Back to work with the rather enjoyable 18:00 to 01:00 shift, where you tend to get lots of drunks, and very few serious cases that require me to do some actual work.
However, you do occasionally come across a job that is tricky, not because I worry about the patients illness, but instead for reasons that to the non-ambulance person are hard to understand.
Our first job of the day was one of those very jobs. The call we were given was 13 year old female with a dislocated knee. Nice and easy I hear you say, but lots of minor problems can build up to make a job less than ideal.
We arrived on scene and found a patient who had a rather obvious dislocated knee - just imagine your kneecap shifted two inches to the left, so much so that it casts a shadow on the rest of your leg. Simple enough to deal with - if you are feeling brave you can slide it back into place yourself, or go the more recommended route which is to take them into hospital and let the doctors fiddle with it.
Then the problems started piling up - To start with there were no adults present, just another (unrelated) teenager, neither the patient or this other teenager were what exactly call brain surgeons. We aren't supposed to deal with children without an adult present, but what else can you do in those circumstances? Her father had been called, but he was travelling from another hospital where he had been undergoing outpatient treatment. So we had to decide if it was 'safe' for us to take the patient to hospital - we use something called 'Gillick competency', but it's always a bit of a gamble on our part.
The patient had fell from her bunkbed - so her friends (who had run off) had lifted her back onto the top bunk. She was screaming in pain (which is fair enough I suppose), and wouldn't let us near her. This little problem was solved by giving her a lot of Entonox, known to some people as 'laughing gas'. After enough of this stuff she started laughing and we essentially 'grabbed' her off the bed.
Now she refused to sit in the carry chair, but because we were upstairs she needed to go in it. After a lot of persuasion, and a lot of her screaming very close to our ears, we managed to get her to sit down - this had the rather excellent side effect of popping the kneecap back in place.
This would normally mean that the amount of pain goes down by a lot - but this girl has a touch of 'hospital phobia', so she continued screaming.
While screaming she was also arguing with the teenager who was with her, telling him that he needed to come to hospital with her - but he was refusing because "How am I gonna get back home?". I must admit I really wanted to tell him to walk it, because the hospital was only about 1000 yards away. But despite her pleading with him, he wasn't for budging - he set his burberry baseball cap square on his head and refused. I don't think she is going to be too happy at him next time she sees him.
Once that arguement had run it's course (and my crewmate and I managed to stop laughing), we had to get the patient downstairs - this was made more difficult by a sideboard that was in the upper hallway bay the stairs. To counter this problem, we had to lift her completely over the bannister - luckily she was a lightweight, and my crewmate and I are both strapping, good looking *cough* men.
We saw her later in hospital, having a plaster cast put on her leg, so that the kneecap wouldn't slip out of place. She was much happier and surrounded by her parents. She even managed to give us a smile - which, in the end, made the job worthwhile.

So this is what we occasionally have to deal with, not so much the life threatening stuff, but more the 'silly little things' that can make an 'easy' job, much trickier.

For those of you who don't read the comments that people leave, Emchi found this story which shows that unlike my previous post, some people do make an effort to turn their lives around.

Came across this story about a 480 pound (34st) woman who died after the "patient extrication from Hell". To think I moan about having to carry a 17 stone patient down a couple of flights of stairs...

It's one of those jobs where you would turn up, take a look at the situation, get back in the vehicle and radio Control with your resignation letter.

Who is too blame? Well, my opinion is that the patient committed suicide by overeating. Where were the social services? Where were the psychiatric services? Where was the GP? More importantly, where were the relatives?

from the ever excellent Boing Boing

My first day back after my holiday, and the Resource Centre thought that I was still on leave - Oh well...never mind. I decided to stay on and work though, partly because the manning at the moment is awful. We are missing three ambulances today, and about five tomorrow - I dread to think what it will be like on Sunday. This time it is due to an actual lack of staff rather than the lack of vehicles as recently reported.

I checked my mail slot to find out that the coroner is investigating the death of the young diabetic that I attended to some time ago (and wrote about here). Essentailly I have to write a statement about what happened, including the traffic situation and access to the house (both of which influenced the job to a major degree). Rather thankfully at the bottom of the request letter is the note "No complaint has been made". I might end up having to give my statement in Coroners Court, and given the problems we had with this job, I may well end up being asked questions by the coroner themselves. I'm not too worried as I can justify everything I did on that job.

On a lighter not, the first job of the day was one of our regular drunks, who was discovered laying in the street by two police officers. As they can't take people who are 'properly' drunk into custody anymore, we end up getting called to them. It was so lovely to return to work and have this smelly, incontinent drunk welcome me back.

(Sarcasm? Moi?)

Currently I'm sitting on station awaitng yet another chance to save a life...

I would suggest that a lot of the people who read this website are doctors and nurses of one persuasion or another. I also guess that many of these readers have some experience of A&E departments (and I'm glancing sideways
at 're-minisce' here, for he signed up for a double sentence in one of those windowless boxes of suffering).

So as an EMT I wish to apologise.

I'm sorry that throughout the shift I will continue to bring fresh meat to the grinder, that is I will be forced to transport patients from 'outside' into your department, where they will need to be looked after and assessed by your own good selves.

I'm sorry that I have to sometimes bring their relatives who will harass you about waiting times, the pain their relative is in and about why you are drinking that cup of coffee while their dearly beloved is 'at death's door'. I'm also sorry that sometimes I couldn't bring the only relative who can translate the patients' moaning and groaning into English, thus making assessment a thousand times easier.

I'm sorry for the dross that I bring to you - the cut fingers, the bellyaches and the spotty backs. I'm sorry that the Primary Health-care workers (the GP's) are often so useless as to be a liability. I'm sorry that you have to cope with the fallout that because there are so few good GPs you have to become the first point of call for coughs, colds and diarrhoea

I'm sorry that the schools don't teach basic health and first aid to their students, preferring to waste time on the history of glaciers or the solving of quadratic equations. This means that the population wouldn't know the difference between a minor cut and an arterial spurt if it jumped up and hit them over the head with a hammer, nor which of these two warrants a trip to the local Emergency Department.

I'm sorry that our communities where our Elders teach our Youngsters and the Youngster listen no longer exists - thus resulting an influx of first time mothers who think that when a baby vomits it is a precursor of death.

I'm sorry that the protocols and guidelines that we adhere to don't allow us to leave patients at home. In England at least we have to transport to hospital. The government thinks that we cannot tell the difference between serious cases and the aforementioned cut finger.

I'm sorry that the police cannot look after drunks on a Friday night, they worry that they will choke to death in the cells, and so we get called - and we have nowhere else to bring them except your department. Sorry.

I'm sorry that I bring in those serious cases five minutes before your shift finishes. If it's any consolation it's probably five minutes to the end of our shift that people decide to have their heart attacks, their amputations and their dissecting aortic aneurysms. Like you this means we get off late as well.

I'm sorry, but it's not my fault.

Previously posted on The Lingual Nerve

Blimey, who turned up the thermostat and humidity in England while I was gone?

I spent a whole week without internet access, stuck in the middle of nowhere. It was so far from anywhere of any interest that I wouldn't have been surprised to trip over a blonde farm-boy with a lightsaber looking to get out of his humdrum existence. One internet café seen, if only in passing, very few English newspapers, and a TV whose only English channel was some 24 hour business channel. I managed to finish reading some books that I had been putting off for a quiet moment - and this holiday was one very long quiet moment.

It felt as if I had travelled back in time to the 1980's, there was pitiful mobile/GPRS coverage - so much so that I could only get a signal at sunset - and that was everywhere I went on the island. The music that was being piped out of shops and coaches was of the Phil Collins/Chris Rea/80's soft rock movement.

But the thing that made me think I was in the 80's was the design of the advertisements. Billboards with the faces of people who look rather uncannily like a (pre-capture) Saddam Hussein, pictures of bad drawings of buildings. Big red stars with whatever the Spanish equivalent of "Sale!" or "50%! Off! Now!". It is a sad state of affairs when you start looking for more and more tacky advertisements for entertainment and for some form of cultural "zero-point".

Some things that I did learn on holiday, taking a laptop is well worth its weight, especially when said laptop is loaded with films. Seeing a 'Marineland' show taught me that Dolphins and sea-lions are smarter than me, because I can't balance a ball on my nose, and that although being a dolphin trainer must be one of the best jobs in the world, they still have to rake the dolphin shit from the bottom of the pool.
Also after a trip to 'Green Planet' zoo, I've discovered that Raccoons are the cutest animals in existence - can we have some released into the wilds of England please...

To get vaguely on-topic, Spanish ambulances are tiny, I couldn't stand up in one...

I was exceptionally happy to fly back into England, catch the last train home and in a fit of rather sad geek-dom, post that I had returned. What can I say - I was itching to get my keyboard under my fingers. For the rest of today (after unpacking my bags) I shall be catching up on all those links on the left of the screen. Understand my journey - click on them all yourself and spread the love of a visit.

I'm back from holiday - it is currently 01:20am on Tuesday,this means I haven't slept in 38 hours - and the first thing I do when getting home is boot up the computer and post about how I'm back.

Tomorrow/Later Today I shall be catching up on what has happened in the world during the last week, sending off an article for Lingual Nerve and posting (and moaning) about my holiday.

Then hopefully it will be normal service resumed when I moan about everything

After much swearing and rebooting, I have managed to get my laptop talking to my mobile and finally I have GRPS running (although for how long I do not know). I'm back from Mallorca late on Monday and so can restart my normal posting schedual. I also note that I've missed my third appearance on TV (from the 'Tube Run') the first being me waving at the camera during a Reading festival and the second being me opening a door into the back of a doctor during BBC's 'Trauma' series (they wisely only showed me from below my waist).

If anyone has a tape I'd appreciate a copy...

Although the holiday has been fun, I'm afraid I'm a Londoner born and bred and am dying to get back home. But at least I've had the time to finish Neal Stephenson's 'The Confusion', to slaughter ants in their thousands as they try to get to my cream cakes, and to sit on my arse doing nothing. (The first person to say "no change there then" gets a wallop on the nose).

Central Europe Time is a funny place to be - at least for someone so stuck on London as myself.

Ta-ta til Monday.

It is hot here, I can't find internet access and GPRS is costing me 10 pounds a MB. I'm feeling cut off, and I can't be sure that this is even reaching my blog. However I am otherwise enjoying myself - when I get back I'll explain how my mother got told off for being a terrorist.

So I cycle into work today to find out that (possibly due to a mistake at their end) my annual leave starts today. One cup of tea later and I cycle home. I'm not unhappy because not only have I cycled a round trip of nine miles, but I have the whole day in front of me. That and it feels like I'm playing truant.

On Monday I fly out to Mallorca, to spend a week in the sun relaxing by the pool. I'm taking my laptop with me, partly because I'm envious of Cory Doctorow's travel-sticker covered laptop, and partly because I want to do a bit of writing on various projects done. Also going with me are a couple of books, including the 'needs a suitcase all to itself' Confusion by Neal Stephenson - a book I'm so looking forward to reading I bought in in e-book and 'dead tree' versions. Also travelling with me will be some episodes of TV programmes *cough* downloaded, otherwise I'd miss out on the next episodes of The West Wing and Alias.

I'll try and post when I get there, this is dependant on whether I consider £10 a MB too much for my GPRS, or more likely - if I can find an internet café. I suspect the café will be a fairly safe bet, so if my next post has lot's of squiggles above the letters it's because I'm using a foreign keyboard.

If you send me an email, I'll probably only be able to reply when I get back, and then only if I don't over enthusiastically delete your mail while pruning the hordes of spam I'll no doubt have.

Right, I'm off to count my Diazepam for the flight out - take care y'all.