I’m mentioned in the Observer today, along with some other great blogs.

Others mentioned are Mental Nurse (Which I never knew of, but after reading the first post has gone onto my bloglines subscription)

Brian’s Brief encounters, a police blog that I mentioned last week.

Tales From The Chalk-face, from a teacher (I keep telling my brother, a teacher, to blog, but he is too worried about losing his job).

And my mate Suw Charman who is our home grown genius of blogging.¹

 Also mentioned is Joe Gordon who is probably the first UK person sacking for blogging about work.

 

So if you are coming over from the Observer, welcome,  and pleas enjoy browsing the archives.

—

^1.Disclaimer: I only recently gave up trying to snog her.

Is this true?

(And do people really have to wait until 2008?)

From the nice Mr. Ellis.

I’m often asked why I started blogging – the honest answer is that I saw a technology that was being used by other people to create great stuff, and it looked like a lot of fun.

To be honest ‘it seemed like it would be fun’ would explain a lot of my life-choices, including the whole ambulance ‘thing’.

I’ve been listening to podcasts for quite a while, and thought that it was something I’d like to do.

So I have exactly that.

My first (very rough) podcast is up there for the whole world to hear.

WARNING: This podcast was made with the worlds cheapest microphone – when/if I do another one then I’ll spring for something more expensive.

I have no ‘stings’ (the annoying “This is radio KNEX 107.1 from Montana” with a sound effect over it), I also have no ‘amusing’ sound effects and I’d really like to have a nice copyright free piece of ambient music in the background (which means I need to dig out my old sequencing software at some point).  What I do have is two great music tracks, a bit of me talking (in betwen the ‘umms’ and ‘errs’).

(I’m wondering how much work I’ll have to do on my ‘radio voice’)

My excuse for how it sounds is this – cheap equipment (a bad workman always blames his tools) and also I have no experience in this sort of thing at all.  Still my bloggin improved with practice, so hopefully this will as well.

—

You can get the first podcast from randomreality.libsyn.com  the feed, for all those using podcast clients is randomreality.libsyn.com/rss/podcasts

The music is ‘Rodeohead’ by Hard n Phirm, and ‘Introspection’ by Osymyso 

So, what do you think?

You can send your comments to podcast@randomreality.org, or just leave them in the comments box.  I’m looking for podcast safe music, (i.e.creative commons licensed), or places where I can download the same,  ‘radio stings’ and anything else that’ll make the show better.

Rotten eggs can be thrown when you next see me.

I was going to moan.

I was going to tell you about the driver who tried to play 'chicken' with me. I would have told you about the brain-dead idiot who ran out, without looking, from behind a bus, causing me to leave 20ft long skidmarks (on the road thankyouverymuch). Maybe I would have mentioned the kid who thought it would be a fun thing to pretend to jump out in front of my car. All while on blue lights and sirens.

I might even have complained about the maternity department who told their patient to "phone for an ambulance" (which she plainly didn't need).

I definitely would have told you about the two drivers who couldn't wait for five seconds before swearing at the ambulance crew and myself for 'blocking the road'. Didn't matter that we wanted to see if the guy lying on the pavement was dead or not. They only stopped shouting when two policemen sauntered over to them in their "I can't believe you are that stupid" way, cultivated by long hours in Newham.

I would have moaned, but I've had two Chinese takeaways, so I am now feeling content and will therefore tell you about how the internet saved the day.

I got called to a 14 year old female in a block of flats who had collapsed.

Nothing particularly interesting about the actual collapse, but what was interesting was how the ambulance was called.

The patient was talking to a friend via a web cam.

Her friend saw her collapse (well slid down under the view of the web cam).

Her friend then phoned the patients house, where the phone was picked up by the patients gran.

Gran then rushed into the patient's room where she saw the patient collapsed on the floor.

Gran then phoned for an ambulance.

We turn up.

We save the day.

Yay for us.

So all hail the internet, saviour of teenage girls!

WARNING: This posting may be just a tiny bit uncharitable. Blame it on me working a busy nightshift.

Poxy bloody heroin addicts.

This post may also be just a shade judgemental...

I got sent to a call, "Male collapsed". I'm first on scene and as I enter the flat there is a partially dressed man on the floor with a woman kneeling over him.

At least she is honest.

"He's clucking, because he used to inject, and now smokes heroin. We had a fight now he's acting strange".

'Clucking' means that he is withdrawing from heroin.

"Is he on methadone?", I ask.

"Yes, but they don't give him enough", she replies.

Heroin addicts never think they get enough methadone, which is a drug that is used as part of heroin addiction treatment.

She continues, "so he went a bit strange, so I gave him a few runs to see if it made him any better".

'Runs' are a description used in smoking heroin.

So his addict girlfriend (she admits to sharing a drug of choice) has seen him go a bit strange and thought that giving him some heroin would help.

Normally this wouldn't be too much of a problem, we'd take him to hospital and let them sort it out...

But this one doesn't want to go to hospital. He is refusing despite using our range of persuasion tricks.

Apparently the local A&E doesn't give him enough methadone either. Apparently he has to take heroin with him when he goes to A&E so he can have a smoke of it outside the department.

We are stuck. We can't drag him out, his girlfriend and mum can't persuade him to go, and the police won't be able to do much.

This is also the sort of job that can (in the local slang) 'go bent'. In other words, this is the sort of patient who will take great pleasure in dying five minutes after we leave.

The ambulance crew decide to get an officer on duty to come down - this covers our backs, and means none of us should get the sack should the patient decide to stop breathing.

I'm sorry to be judgemental, but as soon as you start thinking it's a good idea to start injecting heroin into your veins, you stop being a human being, and instead step outside normal society.

I've never met a heroin addict I've liked.

On the flip side, there probably aren't that many heroin addicts who have found ambulance crews that they like.

It's on jobs like this that I rely on the training, and on my belief that, no matter how little I like the patient I'm treating, if I'm nice and polite to them it makes my life so much easier. I'll also treat them to the best of my ability, because anything else would just be wrong.

But it certainly doesn't help to think that while I am treating this patient there may be some little old lady, lying on the floor with a broken hip, awaiting an ambulance which is slow in coming because we are tied up dealing a heroin addict.

It also makes me both angry and sad that this person has completely wasted their life instead of doing something useful and productive. And don't forget the relatives, friends (and quite possibly) victims of crime) that are affected by his addiction.

And then after this job I get three maternataxis one after another.

Still, as my mother says "It must be nice to be busy - it must make the shift pass quickly".

I'd still like a cup of tea every so often...

And with a bit of luck I'll be in a better mood tomorrow. In the meantime - Does anyone know a good nightclub in London for a Saturday night? Does the LA2 still play 80's music? Every time I work nights I look with envy at people enjoying themselves - so this weekend I intend to enjoy myself and maybe go 'clubbing'.

My ‘one word’ review of ‘Lost’ which starts today on Channel 4 at 8:30pm (For those in the UK anyway).

Unmissable

I’ve seen all of the first series (thank you Bittorrent¹), and it really is compulsive viewing.

Do people in offices still talk about TV around the water fountain?  If so, then I suspect that this could be a big topic of conversation.

—

 ^1. So why exactly is my computer full of malware? Could it be some of the websites I visit?

There is another excellent policeman's blog that I read regularly. He is quite unlike any of the other police bloggers out there in that he has a very distinctive style of writing.

Sunday's post however was excellent as, while I have written about the same subject before, "Brian" has written the post I always dreamed of writing.

Go, read, enjoy.

And if you are lucky, I'll have a 'nice' job to write about tonight.

Now this is what you call moblogging.

For those who aren’t interested, it’s a photo story taken and uploaded by an Ethiopian teenager.

There is much more on Ethiopia Lives.

And this is the power of the internet.

One of the ‘problems’ with working on the Rapid Response unit is, because you are so ‘rapid’, you can often find yourself first, and only, responder on a job where you would much rather have a large number of ambulance crews.

I’m thinking specifically of the RRU who was first, and only, paramedic on the scene of the recent London bombings.

I got sent on a job to one of our main roads, given as ‘car vs bus’, I thought that it couldn’t be too bad, as the speed of traffic on that stretch of road is about 4mph.

The police have already gotten the area taped off, and there is minor damage to the front of the bus.

Sitting some way away, nudged up against a shop, is a blue car.  The first thing that hits me is that there is no way that an impact that does such little damage to a bus, spins a car through 180 degrees and throws it against a shop.

(I later realise that what has probably happened, is that that the bus has clipped the car – the driver has then hit the accelerator and driven over the kerb, ending up ramming the shop).

“Hi”, says a friendly policewoman, “there is a full term pregnant adult female with a head injury, a baby that she was carrying on her lap and six other children, none of which had seatbelts on”.

“Gaa!”, I mumble.

I get onto Control, “I’m going to need at least three ambulances”.

—–

I go to check on the woman – she is pregnant, wasn’t wearing her seatbelt and ‘bullseyed’ the windscreen.  She has the world’s tiniest cut to her head, and minor stomach cramps.

To ‘bullseye’ a windscreen, the head hits the glass and causes a distinctive ringed crack pattern.  There is often hair left in the glass.

A quick examination, and I’m happy she hasn’t broken her neck, and actually not that badly injured.  There is nothing much to do with her.

A very quick look over the multitude of children standing around shows a swollen lip on one of them, but probably nothing serious.

A female police officer is holding the 18 month baby, “I keep stroking his cheek and he keeps waking up and crying”, she tells me.

I take a closer look…seems a bit pale.

He also looks a bit ‘floppy’.

I stroke his cheek.

Not a flicker.

Shit.

 —–

My salvation then comes around the corner.  An ambulance.  A lovely big, yellow, blue flashing lights and sirens ambulance.  An ambulance that can take this child away from me and into hospital where he needs to be.

The police officer and I jog over to the ambulance and I give the quickest hand-over to a crew ever¹.  They take one look at the child and ‘blue’ it into the hospital.  (I later find out that the child was faking it all, and was absolutely fine).

I then have to examine each of the kids to make sure that they aren’t hiding any serious injuries, which thankfully they aren’t.  I then recheck the mother of the toddler, explain why her child has gone to hospital without her, and try to keep her calm.  While doing this I’m also trying to chat up one of the female police officers (but she’s having none of it).

So I’m kept a bit busy.

I’m also being watched by an increasing crowd of people, who aren’t impressed by the power of police tape, and so want to wander over and offer advice.  The police do a good job of shooing these people away, but it is a bit Canute trying to hold back the sea.

Thankfully, there were no serious injuries (although if I had the kit, I’d have liked to have immobilised everyone involved), and the other ambulances soon turned up to ferry away the patients.

My paperwork consisted of one report form with “Multiple patients” written on it, and a description of what I’d seen and done.   

Then I went back to station, had a cup of tea and then got sent on a job on the edge of my patch, described as “12 year old female, collapse”…

—–

^1.Apart from the time my handover was a disdainful, “the patient has a verruca”.²

^2.Incidentally, also the shortest triage note I ever wrote when an A&E nurse.

No, I haven’t dropped off the face of the planet.

Instead I have been healing my wrist (which still makes a funny clicking noise, but is at least less painful), finishing up my move to my new place (the final bit of carpet gets laid today – and so I should be ‘finished’ moving in), working on various secret little projects of mine, and most importantly reading the comments people have left on the last post.

A few things I’d like to say,

• Yes it was a nasty job, but within 24 hours it had passed from my mind (as a lot of things do).  Therefore there is no psychological trauma involved.
• Thanks to everyone who wrote nice things, it’s appreciated – but please do remember that any number of you could do my job just as well as I can.  I’m nothing special, I just happen to be the bloke who writes about it.
• There are a lot of tragedies in the world, but I can’t fix them, I can only do what I do.  Everyone else should do what they can do to make the world a little better, whether that is volunteering for stuff, or just making a little donation to charity.  Those of us who can access the internet are a privileged minority, and should use this privilege to do nice things for other people.

The plan had been for me to go to the Great British Beer Festival, and try and do a ‘proper’ report on it.  Unfortunately I woke up that morning with what can only be described as a hangover…

I realised that if I went to the festival my hangover would be so galactically huge that it would actually have to travel back in time in order to fit in the whole range of agony due to me.

So I decided not to go.¹

I’ve also been a bit incommunicado because (once more) my system picked up a shedload of spyware/malware/etc…  So I’ve spent the last few days alternately swearing at, and then cleaning up my computer.

Can someone set me up with an interview with the person who wrote the Aurora software?  I’d really like to get their side of the story

(And get them alone in a room, so I can punch them in the throat…repeatedly).

I’ve also been playing around with Podcast software, and in an effort to make sure that I keep my promises and actually start podcasting – I’m going to announce that the first podcast will be released early next week.²

For those that are interested, the video of my talk³ is up here, just pick a mirror and download the “Blogs and Social Networks” video (warning large download). You may also need a special codec, which you can get from here^4.

The “UK EFF” Pledgebank still needs a few more people to sign up.  Seriously, if you think you can spare £5 a month in order to stop us sliding down the same silly slope that is American technological law then sign on up.  Digital rights, digital freedoms, call it what you will, but if you want to be allowed to continue to tape programmes off the television, listen to podcasts, and fiddle around with things that you own, then it is in your own best interest to have someone fighting to keep those rights.

I’m back at work on Wednesday (two night shifts), so with a bit of luck there will be some entertaining things for you to read in the near future.  Until then, I’ll leave you with a post I call “Multiple Trauma And Floppy Children”⁵

 —–

 

^1.Which probably causes some astounding paradox that will rent open the space-time continuum or something, who knows…

^2.I’ve said it, I’ll have to do it now, rather than stand around in smoky bars just claiming that I’m going to do one.

^3.A video which isn’t half as embarrassing as I thought it might be.

^4.I take no responsibility if this codec contains loads of spyware.

^5.Which of course you will have read first, what with blog posts being in reverse chronological order.

This is a tricky post to write. Normally I would write something to emphasis how I feel, or to try and get my readers to understand what happened, or to highlight some point.

But I can't do that in this post.

All I can do right now is tell you what happened.

I got sent to a call near the edge of my 'patch', given to me as a "12 year old female, collapse". The navigation point wasn't accurate though, so while I could get into the right general area, it wasn't directing me right to the door. I got there fairly fast, because I always drive fast to my jobs, even if I suspect that the illness is a panic attack, a faint, or a broken fingernail.

I met up with the ambulance crew coming from the other direction while I was checking my map, and talking to Control so as to get a better location on the patient. Control called back and gave me better directions - I told the ambulance crew to follow me.

The location was down a private road, which had huge, unmarked black speedbumps. I hit the first one at about 30mph, and had to check my mirror to make sure that I hadn't left important parts of my vehicle left behind in the road.

The patient was lying in the road ahead of me, with her family standing around her - I parked my car next to her, and got out to see what was happening.

The family were quite calm, and they told me that their daughter was travelling in the family car, told her parents that she felt unwell - so they stopped, she got out, shook a bit and then fell onto the floor.

The parents had laid her into the recovery position, and while worried, weren't screaming and crying.

Examining the patient, I saw there was a small bit of vomit in her mouth.

She then grunted.

I then saw that she had stopped breathing.

I am lucky that the ambulance was right behind me.

By now the medic on the ambulance was with me, and I told him that she had stopped breathing. I threw him my bag with the ambu-bag in it (the bit of kit which we use to breathe for the patient), and while he started breathing for her, I cut off her clothes and connected our defibrillator.

She was in fine VF, which is a rhythm that is 'incompatible for life', meaning that her heart isn't pumping blood around her body. It is also a rhythm that we can 'shock' to try and bring her back.

I shocked her.

The monitor on the defibrillator showed Asystole, which is where the heart isn't moving at all - but this can be 'normal' after giving a shock.

It was about now that the parents realised that their daughter was iller than they thought. They asked us what was happening - all we could tell them was that their daughter was 'very ill'. You can't tell people that their daughter is dead while you are in the middle of the road, in case they mob you and the patient, and prevent you from doing your job.

By now I was doing CPR (pumping on her chest to keep the blood circulating), and she had vomited a large amount everywhere. Normally we care about getting vomit on our clothes - but in this case we weren't thinking of that.

By now the driver of the ambulance had gotten the trolley off the back of the ambulance, so we decided to 'load and go', this girl needed to be in hospital as quickly as possible.

Her heart changed into fine VF again - so I shocked her another two times - once more she was in Asystole.

We loaded the trolley onto the tail-lift of the ambulance - and it wouldn't lift.

We gave everything a kick (because there is sometimes a loose connection) and it still wouldn't lift, so I ran around and got the handle that we use to manually raise the lift - but then the tail-lift started up.

We got the patient, and the father on board the ambulance, I jumped on to continue chest compressions, while the medic was trying to clear the airway and continue breathing for her.

The driver then put in a priority call to the nearest hospital, and started driving.

We sometimes drive fast in this job, but if there is one thing that will have us driving like a maniac it's for a nearly dead child.

While weaving our way through traffic and high speed I was keeping up the chest compressions while telling her father what we were doing.

It is hard to stand up in the back of a Mercedes Sprinter when weaving through traffic at high speed, and it is really hard to do so when some idiot in front of you decides to brake suddenly.

The vehicle lurched, there was swearing from our driver, and I grabbed a handrail. It was then I felt something 'go' in my wrist and hip.

We reached the hospital in one piece, and a nurse took care of the father, while we wheeled the patient into the resus room, where a team of specialists were waiting for us.

The good thing about the local hospital is that they let the parents watch the resus attempt if they want. There is loads of research that shows that this is good for the family to let them know that everything was tried for their child.

I was in the reception area when the rest of the family arrived - I showed them to the relatives room, and took the mother into the resus area where they were still trying to save the patient.

I was outside in the ambulance bay when I heard the family start crying, and I knew that they were crying because they had just been told that their daughter/sister/granddaughter had died.

The ambulance crew and myself had a little de-stress in the nurses messroom, and then the crew took me back to my car.

There was a small amount of vomit and a bottle of water still on the scene.

I went back to station, filled in an injury report form, completed the rest of my paperwork, and spoke to Control and told them that I would be sick for the rest of the night, because by now my wrist and hip were really starting to hurt.

All throughout I wasn't 'feeling' anything, instead I was 'blank', and not because of 'shock'.

I think that it's because, by my fourth nightshift, the ability to care about anything leaves me.

I was contacted by a duty officer, to check on me - and he was one of the nicest officers I've spoken to. He wanted to make sure that I was psychologically alright (I was), and he told me that he would sort out the injury part with my station officers so that they would know what was happening.

I then went to bed.

This morning, while telling my mum what had happened, I started to feel sorry for the girl - so I know I'm not a monster.

Sometimes this job is really shitty - everything went right with the resus attempt, and yet the patient still died. I'm left thinking that while I will continue, and will forget about this job (until the Coroners office asks for a statement), for that family they may never recover.

I got a call at about 5:30 in the morning to a "Collapsed female" with "shouting in the background", not normally a problem, so I took advantage of the empty streets and raced there.

I narrowly avoided crashing into the ambulance also coming to the job from another direction, and so we both arrived at the house at the same time.

The patient was a middle aged woman who had been drinking with her family, and then there had been some sort of argument, and she was feigning unconsciousness.

Nothing unusual there.

Remind me to someday tell you how we recognise when people are pretending to be unconscious.

Still no problem - that the family, while concerned, were happy to agree that the patient was actually 'faking it'.

I went out to my car to pick up a bit of kit, just in order to rule out anything medically wrong with the patient, and on the way back two men in a car parked outside asked me what was going on.

"Nothing serious", I replied, and went back into the building.

It was then that the sole male of the house cried out, "Who's shouting outside my house", and went outside.

I ignored him, and we finished checking over the patient as suspected there was nothing medically wrong with her.

Then the male came storming back into the house, grabbed two kitchen knives and ran outside again.

The ambulance crew and myself thought that this would be a good time to call for the police...

We sneaked out of the house, and stood by the ambulance - meanwhile the six women who had just left the house looked as if they were (a) arguing amongst themselves, and (b) about to tear the men in the car to pieces.

The final result of the arguing, holding people back, pushing and shoving, and shrieking at the top of their lungs, was that the car drove off at high speed, missing me by about half a yard. Meanwhile the argument continued between the sisters/cousins/whoever.

The police did turn up (and to their credit, turn up very quickly), and while they went about collecting statements there was various talk about samarai swords and the like being waved around (which isn't too surprsing in this particular part of East London). We left the police dealing with what seemed to be some form of family feud.

Returning to station, we were all stood down by the duty station officer, so that we could fill in the relevant paperwork.

On reflection three things spring to mind,

1) None of us were wearing our stab vests - and probably wouldn't have felt safe even if we had.

2) Why, when I had my own mobile phone, my FRU car phone, and my work emergency phone, did I use the household landline phone when calling the police?

3) And finally, is it wrong to think "With the paperwork we now need to do, this job'll see me to the end on my shift"?


The 'phone' thing was probably because my brain saw it there, and thought 'I can dial 999 on that', rather than taking longer on wondering which pocket of many my mobile phones are in. Thus my brain was able to concentrate on the whole 'not getting stabbed' thing.