By Neville Dean, PA Crime Correspondent

A 27-year-old man was critically ill in hospital tonight after several youths climbed into the back of an ambulance to attack him.

The victim had initially been injured during a fight involving around 20 youths armed with baseball bats and a knife in Bounds Green Road, north London.

He had suffered a head injury but managed to get to the ambulance, which was close by on an unrelated call to help an elderly collapsed woman.

As the victim sat in the back, several of the youths who had been chasing him then climbed in and assaulted him.

A member of the ambulance crew was also assaulted, though not seriously. He continued to treat the victim and managed to request urgent police assistance.

The suspects then made off. All those involved are believed to be of eastern European origin

The victim was rushed to hospital, where his condition was tonight said to be critical

The original caller, an elderly woman who had fallen, was treated at home and did not need to go to hospital.

Three men were arrested shortly after the fight, which happened at around 9.10pm yesterday. They are in custody at separate north London police stations.

Police are keeping an open mind about the motive for the attack and are taking statements from those involved.

An incident room has been opened at Lewisham, under Detective Chief Inspector Phil Adams. Anyone with information is asked to call 020 8284 4868 or Crimestoppers on 0800 555 111.

Have a look here for the BBC story

From what I hear on the rumour-mill, the Paramedic wasn't seriously hurt.

The victim later died in hospital. It's a sad state of affairs when you have armed gangs jumping into an ambulance in order to kill someone.

Fighting between gangs is something that we are seeing more and more of. Random muggings are fairly rare, but violence between gangs, or people who otherwise know each other is the main type of violence that we see.

Normally fuelled by alcohol...

The police have impounded the ambulance for forensic examination, which is going to be a hell of a job considering the state of our motors.

Dear. God. No. (A bit about Channel Four making a TV drama about Belle de Jour)

Thanks to Casino Avenue, who's response pretty much mirrored mine

Yesterday was almost unbelievably quiet, I did a grand total of five jobs in a twelve hour shift, something pretty much unheard of in our neck of the woods. What made it more remarkable was that half of the crews from Poplar station were off the road with broken ambulances, and yet we weren't needed to cover their area.

The first job was an 'assist only', which most often means that some little old lady has fallen over, or gotten stuck on the toilet. They haven't injured themselves, but just need a bit of a hand to get back on their feet. I've never heard anyone complain about being used for assist only jobs, I suppose it's because they are easy to deal with, and the patient is always grateful.

We used to have to go to nursing homes to help them lift patients, but management, along with our Health and Safety group realised that we were hurting our backs, when all nursing homes should have the proper equipment to lift people (hoists and the like).

I also had to give a statement to the police about a job that I went to in June, it appears that they are charging the fiancée with murder. The policeman told me a few interesting things about the case that I don't think I can go into details about, just in case someone who reads this ends up sitting on the jury.

However I did learn an interesting factoid from the policeman - that Newham has the highest number of paedophiles in the UK. Maybe I should forward this to "Heardsaid".

I also found out that I am one step closer towards my secret master plan...

The title for this post concerns the superstition in all healthcare, that to utter the phrase "It's quiet" is to invite disaster, the correct usage should be "It's a bit Q-word here today".

Well, no sooner than I post about how there is no-one who is ill, I end up 'blueing' into hospital a 44 year old with a severe asthma attack coupled with an Addisonian crisis. As an almost exact opposite to the rest of the people today, the patient is well known to the local ambulance crews as someone who won't call an ambulance until she is exceptionally ill.

We then went to a nursing home to transfer a patient with Alzheimers disease to hospital so that she could receive intravenous fluids to rehydrate her. She had been treated with antibiotics for a leg infection, and it had upset her stomach, so the patient had stopped eating and drinking. Why this job sticks in my mind is that the patient has been suffering from Alzheimers disease for the last 12 years, and that for every day that she was in the nursing home, her husband had visited her. She was very confused, and could hardly recognise her husband, she was doubly incontinent and unable to have a conversation, yet her husband doted on her. He came with us in the ambulance and spent the trip holding his wife's hand, and talking to her to keep her calm. He seemed very happy to talk to my crewmate, I doubt that the nurses in the nursing time have enough time (or perhaps the inclination) to spend some time talking to him, and it meant that he could talk to someone and have a decent conversation.

It was both touching and sad, the utterly confused state his wife was in, and yet the tenderness which he still showed towards her.

Another 12 hours tomorrow.

I'm on station at the moment, as it seems that the people of Newham are taking a break from being seriously ill. Of the three jobs we have done so far, none have really warranted an ambulance. The first job of the shift was a 50 year old male with a painful elbow - we took him into hospital, and he was a nice enough bloke, so we were quite happy at this.

Our next job was to a 70 year old who had tripped over in the street, the police were on scene (for a pub fight - stopping one that is, not arranging it) and so called us. There were no serious injuries, and the woman wanted to go home, so we dropped her off into the care of her son.

The award for the most 'misunderstood' use of an ambulance went to our last call, a 32 year old female who had painful eyes. Essentially she had swollen eyes due to an infection, and had called us to take her to hospital. She had been to the hospital three times in the past two days, and wanted to go to a different hospital. Unfortunately for her, she lives 300yards from the local hospital.

She then let slip the real reason why she dialled 999 for an emergency ambulance, "I want to go to Whipps Cross hospital, but I don't have any money". As she said this I took a long hard look at the cigarette she was smoking, and the way she held that cigarette between her painted nails. I felt like giving her the "An ambulance costs over £800 per call out" talk, but to be honest I couldn't really be bothered. So we walked her the 50 yards to her GP surgery and left her waiting to see her family doctor.

While some people might be annoyed by this sort of job, I'm not too upset - if the patient walks on and then off the ambulance, and doesn't try to hit me, or spit on me, then I'm happy with the patient.

I'm yet to start working with my new crewmate, as she is on a training course that will last about 8 weeks. And I might not be working with her then, if things go according to plan...

For those that are interested, I'll be at the 'Bell, Book and Candle' for the first London Blogger Meetup of the year on Wednesday. Feel free to turn up.

There are three types of road staff in the LAS (well, there is actually four, but they don't count in todays post). There are Core staff, Relief staff and Ghosting staff.

Core staff are the crews who have a fixed shift system and work with a regular crewmate.

Relief staff are moved around the complex (and occasionally off complex) to cover absences and leave. They often work with a different crewmate every shift.

Ghosting staff are temporarily allocated to a crewmate in order to cover a long term absence, for example if one person on a Core staff line is seconded to the Rapid Response Unit someone might 'ghost' that line for six months until they return. This 'Ghosting' can be ended at any time.

For the past couple of months I've been Ghosting a line with my crewmate, but just before Christmas, management decided to fill some of the Core lines that had become empty. One of these lines was the one that I was Ghosting. Because I like the station that I'm working at, I applied to fill any of the lines that were going free at the station. I'm 14th in line to fill a Core line, but because the shift rota at our station is poor, very few people want to work there.

So I was lucky, and got another Core line. This means I am now working permanently at this station. Unfortunately this Core line isn't with my old crewmate...

My old crewmate and I get on really well, at least in part due to us having similar outlooks on the job, and life in general. My new crewmate has a very different personality.

So it will be interesting to see how well we work together.

Yesterday then was the last time I would be working with my old crewmate. At the end of the shift, we were both extremely upset, there were tears, hugs, and declarations of undying loyalty...

...who am I kidding, I just told him to make sure he was in on time on Monday as he is relieving me on my new shift.

Although I try my best for my patients, I am not infallible. Sometimes I make mistakes, and writing this blog has taught me to examine those mistakes.

The first job of the day was to an elderly day care centre, the sort of place where the elderly go to listen to music, paint some pictures, talk about the good old days and get fed and watered by the staff. Our patient was a 96 year old man, who was apparently 'confused, falling over with an irregular pulse' - a category A response. We got there as quickly as we could and were met at the door by one of the staff, who didn't know why we were there - however she soon found someone who knew what was going on - and we were led to the patient. On the way to the patient the staff was telling us how unwell the patient was, and how worried they were for him.

We entered the large dining hall to find a group of old folks who were quite happily sitting around finishing off their breakfast. Our patient was pointed out to us, so I went to examine him.

All I can say is that, should I reach my 90's, I'm as well as this gentleman. He was alert and orientated, had no pain, had no dizziness, was not confused and had last fallen over two weeks ago (and he showed me the bruising to prove it). He told me that the staff in the centre had seen a muscle in his hand twitching (he showed me, it was) and they had thought it was his pulse. They hadn't actually taken his pulse at any point, and when asked why just replied 'I can see his pulse, why would I need to feel it'... I ran a complete set of observations, blood pressure, e.c.g., blood sugar, pupil and motor response, mini mental state - the whole shebang.

Everything was normal, actually some results were better than mine, something I'm getting more and more used to.

So I asked him if he wanted to go to hospital - he didn't see the point, as he was feeling no different than normal, and I agreed with him.

But, the staff in the centre really wanted him to go to hospital - they had phoned the GP who had told them that he wouldn't be visiting the patient, but that they should get an ambulance because the doctor wanted the patient looked at by someone in the medical sphere.

And people still ask me why I dislike GPs so much...

I told the staff that, because the patient wasn't confused, and he was refusing an ambulance, I couldn't 'kidnap' him to hospital. So the member of staff who had been with us ran off to tell her boss. The boss soon turned up and basically bullied the patient into agreeing to go to hospital. I started to argue with her, but she just walked off saying that the patient was to go to hospital and that was that. Honestly - if it wasn't in a public area I might well have had a blazing row about her arrogance, and how she thought that she could know what was best for the patient if her staff couldn't be bothered to take a patients pulse. As my crewmate told me later, he saw me bite my tongue rather than start arguing at people.

So...I caved in, and took the patient into A&E. I had a chat with one of my favourite nurses and she looked after him for me until they discharged him later that day.

The thing is, it left me feeling angry. I was angry that the staff in this centre were so useless. I was angry that I let the boss of the centre bully me because I didn't want to cause a scene in front of 30 elderly people. I'm angry that the GP didn't visit the patient, and instead fobbed the patient off onto the A&E department. And I'm angry that I didn't do more to protect the best interests of my patient by not dragging a 96 year old man into an A&E department full of diseased, infectious people.

Now I have a tiny knot of hate in my stomach that I can feel now, just thinking about that job is making me angry as I type this up on my sofa. Perhaps next time I'll take the boss aside and make my position clear, in some scathingly sarcastic fashion.

Our next patient was a GP referral, who had arranged the ambulance without actually seeing the patient. The GP had then faxed a referral letter to the A&E department claiming that the patients blood pressure was 130/90, her pulse was 100, so on and so forth, and that he suspected a collapsed lung. I was very impressed by this GP who could check a patients vital signs over the phone, just by talking to the patient's daughter.

Grrrrr...

And in both cases, the patients and their families were very nice people.

One of the things that I really enjoy doing, and it is a guilty pleasure, is kicking down doors.

We occasionally get called to a 'trapped behind locked doors', which often means that a patient has fallen/collapsed/died behind a front door that they cannot open. In this case we are supposed to call the police and have them ram the door down with an 'Enforcer', which is a heavy ram - if you have seen the police knock down a door on the television, they tend to use an Enforcer.

But...

There is a visceral pleasure with kicking down a door. Once or twice I've managed to see someone who is really ill trapped behind a locked door, occasionally there has been someone who has just been unable to open the door. And once, I have kicked down a door that the patient refused to open because they were schizophrenic and didn't want to open the door, not that I knew that at the time.

I've even been surprised at the ease in which I can kick down the doors of the flats that I live it. Actually it would be more accurate to say that I am scared with the ease in which the doors can be broken. Oh well, it's not as if I have a lot to steal anyway...

My experience of kicking down doors has taught me which security features are useful when trying to prevent someone from stealing your TV and video.

If you have a deadlock type bolt, then use it - always. The skill of kicking down a door relies on breaking either the lock, or the wood holding the lock - deadbolt type locks are a lot more secure than the normal Yale type lock.

If you are in the house, and have a bolt to the door, then use it. It takes a lot longer to kick down a door when there is a bolt in the way. The skill behind kicking down a door relies on applying the force of your kick to the (hopefully) single point of resistance. If there is a bolt at the top, or the bottom of the door it makes it a lot trickier to break that door.

Windows in the door are a bad idea - they are a weak point that can be easily broken, and then a skinny hand can reach through and unlock the door easily.

If you really want to be safe then have a bar across the door - I've seen it once or twice, and if someone had a bar across the door then there is no way I'd be able to break that door down.

Just make sure you don't collapse behind it.

It would have been a good shift tonight, if only I wasn't sitting here blogging in order to stop my mind dwelling over what I saw on the drive home. As you may be aware I tend to prefer animals to people (apparently a sign of madness...). As I was nearing home I saw a young fox laying on the road, so I drove back to see if it was still alive (which it wasn't), only to see another fox watching me. Now the cynic in me thinks that the other fox wanted to eat the dead one, but I'm not so sure.

It has really upset me (daft I know), so I'm blogging to get my mind off it before I go to bed.

The shift itself was rather nice - Our first two calls were 'non-runners', we turned up and the patient decided that they didn't want to go to hospital (A two year old who had possibly drunk some white spirit he was a happy child with no signs of poisoning, and an epileptic girl who is a bit of a regular, who wanted to stay with her mum). Then we picked up a patient who was having mental health problems and drove them the 400 yards into hospital. He was pleasant enough, so this job was no real trouble.

Then we got a call to another hospital where they needed us to do a 'blue-light' transfer to another better equipped hospital. This is a fairly common job, and I started to drive us there. But, as we were getting some speed up, my crewmate and I both started to smell burning. The smell got stronger and stronger, and we got more and more worried...

I'd love to tell you how the engine burst into flames, how I wrestled the vehicle under control and how I saved both our lives...

...But I've sworn to tell the truth, so I just pulled over, had a look under the bonnet and called up Control on the radio and told them that we weren't happy to continue. We soon had a RAC man out to have a look, and finding nothing he told us to drive back to station while he followed us. So we crept slowly back to station, luckily we didn't burst into flames - but we did get to go to another call once we had changed onto a spare ambulance...

Only a short shift, and I now have two days off, followed by two days on and then it all gets turned upside down (more of which later...)

This is going to be the last thing I write about the radio piece. First off, thanks to Adrian who managed to provide a link straight to the segment that I was on. It saves people having to listen to an hour of chat radio. It will be there until early next Monday morning.

I got a reply back from BBC radio Scotland letting me know that I would be breaching copyright if I edited or hosted the clip, which is pretty much what I expected. Although as 'contributing artist' (or some such) shouldn't I also have some form of say over what happens to the copyright? Oh well, I'm not a lawyer.

Re-listening to the broadcast, I don't think I did that badly, although there was a large number of 'Umms' and 'Errs', but this is normal if I talk to people on the telephone so it's hardly surprising considering that I was the same sitting in a booth on my own. Maybe I'll do better next time...

Thanks for all the comments on the segment, I love the support that I get from you folks every time. I wonder if Bob gets the same amount of support from his employees?

And finally - listening to the broadcast again I realised the irony of Bob's position. Here was a man, talking about how blogging allows people to say anything to a large population of people, and that there were dangers of defamation. Also that without journalistic training there would be no fact-checking or ethical reporting.

The ironic thing was that Bob was ranting and raving to a radio population, slandering me (calling me racist), getting his facts wrong (saying I have a New Year Resolution to hurt drunks, when it was the exact opposite) and having no knowledge of anything that I do ("New Ham"). Yet he was allowed to state these falsehoods to a large audience with no editing of his remarks.

I wonder if Nick, the lawyer, cringed when he heard Bob call me a racist?

So it seems that Bob should learn to keep quiet if he doesn't want to come across as a hypocrite.