Not Gonna Blog Til August

Pretty much as it says in the title really.

The reasons for no blogging lately are:

1) Thanks to FREDA, we're getting off late more than getting off on time

2) Studying for my upcoming paramedic course as we have to learn the first module before we go as the exam for it is on the first day, and we have to learn all the A&P for Respiratory,
Cardiovascular, and Nervous systems - questions like "Briefly describe the components of
somatic and autonomic reflex arcs and explain their role in maintaining homeostasis".
We also have to learn Pharmacology, Drug administration and the theory behind cannulation
(putting a needle in somone's arm to give drugs - IV Access) and intubation (putting a tube
down the throat to secure the airway).

3) Thanks to the above two points, by the time I've got home, eaten and done some study, it's
time for bed, so I can get up the next day and do it all over again.

So I hope you'll forgive me, but I probably won't be updating my blog until August when I finish my paramedic course. Then I'll need to change my blog title. Providing I pass the course that is.

Be Careful What you Wish For (Part 2)

For part one of this post, see Mark's post here

Barry's off sick at the moment, and I've been single manned for most of this week, so I was asked to work on the FRU for a few days.

Since I stopped working on the FRU a few months ago, car staff have been asked to update control about cancelling ambulances/needing them on the hurry-up directly to the appropriate sector channel, so our radio in the car is now left on the SW channel.

I'd just parked up on standby when I heard a familiar voice on the radio. I couldn't quite place it until there was a General Broadcast (done when a call is being held and they're looking for any ambulances to come available,) which ended with the initials that confirmed my suspicions..."General Broadcast at 24*, my initials Mike Mike, Red Base out."

I'd done a couple of jobs that were, frankly, ridiculous calls that could have easily been dealt with by the GP when I got the Vaginal Pain for two weeks call. I'd sent Mark a text message and said I'd find an excuse to call up when he was on the radio. This was the perfect opportunity, as the call certainly didn't warrant receiving attention from a Fast Response Unit, especially with the patient already having been given pain killers by the hospital, so I called up. I could hear the humour in Mark's voice as he answered me.**

I was only joking when I asked him to find me a suspended. His reply had been "If someone calls in your area, I'll get them to murder someone". He was, of course, only joking. When the call came down to the screen. "Cardiac Arrest - Not Breathing At All" I realised it was a bit of a run, so I set off, briefly wondering if Mark was taking the call, but wasn't sure cos the text on the screen didn't say "dead" - Mark's the only person I know in control who will put that word on the screen.

It was a cancer patient, just 68 years old.

I arrived at the address***, and hurried up to the first floor with my kit, the ambulance pulling up just as I got into the flat. The patient was in the bedroom - up another flight of stairs.
As I entered the room, I was faced with pandemonium. The son was fighting back tears, his wife was crying as she was doing CPR, and their daughter was hysterical in her bedroom.
Unfortunately, the daughter-in-law was doing CPR with the patient on the bed. My heart sank. Good effective CPR is only possible if the patient is lying on a firm surface. Because she was on the bed, I had to mark it on my paperwork later as "ineffective CPR" which is a shame, because apart from the patient being on a soft bed, the daughter-in-law was doing good CPR.
I introduced myself, and the son said "It's ok, the paramedic's here" and hung up. I appreciated the senitment, but I haven't done my paramedic course yet...

I got the son to help me get his mum onto the floor, and I started CPR just as the crew came in.
I was relieved to see they were both paramedics. I continued CPR while one paramedic attached the defibrillator, and the other started preparing to put a tube down the patient's throat to secure the airway and put a needle in a vein to give the vital drugs to try and stimulate the heart back into action.

The defib showed the patient was in asystole (flat line). We carried on with the resuscitation attempt, with the son and his wife looking on, trying to hold their mum's hand, but only succeeding in getting in our way, and shouting encouragement to her, hoping that their words would somehow make her start breathing again. Meanwhile, the grand-daughter kept running in, screaming hysterically, and running out again. The crew got the patient intubated and cannulated, and we did over twenty minutes of resuscitation with all the drugs etc that the hospital would have given her. When we still had asystole after 15 minutes, the son asked if we were unsuccessful, not to take her to hospital. Up to that point, we'd been preparing to take her - purely for the family so that they could see we'd done all we could, but the son said they knew we were doing everything possible.
The last dose of Adrenaline was given, followed by two minutes of CPR. At the end of it, the defib still showed asystole. We all agreed that it was right to abandon resuscitation.
We pronounced life extinct at 1546.
The son cried.
The wife cried.
The grand-daughter came in and asked what was happening. I looked at her dad, a question in my eyes and he nodded. "I'm sorry sweetheart, you're Nan's died."
The house erupted in sorrow. It was heart-wrenching. I knew exactly how they felt - my mum died from cancer nearly 5 years ago at just 63 years old.

We put the patient back on the bed, removed the tube (we should really leave this in, but the family asked us to take it out because they wanted the children to say goodbye and they didn't want them to be scared by it) and made her look comfortable and peaceful.

The family just kept saying thank you to us. We'd failed to bring their mum/nan back to life, but they still thanked us for what we'd done. We felt very humbled, and left them in peace to do our paperwork and summon the GP.

I only knew Mark had taken the call when he e-mailed me to say how freaky it was that we'd joked about him taking a call for a suspended on my patch, although this wasn't really my patch, but get pulled into that area quite often.

I'm working on the car again tomorrow, and Mark said he might end up on the FRU desk - you never know, we might get another cross-blog post out.

Our last cross-blog post was so well received, not to mention so long ago, we jumped at the chance to do it again. Maybe next time we'll get a happier outcome.

* 24 is the minutes past the hour, so in long hand he would have said "General Broadcast at 0924, my initials Mike Mike, Red Base out."

** I wasn't really complaining about being sent - I simply asked if he was running an ambulance that might be nearer. In the end, she waited over an hour at least - she only lived ten minutes walk from the hospital.

***To add to the freakiness (is that a word?) of this call, three years ago, I went to a cardiac arrest in the flat directly below this one.

My New Year

New Year's Eve, Barry had the night off - he was going up to the Embankment to watch the fireworks. Meanwhile, I hadn't been lucky enough to get the night off, so I was working. I can't remember all the calls, but those I can are related here....

The shift didn't start well - first was a 30-something woman who'd been drinking vodka since 10 o'clock in the morning, had fallen over and "cut" the fleshy part of the base of her thumb on some glass. Well, to say cut is a bit of an over reaction. She had two very small scratches. She asked if she was going to die. I got her to wash it under the tap, then she decided to put a plaster on. We left her at home.

Later, after being given a break (my first in 4 months) we went to a pregnant lady who had some bleeding. She'd noticed the blood on the toilet paper earlier in the evening, but there hadn't been any bleeding noticed the last two times she went to the toilet. She had rung 999 for advice only. As our call takers don't give advice, and the call couldn't be sent to our Clinical Telephone Advice service because it had come up as a Cat A, an ambulance - us - had been sent, along with an FRU.
"Have you rung the hospital and spoken to a midwife there?" I asked.
"No, I don't have the number cos I lost my notes after leaving them on the bus."
We got the number for the hospital from our control, and I spoke to a midwife. I explained what the patient had told me, and the midwife said "Good grief - she's called an ambulance?"
I explained about the notes. "Oh for goodness sake. OK, I'll speak to her, can you put her on please?"
I handed the phone over, and after a lengthy consultation, the midwife had obviously said she wanted the patient to go to hospital, and the patient was refusing. The call ended. We tried to persuade her to go:

Me: Look, you rang for advice, you got us, we've found you the number for the midwife, you've spoken to her, and the advice you wanted is that you should go to hospital. We're here now, and we'll take you.
Patient: Yeah but who's going to look after my other child?
Me: Is there no family close by who you can call and ask them to come over? We'll wait for them.
Patient: No, nobody. I'll wait to see if the bleeding starts again, if it does, then I'll ring again for an ambulance. (This is what she had said on the phone as well)
Me: But I'm sure the midwife has just told you not to call another ambulance?
Patient: Yeah, but it's New Year's Eve - I won't get a taxi for hours.
Me: After midnight, you won't get an ambulance for hours either, cos there'll be far more calls then there are ambulances, so some will have to wait.
Patient: (bear in mind the answer to someone looking after her child) Oh, well I'll call my sister who lives round the corner to take me.

We gave up, did the paperwork and left her.

By now it was almost midnight, and we decided we'd go and sit on one of the bridges to see the New Year in and hopefully see some of the fireworks. I pressed the "Green Mobile" button, and selected "Declined Aid Against Advice" and "Send".

Almost instantly, we got another call. "Red 1, 59YOM Cardiac Arrest, Purple"
Red 1 is our highest category of call, Cardiac Arrest speaks for itself, and Purple meant beyond help. The call had just come in, and we were only around the corner. We were with the patient inside two minutes of the call.

The patient was laid in bed, and he was indeed in cardiac arrest. I pulled back the covers, and put my hand on his chest. He was still as warm as you and I are. He'd clearly only just arrested. We got him onto the floor, and I started CPR while my crewmate set up the Defibrillator. The machine showed Asystole (flat line). A paramedic arrived on an FRU, I briefed him, and we continued to work on the patient for the next 20 minutes using cardiac drugs to help stimulate his heart back into action. It didn't work, and after 20 minutes, with the patient still in Asystole, the paramedic asked us if we agreed to terminating resuscitation. We did, and the patient was declared deceased. We checked our watches to get the time of death, and realised it had gone midnight.

There were now various bits of paperwork to be completed, and the paramedic said he would deal with it all. We wished each other a Happy New Year, and we left.

Next was a panic attack, which with everything I could hear kicking off on the radio, I suspected the hospital wouldn't have been impressed with us taking in, so we spent an hour and a half talking the patient out of the panic attack. We succeeded, and it turned out she was a student nurse, and felt very silly that someone had called an ambulance for her, had never had a panic attack before, and said she would go to see her GP about it.

Two or three more calls that I can't remember, and we were looking for our "off job" - a call that is fairly easy, goes to hospital, then we go home. What we got was a call miles away to a care home, where a little old lady had fallen out of bed, and waited almost three hours for an ambulance.
It was a care home that actually does care. If you read ambulance blogs regularly, you'll know that they are few and far between in our experience, so this made a welcome change.
At first, it seemed our patient hadn't hurt herself, and we got her up and watched her walk with her frame. She was limping. "Is that normal for Mavis?*" I asked her carer.
"No, apart from using a frame, she usually walks normally."
Bugger. I really hadn't wanted to take this lovely old lady to an A&E bursting with loud abusive drunks vomiting all over the place and trying to pick fights with each other, but now I'd have to.
"Which hospital does she normally go to?" I asked, stealing myself to be told a hospital that was even further away from home.
"Town Hospital," said the carer. Oh yes, someone was watching over us, it was the hospital nearest to our ambulance station. I gave a silent thank you, we got Mavis into our chair, and we took her to hospital. It wasn't as full as I'd expected, but the nurses were pleased to see someone that wasn't drunk for a change.

I arrived back on station to find Barry, his girlfriend, and my girlfriend (Barry had taken her with them so she wasn't on her own for New Year) all sleeping on the sofas. I accidentally-on-purpose dropped something heavy and woke them up. "What are you lot doing here?"
"Can you take us home? We missed the fireworks - we were stuck on Waterloo Station - there were so many people trying to get out that the police closed all the exits and kept us in there. All we heard of the fireworks were faint pops."
They'd finally managed to find an exit that nobody else had, and got out of the station just in time for the fireworks to finish. Then they couldn't get back into the station to get a train home, and had spent the next five hours trying to get to the ambulance station to ask me to take them home.
I told them we'd missed New Year too doing a resus, and we all commiserated each other.
We'd Sky Plussed the BBC's New Year programme, so last Saturday, Barry and his girlfriend came round to us, and I started the programme at 11.10, as it had on New Year's Eve, and at midnight, I opened a bottle of champagne. We sang Auld Lang Syne very drunkenly, and had our own little New Year celebration, watching the fireworks on the TV**. The neighbours must've wondered what on earth was going on, but we enjoyed ourselves.

Happy New Year everyone!

*Mavis isn't the patient's real name

** Note to the BBC's director - next year, we'd like to actually see the fireworks, not watch two blokes racing up and down the Thames in a boat, and the crowds going "Ooh" and "Ahh". Thanks.

Happy New Year

Like Mark I should make a resolution to update my blog more often - but as research shows the vast majority of new year resolutions are broken, I won't make any at all.

I'll do my best to do an update at least once a week, but that will taper off during my paramedic course whenever that is in the coming year.

I'm gearing up for working tonight - Barry has got the night off and is going up to see the new year in on the Embankment, so I'm working with a trainee tonight.

To all the EMD's working tonight - in whatever service you work in - be nice to the crews. A thank you every so often on the radio doesn't go amiss. That also applies to the crews working tonight.

Everyone stay safe, and have a happy, and hopefully peaceful (unlikely in our job) New Year.

See you in 2008

Merry Christmas

I'd just like to wish all my readers a very Merry Christmas. Spare a thought for those from all the emergency services working to keep everyone safe.

I'm working the big day itself, and nights New Years Eve - it's just the way my rota's fallen.

Stay safe, and don't eat too much turkey & mince pies!

FREDA

You may remember that I had a bit of a whinge about FRED. Well now, we have FREDA. Beaker has posted in more detail about her.

In short, Freda is pretty much the same as FRED except it's for ambulances, has a larger mileage range, and works in a more complicated way. This could be the reason why when it was first switched on, it had crashed the entire system inside 30 seconds.


Well Freda's now been "sorted" and has been switched on.

The word "sorted" is being used very loosely - a crew got sent to Notting Hill from just outside Putney station, and the other night, Barry & I ended up seeing Canary Wharf, and after begging control to "hide" us from her, we managed to get most of the way back to our own area via the Limehouse Link (it's always mentioned on radio travel bulletins, but I didn't know where it was until the early hours of Saturday morning) and Tower Bridge. To add to the pandemonium, Freda was tagging every job, including jobs in the street, as a high risk address - it tells you to contact EOC immediately - so of course, crews did.

I really felt sorry for the team on our desk in control. Freda was clearly causing havoc. They were trying to overrule her, cancelling crews that were being sent stupid distances, but Freda just insisted sending the job straight back down. It seemed from our perspective that the Humans were fighting the Computer for control of the service.

I really hope they switch her off on New Year's Eve - I'm working nights, and have visions of ending up in Hendon!

Update

I haven't posted for ages, I know. Sorry about that, but I've had my head in the books studying for my Paramedic Pre-entry Assessments.

I passed.

I just have to wait for a date for my Paramedic course. However, I did come away from the day with a ton of books, as we have to self teach the first module, with the exam on the very first day of the course.

I've had some e-mails asking about Tom - he's fine and back at work. The police haven't caught the little buggers that did it, and he has to pay an absolute fortune to have a tooth implant fitted, but he is in good spirits.

I should now be able to post regularly again - until I get on my paramedic course. Then I'll probably be spending every waking moment with my head in the books again.