I could hardly believe it, the first job of my shift was to the 45+ Stone patient who was my last job on my last shift.

It only took 45 minutes to get him out of his flat this time, which just goes to prove that practice does indeed make perfect.

I promised answers to some of the questions asked in my comments area, so here goes...

Do you deal with a lot of hoax calls personally?

In my own personal experience, I have found that hoax calls tend to be fairly rare these days. The youths these days tend not to make hoax calls - instead they set objects on fire and wait for the Fire Service to turn up. Just a few nights ago, the target of these pyromaniacs was my block of flats. One of our crews was on the way to a job, and as they passed my flats saw flames leaping out of a window. One of the refuse chutes had been set on fire, along with a couple of waste bins.

So, no. We don't get many hoax calls, we just get people causing trouble.

When people are having epileptic fits, is there any medicine you can give them

Paramedics carry Diazepam in rectal and intravenous forms, which can be used to bring people out of fits. Unfortunately EMTs are not permitted to carry or administer these drugs - in my eyes I think it would make a lot of sense for us to carry these drugs, as seizures can be a life-threatening condition.

Do you have to do any paperwork after a job

Yes, I do, I have to fill in a 'Patient Report Form', which contains the patient's details, what is wrong with them, their 'vital signs', the times that I get to the job, and finish the job, how far I have travelled and space to 'code out' the patients problem.
I also have a 'Running' form, where I fill in the times to the job (again), the miles I've done (again), Where I went to (again) and the serial number of the patient report form.
Then there is a special RRU form, where I fill in the times (yet again), the mileage (yet again), where the job was (yet again) and do some maths to work out if I got to the job in less than eight minutes.
Luckily I don't have to fill in HIPAA forms or anything like that - but it does seem that most of the time I'm filling in paperwork rather than actually seeing patients.

What do you give for a heart attack

In London we give Asprin, which reduces the mortality of a heart attack by 25%, and GTN (nitroglycerine) which 'opens up' blood vessels, hopefully allowing more blood to got to the heart so that the damage done by the heart attack is minimised. In some parts of the country ambulance paramedics can give anti-thrombolytic drugs. These 'clot busters' break up the blood clot causing the heart attack - but because of the risks of serious side effects and the nearness of hospitals we don't yet have these drugs in London.

You didn't like 'Constantine', what was the last film you liked?

I went to see 'Robots' last night and thoroughly enjoyed it. Laughed out loud at the fart jokes, the Britney Spears pastiche and the ever funny Robin Williams. There are lots of interesting films coming out in the next couple of months, so I'm considering getting a Season ticket.


I think that's all the questions, many apologies if I've missed yours. If you want to ask me anything then please do feel free to leave a comment, or drop me an email.

From the excellent Mac Hall
Please note that this has nothing to do with anything going on in my personal life now, or in the past or present, it is presented purely because it is amusing. Go there, read the other comics, enjoy them and then buy merchandise.

A couple of people have asked me some questions in the comments of the last few postings, I’ll answer them all in tomorrows posting.

Yesterday was fairly busy, but the two remarkable jobs of the day were caused by what we in the trade call “Tricky extrication”.

The first job was to a young male collapsed in a bookmakers toilet.  I’ve been to a couple of these, and for some reason bookmakers toilets are favoured places for junkies to ‘shoot up’ in.  I’ve been to more junkies in bookmakers, than I have drunks in pub toilets.  Do not ask me why.

The toilet itself was 3 foot by 5 foot, and in it was a heavily drunken Lithuanian, covered in vomit, urine and the drink of champions – “White Lightning”, about three litres worth.  He was, for all intents, unconscious – unable to talk, stand, walk or do anything except drool.  And he drooled a lot.

Because of the size of the toilet (barely enough room for one person, let alone me as well), the slippery floor (vomit, urine, cheap nasty cider) and the state of the patient (big, thickset, heavy, completely unable to help) I had to grab him by his belt buckles, and with the aid of the crew man-handle him out to the ambulance.

I followed the crew to the hospital, so that I could wash some of the ‘stuff’ I had all over my arms, and the hospital knew the patient, because he had been there yesterday, for exactly the same thing…

The last job of the day was to a 45 stone male (285 Kg) with difficulty in breathing.  He was up one flight of stairs, found it very difficult to walk, and was in a flat full of cardboard boxes.  It took us an hour to get him out of the house, down the stairs and into the ambulance and at the hospital it took another half an hour to get him in.  Our trolley-bed (and these are the new trolley-beds, fairly strong things) was buckling under his weight, and there was a moment or two when I thought it would collapse under the weight.

It took so long to get him out of the house that I got an hours worth of overtime – which, for my mercenary nature, was rather nice.

No posting yesterday because I couldn't get to a workable computer at any point during the day. The computer at work wasn't working, and I ended up going to my brother's house after my shift because we were going to see the film 'Constantine'.

(I could give you my review of the film, but I try not to swear too much on this site... Lets just say that the acting was awful, the story wasn't that inspired, and it was a very poor reflection on the themes of the comic on which it is based. My brother hated it more than I did.)

Yesterday was busy, but busy in a good way in that most of the calls that I got actually warranted an ambulance. Actually, if I had been dropped on my head repeatedly as a child leading to me believing in the supernatural, I would have thought that there was something strange going on. The majority of my jobs, and a lot of the jobs that I heard being given out over the radio were for people having seziures.

The first call of the day was to a known epileptic who had been fitting while in the bath. Luckily his father heard him thrashing against the side of the bath and pulled him out before he could drown. He was still quite drowsy, confused and a bit 'punchy', normal for people who have just finished having a fit. The ambulance crew got there, and as the patient was a know epileptic, and was feeling better he was left at home with the instruction that should he have another fit, then he should go to hospital.

I then bounced from that job to another young male who was having recurrent epileptic fits, in over an hour he hadn't managed to recover from a fit. He had three fits, and was still extremely 'floppy'. The crew asked for my help in controlling him in the back of the ambulance, so I left the car and helped keep his airway clear while we 'blued' him into the local hospital. He had one more fit in the back of the ambulance, which I never like dealing with, as there are a few too many hard surfaces you can injure yourself on.

The ambulance crew then returned me to to my car, and I was pleasantly surprised to discover that it was still there, and that the wheels were still attached.

I then ended up going back to my first epileptic, as he had suffered another seizure. This time the ambulance crew took him to hospital for a check up. There are a couple of things that can reduce the effectiveness of anti-epileptic medication, and while the patients family believed that he had been drinking recently, it is always a good idea to rule out the other causes for an increase in seizure frequency.

Then there was a hoax call for a 'pedestrian vs. car', which had me, the HEMS doctors, an ambulance and the police trying in vain to find a victim. Great.

Next was a middle aged man, who was having his first Heart attack. The call was given as a chest pain, and when I walked in the room and saw how ashen he was, I was breaking out the oxygen and medication. He gave a classic history and description of a heart attack, luckily the ambulance was quick in turning up and the job went like clockwork, with the patient getting transported to hospital very quickly.

Then I went to a patient with cancer of the bowel who had abdominal pain, an easy job in one way, but rather shocking in another because the patient was the same age as me...

My final (late) job was to a one year old child who had been...wait for it... fitting. The normal type of febrile fit. When a child has a temperature that rises quickly, they can often have a seizure. While a medical emergency, it's something that, because we deal with them a lot we find it an 'easy job'. Essentially you cool the child down, and give them oxygen.

In more general news, the Sat-Nav screen on one of our ambulances was stolen the other night. Someone broke into the ambulance to steal a bit of equipment that helps the community. It says it all for some of the people in this area really...

Drinks last night = hangover in the morning.

“40 days of blogging” seems like a bad idea now.

Back to work on day shift tomorrow.

More stuff then.

Now I need to lay down in a dark room and drink Red Bull.

Listen to Uncle Reynolds as he sits you on his knee and explains these simple facts to stop you losing your job over blogging.  These points relate mainly to work-blogs, but with a bit of thought will translate pretty well to anything that you write on the Internet.  Most of this is just common sense stuff, but there are people out there who falsely think that bloggers should be elevated over non-blogging employees.

Disclaimer – I am not an expert in employee law, I just have my opinions.  Seek professional or union advice if you feel your job is under threat.  At the end of the day, my company is trying to get less customers, not more.  So my ideas may be a little screwed up.  Don’t come crying to me if you lose your job following my advice.  Also don’t come crying to me when I’m sitting on station trying to have a cup of tea.

 

How To Blog, And Not Lose Your Job – Version 1.0

You are not anonymous, in todays world of easy investigation (via the Internet of course) it is normally a matter of an hours work to find out who a blogger is.  It’s really easy if the person who is doing the investigation works for the same company you do.  Sure, you might use a pseudonym and reduce your boss and fellow workers to nicknames, but it only takes one mention of some uncommon point to blow the whole thing open.  For me, it was when I wrote about swallowing some HIV+ blood, the news spread around ‘in real life’, and it didn’t take a genius to work out who was writing my blog.  In some places your company might be able to force your blog hosting company or ISP to reveal your details.  So write as if you are writing under your own name, or be honest and don’t bother with a pseudonym.

In a related note, you will probably be read by people who know you, it’s probably inevitable, but folks who move in the same social circles as you will have similar interests.  Your interest in blogging about your job in sheep shearing may well mean that when your colleague does a search for websites about sheep shearing for promotional interview reasons – your page may well turn up.  If you are going to be publicizing your blog, then there is a large chance that your target demographic will include some of your friends.  Actually if it doesn’t then either your blog, or your friendships are not very honest.  So blog as if everyone you know reads every word.

You are not immune to the rule of law – really, you aren’t.  Blogging may be a great new thing, it may well have expanded quicker than any other media in the history of humanity, but the laws of Libel, Slander and Defamation of Character* still apply to you.  Sure, the Internet fosters a sense of anonymity, and of free speech – but that only goes so far.  A lot of bloggers who have been fired from their jobs have found out the hard way that you can’t breach your company’s rules/country’s laws and expect the defence of ‘But it was on the Internet’ to hold much water.  If I write something that defames the character of someone, then they are fully within their rights to sue me, whether I’m published in a paper, a book or on the Internet.  You have to follow civil and criminal laws online as well as off-line.  These will vary depending on where you live.  For the Americans in the audience the whole ‘Free Speech’ bit in your constitution concerns your government making laws to curtail free speech, it says nothing about companies.

*Your country’s laws may vary.

The truth will find you out, if you lie on your blog, and there are any number of people reading then you will be found out.  I’m not suggesting that there are a multitude of fact checkers out there, but it only needs one falsehood to completely blow any reputation you may have built up.  If you lie about people then once again you are laying yourself open to a juicy bit of court action, which might bump up you pagehits, but not in a good way.  If you aren’t sure about a bit of information that you are writing about mark such inconclusive evidence as being just that – inconclusive.

If you think you will get in trouble with your blogging – ASK.  I know that it may be easier to ask forgiveness than permission.  But your company might be all out of forgiveness.  If you think that your blogging might cause friction, or lead to you being disciplined then ask your boss first.  Go in prepared, with all the opinions and evidence that blogging is a good thing.  Do a good enough job convincing them, and they may start paying you to blog.  If they flat out won’t let you blog, then consider if this is a company you want to be working for, or if you want to blog strongly enough to risk losing your job.  Do this, and don’t be surprised when you get the sack.

Companies, as well as people have secrets, and they will be mightily annoyed if those secrets are aired for everyone to look at.  Companies have bigger secrets than individuals, they have to protect their profits, enjoy the support of their stockholders and maintain patent pending secrets.  If you blab about ‘Secret Project X’, then the company will find some way to fire you.  You might not think that revealing that chip X will be used in the new graphics card you are working on is propriety information – but it never hurts to check first.  Just think before posting - “who will this revealing secret hurt”, if you aren’t prepared to deal with the consequences, then don’t post.  Of course, if it is in the public interest to post about something, then you need to weigh up the possibility of being disciplined.

Companies, and people, have a reputation to protect, if you want to shout about how working in company X is like slavery (complete with whipping and a bread and water lunch programme), then that company might take a dislike to you doing so on the Internet.  Actually this is one of those things that is made worse because of the nature of the Internet.  If you tell your wife that your job is awful – then your company is unlikely to find out.  Tell the same thing to a bunch of your friends down the pub and, if found out, the company may discipline you.  Paint it in six foot high letters on the side of their building and you would expect to get the sack.  Writing something on the Internet is much like painting it across the face of the moon.  If you are that unhappy, then find another job.  If you can’t get another job, then at least be fairly subtle about your moaning.  Your employers love you, and want what is best for you, if you are really that unhappy at work they will help you with some tough love by forcing you to choose other career options.  You’ll have to clear out your own desk though.

A lot of people won’t like being written about – I mean, the Internet is full of freaks and weirdos right?  Who’d want any details of their life on the ‘inter-web super-info-highway’ so just about anyone can read intimate details about them?  If you are going to write about other people, then anonymise them.  How you do this depends on the style of your blog, do you give them all nicknames, refer to them as initials or call them ‘one of my workmates’?  If you do give people nicknames, remember – they may well find out about it, and while calling your boss ‘SmellyGit’ may not be a sack-able offence, it may well have a negative effect on your chances of a future promotion.

If work has a problem with your blog, find out exactly what the problem is, and work with them to correct it.  Some workplaces won’t let people blog at all, some have no policy for blogging, while others (perhaps most) have no idea what blogging is.  Work with them to get a policy written, be helpful, be cooperative and be evangelical.  Telling your company that ‘it isn’t fair’ when they ask you to stop your blog will work about as well as it did on your mother when you wanted to get that tattoo.  Let them know how blogging ‘humanises’ the company, talk about how ‘branding is a conversation’; let them know that you are performing ‘grassroots, viral marketing’.  If that doesn’t work, let them know that people are going to start asking questions about why the blog has stopped, and that they will draw their own conclusions.  This isn’t a threat, but a reality – get them to let you continue the blog but that they get to clear any information that you post about.

Can you blog on company time?  Most companies have a policy about Internet usage.  Your work might well have a policy that covers blogging without actually mentioning the word ‘blog’, probably something about using the Internet on company time.  I suggest that if you are going to be posting during working hours you take a good long look at those policies.  Remember, they are paying for you to work, not to write your diary (no matter how many people read it).  Obviously this doesn’t apply to people whose job description is to blog.  If blogging is encroaching on your work or personal time in a negative way, then stop blogging.  It’s just not worth it.

Sometimes blogging is just an excuse to get you fired.  Sure, you might roll into work drunk, do very little work, backchat to your boss and fall asleep during the afternoon – but the reason they sacked you is because they found out you have a blog!  I’m no expert on how easy it is to sack people, but I suspect that ‘gross misconduct’, ‘failure to follow Internet policy’, ‘bringing the company into disrepute’ and ‘Revealing company secrets’ are fairly easy things to get past an industrial appeal board.  I would imagine that some of the people who have been fired or disciplined have comforted themselves with the thought that “it’s because I have a blog, that’s the only reason”.  So be a good worker, then they won’t be so quick to sack you.

Just because you blog, it doesn’t make you special.  Sure, you might have 10,000 pagehits a day, you are Slashdotted on a regular basis and you have Dave Weiner’s home phone number – but that means nothing to your boss.  Blogging doesn’t bring with it a ‘Get Out Of Jail Free’ card, you have no ‘Freedom of the Press’, and just because thousands of people hang on your every word – it doesn’t mean that they will help you keep your job.  Blogging grants you no immunity to normal disciplinary procedures.  Sorry about that.

Does this emasculate your blog?  Well, perhaps a little – but if you are posting inflammatory lies about people, revealing industrial secrets and whining about how much your job both ‘sucks’, and ‘blows’, then be fully prepared to be fired.  If you are writing things that are really that negative, ask yourself if you are in the right job.  Journalists working in countries under a dictator need to be careful about what they write –  and while you might not get thrown in prison, or worse, just be aware that bad things happen to people who rock the boat.  It’s not fair, but it’s the way the world works.

Finally.  If you do lose your job, you have a whole audience of people finding out about it, any of which might help you get a job.  I know at least two people (people who I’ve met, not including people who I’ve read about), who have gotten jobs based on their blogging.  In most cases people are happier with their new jobs than their old, if only because their new company understands and supports their blogging.

This, like everything that I create on this blog, is under a Creative Commons License – so please feel free to remix, edit and add your own observations to the above.

For those that are interested, one of the photos that was taken, and the Times article is up over here. I'm just glad that they didn't use the one of me using a laptop - I can see why they might use a "Here is the blogger updating his website..." photo. But the computer I was 'using' was the photographer's Mac.

Not that I have anything against Macs, but I don't think think that they are as wonderful as everyone makes out. I sometimes take a vaguely non-Mac role on IRC.

Of course I'm saving up for a Mac Mini because, at heart, I'm a computer geek.

I've now got a day or two off before returning to day shifts (depending on if I get granted the annual leave I asked for), but I have a project in the works... Another Ambulance employee has asked how they can start writing a blog (and not get sacked), so I'm going to write a bit about 'How not to get the sack for blogging', seeing as it's why I keep having these interviews, while written from my perspective, it might be useful for other people.

While I don't really 'do' guilt, I did feel a little troubled by last nights work. While all our ambulances were racing around East London, run off their feet, I spent the majority of the night unused, sitting on station. Apparently a dearth of Category A calls.

Personally, I'd rather be working for my money.

The first job of my night was to an asthmatic woman, who was also, judging by her paintings on the walls of her, spotless, house, a rather good artist.

I hate asthmatics. Actually that's wrong, I've got nothing against people who have asthma - it's just that I've seen more than a few asthmatics 'go off', which means that their condition gets a lot worse very quickly. There is very little scarier than seeing someone deteriorate before your eyes. Normally it is the nice patients who wait until they are seriously ill before calling an ambulance - so they will struggle for breath for a couple of hours, before calling us out.

Please, if you are having trouble with your breathing and your inhalers aren't working, then call us out. We can give you the right medicine, and if you improve then you won't need to go to hospital. It also gives us a nice fuzzy feeling to actually help someone for a change, rather than act as a glorified taxi.

So I walked into the patient's house, and could hear her wheezing from down the hallway. She was having real trouble in forming sentences, which is a priority symptom - so I wasted no time in giving her a Salbutamol nebuliser, which is a medicine we give to 'open up' the patient's lungs.

Thankfully she responded well to the medicine, and as the ambulance was only a minute or two away, she got a nice quick trip into the local hospital.

My second job was to a three week baby which had, over the space of a couple of hours, developed a general red rash over his face and body. The baby was black, which always makes assessment of rashes tricky, black people come in a variety of 'shades' and without knowing what the child looked like before the rash started, it's hard to tell how severe the rash is.

It doesn't help that I'm not the worlds expert on rashes.

The first thing I always tell a parent about a child's rash is whether it is meningitis or not, as this is normally the first thing on their mind. In this particular case, the rash looked like a mild allergic reaction to some substance and after talking to the child's mother, and eliminating the normal suspects (washing powder, baby bath, cleaning wipes) we decided to lay the blame at the feet of a friend who had visited mother and child wearing a very strong perfume.

Now, there is a major problem with being on the Rapid Response Unit when everyone is busy - there are no ambulances to send to actually transport the patient.

So for 45 minutes I had to make small talk with the mother until an ambulance became free to be sent to me.

Control Desk did however phone me up to make sure that everything was alright, and that we didn't need an ambulance as a priority. I'm not supposed to transport patients in the car, as it's not really equipped to carry anyone other than me - but even if I had decided to ignore that rule, I couldn't really justify taking a baby carried in it's mothers arms as a safe thing to do.

Especially with my driving...