life is up in the air at the moment while we sort out what is going on, just as I was planning on going on two London Blogmeets in the near future.

I think I'll go and have a chat with him tomorrow, and make a few suggestions - I don't think he'll listen as to change things back would be a headache for him, but I may as well give it a shot.

I finished my ECG course today, and I found it a good course, most of which was a revision for me, but it did teach me a few new tricks.

Back to the road tomorrow - Happy, happy, joy, joy!

Today was my first day back at work in a month - although to call it "work" would be a bit of a lie. Instead I'm on a two day course concerned with reading ECGs, this is easy for me as I spent eight years as an A+E nurse taking and reading perhaps 20 ECGs a day. So instead I caught up on some of the gossip from West Ham via my crewmate who is also on the course. However the most exciting bit of gossip came not from him, but instead from an old friend of mine.
The center in which this course is run, is also where the new trainee EMTs are trained, and I was surprised when I saw a receptionist from one of the hospitals that I worked in wearing the trainee "boiler-suit". When I asked her if there was any news from the hospital she told me of one of the sisters being sentenced for six months in prison!
When I was still working there, some Pethidine went missing, Pethidine is a "Controlled drug" as it is a powerful opioid, in America it is better known as Demerol and is often abused. When this drug went missing the sister in question blamed agency nurses - this apparently happened on a number of occasions and the police were eventually called in. It then transpired that this sister had been faking patient documentation in order to feed her habit. Now her marriage (to a policeman) has ended, her four children have been taken, she is spending the next six months in prison and she has lost her job.
The judge commented that although her friends had been witnesses to her good character, she tried to blame them as soon as she took the stand; also she had abused the trust given her by both patients and other staff.
Now if you had asked me which member of staff would have taken the the drugs, she wouldn't have even been on the list.
Just goes to show, you never know who to trust...

In twelve hours I will have stopped PEP. Those pills are the last ones that I am going to take. I am extremely happy about this. It has been a month since my stomach didn't feel as if I were waiting to vomit, a month since my thought processes have seemed even remotely like mine. A month since I last worked, good grief, am I bored! A month of wondering if my life is about to change for the worst. A month of my mates looking sideways at me when I had to take the pills in front of them (but still enough my friends to laugh and joke with me about it). A month of having to get out of bed to eat breakfast, because the pills need food in my stomach. A month without shaving (why bother, I'm not allowed to have sex). A month of feeling just the tinest bit isolated. A month of people who I have never met, from places around the globe I have never seen, wishing me well. A month of always feeling grateful to those people, for this is the kindness of strangers - in itself a random act of reality.

All over now.

In two months I get to go for my HIV test, which should be fun and giggles.

But for now - I'm happy.

Unlike America, the fire service and the ambulance service are two completely different things - all I know about fighting fire is to throw water on it, and all the firebods know about medicine is that they need to call us out. There is a bit of trouble in Tower Hamlets at the moment, as the government wants the fire service to start responding to medical emergency calls. They will provide a whole two days worth of training so that a fire engine can be dispatched to "Cat A" medical calls (Cardiac Arrests, Difficulty in Breathing, "Serious" bleeding). This is in part due to the Bain report that recognised that the fire service spend too much time sitting on station, and is looking for new roles for them.

The following Press release pretty much says it all

The Fire Brigades Union balloted for industrial action yesterday over what it claims is an attempt to force members to work as surrogate ambulance crews.

The FBU is angry about plans to run a "coresponder" project in Tower Hamlets in east London, which would see fire crews trained to make an initial response to medical emergencies. Both services would receive emergency calls and fire crews would be dispatched to emergency medical cases where they were judged most likely to reach the patient quickly. They would carry a defibrillator, first aid kits and oxygen to keep patients stable until the ambulance arrived.

The FBU says its members are being forced to undertake the training, unlike some of their colleagues in rural areas who have volunteered to train. They say there has been too little consultation on the training and no clarity about the legal liabilities of those who become involved.
The union is asking its 260 members in Tower Hamlets for permission to take any industrial action short of a strike. This would mean fire crews refusing to train for coresponding duties, declining to use the equipment and refusing to attend any coresponse calls.

Mick Shaw, a member of the London FBU executive, said: "If we are out dealing with ambulance calls we will not be dealing with fire calls and that will worsen the fire service. We also don't believe our members will be properly trained to deal with the sort of situations they are likely to encounter. What we need is a properly staffed ambulance service able to meet its response times."

But Brian Coleman, the deputy chairman of the London Fire Authority, criticised the union. He said: "How can anyone have a dispute over the introduction of life-saving mechanisms? It is absurd that as things stand, a fire engine can pass someone having a heart attack and cannot do anything about it."

A spokesman for the Fire Authority said they were trying to negotiate terms with the FBU. There are similar arrangements in Devon, Cornwall, Lincolnshire, mid and south Wales and in Berkshire, where the management and the local FBU are in dispute.


There are a number of problems with this idea as I see it so far...

Would you like a pump and eight firemen turn up to your first heart attack?
Learning Basic CPR and some advanced skills takes two days, they may be able to deal with a cardiac arrest (but not to the same degree the LAS can) but won't be able to deal with anything else.
They may find themselves sitting around looking at you while you are dying, waiting for the LAS to turn up.
Most of our Cat A calls are complete rubbish - the firebods aren't going to be happy running on some of the calls we run on...
Why not throw the money at the ambulance service, so that people properly trained to be medic responders can get on with the job?
Ambulances aren't equipped to put out fires, fire engines aren't equipped to transport patients...
I suspect that it will put more of a strain on our inter-service professional relationship.

So good luck with the industrial action lads - I suspect a lot of the LAS are behind you.

We get called to a lot of "Rubbish" jobs, and always there is the temptation to leave them at home after giving them a bit of health promotion advice (A.K.A "Telling them off"). Sometimes however you have to listen to your intuition and take them - even if the patient doesn't want to go...

(You have to "persuade" them, we can't kidnap people off the street - not yet anyway)

We got called to a 53 year old male who was complaining of difficulty in breathing. When we got there the man was sitting on the floor hyperventilating, after a bit of a chat he told us that he has a history of hyperventilating and of gastric (stomach) pain. He looked alright to me, but there was something that I didn't like about him. He didn't have any other symptoms and his breathing soon settled down to normal leaving him with the gastric pain - which he could control with his medication.
But something just wasn't right - so I persuaded him to come down to the ambulance for a check-up. We wheeled him downstairs and connected him up to our ECG machine - which shows the electrical activity of the heart.

We saw this...



Which I suspect will have the medics who read this weblog jumping up in their chairs.

Basically he was having a heart attack.

Needless to say, we rushed him to hospital, where he got the treatment he needed and has made a good recovery. He had none of the other signs and symptoms of having a heart attack - he wasn't sweaty, his breathing was due to his hyperventilating, he wasn't having any cardiac pain and he just didn't look like he was having a heart attack.
Don't ask me why I thought he needed an ECG, don't ask me why we wheeled him downstairs instead of making him walk, I just guess it was intuition - and I've learnt to always listen to my intuition.

For those who don't know what the above picture shows, allow me to educate you.

The pattern that is normal for a heart trace is more or less this...



But in a heart attack something called the "ST Segment" is raised above the normal line like this...



Basically if it is raised more than two of those little squares there is a strong suspicion that a heart attack is causing it



For all those who are medically trained, I know that this is overwhelmingly simplistic, but I thought I'd give it a go...

For more information you might want to check this site or even here