Some unusual jobs today, the first call was to a concrete company (which will remain nameless - no doubt they have better lawyers than I). We were told to meet with the Police and Fire Service at a RVP (meeting point). It turns out that some animal liberation types have taken offence to this company (rumour being they are supplying to concrete to a new animal testing lab), and have sent some deactivated incendiary devices to various branches in order to scare them. Today in three of the offices across London some 'suspicious packages' had turned up, and we were being sent to cover the defusing of these devices. Two ambulances, one Duty Officer, three fire engines and countless police were there, standing around the, now evacuated, offices. Our Duty officer started allocating 'Major incident' roles to everyone. I don't think he wasn't best pleased when I asked him why, when major incidents are designed to deal with multiple casualties, we needed to play that game when the only person in any danger in the now deserted office was the bomb disposal officer.

He sent me to arrange the parking of the emergency vehicles.

We were soon stood down however, when it was discovered that the 'device' was actually a packet of envelopes.

The next call was to two brothers who had fought over possession of a bong, with one brother trying to sell it to a third brother. Both we and the police were sent, when we got there both brothers had calmed down and there were no serious injuries. One policeman was confused about what a bong was used for, until I explained that it was 'drug paraphernalia'. One of the brothers told the policeman that he was selling it because he didn't use it - he much preferred smoking his cannabis in a spliff.

Luckily for him the policeman ignored this massive blunder (and me collapsing in tears of laughter at this idiot essentially confessing his drug habits).

Our next interesting job was to a man in Docklands who had a head injury caused by trying to avoid an attacking seagull. It turns out that there is a seagull living there who dive-bombs people passing by. This man had ducked the avian attack, then tripped and fell flat on his face, knocking himself out. He had only minor facial injuries, but the loss of conciousness will mean a short stay in hospital being watched. My old crewmate suggested that he sell his story to the newspapers.

The rest of our jobs were rather boring after this early excitement.

...because it is more trouble than it's worth.

An exceptionally good article over at Black Triangle, I was going to comment on the Plans to make 'inciting religious hatred a crime', but this is so much better than anything I could write.
It also confuses me - If you believe in *insert almost certainly fictional, all-powerful entity here* and that entity tells you that all other religions are wrong, then isn't it a tenet of most faiths to speak up against 'false' Gods and unbelievers. Couldn't this be construed as inciting religious hatred?

For me the Christian God exists only in so much as it makes the shops shut early on Sundays and I get extra money for working on Christmas.

(Given our multicultural/multi religious society, shouldn't I get extra money for working on Eid, Guru Nanak's birthday and Purim? Or should I get nothing extra because I'm a godless heathen?)

Today was extremely windy, one of the things that I learnt when I was pretending to be a teacher was that if there is high wind, the kids will go nuts. It's not just the children that go crazy, it seems some of the adults will go mad as well. On my first job, a grand total of seven pedestrians leapt out in front of my ambulance. I managed to miss all of them which was a minor miracle as I hadn't had my early morning cup of tea - and was therefore not properly awake, and in a bit of a foul mood. Luckily I had the 'pride of the fleet', a decrepit model LDV with the acceleration of an arthritic snail.

My mood wasn't helped by the 14 year old boy who, having been slapped by his stepdad, called the police and an ambulance. The boy (who has been permanently excluded from school) had an argument with his stepfather, who had then slapped him on the neck. Absolutely no injury at all, and I'm sure my buttocks had gotten worse than that when I was a kid. This stroppy child had wasted the time of four policemen and an ambulance - all because he had probably misheard some of the recent debate about smacking.
My personal view is that children are like puppies, they sometimes need the shock of pain to learn a lesson - all the 'hippy' ideals of the eighties have bounced back as teenagers who have no respect for discipline.

It's not just the children either, one of our jobs was to a school where a twelve year old boy had been in a fight, his sister, who was about 25 years old was there with her friends, and she was shouting about how she was going to beat up the kid that had hit her brother. My crewmate decided that the best thing (given that the hospital was no more than 1000 yards away) was to ignore her comments and get them offloaded onto the hospital as quickly as possible. I was grinding my teeth the whole way, the sister was extremely aggressive and constantly 'mouthing off' about how she was going to cause trouble. When we got to the hospital she asked me 'where's the toilet?', and I must admit it took a serious effort of will not to ask her where the 'please' had gotten to. The last we heard of her, was her shouting in the childrens waiting room "I ain't gonna f**king turn off my mobile, I read in the paper it don't do f**k all to the machines".

She could do us all a favour by stopping breathing.

But it wasn't all bad, we had two calls, one after another to an 'Arthur'. Neither of these two elderly men were particularly ill, but both were very likable. One had a habit of inserting 'f**k' in the middle of sentences, as in 'My pills are in the f**king cupboard over there'. Arthur doesn't mean any offence by it, it is just the way he is, we occasionally get people like him and you can have a nice little joke with them in the back of the motor. That this habit of swearing is the same one my crewmate has, and that Arthur looked like how my crewmate could look in 30 years, only added to the fun.
The second Arthur lives in a warden controlled flat, and when we turned up a woman was fussing over him, when we asked him if it was his wife he replied, ' If I had married her, I'd have topped myself by now'. The woman was actually his warden as was quite bossy.

Not a bad day (no-one died on us today), I'm working the same shift for the next six days, so we'll see how it goes tomorrow.

So, after the assessment, the training and the first time racing around the streets of London being sworn at, you finally end up on your own, in a new part of town where you are expected to get to emergency calls in eight minutes.

I got posted to Newham, which is a ten minute drive from where I live; but unfortunately I'd never driven there and my navigation was awful. When I told my new workmates where I lived they thought (after, 'If he lives there I wonder if he'll steal my car?'), 'Good someone who knows the area'. This was before the days of satellite tracking where you just have to follow the dulcet tones of the computer (Sometimes in Danish if some bright sparks has reprogrammed the computer); in those days you had a mapbook and were expected to get on with it.

Gradually you get to know the streets, where the regulars live, the pubs that are 'trouble' and where the 6'6" width restrictions are. You then have to counter every threat the 'natives' throw at you.

For instance, I might be driving a big white (or bright yellow) van, covered with flashing lights and 'ambulance' written on the side, occasionally - if I feel like pushing out the boat, I'll even have the sirens going. You might expect people to get out of the way; instead pedestrians will be drawn to run out in front of you, like a particularly dimwitted moth to a flame. People in cars will suddenly develop selective blindness, and idiots with Drum 'n 'Bass pounding out stereos worth more than their car will argue that I should make way for them.

Drivers will pull out from side turnings in front of you, and as for the bizarre ideas some people have as to the best way to clear a path for us (jump on the brakes, swerve in front of us, sit there and panic), well, it's a good job we often don't have far to travel.

However there are benefits to driving an ambulance; driving on the wrong side of the road (at a top speed of 20mph mind you) still makes me happy, driving over kerbs is often a giggle, and lets face it, who wouldn't like to treat red lights as a 'Give Way'?

Despite popular belief, we don't actually go that fast - we can't, we never know when some young mother is going to push her baby buggy out in front of us. At best I think we have a maximum speed of 40mph, not only for our safety and the safety of other people, but purely because the worn out ambulances that we drive have an acceleration that would embarrass a milk float, and a top speed of..oh...about 42mph.

I once got on a motorway and 'opened her up', we got up to 70mph (downhill naturally) before the front of the ambulance started lifting up and the steering became a trifle 'unresponsive', luckily I managed to stop screaming in sheer terror enough to regain control.

Most of our accidents (as a firm) come from reversing, I've *cough* occasionally reversed into pillars and lampposts; one person I worked with managed to reverse into a low-flying balcony. I have on at least two occasions gotten stuck in a width restriction (I swear, one day I'll get our 7'2" ambulance through a 6'6" restriction - I just need to get up a decent head of speed before tackling it). Thankfully our ambulances are so old and battered that small amounts of damage just add to the character of the vehicle.

Of course all that has changed with the new yellow Mercedes Sprinters. Or at least it would if they haven't all started getting faults around the 5,000 mile mark. Our station had three of the new ambulances, now we have none. They are all either being patched up, or shipped back to Germany to have major repairs done. Current reports are that the fibreglass back is splitting from the metal chassis - possibly due to the number of speed-bumps we have to contend with.

Speed-bumps - Good idea in theory, but in practice they slow us down by a hell of a lot, wreck the ambulances, and in five years time I intend to go on permanent sick leave because my kidneys have been shaken out through my mouth. My plan to get local councillors thinking a little more sensibly about speed-bumps would be to strap them down on a spinal board and drive them through the streets - I think they would be begging for mercy after five minutes.

Parking is a nightmare in Newham as well, we often have a line of traffic parked on either side of the road, making side streets effectively single track routes. When we get a call for a 'Chest pain' (you know, the sort of thing that could be a heart attack), then we have no choice but to park in the middle of the road, blocking any other traffic. At no point do we engage in the 'how much traffic can I stop' game - we don't like confrontation at all, we like a nice quiet life, so we aren't trying to wind people up on purpose.
Unfortunately some people don't see it like that and will sit there honking their horn at us to get a hurry on. To be fair I tend to spend a maximum of 10 minutes on scene, and if you honk your horn at me, I'll then change my working speed to 'go slow' (patient condition willing obviously).

I think it's incredibly rude to think that your journey is more important than that of an emergency ambulance.

Don't you?

I'm off to work now to drive around those selfsame streets...wish me luck, and if you see me in your rear view mirror, please get out of the way by pulling over and stopping on the left of the road.

Lots of new people coming here, which is nice, if slightly confusing.

First off I'd recommend you going and reading some of the people I link to, there are some absolute gems over there.

Then if you want to play catch up, and read some of the posts I think best explain me/my job - then look at 'The Story So Far' between my blogchalk and the Webrings. (Suggestions for additions here will be gratefully received).

If I disappear it's because my bandwidth got broken, if so come back next month - I'll still be here...

When you train to be an ambulance technician, you have to do two weeks of 'driving instruction', where you are split into groups of four, get given a 17 seater van that has been hired for you, and you learn how to drive your ambulance using this equipment.
Perhaps the most important difference between an ambulance and the 17-seaters that we are given is that ambulances are automatic, while the 17-seaters are manual (I believe the American term is 'stick'), and that 17-seaters just don't 'feel' like an ambulance.
The training course consists of two days of fun, and the rest is chasing each other around the countryside at high speed.
The two days of fun include driving around a racing track, spinning around a skid-pan and swerving around traffic cones at high speed, both forward and in reverse.
Then for the next two weeks, you learn some theory in the classroom such as the 'limit point' and the forces that act on a vehicle (and why sometimes speeding up when you are losing control is a good thing). The rest of the time is spent driving at high speed around the countryside, making sure that you have the correct gear speed and suchlike for high speed cornering.
There are a few things that make this training course less than effective - the first is that as the London Ambulance Service, it is extremely rare that you find yourself driving in the countryside, it is also rare that you drive at any speed above 40mph and as mentioned earlier, ambulances are automatic vehicles and as such don't have gears.

I drove an actual, real ambulance a grand total of once during training. I sat in the drivers seat, pointed to the lever in the middle of the floor and said 'whats that, and where is the clutch pedal?'

Luckily for me learning to drive an automatic is pretty easy.

At no point during the driving course did we drive on 'blue lights and sirens', something that may have caused my first RTA.

(insert wobbly flashback special effect here)

The first day out on the road, out of training school went well - I was attending (A&E nurse for some years) and my crewmate was driving (previous job? 'Man and Van'). So the driving went well, as did the attending (dealing with sick people). The next day our roles were swapped, I warned our supervisor that I'd never really driven an ambulance before - but he said that we'd be fine if we worked like yesterday.

So on my first emergency job, blue lights went on, sirens went on and people started moving out the way - it was then that I realised that you can't fit a 7'2" ambulance through gap made by two cars which is only 6'6" wide. First (and hopefully only time) I've been called a 'C**t!' by a boss, although to be fair- the only time I think I've deserved it. I learnt how to fill in accident forms that day...and how to judge distances a bit better. (An ambulance is wider, longer and taller than a 1.0L Ford Fiesta).

Soon my training came to an end and I was thrown into the world of emergency driving in Newham...

(End wobbly flashback sequence, cue end title "To Be Continued...")

For those that are interested, Jane Perrone interviewed me for the Guardian. You can find the result here. The only thing I'd argue with is that I don't pay any money to the lovely Blogware, but instead to a third party hosting service myOstrich.

Otherwise I'm happy with the results - I think you can tell it's my first (and I'd imagine last) interview, and that I'm just a normal bloke.

When you apply for a job as ambulance personnel for the LAS, one of the things that they look for is that you are a competent driver. Therefore as part of the interview process they throw you into the most run-down, barely working 14 seater lump of crap they can find, and tell you to drive around Earls Court. For those not from London, Earls Court is a congested area with fairly small streets, constant roadworks and the sort of people who think it is amusing to leap out in front of a scared looking interviewees on their driving assessment.
Before you see a vehicle you are given a piece of paper that tells you what the assessor is looking for, the crossing over of hands when steering is a big no-no, as is over- confidence - along with under-confidence, speeding, going too slow, incorrect use of gears, incorrect use of signaling and a myriad of other things you haven't worried about since you passed your driving test as a teenager.
When I first went for my driving assessment I noticed the 'overconfidence' bit, so I thought I'd be sure not to come across as too aggressive a driver - so I was a model gentleman, I let people out of side turnings, allowed pedestrians to cross in front of me and didn't hassle people who were driving too slow.
I failed my assessment for being under-confident. 'Come back in three months' I was told.

Three months later and I was determined not to make the same mistake (an additional three months stuck in A&E nursing will make you ever so slightly determined). So I got into the worst piece of crap in the fleet, and off we went. Leaving the yard I hit a kerb, about 200 yards down the road I did the same thing. 'Turn around and go back' I was told - so I slunk back to the yard and vowed to do better in another three months.

Three months later, and I thought - Sod it! Lets drive how I normally drive. So I crossed my hands turning the wheel, sped up to stop signals, refused to let anyone out of a side road and drove as if I were driving my 1.0L Ford Fiesta.
And I passed. Needless to say I was more than happy, and fairly skipped out of the yard that morning.

Of course this double failure didn't help my confidence when it came to the driving part of my training course.

I'm not a big fan of children, they are small, noisy, badly behaved and get under my feet.

Which is why I am ecstatic about having a late shift where I dealt with nothing but children. Children who were 'foaming at the mouth'. or had 'serious head injury following football game' and even the old favourite 'high temperature'. We even had a 'car vs child' accident - the car had run over the 11 year olds foot. With no serious injury, the child now promised not to run across the road again.
We had one job that could have been serious, a 6 year old boy had had an epileptic fit at the top of the Mosque stairs and fallen down all 20 of them. The boys uncle had then carried him home, where he had another fit and we were called. Due to the fall I decided to immobilise his cervical spine (you know the bit on the telly where the patient is trussed up on a board with a collar around their neck? That is cervical spine immobilisation) - I doubted the child had a broken neck, but you can never be too sure. Normally six year olds are a nightmare to immobilise, they scream, cry and wriggle - you are often better just trying to lay them flat because a determined 6 year old will tear off collars and head blocks rather easily. Luckily for us, the child was still drowsy from the epileptic fit, and so didn't complain as we strapped him down. An uneventful transport to hospital, and within the hour he was sitting up on his trolley waving at us as we brought in yet another child.

I'm tired now, and am going to bed - stay tuned for tomorrow (erm...actually later today) I bring you the first in the series "Driving For The LAS For Dummies".

So, two nights ago I was dealing with death, people collapsing on the DLR, young men vomiting blood and looking like death warmed up, and women having miscarriages. Basically everyone I attended to on Wednesday night needed an ambulance.

Last night we had...

One patient with indigestion (for two years - FRU on scene when we got there as it was given as a 'chest pain')
One 'gone before arrival' (a drunk who phoned 999 complaining of a broken arm, but had wandered off before we got there).
One Overdose 'acting violent', who also had gone before we turned up (driven to hospital by her brother)
One 'Facial injury' (A woman slapped by her husband, no injury and she didn't want to go to hospital - her husband was taken away by the police)
One patient with Ascites and chronic alcoholism, who was referred to hospital by the GP. Could have travelled in her husbands car.
One call to a police station for an accused who had swallowed some drugs - he denied everything and the police doctor cleared his health.
And one patient with an arthritic knee...

The patient with an arthritic knee was a 70 year old male who had called out his GP. Said GP had then diagnosed arthritis - and decided that the patient needed hospital treatment. We got the call, and had to go out of our area we are supposed to be covering to pick the patient up. The booked hospital was even further out of our area - so much so it was in another sector.
When we got there the patients son was present and as we loaded his father into the ambulance we were told that 'I'll follow up in the car'.
The look of sheer despair my crewmate gave me had me in fits of laughter, thankfully I was outside the ambulance so neither the patient (or his son who had gone to get the car) could see me.
There was no reason why the patient couldn't have been driven by his son - yet here we were, out of area, going even further out for someone who didn't need an ambulance.

Still, after the past few days it was nice to have a shift where no-one was actually 'ill', and so we could spend the shift in a fairly relaxed state.

(What I'm going to post about might come across as being heartless, or myself being lazy - I don't think I'm either of them, but if you disagree with this post, as always feel free to leave a comment)

Tonight we got called to a residential home for an 87 year old female with 'difficulty in breathing', once again it was way out of our area of coverage, but we made good time to get there. I've been to this home before, and it is one of the better homes I've visited - the residents are always clean, and appear well looked after. The care staff know their 'charges', and are always friendly, helpful and courteous towards ambulance crews.

I knew there was something wrong from the face of the member of staff who met us, she had a look of total concern, and I don't like to see that look on someones face - it never bodes well. We went through the clean corridors and busy lounge of the home into one of the residents rooms. There were three nurses there, one of which was crying (something I don't think I've ever seen before) - laying in the bed was a little old lady who was extremely close to death. Her pulse was weak, and thready, something I could have guessed by the patients colour. I very quickly told the staff that, yes, she was extremely ill and that she would have to go to hospital unless she had a 'Do Not Resuscitate' order. The staff said that it would be best to take her to hospital. We scooped her up, and her heart and breathing stopped in the lift to the ground floor.

I don't believe in a 'slow blue' (where CPR is performed by 'going through the motions' knowing that the patient will not survive and that the CPR is for the benefit of the relatives), so I started active, aggressive treatment while my crewmate drove us the five minutes to hospital. The patient remained in Asystole (no heart activity at all) and on reaching hospital the doctors there declared her dead.

I may have previously mentioned the study that showed that "out of'185 patients presenting with out of hospital Asystole arrests, none survived to be discharged". Both my crewmate and myself, and the hospital staff knew that this patient had no chance of survival - and that the reason we started CPR was because of our policy to commence resuscitation except in certain tightly defined circumstances.

If we had got there a minute later, the patient would already have died - in her bed surrounded by people that cared for her (although not her family) as opposed to being hoisted out onto a chair and then suffering the indignities of CPR in the back of an ambulance. While trying to resuscitate her during the transit to hospital I found myself looking into her dead blue eyes, apologising to her and hoping that she couldn't feel anything that I was doing to her.

I don't know if it is because I've had one and a half hours sleep in the past thirty eight, but it made me feel bad to put her through the indignity of pointless CPR. I know the policies are there to protect us (and members of the public), but sometimes I wish we could use some discretion.

Now I'll see if I can get some sleep.