A round up of recent media stories about ambulances and the talk of the ambulance loading bay at the hospital the other night.

Dozens of patients were removed from hospital wards after two ambulances caught fire and exploded.

I'm glad there were only minor injuries.

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Bottle thrown at ambulance on emergency call

“We were on blue lights on the way to a call and we heard an explosion. The next thing we were covered in glass – it was everywhere”

Ambulance bicycles stolen in the City

The London Ambulance Service is appealing for the return of two cycle response pushbikes after they were stolen from outside the home of a patient in Finsbury. The custom-built Specialized Rockhopper mountain bikes were taken yesterday evening (Wednesday) from Joseph Trotter Close, EC1, after staff had been called to attend a man who was unwell.

Which sort of sums up how some 'members of the community' treat ambulance services.

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Woman Dies In Pub After Paramedic 'Delay'

Then there is this, which is very sad - but I know that there are certain pubs in my area that I hate going into because, well, people get killed in them. Once more it's a case of 'blame the person who wants to survive their shift'. And once more, as usual, the blame is being put on 'health and safety' - at which point I'd like to tell those commenters that if they would like to live without health and safety legislation I'll be seeing them later in the back of my ambulance.

This sort of story is happening more and more - I really should just do one blog-post that I can refer to when another similar story happens.

Incidentally, can someone explain the laws of grammar that have newspapers 'quoting' their own stories? I always read it as indicating sarcasm.

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The current gossip outside the A&E department the other night was how there is a local estate where someone seems to have taken a shine to shooting at ambulance crews with an air pistol. Apparently the official advice is that if you get a call there the crew should wear their stab vest and safety helmet.

This is the sort of 'welcome' that we are dealing with.

I've told you all many times about the 'vulnerable adult' forms that we fill in when we come across someone that is, well, vulnerable. Normally we only sometimes have feedback into any action that has been taken, so we dutifully fill them in and throw them into the ether and hope for the best.

We were sent to a man living in a warden controlled place, he'd half slipped out of bed and couldn't move. He'd pulled his emergency alarm and the duty warden had come over and had then called us.

(Don't get me started on the utter idiocy of plans to cut back on live-in wardens)

My crewmate and I both recognised the name but couldn't place it, nor, once we reached the patient could we place his face.

He was a large chap, and so we were somewhat thankful to have a student working with us who could help us get him back onto the bed so that the patient could sit up.

Dusting down the patient he told us that he didn't want to go to hospital, and seeing that he hadn't hurt himself in his slip, I couldn't really blame hime for wanting to remain in his home.

My attention was drawn to his elbow, it was red and hot and a little swollen - probably cellulitis, maybe an infected joint. It was this that had caused him to slip as he'd been unable to use his grab rail properly. Again he didn't want to go to hospital, despite me pointing out that they could treat his elbow.

Instead we settled on a compromise, I'd arrange to get the patient's GP out to see him, then if the GP thought that the elbow needed hospital treatment, and that it couldn't be treated at home, they could better browbeat the patient than a man in a green uniform with a bag full of bandages...

I went out to the ambulance to arrange this and to write up a report for the GP, and once it was arranged I went back to the patient.

The patient looked at me funny, then told me that we had met before - but then he had lived in a different home, he mentioned the street name but I didn't remember it. He told me how, soon after I'd picked him off the floor there, someone had visited him and suggested that he move to this warden controlled flat - a place he really enjoyed living in.

I left the note, bid him farewell and went back out to the ambulance.

As I got back into the ambulance my crewmate told me that she had remembered the patient. We'd been sent to pick him up off the floor, but the place where he lived was a terrible run-down place, broken windows, poor heating, no lighting and, because of the gentleman's mobility problems, he essentially lived out of one room due to the stairs being ramshackle.

I'd filled in a 'vulnerable adult' form for him after we'd picked him up.

I don't know if it was that form that got the ball rolling, but if it was then I'm exceptionally happy - living in the warden controlled flat has meant that he keeps his independence, yet has the care and help that he needs. I'm a big fan of warden controlled flats and, should I manage to live that long, I wouldn't mind ending up in one of them should I need to.

So, a bit of a success story.

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I think i have an iTunes problem - my library has gotten so large it will no longer fit on a 500Gb external disc. So I'm currently copying all 500Gb onto a shared USB 1Tb disk using my Mac mini/media server.

It may take some time.

Long term readers may have noticed that when I write about the London Fire Brigade I often indulge in some slight mocking. It's an attitude that is taught to you in training school and one that is continued by the 'old hands' of the service.

When you start in the ambulance service you find yourself asking why this is so, surely it can't just be because they often get to sleep all night while we get moaned at if we find ourselves blinking for longer than necessary?

After all, when dealing with an RTA, they are instrumental in turning a car into a convertible so we can safely get a patient out. Likewise, when something is on fire they are pretty good at throwing water at it.

The less charitable amongst us might also say that they are also experts at blocking off roads with a multitude of unnecessary appliances and flooding the streets with fire-fighters who then stand around and do nothing.

Maybe it follows that there is this derision because they work less than us, get paid more than us and for some reason end up on calendars and are drooled over by otherwise sensible young ladies.

So, jealousy really.

My crewmate and I were sent to a 'fire call' in a residential street - we arrived to find that the fire had already been put out, three fire trucks and about 12 fire-fighters had successfully dealt with an electrical fire that had caught a mattress alight. Our patient had been laying on the mattress at the time.

Surprisingly, for someone with very much reduced mobility, he'd managed to get himself out of the burning bed and into another room. Relatives had then called for the fire-fighters but by the time they arrived the fire had gone out itself causing minimal damage.

Our patient was more 'shook up' than seriously ill. He was a large fellow with a number of long-standing medical problems, including lung disease and the aforementioned mobility problems. As it was a foam mattress that had burned we decided to take the patient to hospital.

Meanwhile the dozen fire-fighters milled around chatting to the extended family of the patient, or stood on the pavement taking in the sun.

Then I heard the head fire-fighter (the one wearing a white helmet) suggest to the family that they could all stand for a cup of tea. As she left to start brewing he confided in me that it 'keeps them busy, and takes their mind off the fire', which is fair enough.

We soon got to carrying our large patient to the stairs where his installed stair-lift could do some of the hard work of getting him down from the upper floor of the house. It was a real struggle - the patient was large as well as heavy, and despite having leapt from his bed before he torched himself, now seemed largely unable to move.

So we puffed and we sweated and we strained - getting him downstairs and back onto our carry chair.

Then we had to move out of the way so that one of the women of the house could carry a tray full of tea out to the heroic fire-fighters that were chatting in their garden.

We left the house with every fire-fighter having their own cup of tea - can you guess what poor bastards didn't get a cup of tea? Yes, that's right, those of us actually doing some work.

Not that we would have accepted, we were looking after a patient after all, but it would have been nice to have been offered.

As I say, pure jealousy.

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It seems that whenever I'm not working I miss all the excitement. Actually, having been involved in a few riots in the past, I'm rather glad that I wasn't working - for one thing I don't think that my stab vest still fits me.

Just got back off my holidays, a week in Egypt and then three nights in Cumbria. I now have a few days before I head back to work and the grind of driving to people's houses and telling them to hop into the back of the ambulance for a nice taxi ride to hospital.

In those few days I aim to do some writing, including planning for a series of longer form blogposts, but first I need to clean my flat from top to bottom.

What I will leave you with is my new website, upon which you can find a job offer.

I'm glad that all the posts that I wrote in advance went up automatically while I was away sunning myself in Egypt. While it was nice to get away, I did feel rather disconnected as there was no phone or internet service where I was staying.

I would have loved to used Twitter, but as the roaming data plan was £6/Mb, I thought that I'd keep from bankruptcy and not use it.

Instead I wrote my prospective tweets down in my notebook and will now reproduce them for you now.

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WEDNESDAY

Arrived in Egypt in the dark, did not plunge, flaming, into the sea - this makes me happy.

Also - no screaming children on plane, however in-flight entertainment was a rom-com. Deciding what was worse.

Arrived at hotel just after the dinner service was finishing - never mind, they have a 'midnight snack option'.

Only two double beds in the room, despite asking for three beds - once more one of us will be sleeping on a cot.

Yes, I'm travelling with my mum and brother.

No, Mr Receptionist, I'm not sleeping with my mother.

Also, my brother cannot stand to be touched by another human being, so I'm not sharing a bed with him either.

Midnight snack service has beef... I *adore* beef.

Time to sleep, nighty night.

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THURSDAY

Mother unpacks her kettle and teamaking supplies from her suitcase.

Cup of tea, now down for breakfast.

Heh, they have beef for breakfast - well, you can never have too much beef I say.

Musak in the restaurant is quite interesting, a jazzy piano version of 'Dark side of the moon' - I wonder if I could buy this on iTunes.

Partaking of the all-inclusive drinks.

Two halfs of gassy lager later I decide to stop partaking of the all-inclusive drinks.

Lunch - Beef or Fish, well I don't eat fish, so I have the pleasure of beef again.

Time to sit on the balcony to read, start off in the sun slowly.

Reading the 'The Strain', it's actually not that good.

This resort is really popular with Eastern Europeans and Russians - a bit like home really.

Dinner - Beef or Fish again, so beef and rice. I wonder what they'll have tomorrow.

Also they are playing that piano Dark side of the moon again.

I plug my laptop into the room TV, the family movie tonight is 'Taken'.

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FRIDAY

I think I'll skip breakfast, lay in bed instead.

Time to sit by the pool.

<Twenty minutes later> Time to head for some shade before I crisp up too much.

Lunch, beef again... Does Egypt have nothing but cows? I mean, I understand there being no pork...

Finish 'The Strain', entirely predictable and too many plot holes.

Start 'Orcs', it's a big book, should last me a while - I've owned it for ages but never got round to reading it.

Dinner - Really? Do they not have anything other than beef?

Or that Pink Floyd track?

Tonight's movie, courtesy of iTunes is 'Gran Torino'.

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SATURDAY

Holiday rep is Scottish, but has a Spanish name - strange.

Brother is watching athletics, in German, on the TV - I suspect he's going through WoW withdrawal.

'Orcs', is simple but fun - makes me want to roleplay an Orc in WoW.

Did I mention? Beef for breakfast and lunch. And Pink Floyd.

Somewhat melancholy, so many couples here, yet I've never been on holiday with any of my ex-girlfriends. Wondering if I've missed something.

Dinner. I think I just passed wind and it sounded like a cow mooing.

Movie night is 'Madagascar 2', my mum loves kids films about animals. She falls asleep halfway through.

That isn't a critique on the film, she's just tired.

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SUNDAY

Just, you know, take it as read that for breakfast, lunch and dinner there is some sort of beef component.

And Pink Floyd and that bastard 'Dark side of the moon' piano tinkly thing.

Finished my book, now starting on the 112 video podcasts I have to watch.

Alternatively I could sit here and watch scantily clad young ladies walk past me.

TEDtalks it is...

Am I growing cow horns? I feel like I'm growing cow horns.

Watching the families play on the beach, once more wondering if I've missing something by not having wife/kids.

I really need to think less sometimes.

We take in the hotel entertainment by the pool. It's dire. We lay on sunbeds while I try and explain what shooting stars are to my mum.

She feels sad that the shooting stars burn up and 'die' in Earth's atmosphere.

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MONDAY

Last full day, tomorrow will be full of travelling.

Brother sits on the end of his bed and weeps over the thought of Beef for yet another day.

I feel like going on a hunger strike.

We venture into the dining area - the familiar, maddening, Pink Floyd is on repeat.

TURKEY! - God, I *adore* turkey.

We make plans for tomorrow - kicked out of our room at noon, picked up for flight at 18:50

We land at London Gatwick at 2am, when there is no tube to get home.

It's going to be a long day tomorrow, and it casts it's shadow over the whole of today.

I have no tan - I consider this a success. No tan=no melanoma.

I am not a hypochondriac.

Movie night is 'The Last Mimsy' - Mum goes back to sleep as it's too complicated for her.

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TUESDAY

Like an episode from 'The Great Escape' we take nine rolls from the breakfast service - otherwise we won't eat until we land in London.

Kicked out of hotel room at noon, coach to pick us up is a 19:00 - a long wait in reception.

Sitting in reception, our task is to drink 14 bottles of water, because we wouldn't want to leave any free water behind...

...Yes, my mum is crazy.

Hold up, what's that I hear on the muzak? Pink-sodding-Floyd. The same song. On loop.

Isn't that against the Geneva convention on torture?

Brother and I work it out, we'll have to listen to it eighty-four times before the coach arrives.

I discover that it is impossible to cut your throat by using a papercut.

Drinking the water - going to the toilet - wondering if water intoxication has the ability to drown out muzak.

Seven hours later, one game of scrabble, five videos and 30 'Professor Layton' puzzles later and the coach arrives.

Time for the repeated 'remove things from trouser pockets and put them in bag for x-raying' dance.

On plane. Murderous. Considering looking up how much room is needed by law in transporting livestock. Wondering why it doesn't apply to humans.

English border control woman is the most foul-tempered person I've met in some time. Still it is 2 a.m.

Sitting on the floor at Victoria waiting for the Underground to open at 5:20.

What's that noise in my head? Pink Floyd.

Buying a sandwich. Anything but beef please.

Tube - walk - drive. Now finally home at seven a.m. Time for a few hours sleep.

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To be honest, it was a lovely holiday - sitting around doing pretty much nothing, being fed and watered without having to cook (or in my case, warm something up in my microwave or phone for a takeaway). It gave me plenty of time to sit and think, which isn't always a good thing for me to do, but in this case it gave me some breathing room away from everything.

Now I'm going to have a long weekend in Cumbria so we can take our mum to see a zoo where they let lemurs run free - and so I can run around with a camera trying to pick up some photography craft, then five days of free time before returning to work. Which should give me some time to get my emails answered and some writing done.

In the absence of an 'instant sobriety' pill, a pill or injection that would instantly sober someone up (like Naloxone does to opioid use), I'm wondering if we should go the other way...

You see, I find myself taking drunks into A&E on a regular basis, once there they are given a nice soft trolley to lay on, some poor nurse to clean them up and often some IV fluids to counter the dehydrating effect of alcohol. This means that any hangover is prevented, or lessened.

Like rats who receive a pellet every time they push a lever, these drunkards know that they can drink to excess and the 'emergency' services will babysit them and make sure that they are fine in the morning.

And then we wonder why alcohol related calls are climbing by 12% every year.

I have two solutions.

First - being unable to instantly sober someone up, we should work on a pill that enhances the effects of a hangover while making any use of analgesia ineffective. By making the hangover worse we would be teaching these little alcohol sodden rats that drinking to excess is bad. Send them home sober but vomiting, with a headache and with aching joints.

Secondly - there should be enacted, in legislation, a new policy where - if you are drunk and incapable, any ambulance called to you is allowed to go through your pockets and take any money for themselves (or the ambulance service benevolent fund if that crew is feeling particularly charitable). Not only will this inspire the rats to keep some degree of sobriety, enough to defend themselves from the grasping hands of the ambulance service, but it will also remove some of the money that would no doubt only go on to be spent on alcohol.

It would also have the happy side effect of boosting my pay packet.

Please send the Nobel prize for medicine to the usual address.

'Male - behaving strangely, threatening self harm'.

"Would you like the police to attend?", asks Control.

For some reason I'm feeling brave this morning so I let them know that we can save the police some time and I'll take a look at the patient first.

It's a hostel, not one that we usually go to - as the owner leads us to the patient some other residents walk past us, they seem remarkably normal. I know that may seem judgemental but most of the hostels we go to are full of people with psychiatric problems and alcoholics. It's one of the perks of the job, we get to see all the nice places.

The landlord gives me the impression that he just wants our patient out of the hostel. For reasons best left unexplored it would seem that he prefers us tramping around his hostel than the police.

My patient opens the door to his room and looks at me. I look at him and realise that this person has serious mental health issues.

I'm sure that if you were to read this person's medical notes it would state 'flat affect', 'unable to maintain eye contact', 'meandering conversation', 'issues with self care' and 'threatening body language'.

For me, for any ambulance person, it's all laid out for me in that split second look.

He looks at me with confusion and with a grunt, invites me in.

He doesn't tell me much, he starts to talk then stops. He paces about like an animal in a too small cage. In and out of his room he paces, when he passes his door he rests his head on it for a moment.

From down the corridor two police officers arrive.

"I told Control we didn't need you", I say to one of the (by coincidence the good looking female one).

"We were only down the road", she says, "thought we'd come and check up on you, make sure you are all right".

The patient sees them, he's obviously had run-ins with them in the past.

"Who called them?", he says, "I've done nothing wrong".

Hoping to build some sort of rapport with the patient I ask if the police could leave - while their presence can often have a calming effect, for some people it's a red flag to a bull.

With a friendly wave the police disappear back down the corridor.

Now, of course, the patient doesn't want to come to hospital - I let him know that while I'm not allowed to kidnap people, he'd be better off coming to the hospital for a check up.

He refuses a few more times. So we leave.

The landlord looks most upset, he wants me to take the patient away as he is 'disturbing other guests', but as I've told the patient, I can't kidnap people and that if he wants the person forcibly removed he'd be better off with the police.

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I'm in the ambulance outside the hostel completing the paperwork when the landlord knocks on the window.

"He wants to go now", he says.

I wonder what the landlord has said to the patient, but who am I to judge, so I open the back doors to the ambulance and the patient gets on board.

It's a very short trip to the hospital and I take the patient into the majors area to hand him over to the receiving nurse. The nurse is one of the good ones.

I explain all what has happened, and about the patient's mental state - not self-harming but 'not right' either.

Sadly (thanks to the healthcare commission, about which I will write later) there isn't any place for our patient to go than out in the waiting room.

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We sit him out there and explain that a nurse will see him shortly, then go and book him in.

We watch our patient get up and walk out of the department to have a smoke. He walks back in with the lit cigarette and heads for the patient area.

I go to stop him - I explain politely that he can't smoke in the hospital, that it's not good to have naked flames near piped oxygen.

He bristles, squares up to me, stares me in the eyes.

"Arrest me".

I try again, polite but firm.

"Arrest me".

I signal one of the nurses, to let her know that this might get nasty. I can see the aggression in his eyes. I know that patients with schizophrenia aren't meant to be violent, but they still make up a sizeable proportion of people who have taken a swing at me.

Once more he squares up to me, daring me. his posture, his body language, his voice (the first time I've heard emotion in it) all have me wondering if I should be the one to make the first move.

But once that happens, there is no turning back - and I don't like fighting people.

"Arrest me".

I'm getting ready for him to take a swing at me when I hear a tiny voice behind me, "You can't smoke in here".

It's the triage nurse, all four foot of her.

Our patient looks down at her, up at me.

He drops the cigarette and crushes it with his foot. Then walks back out to the waiting room.

I leave the department wondering if this little nurse could come with me when we get our next potentially violent call.