Blogging is continuing to be a bit light as I’m making a bit of a push on getting the book done.

So I’ll ask you a question.

As an ambulance service our main role is to quickly get to sick people, stop them from dying and take them to hospital.

But it’s not that all we do, we help plan for major incidents, do school visits, run CPR courses and the like.

So…what do you think is the latest thing us frontline ambulance staff are expected to do?

While I continue my experiment in how much sleep deprivation I can stand until the hallucinations get too distracting, I shall point you in the general direction of this amusing video.

I promise, not as addictive as the Falling Sand Programme.

It took me about five attempts at spelling ‘humorous’ until I gave it up as a bad job and substituted ‘amusing’.

It’s 5:30am.  I’ve been up all night working on the book.

Why then am I both hypnotised and horrified by my first viewing of iconic 70’s TV programme “The Love Boat”?

It is, however, less surprising that I’m hypnotised by this zen non-game.

It’s also not surprising that I can barely string a sentence together…

 

This is the sort of thing I get called to, given as "Male, Possibly Dead, Caller Unable To Remain On Scene".

I mean…really…does he look dead to you?

Merys Jones of Bloody Students sent me a New Year gift of a Wallace and Gromit DVD.  Thank you very much Merys, it will bring me joy in the dark hours of a night shift.

“19 year old male – Patient has lump on ribs – difficulty in breathing”.

I’d just been to the Christmas Crisis run homeless shelter at the London Arena three times on the trot (I’d be back there once more later that night).  I’d never seen so many alcoholics in one place.  The people running the shelter were all nice in a worthy sort of way.  This is good, we need more people like this, and less people like me…

But I digress.

Halfway to the address, a private house, my screen was updated.

“Patient has taken cocaine”.

I was met at the front door by a young male, stripped to the waist and obviously agitated.

“Comein, myribsfeelfunny, andmyshoulderbladeedon’tfeelright”.

“Slow down”, I said, taking his pulse – 110, a bit on the high side, but he was bouncing off the walls.

“My ribs man!  They don’t feel right!  Have a feel”, he then started running his hands up and down his chest.

“Have you fallen over?  Been hit?  Anything unusual happened?”, I asked.

“No man – just feel them…FEEL THEM!”

“Look you need to calm down”, I replied, “I can’t do anything while you are hopping all over the place”.

He started shouting, “FEEL THEM!  JUST FUCKIN’ FEEL THEM!”

He turned his back to me, indicating that I should feel his normal looking ribs.

I sudden wave of anger passed over me – it was all I could do to not punch him in the back.

“There”, I said, “Your ribs are fine”.

“What about my shoulderblades man!?”

“Look, you’ve taken cocaine right?  You are feeling paranoid, it’s normal, just try to relax a little”

“WHAT…ABOUT…MY…FUCKIN’…SHOULDERBLADES!”.

He turned his back on me again.  I grit my teeth and grabbed his shoulderblades, “They are fine, Now. Sit. Down.”.

He sat down.  Then he stood up, then he paced around the kitchen.  I noted that there were no knives on the washtop, but even so I kept close to the door. (Mum didn’t raise me to be a fool).

“Look”, I said trying to calm him, and me, down, “Is this the first time you’ve taken cocaine?”

“No man!”

“OK, well if you want we can take you to the hospital, get you checked out if you’d like?”

“NO!”, he shouted, “I’m not going to hospital”.

Fine, I thought, not that the hospital will thank me…

“Ok mate, then are you alone in the house?”

“Nah, my dads asleep upstairs”

“Well I’d like to have a chat with him, so he can keep an eye on you”.

“NO!  Get out of my house”, he started advancing towards me, “No hospital, no waking my dad up, just get the fuck out of my house!”.

I left the house, while a fight with the patient would have done absolute wonders for my stress levels, it wasn’t worth the hassle.

But what now?  Should I post my patient report through the letterbox (if the patient isn’t transported then we should leave a copy with them).  The problem being, that if his father saw the report I’d be breaching patient confidentiality.  I’m guessing that they police wouldn’t be too interested in paying him a visit either.  So I left it – there was little else I could do for him, as he didn’t want help.

I sat in my car, filled out my forms and took a couple of deep breaths.  It would be a long Christmas…

 

The Medical Weblog Awards are up for voting at the moment. I've been nominated in two categories, best literary blog and best medical blog. Please feel free to go and vote for the blog that you like the best*.  NeeNaw is also nominated for the best new medblog (He’s streaming ahead – and quite rightly so).

*Obviously I want to you decide which one you like the best, and vote accordingly – but if you vote for me it might spark a little light in my dead, cold heart…

It’s also time for the 2006 Bloggies, where it is always fun to see who pops up in the nominations.

Blogging may be a little sparse this week, I’m taking some time to work on the book before my final set on nightshifts on the car next week.  Then from the 16th I’m back on an actual ambulance.

I can’t wait…

 

 

Blatent whoring is now over until I have something to sell you sometime later this year.

The honour of hosting the first Grand Rounds of 2006 has fallen to me.  Well…. actually the evil minds behind it got me drunk first.  When I said ‘yes’ I thought I was agreeing to another round of drinks.
Grand Rounds consists of mainly medical bloggers sending the links of their best post of the week to some poor sucker who has to collate them all and post them on their own blog.  It’s a great way to be introduced to some of the excellent blogs out there.  Unfortunately in this case you are going to be directed to much more interesting people than me – so please promise to come back here when you are finished…
Reading through these posts has meant I'm adding yet more blogs to my already overflowing Bloglines subscription.

Next weeks sucker host of Grand Rounds will be Clinical Cases Blog

In no particular order (and please note, some descriptions may be slightly tongue in cheek) I present this week's Grand Rounds...

Dr Charles has hallucinations while treating a patient!

Sumer asks “It can be tough being married to a doctor, but if they are a radiologist, is it tougher?”

Red State Moron comments on how difficult it must be to announce the birth of a child with a disability.

Orac has a very personal post touching on how hard it is to be medically trained, and to have a family member critically ill.

GeekNurse talks us through an unusual x-ray (and yes, I jumped to the obvious conclusion as well).

HealthConcerns has one of those interesting thoughts that comes to you at three in the morning. Her thought could also apply to medical Blogs.

Was there really a malpractice crisis?  Medpundit disagrees with the local media.

Doc around the clock plays guitar and sings then points to an article on physician musicians.

Medical Connectivity Consulting reports on GE Healthcare staking a claim on wireless networks in hospitals.

KidneyNotes expresses concern about recent news that bowel cleansing preps may cause kidney damage.  (And provides further references).

Anonymous rating of doctors, is it a good thing?  MSSP Nexus blog investigates.

Joan H. over at Oasis of Sanity tells us about the peculiar body image issues that female cancer patients should deal with, but often don’t.

Jim Hu notes an interesting idea that Proton Pump Inhibitors may aid Clostridium Difficile.

In a very scary report, Clinical Cases notes that for Doctors, speed can kill.

The Daily Rhino presents a clinical case that every medical professional must have thought about at one time or another. Vroom, vroom!

I read Medviews’ post, but being in the land of milk, honey and socialised medicine I have no idea what they are talking about.  I think it’s something about Doctors and pay.

Fixin’ Healthcare looks back on 46 years of medicine, and points out a possible future path.

The UK has just started allowing patients a choice of hospitals, Insureblog points out a problem with this ‘consumer driven healthcare’ in America.

Genetics Health points out that there are plenty of jobs in clinical genetics.

Healthcare.wurk.net meanwhile tells us about a simple way of getting the message across – comics.

Health Business Blog comments on ideas to prevent runaway spending on biotech.

This ain’t livin’ has a funny post that makes me glad that I have ‘man bits’ for my own personal undercarriage.

The pleasures of the internet include seeing how other countries deal with healthcare.  Mexico Medical Student tells us (in four posts) about Mexican community medicine (you can read the other posts easily as they are linked in his sidebar).

Diabetes Mine has good news for type 1 diabetics, it seems that all the hard work of controlling your blood sugar is well worth the effort.  She also reports on a potential new way of measuring blood sugar.

NHSBlogDoc (who seems to be turning into my nemesis, although for that to work he’ll need more flying attack robots with death-rays), well…he has a crap in his office, and it’s still there.

Dr Tony examines some testimony from a doctor who has…erm…strange views of medical practice.

Steve, over at The Eyes of an EMT, writes about the thing all us ambulance people dread – the complicated ‘late job’.

nbm at DSPS – the sleep disorder, has got me as a new regular reader – because this post rings very true to my sleep patterns.

UPDATE: You know, there are always a few people who leave it to the last minute.  Some people also forget that due to timezones and other arcane things I’m a couple of hours into their future.

So here are some late Grand Rounds submissions.

The Medical Blog Network has had a site redesign.

From Manila in the Philippines we have a detailed post on fireworks injuries.

GruntDoc has a scary report on how to spread measles to as many people as possible.

DB’s Medical Rants shows us the importance of clinical judgement.

Herbicide as cancer cure?  Interested-Participant thinks not (and so do all right-minded people).

Some stories on how to make a Christmas in hospital as special as possible from Hospital Impact.

Biotech Weblog reports on a phase one study on using stem cells for child brain injury.

Remember, next week Grand Rounds will be hosted by Clinical Cases Blog

New years night was a busy one for the London ambulance service. There were 38 stabbings over the course of the night. I spoke to my workmate who was on the car that night, he attended four stabbings one after another.

By 5am there had been in excess of 2,000 calls (we normally do a shade under 4,000 calls over 24 hours).

On the television one of our top-ranking management people described the night as 'horrific', which I would say is a pretty fair assessment.

The 'drunk bus' also did a lot of work, although I wonder at the need to take drunks to hospital, it's not as if they are actually ill. Also you must be able to sit in a chair in order to use this vehicle, so I'd suggest that they weren't 'life-threateningly' drunk.

I am extremely glad I wasn't working that night...