I really need to sort out the template of this page so that when a post doesn't have a title it doesn't write "Untitled" in big letters at the top of the post.

What happened today - the full story...

I got a call to a house on an estate in Bow to a 60 year old female diabetic with 'low blood sugar'. No problem I thought, I got there quickly and was happy to see that the flat was on the ground floor. I thought that I won't need my cardiac monitor/defibrillator so I went to leave it in the car, but that was when I heard someone wail. I've written about this wail before, it's the sort of thing you hear when someone is dead...

I grabbed the defibrillator and ran into the house. I was led to a bedroom where I found a very unwell looking Bangladeshi woman, the first thing I did was to check her pulse, as on first impressions, she looked dead. She had a pulse, which pleased me a lot...

Oxygen was given and I checked her blood sugar level, and it was 2.2, which is dangerously low. We have an injection that will raise a patients blood sugar. So I gave that, and within ten minutes she was coming around, the ambulance crew then gave her some sugar and the last I saw of her was her walking out to the ambulance.

What a bunch of heroes...

So, I then wanted to turn the car around to leave the estate, so I drove into a parking space that is guarded by a pole that is folded up when the space is empty. As I went to reverse out of the space I heard a horrible grinding noise and the engine cut out. There was then a strong smell of petrol - So I thought something may have gone wrong with the car.

This pole had lept up catching against the underside of the car, and I later found out that it had torn the fuel line. I think it has some valve in the fuel tank that stops it emptying the whole tank, which is rather handy, or I'd have been swimming my way out.

I was then low-loaded away to Waterloo, because the car is originally one of theirs, when I filled out a ream of paperwork, and stroked the station cat. I then had a Station officer from Newham pick me up to take me back to my station (I caught him singing "Life in a Northern Town" by the Dream Academy, and the "Just One Cornetto" songs on the way back)

When I got back to West Ham the fitters had a spare car, but they wanted to make sure it was safe to drive (they had just gotten it back from a service or something). But then a couple of ambulances turned up which were broken, and they didn't have a chance to check it out - so I sat on station, had a cup of tea and finished reading my book (and very good it is too).

I will be posting more on this later, but after saving a patients life (yay for me), I have now broken the RRU car. Fuel has leaked out over the floor, and I am currently sitting behind Bow road waiting for a truck to tow me away.

I explain more about how I managed to break the car once I have worked it out myself...

Well I'm back home, where I am microwaving a curry, putting my feet up and will soon be playing a little bit of World of Warcraft.

Following that I may well be spending some time on IRC before going to bed and repeating this sort of day again tomorrow.

Looking back it was a fairly average day, no lives saved (particularly), no multiple trauma, no-one trying to hit me, and very little time sitting around doing nothing.

Blogging throughout the day filed up most of the free time that I had, and while it was a fun little exercise, I don't think I'll be doing it again soon. While I don't mind moblogging, I feel that I can't 'polish' my writing as much as I can when I get home and blog from there.

There is also a lack of reflection - if I write about a job immediately after doing it, then what time do I have to look back on it and pick out the interesting parts, or relate it to jobs that happen around it.

So while I may well moblog again, I don't think it'll be on the same scale as today.

"My name is Jack Bauer, and this was an average day in my life..."

It's half past four, and as I mentioned this morning, my body just wants to sleep.

At least I've made a cup of tea, I just wonder if I'm going to be able to drink it.

Two hours and counting until the end of my shift.

Then I get to do it all over again tomorrow.

"Can we send you this job? It's a long way away".

"Sure, why not..."

Three miles through heavy traffic, from one end of my complex to the other. Blues lights flashing and sirens wailing.

Five minutes it took me to travel it, well within the all important 8 minutes.

I only clipped three cars on the way here *joke*

Patient is a 74 year old male, recently flown here from India, very nice person who gave a good description of Cardiac chest pain. He had a heart attack two years ago and it feels similar to that episode. The ambulance which was from another sector was also pretty quick to turn up. The patient is now winging his way to hospital for assessment and treatment.

I fancy another cup of tea.

Just finished a job dealing with a 64 year old female with angina-type chest pain. While the job is one of our fairly regular types, what was unusual was that the GP was still on scene and that he had given the patient some Asprin. I know I've mentioned before how GPs often don't do this important treatment.
Of course, as soon as I turn up, the GP disappears - he was obviously intimidated by my superior medical knowledge...

*cough*

Before that, I went to a job that was given to us by the police as "Male, 30 cuts to hand, self inflicted". As it was halfway across town, the ambulance got there first (but I still made it in under the all-important 8 minutes) - I then saw them leading the patient into the ambulance. Chatting with the crew it seems that the patient fell onto his hands and had nothing more than scrapes and grazes.

I suspect that there is more to the story than that, so I'll try to have a chat with the crew about it later.

Now I'm going to try and have my second cup of tea for the day.

Second job of the shift is a 57 year old female with chronic emphysema, who for the past two weeks has had increasing difficulty with her breathing. While she was able to talk I could tell that she was having trouble breathing.
Once more, I was able to give her oxygen before the ambulance turned up, and as we were only 400yards from hospital she has had a rapid transport to hospital.
I'm now going to cruise the area looking for trouble while listening to some Polyphonic Spree on the CD player.

Hard life this ambulance work...

So I spent some time at my standby point, then returned to station. I always have trouble around 10am and 4pm during the day, it is when my circadian rythmn hits its low points and I just want to sleep. If I'm not busy seeing to patients then these two times of the day are really tricky for me.

It doesn't help if I haven't been sleeping well - which, or course, I haven't.

At the moment the seat of the RRU feels as if it has rocks in it, maybe because I was doing something physical yesterday, or it might just be where the Night shift has adjusted the seat.

If I don't get busier, todays experiment in hourly blogging will get boring very quickly...

At the moment, instead of three ambulances running out of West Ham, there is only one. It is funny that there was no problem in manning ambulances during the Easter break (where you get paid more money for working overtime during that period), but that today, at least locally, manning is poor.

First call of the day was a 90 year old female with shortness of breath since last night - the call came just as I sank my teeth into the first of two bacon rolls.

As always the person who needs the ambulance holds off calling us, and apologies when we do turn up. Here oxygen levels were rather low (88 out of a possible 100), but a bit of oxygen soon brought these levels back to normal. The ambulance crew weren't too far behind me, and have just driven off while I'm writing this.

Now I'm off to sit at my standby point for a while (and watch commuters struggle through the rain).

I am allowed a short period of grace first thing I the morning. During the day I am not supposed to spend more than 20 minutes on station - any longer and I get someone from Control phoning me up to ask me to either roam around the area or to sit on standby. However because of union negotiation, Control can only put you on standby between the hours of 08:00 and 20:00 - so if there are no calls I can sit on station from 06:30 until 08:00. This means cups of tea, and BBC breakfast news.

I've just had a look at Google, and guessing from the logo, it's Van Goghs birthday. I wonder if they will do anything for St Georges day on the 23rd of April, like they did for St Patricks day - somehow I doubt it, the government of England seem to do pretty well ignoring it.

If you look at the events on the St Georges website, it really does look pretty pitiful, cafes doing Ska nights for instance...

Talking about BBC Breakfast news...doesn't Ruth Kelly have a deep voice (and an awful website).

For the next few hours, I imagine that I shall be moblogging, so the standard of writing will plummet.

It is a source of amusement, when driving into work that you find the Rapid Response Unit you are going to be working on speeding past you on the way to a call. What it means is that there is definitely time for a cup of tea before the night shift gets back for me to take over - this means a slightly more relaxed, yet awake, EMT will be serving the people of Newham today.

It also means that I can read some blogs, write this post, catch up on some work bulletins and generally start feeling a bit more humaan.

I'm also happy for the bloke working the nightshift, he likes to get back to station late - as it's a bit more overtime.

Throughout the day, in an attempt to be as geeky as possible, I shall be telling you exactly how far I have travelled and the average speed that I drive at to get to jobs (answer:as fast as possible, but you may be surprised at how slow that speed actually is).

Today I was sent on a course to learn “Conflict Management”.  As part of their responsibility under health and safety legislation ‘Da Firm’ has decided that we all need to be trained in personal safety.

I was quite happy, as it is an eight hour day, and I was taken off a twelve hour shift in order to attend this course.  I have been to four of these courses in the last 10 years or so, so I wasn’t expecting any surprises.

The actual location of the course was in ‘Partnership house’ which is a Christian building opposite Central Control at Waterloo.  It was bloody freezing there as well, and the coffee they supplied was completely undrinkable…

…Luckily I had a can of Red Bull in my bag.

The course was run by a free-lancer for Maybo, he was ex-army, and ex-police, and a very good tutor – although I was a bit surprised when one of the first things that he said was that “This course is copyright Maybo”, it just seemed like a strange thing to say.

As expected, it was the usual mix of talking about how to assess and defuse potentially hazardous situations, coupled with some physical skills of how to escape from people trying to grab you.  When I first did a course like this, many, many years ago the skills were all rather more ‘hard’ and involved pushing people away – this current course was a lot more ‘soft’, which is more useful because the people who tend to grab us are ‘little old ladies’, so punching them in the face is vaguely discouraged.

Quite a fun little day, and I learnt a few new tricks that’ll come in handy when I’m wrestling people to the ground…

Tomorrow, I shall be trying to blog every hour in some strange attempt to mix “Extreme Blogging” with the episodic format of Television’s “24”.  This will either be fun, or really tedious.  There will even be pictures.

Sometimes patients can be awkward buggers, all their signs and symptoms point to one thing, and it is only a bit later, with a bit more investigation that you find out what is actually wrong with them.

Today was a case in point, I got called to a 40 year old male who had been suffering from chest pain for the past two hours.  I turned up and started my examination of him.  He had fallen down the stairs the day before, his chest was painful when I pushed on it, and he had no symptoms leading me to believe that the problem was anything to do with his heart.  I immediately thought that the pain was muscular in nature, rather than a more serious cardiac problem.

The only thing was that his pulse felt ‘funny’, a strange little ‘thrumming’ sensation that was a little like a double heartbeat.  So I thought that if I hooked him up to my cardiac monitor I’d have a better idea what was going on – but the leads on the monitor weren’t working, so I would have to wait until the ambulance turned up.

It was a little embarrassing because the patient and his wife were both doctors (probably working in research)  Both were happy with their treatment and the ambulance soon turned up.  The patient was connected to their monitor and we found out that he was in SVT which is a rythmn problem with the heart, causing it to beat too quickly.

So the actual ‘Chest Pain’ was probably related to the fall, being either a bruise or a muscle strain.  While the patient’s real problem was hidden from a cursory examination.  It is only because we have the capability to electrically examine the heart that the patient was sped into hospital rather than taken in normally.

I’m wondering if the fall somehow caused the arrythmia, it’s probably not outside the realms of possibility.

Knowing what the patients problem was also meant that the ambulance crew didn’t look embarrassed after handing the patient over to the nurses at the hospital.

Tomorrow I have a special learning day – learning how to ‘maintain personal safety’, how to defuse aggressive situations and how to escape from grapples and the like…

Then on Wednesday, I have a plan for something a little bit special – that will either be fun, or really tedious.

There are 1265 British blogs listed in this directory, one of which is this site.  At the moment it has little function beyond the directory itself, and the ‘Top Ten’ and ‘Bottom Ten’ charts.  I would suggest that it needs to implement something that will better produce a community (Forum?  Mailing List? Chatroom? Or something more left-field?)  As once you have filled up your ‘blog reading time’ with blogs that you enjoy, you won’t return to the directory itself.

I wonder if an RSS feed of the ‘Bottom Ten’ blogs would be interesting to read, or if it would just consist of  “I have decided to start this blog…” posts.  Perhaps an RSS feed of ten ‘Random blogs’ would help get people attracted to new and interesting blogs?

I really should have some caffeine before blogging.

It seems that Siemens has recognised the power of blogging - they are offering a chance for people to test-drive some of their new phones, and to report their experiences in a blog format.

It'd be interesting to see how this works out for them - the chance to listen to your customers during a beta test is nothing new, but this is the first time I've heard of a company using a blogging format to structure such feedback.

Testers will release their opinions on a blogging platform, which will be an integral part of the Siemens Communications site. Individual tester blogs for each product will be aggregated and linked to from the product pages within the next generation section. After the release of a phone the posts from categories like "Bug", "Idea" or "Hack" will stick to the product´s page.

If you are interested in signing up you can have a look here.

I've just come from a job where the ambulance crew who responded called me 'Mr Blog' - they wondered if I'd write about the job we were at.

18 year old male, normally fit and healthy, with a dry cough for one day. Location? 400 yards from the hospital.

Erm...and that's it - Cue a phone call to 999, one RRU, one ambulance and all the work/paperwork that any attendance to A&E requires.

Before that I went to a patient who gave their complaint as 'Chest pain', and sat there talking to me, rubbing their ample belly, which had been hurting them for the past week. I'm sure some people think their chest is the two inches around their belly-button.

I've mentioned before how some addresses are 'flagged' as dangerous, when a crew goes to an address and gets punched, kicked, spat at or otherwise abused they return to station, fill in a form and that address is then flagged.

We will still go to these addresses, but the police will normally be called first, we then wait around the corner until the police turn up and we go to the patient together.

The police have a similar system, but it's much wider in scope, and we don't have access to it because we are an 'essential' and not an 'emergency' service.

When an address shows up as 'flagged' the crew are informed that they should wait for the police to turn up...

...So why then, did I turn up to a flagged address, have a chat with the patient, and then, a couple of minutes later, I opened the door to the police and the ambulance crew? Could it possibly be because no-one told me it was a flagged address?

I heard the crew being told that the address was flagged, and that they shouldn't approach, but as I didn't know what call they were going on I couldn't have known that it also should have applied to me. The FRU desk which handles my jobs should have told me about the address and given me the same advice, but that didn't happen.

At the end of the day, I was alright (the patient is well known to me, if only because he is a neighbour of mine) - but when I called the FRU desk to ask why I wasn't told about the dangerous address the best answer I got was a 'Sorry about that- are you alright?'.

I know it gets busy up in Control (especially last night - everyone was busy), I also know that communication between the Sector desks (who control the ambulances in the area) and the FRU desk (who coordinate the RRU's across the whole of London) is often not brilliant - but this is the sort of thing that could lead to really bad things happening...

...bad things happening to me.

One of my regular readers is someone from an Ambulance Control, she left the following in my comments section about why we on the road tend not to see too many hoax calls.

We do get a fair number of hoax calls in control. Most of them can be spotted a mile off, however, and consist of someone under the age of 16 requesting police, fire and ambulance for some unfeasible event. They usually hang up when you read them back the address they are calling from, or, if they are in a call box (which they usually are) tell them to "look up at the 'security camera' in the box so I can see your face" or "the doors of the phone box will now lock automatically - the police are on their way to catch you for making NAUGHTY HOAX CALLS". Obviously, you have to be 100% sure that it is a hoax before you do this, otherwise someone will die and then you will get the sack.

I also spend a fair deal of time when working on the dispatch desks calling back suspected hoaxes from call boxes until a member of the public answers and confirms there are no dying individuals lying around that we ought to be attending to.

One or two do slip through the net, though. There was an almighty ruckus when some really "funny" people decided to tell us that someone had fallen down the stairs and then given birth to her sixth baby on the spot. A whole fleet of ambulances and midwives turned up to find a bunch of sniggering teenagers on the doorstep and no sign of any woman or baby. They didn't even have the sense to give a false address. One of the midwives rang up and shouted at me for half an hour.

So, thanks to the folks up in Control around the country for dealing with the obvious hoax calls

I think this will make up for the moan I'm going to post about Control in a little while.