Only a short post today as I'm off filming for the Alan Yentob series 'Imagine'.

I'm racing down the road on lights and sirens, there is a traffic light controlled pedestrian crossing so I have to slow down to avoid running over the people who think that it is a good idea to run across the road in front of me.

Sitting, quite calmly, on the side of the road is a Guide dog for the blind. Amidst all these people running across the crossing, trusting that I'll try to miss them should they fall over in the middle of the road, the dog sits quietly and doesn't make a move.

The dog has more sense than the people of Newham.

The other night I was working with a friend of mine, he's built like the proverbial out-house, is a martial arts master and looks scary. While I'm not an expert fighter I tend to have no fear.

That night we earned our name as the 'Danger Bus'.

It must have been that the police had fewer numbers than normal as job after job was us being sent to 'Fight'. No injuries reported, just that there had been a fight (or that a fight was in progress). Sometimes we would get more details, sometimes it would just be that word.

There are two ways of dealing with a job like this. 'Officially' we are supposed to hold back from the scene of violence until we are either sure that it is safe, or we have a police escort. What often happens in real life is that we will 'take a look', we tend to know when a scene is dangerous and often don't want to bother the police who are as overworked as ourselves. Sometimes something in the description of the call will give us cause to want the police there.

This job was one of them. It was given as 'Russians fighting in house'.

If you work with Russians in an emergency setting you will be nodding your head and agreeing with me that this situation was too dangerous for us to enter.

You see... I like Russians, they are fun, normally polite and tend not to make a fuss. However, when they have been drinking and fighting... well... Lets just say that when they fight they tend to play for keeps. I've seen 'friends' beating each other over the head with planks of wood - then refusing to go to hospital as the inch long gashes in their scalp were 'nothing to worry about'. Being between two fighting Russians is not a safe place to be.

So we waited for the police to arrive which didn't take too long - then we advanced using the police as a shield. It doesn't look too good to need police to go into the job, especially when they are both female and are half the size of us. But you know what - I'm no sexist so I know that they are more than capable of handling pretty much anything. While it might not look good, I felt a lot safer.

The patient had a rather large split to the lip that would require an operation in a specialist unit, nothing life threatening but nasty nevertheless.

The next 'Fight' we went to was in a DLR train station. The police had arrived before us and were told, to quote the officer we met, "You can go lads, it was two teenagers and one of them gave the other a slap - I told them to stop being silly". We could see the two teenagers slinking off into the night.

If people were nicer to each other I might be able to get a cup of tea once in a while.

Ok, lets finish these off...

What's the most embarassing crush you've ever had? (eg, school teacher etc)

I'd guess my primary school teacher, she used to lean over me wearing low-cut tops and a black bra. Not that I had any idea at that time why I was so interested in that sort of thing.

What's your earliest childhood memory?

I don't really have any childhood memories. Perhaps it would be this.

If you were to meet your dad now, what's the first thing you would do/say?

Laugh, and tell him to p**s off as we are doing rather excellently without him. Then show him. Then laugh some more.

If you dial 999 on your mobile by accident, while it's in your pocket, when you realise (eg you hear the call taker saying "Hello?") is it better to end the call, or is it better to explain and hang up?

As another commenter said, it's better to explain otherwise I get sent to a 'dropped call' to make sure everything is alright.

What is the worse injury you have ever seen?

Trauma is all well and good (and I've seen some very mucky things with that) but the most depressing is pressure/bed sores in the elderly - it means that they aren't being looked after well enough.

What is the most painful injury?

Depends on the patient - I've had people try to tell me that the cut to the arm that I can hardly see is the most excruciating pain they've ever had. Sciatica and dislocated knees seem to be the worst though.

If I chopped my little finger off with a big knife, would it be life threatening?

It's very unlikely that you would bleed to death, however there are some nasty infections out there...

If you were in your ambulance on the way to a call and you came across a serious road accident that had only just happened, would you stop for that or drive on to the original call while radioing for another ambulance?

You have just described a 'running call'. Basically if we are waved down we are to stop and sort that call out while telling Control that we have been waylaid so that they can send another ambulance to the original call. We do have some discretion in this though.

If you had the choice between sweating peanut butter (the chunky variety) or having a hairy tongue, which would you choose?

Nurse! Get the straitjacket!

How much moolah did you make on 'Da Book'? And a related question, will the book make you a significant amount of money? Or is it just small change?

I don't have the figures right now - I'll find out in February when I get my first royalties. It's looking like a reasonable amount of money though.

You are alway complaining about the 8 minute rule but you never say what you think might be a good target. Do you have any ideas?

Patient satisfaction, survival rates, more realistic times. All of which have their flaws and are less easy to work out than 8 minutes good, 8 minutes and 1 second bad.

you sound like a great bloke to work with. want to come and do a week with me at Y.A.S? kind of 'work-exchange' thing, see how the other half live! (same dross, different accent)

Why would I want to work on my day off? But yes, one of the things I'm thinking of doing is travelling the country to see how other ambulance services work.

Have you ever seen womble porn?

Never. Honest. Clangers Bukkake however...

Would you recommend LAS as a job to anyone? And if so, do LAS do things like ride-alongs so you can get a bit of an idea what you're letting yourself in for?

I love my job, so I'd recommend it to most people, the LAS don't do ride-alongs for members of the public though, there are too many clinical/confidentiality issues for that to work.

Out of all the drugs that people take of a Saturday (or Monday, Tuesday etc) night, which one creates the people that are the biggest pains in the ass to deal with?

Alcohol. Makes you fight, makes you ill, makes you vomit, makes you suicidal, easy to get hold of, fairly cheap, socially acceptable and places a *huge* burden on the NHS.

Windows PC, Mac, or Linux?

Windows for games and using my pocket PC, Mac for 'business' and creativity, Linux for when I want to throw my computer out the window for failing to do anything the easy way and for reminding me that the 'cool kids' are all insane.

What's for dinner tonight?

I'm at work tonight, so probably George's savaloy and chips.

What's more nerve-racking? A Cat A call or appearing on the telly?

Telly - Cat A calls are ten a penny and I (like to think I) know what I'm doing. Telly is a strange environment where everyone else knows what they are doing apart from myself.

What's your favourite bit / song from Bugsy Malone? (a classic film, I noticed it on your wishlist!)

I just love it all to be honest, but I do like the pedal cars.

What's your favourite food and who (living or dead) would you like to share a dinner party / date with?

Any food which is (a) hot, and (b) I can sit down to eat. After living off takeaways I have low standards. But you can't beat my mum's roast dinner. Reasonably I'd like to have dinner with my boss Peter Bradley, so I could listen to what he has to say and I could let him know what us road staff are thinking without it being filtered through half a dozen layers of management. If *anyone* then Leonardo di Vinci, I have a sneaking suspicion that he was an interesting bloke.

Jeanniecool (who I know personally) asks a question she keeps asking me... So now you *gotta* tell me, having opened yourself up so graciously here:
Did you or didn't you??!?

I am a gentleman (sometimes) and refuse to answer that.

What's your favourite holiday destination and activity? ( not *too* rude remember!) Ever been to Canada? I ( Uk born) now live in BC on Vancouver Island where today its blue skies, 28'c, gorgeous scenery and seems like one long holiday.

I spent some time in Toronto and thought it was once of the nicest countries I'd ever visited with some of the nicest people. Very similar was Seattle which proved that there are a lot of very nice Americans out there. I've got to say that I loved Mexico and that I have a soft spot for Scuba diving. But anything that is 'active' is enjoyable for me - sitting on a beach drives me mad.

Kirk or Picard?

Picard - I'd never have to worry about him running off with my girlfriend. Something to do with the bionic heart?

What made you get out of the hospital and onto the roads with the ambulance service? and do you have any regrets?

Being stuck in a windowless box for 12 hours straight on the worst rota in the world *ever*, surrounded by patients that you can't help because there are no beds for them to go into and being constantly, and I mean *constantly* harangued by angry relatives. Why wouldn't I want to change job? No regrets at all although I do occasionally miss looking after a complex case in resus.

I was wondering if you could help me out. I suffer from regular headaches which I think are a result of sinus problems. This started happening after my dad and I got beaten up in the street completely unprovoked.
I've been to the doctor's and he's given me nose sprays for the last 18 months which don't seem to work.
Anything else that could be causing them?

I don't do medical advice - headaches are a particular pain as they can be caused by *anything*. I'd suggest seeing your GP again and maybe getting an eye-test as eyestrain can cause headaches.

Does Tom do things that Brian wouldn't?

Oh yes. Plenty of things...
Like going on the telly while looking relaxed.

What motivated you to go into healthcare (in any form) to begin with, and does it still motivate you now?

I found myself living at home while unemployed, my mum kept moaning at me that I'd make a wonderful nurse, to which my reply was, 'I'm not wiping people's arses all day!'. But she kept needling until I sent off an application form in a fit of anger. Then for some reason they accepted me, I turned out to actually enjoy it and the rest is history.

How does all *this* make you feel (by "this" I refer to thousands of readers hanging on your every word, the TV appearances, the adoring fans..)? It must be almost otherworldly.

A vague sense of unbelief but with an undercurrent of stoking my secret meglomania. Weird, very weird but fun as well. It does make you feel like a secret identity when I trawl around the streets in my ambulance and no-one knows anything about the book/telly/blog.

We had a patient recently who was >200kg and needed an MRI, but was too big to fit in our scanner. Rumour had it that they were taken to London Zoo to use the RhinoScan (or whatever it's called) in the dead of night....
Have you taken anyone to the zoo lately, or is this another one of those urban myths...?

Nope, not an urban myth. I nursed a patient who needed to use the CT scanner in the local Vet hospital that they use to scan horses. Big fella...

Do you ever come across incidents while "off duty" and get involved?

Once or twice - I try not to (although apparently you can get paid overtime for them)

Why "Tom Reynolds" - who is he?

Only a few people know why, but the name Tom Reynolds is made up of my middle name 'Tom', and Reynolds comes from (a) a butchers shop that I was passing on the bus while trying to think up a name and (b) Tom Reynolds is an old English expression similar to 'John Doe'. the other reason is probably hiding out there on the internet somewhere.

Did the police dog handlers teach you the deeply criminal technique of opening locked doors in 10 seconds ? ( Not that I want to know how, I'm just curious...)

They didn't teach me, but I'm a nosy bugger and watched them do it. Never had to use it in anger though.

I've been reading this blog for about 2 weeks now and have noticed that it is advertising a book that you are reading. Are you enjoying it?

Yes, I only put up the books that I'm (a) not ashamed to be reading, and (b) that I'm really enjoying. Which is why the current book has been up there for some time...

Ok, me, a future Paramedic. I got a place on the Cadet Scheme. Starting my 6 week induction on Monday :D What advice would you give to me [I'll be working on various wards for two years] and how do the wards compare to Ambulance work? AND is inserting a catheter into the bladder difficult? [first few times]

Catheters are pretty easy, men are difficult to miss and women for me were easy as I'd *ahem* seen a fair few examples of female anatomy in my youth... As for general advice, keep your eyes and ears open and don't be afraid to ask if you are unsure of have any questions. Oh, and be careful of the nurses - they tend to bite...

AFC good or bad for you??

Hmmm, not too good, not too bad. We are yet to see the full impact this will have on our service.

Tom, how did you broach the subject of this blog with your employers? were you worried about their reaction? and what the hell is a "womble"?

I didn't let them know, they found out about it in their own. Thankfully they have been pretty supportive of it. Part of the reasoning behind the pseudonym was to make it harder for management to track me down if they didn't like it, it would have given me the chance to stop if they had taken a dislike to it. I'll let Batsgirl answer what a womble are, ''Wombles are the fluffy yet sadly fictional stars of a set of childrens books and later a TV series and some hit novelty records a couple of decades ago, and are fondly remembered for going round picking up the litter on Wimbledon Common (a real place in London), taking it home and recycling it into amazing and useful things'.

A mate is about to take the paramedic entrance exams - do you know how tough the basic numeracy test is and what does it cover?

Depends on the service, I touch on it here.

Also is "The Girl" as wonderful in real life as she is in her blog?

Yep, a top girl which is why we didn't like what was done to her.

How may people have now asked you for a date!

Because of the blog? Maybe one. I'm still waiting for someone to send me their underwear through the post though.

What were the first words that came to mind when you saw how many questions there were ?

It was a bit sweary. I didn't think so many people would ask so much. Still, good for a laugh.

Do the FRU's serve any real purpose (forgetting the bikes in central london for the moment)

They can get to seriously ill people quicker than an ambulance, so they aren't completely worthless - it's just, how many seriously ill people do I see in a week? If I were really ill I'd rather have an ambulance who could take me to a hospital though.

Which do you find the most unpleasant/disturbing: blood, vomit or shit.

None. Cheap cider is my own particular disgust trigger. With a pair of gloves I can deal with pretty much anything, and even without it doesn't bother me much.

Why do ambulances have about 10 different sirens? Surely just a couple would be enough?

Because changing the siren's tone makes people more aware that we are bearing down on them (in theory), folk tend to tune out a constant wailing but the change in tones will catch on their consciousness.

I have seen many different types of ambulances (American shaped monsters, transits, LDV vans etc.) which is your fave and why?

LDVs are comfortable and you can bash them around, but the back isn't as well laid out. the new Mercedes Sprinters aren't as comfortable for lanky sods like myself, but the back is much better laid out - that and they have a radio installed for chilling out to. (Or barrelling thought the streets singing along to Queen's "Don't stop me now").

Was the decision not to be Tom Reynolds on Sky yours, or theirs?

Their mistake really, I mentioned my real name (because I wanted to get paid a cheque in my correct name) but then let them know that I write under the Reynolds name. Someone, somewhere mixed it up. Oh well...

Salt and sauce or salt and vinegar?

Salt and sauce.

Is the kettle at your station connected to the LAS control room so that whenever you switch it on, you get a cat A call? (like mine)

That and the toilet seat, yes.

Do you get sick to death of meeting a relative at the door of a house to be told "you'll need a chair"?(like I do)

There are things that annoy me more, but yes, being told how to do my job does wear a little thin even if they are trying to help.

Do you get the same questions; Are you busy? What time are you on 'till? (like I do)

Always. But then I always ask the same questions as well, like 'Have you taken your own painkillers?' and 'Why did you feel the need to call an ambulance at 3am when you have been ill for the last two weeks?'

Now that you are famous, do you wish you'd chosen a name other than Tom Reynolds?

No - for secret reasons it makes me giggle. Besides, nothing wrong with a name like Tom Reynolds.

Do you like Marmite?

No.

Question for you, how do you like to unwind and relax after a long (bad) shift?

World of Warcraft. Tub of Ice cream. Sleep.

"I've walked ten miles through North London barefoot in the rain." - You, in your 'about me' page. For the love of God, WHY?!

I was going to a club but the bouncers didn't like my trainers. I borrowed some shoes off a mate who lived nearby, unfortunately they were 3 or 4 sizes too small. We then got separated in the club (alright - he pulled and I didn't), I couldn't remember where he lived and had no money, so I walked home. It was less painful to walk in barefeet than squeezed into tiny shoes.
I have solid soles to my feet.

f you were an animal, what animal would you be? If you were a shape, what shape would you be?

A rat, cute, cuddly, intelligent, a much maligned survivor in London. also riddled with disease. Shape? This is a psychiatrists question isn't it? Ok - a Blue Circle, or a Plaid Dodecahedron.

Will you marry me?*
*Not really - just thought it needed to be asked to complete the growing female adulation thang : )
And real question - would you actually ever date a long-term reader of your blog (who would know a hell of a lot about you)?

Are you rich? Seriously, yes I would date a reader, the blog is pretty open but it isn't *everything* about me, and I don't write stuff that I'm not happy for people to know about me.

A couple of years ago, my wife took a whole box of diazepam along with a bottle of wine. I didn't know what to do - whether a box was dangerous or not, so I called an ambulance and followed on behind in my car. Was this the right thing to do, or should I have taken her in myself?

Ambulance is fine, you aren't medically trained and don't know how serious such stuff can be. Besides we are better equipped for such patients vomiting. It's only the people who blatantly take the p**s that annoy me these days.

You've always tried to be anonymous as "Tom", I heard you on Radio 5 under that name some time ago - now the book is out, your real name is getting mentioned in the press. Is this disappointing to you, and is it a problem with your work, or does it make you reconsider what you say from here on?

Not disappointing really and I've always written as if people know who I am. I still use 'Reynolds' as that has become part of my identity (or 'brand' in nauseating marketing speak), that and people who knew me as Tom have trouble changing that name to Brian - And I've been answering to Tom for longer than I can remember. So no, I'm happy with either.

If I send you my book will you sign it for me?

While I'd love to do this I have enough trouble answering all the emails I get sent. Books would disappear in the post and there would be bad feeling. We are considering a limited edition of signed copies that you can buy direct from the publisher for those who really must have my scrawl inside their book.

I've decided I'd like to work in the ambulance service when i finish Sixth Form. What do you think is the best route to get in. The local university offers a degree in paramedic science but I don't know how helpful this will be. Any ideas?

I may have answered this already - but the degree course is the way of the future. Form what I have seen it's not a bad course either and there is no longer the stigma that being a 'uni-bod' used to be.

I have 2 teenagers. Last week my 15 year old daughter drank a quarter litre of vodka,vomited a lot and passed out. I found her and called the GP who told me to get an ambulance. I did and the lovely paramedics checked her over-blood,oygen levels and pulse- and said she was OK and didnt need to go to hospital unless I wanted to. fter a few hours she came round and remembered nothing. What are the warning signs re needing A and E if this happens again?

Unconsciousness really, and in young people it's easy to overdose on alcohol. Your daughter doing this again would be a sign of stupidity on her part mind you...

And more from Jeanniecool...
How many miles must a man walk down - before he can say he's a man, that is?

42.

Which one of us is cooler?

You are, just look at your name!

Does Robert ask about me regularly?

Never, but don't feel left out, he never asks about me either.

Why do fools fall in love?

Because they are fools

What is the ultimate question?

Watt is a unit of power, not a question.

During my next trip to London (sometime in 2007), will you be a) as nice, b) nicer, or c) less nice to me than you were during my first trip?

(d) none of the above?

Do androids dream of elctric sheep?

Do sheep dream of real androids?

Do you?

My dreams are technicolour Buzby Berkley affairs of blood and violence.

When are you coming back to Seattle?

Sometime in the future.

If a hen and a half can lay an egg and a half in a day and a half, how long will it take a monkey with a wooden leg to kick the seeds out of a dill pickle?

Nurse! The straitjacket again!

Will you autograph my book?

If a book is personally presented to me, then yes I will sign it. Then demand a drink/kiss depending on who is doing the asking.

Would a drink drive conviction disqualify a person from working as a para medic ?

Yes, sorta, you need to have a current valid driving license to work on the ambulances, you *may* be moved to another section of the firm so you can keep your job but change your role.

Why do you think your blog caught on so much? Did it get advertised in the beginning?

Because of my superb writing? It's caught on because people love medical stuff (see the popularity of Casualty/E.R) and they love reality TV (see Big Brother/Celebrity GMOOH). This mixes up those two very popular things. My readership really took off when I got mentioned by Jane Perrone in the Guardian.

Do you actually get to go to scenes of accidents where you have to scoop people up off of the pavement or are you more of the response to the walking wounded who do not require intensive resusuitation efforts?

Yep, that's the great thing about this job, One minute I can be going to an accident where someone has lost a leg, and the next I'm picking a little old lady up off the floor. So I do it all really. I am expected to go to, and deal with, *everything*.

Why is it that you've decided to give up drinking for a year?

Partly because I was coming home from work wanting a beer after every shift, partly because I make bad decisions when I've been drinking. Partly because I can.

Very simple one. What are your life aspirations?

To keep breathing, to be happy, to try and help people (and personal immortality).

Ok - if I've missed your question please do let me know, otherwise I suspect that this is the last time I'm doing *that*.

For those that are interested, some feedback on how Da Book is doing.

Perhaps vindication of the whole Creative Commons thing?

Well... That's the last time I ask for questions, I'm going to spend all weekend answering these. Still, I did promise. Half are answered in this post, the remainder will in the next posting. It's all a bit quick and nasty but I refuse to spellcheck the questions.

(And where did I get some many insane readers?)

Let's begin.

I am starting medicine in September and was wondering how you get on with the medics to whom you hand over your patients, how do you rate your skills against theirs, In what way do they differ? Do medics get a chance to go out with you and see what you do and thus get an idea of what the patient has been through before they get to hospital.

We tend to hand our patients over to the nurses rather than the doctors. While we know that doctors are way more educated than ourselves we do pride ourselves on our 'real world' knowledge which can come in handy sometimes. The LAS do had doctor ride-outs and crews tend to like them because it normally guarantees a quiet shift.

If you were a dinosaur, which would you be, and why?

Want to be or most like? I'd say I'm most like an Diplodicus (or whatever they are called now) - a large, peaceful plant eater with a small brain.

How often do women "come on" to you? Ever gotten involved with someone you met on the job?

Not often enough (as in almost never), and yes - I have got involved with women on the job.

You seem to be slightly schizophrenic. Your blog was originally called "Why I Hate Humanity" :-), and you frequently say in your blog posts that you hate everyone the same.
BUT you come across as a really caring guy, who doesn't hate everyone at all, in fact you quite obviously care about everyone.

This was perhaps going to be a posting on it's own, but I'll touch on it here. When I started writing the blog I was pretty reactive. While writing this blog I've started exploring the thoughts and feelings of the people I write about. When you start putting yourself in their shoes you start to be a lot more forgiving.

Bless your heart, are you going to brave it, forget the shyness, and ask one of your many lady-friends on here out, and get yourself a date?

Nope.

What's your idea of a perfect date?

Can I be rude here...? But seriously, any date where we get on really well.

[On Speedbumps...] So, has anybody ever tried getting the damned things ripped up on the basis that they've been constructed in breach of the regulations?

Are they really? Hmmm, something I'm going to have to have a look into, as I do like causing trouble over such things. It doesn't surprise me to be honest as some of them are simply a row of bricks in the road.

Station supervisor asks if I'm 'up for another beer'

I'm always up for a drink, not a beer for the next couple of months, but definitely drinks in a pub.

If you could meet one person from the whole of history and either shake them by the hand or kick them in the reproductive organs, who would it be and which would you do?

Could I do both? I'd shake Sir Joseph Bazalgette by the hand, and kick either Osama Bin Laden or the bloke who dreamt up religion in the testicles.

If you bumped into a genie and he granted you 3 wishes, what would you ask for?

1) That everyone *knew* that when you die, that is that, no Heaven or Hell.
2) So that when you intentionally cause pain to another person, you feel that pain as well
3) Personal immortality, so I can see all the cool things humanity will think up.

Random acts of kindness and sensless beauty are words from some Daoist text are they not. Are you a Daoist?

Are they? I think I was drunk when I thought up the title... I've read some Daoist stuff, but I'm not one myself.

Do you think your experiences, that you've written about here (and in your book) are typical of ambulance drivers and/or paramedics in the LAS?

Absolutely, It's the feedback I get from my workmates and from ambulance people around the world - that it's the same stuff, just with different scenery.

Do you think your experiences are typical of ambulance work in general (eg, other locations in the UK, other countries, other specialties like Helicopter Air Ambulance or military medic)?

Well, HEMS go on 'sexy' trauma, and military medics probably deal with a lot less little old ladies than I do. I think that they have the advantage in that a lot of their patients are young and fit.

So your book takes off, Hollywood comes knocking, and you get to cast the actor who will play you; discounting Nicholas Cage who already made a middling ambulance/emt movie, who do you choose? And of course there needs to be a leading lady--and she would be....?

Why would there be a leading lady? For me... possibly Jack Dee (not as the leading lady mind you).

How would you like to work in ambulance comms, like us poor folk stuck in this red hot room whilst you have all the fun on the road??

No thanks. (although aren't you air-conned?) I quite like not having my every move watched over and audited by an officer. An I've heard some of the nutters you have to be polite to.

Also, have you ever (or ever seriously considered) hurting someone or delaying their care due to their conduct? I'm guessing that this answer is no since I whole-heartedly believe you would never do any such thing, but you never know.

Considered it? Yes. (More so in A&E), have I ever done it? Not on the road, no. But as a nurse I've delayed stitching up people's heads because they were obnoxious drunks or similar.

Do you think about what you're going to write about in your blog, and how you're going to write it, before you sit down at your computer - or even while the events are actually taking place? I wonder if you have a "running commentary" in your head?

Yep, after every job I sit and think 'Can I turn this into a blog post?', but the actually writing happens as I sit in front of my keyboard, part of the side effect of writing how I talk.

Related question Do you write these things as they happen or store up the "good" ones to keep the blog ticking over?

I make quick 10 word or less notes on jobs that I can write about in Ecto. Then if I'm not at work I can go back and write them up properly.

What new fun item are you going to take up as a way to open up (ie new leisure pursuits) on your off hours?

Between Work, Writing, (new) Social life, Sleep and World of Warcraft I don't have time for any new leisure pursuits.

Do you agree that a 14 gauge cannula is an acceptable means of discovering whether a patient is feigning unconsciuosness?

No - there are better ways of waking people up that don't involve them possibly spraying blood around. A god old fashioned sternal rub works wonders for me.

You mentioned you hadn't cannulated for a few years and declined the offer of cannulating a patient recently (in da book). Do LAS EMT's routinely cannulate or were you referring back to your A&E days?

I was referring to my A&E days. EMTs in the LAS don't cannulate, although they sometimes will under the supervision of a paramedic - mainly for folks who work together for a long time.

Any tips for getting a job? (I'm finishing my nursing course first) I have tried contacting the local ambulance service but I have yet to hear anything from them....

Here you go...

Oh...and how old are you? My friends and I have been trying to guess, but we have no idea!

34. 35 in November.

Have you seen or read "Bringing out the Dead", and what did you think if so.

Seen it and loved it. It's one of the few ambulance films around. Once upon a time I tried writing a voiceover for an ambulance script. It was pretty much word for word the starting monologue for 'Bringing out the dead'. So that is how many targets it hits. And the gradual disintegration of Nick Cage is spot on for working nightshifts.

Who would you prefer to direct the movie of your life? My vote would go for Micheal Winner.

Uwe Boll.

*joke*

Mike Hodges.

Was I wrong to call 999?
Last week an elderly lady fell down some concrete steps backwards right in front of me. There are only four or five steps but she kind of wobbled half way up lost her balance and fell backwards. I saw her bang her head. I did first aid years ago but can't remember much. I went over to her when the fun began! She was deaf! I was extremely concerned because I couldn't communicate with her. After some help from the local cancer shop which we were in front of, we sat her on a chair (I was reluctant to move her immeditely) someone got her some water - (I wasn't sure if this was a good thing???) and I basicially held her hand (inspected her head - wasn't bleeding) and tried to communicate with her (unsucessfully it seemed). I then proceeded to tell the lady that I was calling an ambulance for her because I was concerned for her - she seemed to know what I was saying. Anyway since Im waffling - FRU (I guess) turned up - inspected her, had the same fun as I did trying to communicate (I have now decided to learn sign language) - said she didn't need to go to hospital and instead took her to her deaf club where she had been heading.
I did feel guilty about calling 999 but think I would have felt more guilty not and just leaving her to go on her way.

Nope - head injuries can be nasty and without medical training how can you be sure that she hasn't seriously hurt herself?

Have you chosen not to be a paramedic? I know you prefer to be in the ambulance rather than the rapid response car, is that anything to do with it?

Nope, I'll be going for the training as soon a a course comes up that I can get on. All our ambulances *should* have a mixed para/EMT crew.

Do you think paramedics get better training via the EMT route of the degree route? I reckon the former if nursing is anything to go by.

Six of one and half dozen of another to be honest. The EMT route gives you more experience of working the streets before making you up to paramedic, but it looks like the degree is the way to go if you want career advancement.

what is the ditterence between a paramedic and an EMT?

We do the same job, but paramedics can intubate people who aren't breathing, cannulate and have some more drugs to play with. They also carry the can for anything an EMT does wrong...

I am part of the SJA team that assists out of Oldham & occasionally Newham. How do you feel about us?

I think you are mad for volunteering to do this job for no money, but you do get some nice stadium/event jobs I suppose. Like everyone else I take people as I find them, I haven't got anything against St John.

I've heard you describe you vehicle as a Materni-taxi, and I've seen a couple of mentions of it being used for that purpose, but have you ever had an actual unplanned front room delivery to deal with?

Two or three... They do happy and I don't moan about people who are about to give birth, just the ones who use us as a free taxi...

How can one speak of the outer boundaries of the universe when the universe is infinite?

It's not infinite, it is bounded by the light cone of the Big Bang (give or take the possible fluctuation of physical constants in the forming moment of the Universe). Speed of light * age of Universe = Size of Universe.

Yes, I was a physics nerd.

Are there no paras on the bus/trucks then?

We are supposed to have mixed para/EMT crews on all frontline ambulances.

2) and is that why you've not put yourself forward for para training?

Nope, lack of courses/time/brains.

3) What's the relationship between the crews and HEMS now? used to be sh*t

Not too bad to be honest - we might not like it when they 'stay and play' but when we need them they are excellent. And they make a real effort to be nice to us crews. So it isn't anything like it used to be.

4) Are ECPs still around in LAS (the rumour mill says they've been made redundant and re-employed as paras).

We have ECPs in Newham, but it all depends on PCTs funding them. Remember the big plan is that we get more and more ECPs out there (to cover for GPs and so the government can shut down yet more A&E departments.)

5) Can you guys thrombolyse STEMI patients?

LAS can't (and it would be silly as we diagnose and take patient's for primary angioplasty), but where there are miles between hospitals the outer counties firms do.

6) Are you up for a (non-alcoholic) beer when I'm next in town?

Sure!

In a fight who would win a mars bar or a pot noodle?

Pot noodle, for the reasons that are made in the comments.

Do you enjoy US emergency TV series? And a related questions. Do you ever find yourself watching episodes of Casualty and trying to diagnose things before they do, or shouting at the TV when they do it wrong? And I can accept that on the telly, Casualty, ER, etc have a duty first of all to entertain the public, but is there anything that they get consistently wrong that gets your back up?

I like Third Watch and ER (well, until it became more concerned with the love lives of it's characters). Casualty makes my teeth itch because the ambulance crews (and nurses and managers) don't act like they would in real life. That and too many people survive CPR, too many babies are born to quickly and loads of 'Why are they doing it like that!' moments. This is why I don't watch Casualty...

Has the success of this blog and your book had any impact on your professional life and dealings with colleagues / patients, in either a positive or negative way?

Yep, my mates have something else to rib me about. My patients don't often know about my 'fame', and my crewmates know me too well.

Because I've been 'in school' this week it has felt like I've got a normal 9-5 job. Consequently I've had what some people would call a 'social life'. With the exception of Wednesday I've gone out and met with some lovely ladies. It's been nice having a chance to meet other people (something that is normally quite tricky with shift work). But it's all over now - I have nowhere to go tonight and during the weekend, which is a bit of a shame as I've really enjoyed this whole social thing. Although it will give me time to answer some of the questions that people have asked in the last post.

I'm back to normal shift-work on Monday, which I'm looking forward to but, it has been nice to experience what is normal for so many other workers. It's good to have a bit of company even if it is for only a short while.

So, I'm going to start planning some Blogmeets where bloggers and readers can meet up for a friendly drink. Once I sort out a few details I'll put something up here, but consider this an open call for suggestions.

Ok, something a little different...

Ask me questions in the comments field for this posting. Just leave a comment with your question and your name. If you don't have a reader account (which you can make following the link from the top right of this page) then you can log on as 'guest' with a password of 'guest'. You can leave more than one question, but depending on response I may answer only the first one you ask.

I'll answer them this weekend. Now is your chance to get that burning question to me off your chest.

(Try not to be *too* rude).

I honestly can't believe it, a Friday night and I went to someone who had genuinely been mugged.

Please allow me to explain...

Now, I may be accused of being overly cynical and those accusers may have a fair point, but given the amount of street violence that I see I have come to a few conclusions.

(1) Many people who get beaten up have done something to 'deserve' it. even if it is a stupid, childish or other pointless reason.

(2) As someone wiser than I said, 'For instant a$$hole, just add alcohol' - a large amount of beatings are fueled by alcohol.

(3) Truly 'random' violence is very rare.

This is what gives me confidence when I'm walking down the otherwise frightening streets in the dangerous parts of town during the hours of darkness. I'm not involved in drugs or gangs. I have no bank of 'respect' that I have to protect and, for this year at least, I'm not drunk and combative. This means that it is unlikely for myself to get mugged.

In the three and a half or so years I've been doing this job I can count the number of genuine muggings I've gone to on the fingers of one hand. This is obviously a good thing, I'd rather have frequent jobs to drug dealers who have beaten each other up than to an innocent who has just been robbed. With the former you can turn up and treat them while with the latter there is a distinct feeling that you will feel sorry for them - something that does your 'ambulance street-cred' no good whatsoever.

The poor soul that I attended to had been punched in the face and the criminals had stolen his bag. The local kebab shop had taken the victim in, had called the police and ambulance and had sorted him out with a towel (for his bust lip) and a bottle of water. The unreported kindness of strangers often makes my job bearable.

I was first on scene and quickly determined that while shocked, he wasn't seriously hurt. He'd need hospital treatment for a cut lip and eye, but wasn't in any danger to life or limb.

The 'street crime' squad arrived a minute or two after us, we let them use the back of our ambulance as an impromptu interview room so that they could get a description of the attackers. Two of the team questioned the patient, my crewmate attended to his injuries, meanwhile I stood outside (to give them room) and chatted with the final officer. As is often the case the police were sympathetic and professional.

With the details collected we took the patient and his friend to the local hospital. The problem the patient has is this - as the injury itself is fairly minor, they are often a low priority and are sent out into the waiting room. But I think that the psychological trauma of being mugged should warrant a cup of tea and a bit of a sit down somewhere quiet (not out in the waiting room with the noisy drunks). Unfortunately this doesn't happen because there aren't the resources available and this is a damn shame.

This is why we try to make the transport to hospital as nice as possible, as it's often the last time they'll get proper one-to-one care.

Today in 'school' we had a whole day on 'diversity', while I don't think it taught us East London crews anything new it was more interesting than expected. I have no idea what is in store for me tomorrow.