I’d just like to say that opposites attract.  Just bear this in mind when you read this entry.

Picture the scene – our first call of a beautiful sunny Sunday morning.  Most folks were in bed, so the ambulance station had been particularly quiet, it was 8:30 and no ambulances had gone out.  Then we got a call, it came down to our ambulance as “68 year old man, clammy, possible stroke or heart attack”, so we got to the address as quickly as possible.

The gentleman was lying on the floor, he was a short Indian man and he was swearing at three younger Indian lads.  I learned that they were his next door neighbours and had heard him shouting.  When he didn’t answer his door they had kicked it down and found him…

…acting strangely.

The first thing that I thought was that the patient was a diabetic with a low blood sugar.  He was shouting and screaming about Allah and the Devil, telling us that we were all going to die.  He also told me that he was thirsty, but when I gave him some water he told me, “Allah won’t let me drink it”.

He then slapped me in the face.

My crewmate and I leapt on him and restrained him as gently as possible.  I had three times his body mass, my crewmate is a dedicated martial artist and a wall of muscle.

We managed to get enough blood to check his sugar levels – they were fine.

Getting what little history that we could it seemed that the patient had suddenly ‘gone mad’.

He was swinging between being calm, talkative and fairly pleasant and being a little hellion of violence.  There was no hints as to when he would change his attitude.

We were getting a bit concerned, we were trying to work out how to get this aggressive, violent and delusional patient out of his house and into the ambulance.  His neighbours tried talking to him, and they got slapped for their trouble.

My crewmate went down to the ambulance and radioed Control to ask for police assistance.  He let them know that they weren’t needed ‘mob handed’ as the patient was pretty small and frail.

While he was doing this I managed to get slapped again.  I was also called a ‘pharoah’ and was told that I would drop dead in the next five minutes so that I could be sent to Hell.

While he was annoying I was feeling sorry for this man, as he was obviously ‘mad’ and not ‘bad’.

My crewmate returned and the patient indicated that he wanted to spit on him – but his mouth was so dry he could summon up the liquid required.

Somehow we managed to get the patient to go down the stairs (after slapping my mate on the arm) and as we made it to the front door the police turned up.  They did act in a very ‘softly softly’ manner, but as we crossed the pavement the closest policeman was called a “bastard” and got a hell of a slap on the face.

The patient ended up on the floor – and then got manhandled into the back of the ambulance.  He was handcuffed and we made our way to the nearest hospital with one of the police aiding me in restraining the patient in the back of the ambulance.

The policeman nearly got a punch in the testicles.

All throughout the transport the patient was shouting about how we were all going to be ‘blown up’, and that Allah would alternately love us, or damn us.  It was an interesting five minutes.  He nearly managed to kick me once or twice.

We reached the hospital, and were met by one of the Sisters.  She didn’t seem too impressed with the two brawny men sitting on a little old man.  So she tried to be nice to him.

Until he called her a “cow” and tried to kick her.

We left the patient in the tender mercies of the hospital.  I love my job and I especially love it when I can leave patients like this with someone else looking after them.

Control contacted us to ask if we were alright.

“Fine”, I replied, “apart from us both being bitchslapped by a 68 year old man”.

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My crewmate and I had a cup of tea and returned to the station to fill in our paperwork.  I know it might sound strange (and I’m guessing it’s one of those things where you really had to be there), but we were laughing all the way back.  It just struck us as amusing that this little man was so aggressive, and that he managed to strike everyone that he met.  Obviously no-one was hurt, even the patient.  We agreed that if it had been a drunk thirty year old then it may have ended differently – but we really didn’t want this patient to get hurt.

We took great pleasure in telling this story to every workmate who would listen.

I hope that the patient had nothing wrong with him that couldn’t be cured.

 

Today my first job was to a near repeat of this patient, except in this case the cause was drugs, and he wasn’t as aggressive, just annoying with a vague undercurrent of threat.

There is a bit of a kerfuffle in London at the moment about the failure of communication during the July 7th bombings.  In November one of our top management people told the review committee that our radios “worked well”.  This is being reported on as a misrepresentation.  While I don’t have any ‘inside information’ I can tell you that the communication gear supplied to us is inadequate.

And it’s the government’s fault.

Currently our communication equipment is -

a) A VHF radio installed in each ambulance/RRU

b) An ‘emergency’ mobile phone.

c) Managers and other important people have pagers.

The pagers are, as I understand it, in direct response to the July bombings – our managers became unreachable after the mobile phone networks were ‘switched off’.  We were quite lucky that a whole bunch of our managers were at a meeting in Milwall – and so large numbers of them could be contacted.

We used to have hand-held radios, but almost all of them have disappeared.  They were seldom in a good working order, the reception was awful, the battery life was crap and they weighed a ton.  They were so heavy that, should I be assaulted, I’d be better off using it as a weapon rather than trying to call for help.

Our mobile phones are also fairly useless – they are locked so you can only call certain numbers and because of the lack of staff up in Control you can be waiting a long time for the phone to be answered.  They are also pretty poor at getting a signal – they don’t like tunnels.  Or walls.

So – quite rightly – we will be getting a brand new system that will be integrated with other emergency services.  It is spanking new and apparently much better (although there have been some concerns about possible health risks, although others play such risks down.)

The problem (besides the chance of getting tumours) is that we will only be getting this system in 2008, this is of course, hoping that a government I.T. plan goes to plan – which, given recent schemes which have gone five times over budget, is highly unlikely.

I’m guessing that effective radios for ambulances is a pretty low priority given the financial state of a lot of NHS trusts.  Most of this problem is due to the unexpectedly high cost of Agenda for Change (40% of the extra money earmarked for the NHS) - it has gotten so bad that at least one hospital is making 1 in 7 staff redundant (because we obviously need less nurses, not more).  Although, at the risk of sounding like NHSblogdoc, the blessed Patricia Hewitt is blaming ‘bad management’.

We can only work with the money that the government gives us - there is no way we can ‘turn a profit’ on ambulance work – especially as we seem to be doing more and more community work for no additional funds.

So – communication failure has little to do with the LAS, and all to do with the money the government gives us.

(And this is after the government screwed EMTs over Agenda for Change bandings in order to give us as little money as possible)

It is a small matter of amusement for me that, while I am in one of the newest ambulances we have, the tax disc holder is affixed to the dashboard by medical tape.

While the colour scheme is horrendous, the text is actually quite funny.

EMS STUPID Frequently Asked Questions -- With answers!

Found while doing research for my next post.  Yes I do research on my posts.

Since I am feeling (and to be more honest looking) fat I’ve decided to take up cycling again.  I’m sure that I gave a great amount of joy to anyone who saw this particular tubby man puffing and panting against the wind while cycling along at 1mph.  Still, if I want to stop from looking 6 months pregnant I need to start some exercise.  This is due, in part, to a job I did yesterday.

We were sent to a strange call.  It was given as “Elderly woman laying on the green as you enter Kellett road.  Woman may have got up”.

Rushing to the green we found it empty.  So we decamped from the ambulance, grabbed our bags and went for a little wander to see if the patient was hiding in a dip in the ground.  Across the green, near some houses, some people started waving at us, so we trotted over.

The patient was a very elderly woman.  She was wearing a nightdress, a threadworn cardigan and nothing on her legs.  She was also barefoot – I was surprised that the thin skin on her feet hadn’t been torn apart by the pavement.

The temperature, not taking into account the strong windchill factor, was around 1 degree Celsius.

She was – unsurprisingly – a bit blue and she felt like a block of ice.

We just had our medical equipment with us, we didn’t have a blanket, so I took off my fleece and wrapped it around her before running back to the ambulance to bring it closer to the patient.

Twenty-four hours later and my ankles are still in pain.  I was shocked by how out of breath I was after jogging about 150 yards.

I brought the ambulance closer and we bundled the patient into the back, turned the heating on full and wrapped her in our blankets.  The patient was one of those little old ladies that you would want to give a good cuddle to if she were your Gran.  We had a short and uneventful trip to the hospital where she was soon receiving the attention of the nursing staff.

My crewmate filled in a ‘vulnerable adult’ form, which means that the Social Services will get involved so that the patient will (hopefully) get any long-term care that she needs.

I managed to get my fleece back.

It now smells of granny wee.

It’s in the washing machine as I type this.

One of the curses of working shift work is that you can find yourself watching the dreaded "Daytime TV". At the moment the TV is on GMTV. One of their regular slots is all about 'food allergies'. Now for me (as a medical professional) and allergy is a severe reaction to a stimulus. What these people on the TV are talking about is a sensitivity.

So, as I'm a bit bored, I decided to take their online test to see if I have any food allergies.

"It’s pretty much guaranteed that you have an allergy"

Why is this so? Because I'm often tired (Duh! I work shifts), that I sometimes feel bloated and sleepy after eating (Isn't that the point), I sometimes get aches and pains (who doesn't? I'm carrying people all day), and that while I sometimes feel depressed I often feel better when I go on holiday (How many people don't feel better during a holiday?).

This seems like a fine example of quackery. An allergy/intolerance is diagnosed after a skin tolerance test, not from fourteen yes/no questions. People who take this questionnaire might think that a more serious condition is likely to be a 'food allergy'.

Black Triangle is excellent at shining a light on these sorts of things and is one of my daily required readings (When I'm not stuck on 12 hour shifts that is...)

He's also posted a reasoned post about the recent critical illness of participants in a clinical drug trial. I would add to his post that the drugs that doctors are using to try and save the participant's lives would all have gone through the same clinical trials as the test drug that may have caused this reaction.

Hmmm…I wrote a couple of these posts on my mobile and only two have turned up.

Essentially I’m too busy to write a full post for the next two days or so, and so sought to ‘fill the gap’ with a number of ‘micro-posts’.  Obviously some of them have been lost in the ether.

'Blood, sweat and tea', sounds like a good title for a book. Especially with a subtitle about how it is based on this blog.

When the weather is nice, a polite ninety year old woman who has drunk a bit too much wine and has fallen over can be a very endearing patient.

For the radio piece that this is based on, you can listen to it here until Saturday.  (Clip generated by the very clever Adrian McEwen with his genius McQN.net Real Audio Clip Generator).

The BBC website has a story about it here as well. (Thanks Batsgirl).

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World Weary Detective recently stopped blogging in response to a memo from the Metropolitan Police Force (‘The Met’).  He reports,

This statement is followed by 'guidance' on writing blogs. In summary, this states that although 'blogging' cannot be stopped, the 'impact of expressing views and opinions that are damaging to the organisation or bring the organisation into disrepute' must be considered. Disciplinary proceedings may be considered against posters of material that may be (among other things) defamatory, offensive or otherwise inappropriate.

You can read the whole memo here.

So far, according to Technorati, there are 71 posts linking to this story.  Due to work (and other) commitments I’ve not been able to comment until now.

My initial thought on the majority of the memo is that it is fine advice.  Police bloggers are reminded that they should not ‘defame’ people (which is illegal anyway), and that they should not bring the police into ‘disrepute’.  Bringing the service into disrepute would be a disciplinary offence in pretty much any employment.  You can ‘whistleblow’, but you can’t bring into disrepute.

Then we move on to ‘offensive’.  One man’s ‘offense’ is another man’s ‘joke’.  It’s a bit tricky to determine what is offensive and to whom, in fact the government can’t get a law through that outlaws religious offense.

Finally, and for me the crucial point, is the part that says ‘or otherwise inappropriate’.

What is that supposed to mean?  Is it ‘inappropriate’ to speak out about the flaws in the proposed ID card?  Would it be ‘inappropriate’ to write a satire?  Would it be ‘inappropriate’ to write the truth about ‘binge drinking’?  Actually – would it be considered ‘inappropriate’ to write about the memo that has started this whole trouble?

While I might admire the Met for considering a blogging policy, they have unfortunately made a complete balls-up of it.  They have, instead of clarifying points, only made the police bloggers unsure of what they can write about.  With this lack of firm guidance many have decided that blogging in the police is simply too dangerous for your career.  Police bloggers have all shown amazing common-sense in the things that they blog about.  They have not mentioned anything that could breach confidentiality, nor have they compromised any on-going investigations.  There has been no defamation, racism, sexism or other subject that could bring the police into disrepute. 

What police bloggers have done is to show us that they are individual human beings.  They have proven that behind the uniform is someone who thinks about what their management tells them, that they too have their own ideas on politics, crime, religion and class and that the police come from a whole spectrum of people.  You have right-wing police bloggers, and bloggers who probably have a subscription to ‘Socialist Worker’.  They have all behaved with the professionalism that would be expected of them.  And yet the Met do not trust their workers.

Blogging is the great humanizer.

The Met are scared that the voice of one person will bring down their anti-crime policies.  I think that Stan Hill sums it up best when he says,

It is sad that the senior officers at the Met don't seem to have confidence in their decision making and policy making abilities. Were they sure of their ground, then the "challenge" posed by some blog articles would be easily dispelled.

Finally, and perhaps more frighteningly – the Met management have given us a glimpse into what it must be like to work for them.  That you would be scared that ‘otherwise inappropriate’ could be used to discipline you.  That you are expected to toe the company line in all ways and that you dare not show any signs of individuality.

In purely Public Relations terms, what the police bloggers have built - the Met has demolished in one easy step.

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(I would have liked to have spent more time on this – I’d liked to have done more than one draft, but the radio slot is time limited.  My apologies if this seems a little poor, but I have been working twelve hour shifts).