NHS Direct and a Lassie story

Last week, I spent some time in the control room listening to Mark from Neenaw taking some calls. There's quite a bit to write up, and I'm working on it, but before I publish it on here I'm going to send it to Mark to make sure he's happy with what I've written. Watch this space...

This last weekend, I've been working day shifts. I think a good 40% of the calls I went to were referrals from NHS Direct. I know this, because there's a box on the screen where the call taker is supposed to note who has made the call e.g., brother, mother, passer-by etc., and for some reason we're supposed to write it on our patient report form.

One of these was to a "severe asthma attack". The MDT reported that the patient was having "difficulty speaking between breaths" and that the call had come from NHS Direct. I arrived to find a patient who could say more in one breath than I could, so much so I had trouble getting a word in edgeways. I finally managed to find out that she had had her attack the previous day, but decided she now wanted to go into hospital.

The rest of the calls were to people with 'flu, and chest infections where they'd been given anti-biotics 6 hours ago but they weren't having any effect. (anti-biotics can take 24 - 48 hours to start having an effect)

One call that reminded me of the stories you hear of pets saving their owners lives, was to a man who had been found by his wife fitting in the garden. He had no previous medical history at all, wasn't taking any medication and kept himself fit. He'd been out washing the car, and his wife heard the dog barking. She didn't think much of it at first as she thought her husband was probably playing with the dog spraying it with water, but after five minutes of relentless barking, she decided to go and see what the dog was barking at, and found it barking at her fitting husband. The crew arrived shortly after me, and the paramedic put a needle in his vein, gave him something to stop him fitting, then took him off to hospital.

I hope the dog got a big bone as a reward, a story line suited to an episode of "Lassie"

Geeks and Disabled

Well it wasn’t as dire a weekend as it could’ve been.

There was only one point when I really had to work hard to keep my mouth shut.  That was for Kate Mulgrew’s talk.  (she was great by the way – much deeper that Star Trek, is a big supporter of fundraising for research into Alzheimers Disease which her mother suffers from, and she was really frustrated and was quick to put down the real nerdy geeks who asked stupid questions.)

There was a woman in one of those three-wheeled electric buggys, who parked herself at the front.  Sideways, creating a blocked view for as many people as possible.  Nobody said anything, because we all thought she was disabled.

Until the disco at night, when she miraculously left her buggy at the back of the room, strolled forward to the dance floor without a hint of even a limp, and promptly began to dance.

Her behaviour disgusts me.  I have no problem with genuinely disabled people parking where they like – and usually, they are very considerate and careful to not block the views of others.  But people who take the p*ss like this woman did really gets me riled.

I have many disabled friends, and they would have been outraged that she had used whatever her disability is (if she has one) to give her advantage in such a manner.

It’s back to the grindstone this week.  I have today off, on overtime tomorrow, normal shift Friday, and I’m also visiting EOC – Emergency Operations Centre (control room, formerly known as CAC – Central Ambulance Control) to listen to Mark Myers take some calls.

Weekend Away

I’m going away again this weekend – this time to Bournemouth, to the Star Fleet Ball.  This is the fault of my last crewmate.  He’s been several times before and has persuaded me to go this time.

I’m a little concerned I’m going to be surrounded by geeks dressed as Star Trek characters talking about things like “In episode 12, time stamp 14 minutes and 32 seconds…blah blah blah.”

Still, the other side of it is I’ve never been to Bournemouth before, so if it gets too geeky then I can always go and have a look round the town, there’s the beer aspect of it – I haven’t had a good piss up in ages, and on Saturday night there’s what they call a “banquet” which is a black tie affair with cabaret etc.  At least I’ll get to spend the evening without the fear of having to look at Star Trek characters.

Next week, I get to go and listen to Mark from Neenaw take some 999 calls, and it’ll be my turn to write up about his job.

Overtime

Not been at work much this week as it’s my week off, hence the lack of posts.  I have done a couple of overtime shifts though.

The more interesting calls came on the second shift.  I got a call to a bus, where the MDT said there was a 14 year old male vomiting and had a head injury after being attacked.  It turned out he’d been in a fight an hour before and had been hit in the head a few times.  He was now pale, had vomited, felt dizzy and was complaining of a thumping headache and neck pain.  I suspected he was suffering from concussion after the head blows.
The crew arrived shortly after me, and we put a collar on to stabilise his neck, laid him onto a spinal board just as a precaution, and the crew popped him off to hospital.

The second was given as a 74 year old female ?suspended (LAS slang for possibly in cardiac arrest.)  I arrived to find her sitting on the sofa, cyanosed (blue), and confirmed she wasn’t breathing.  She was still warm, so I quickly laid her on the floor and attached the defibrillator pads.  While I was doing this, I asked her husband what had happened.  He said they had been watching Neighbours on TV, he’d heard her give a loud sigh and then she stopped breathing.  (I managed to refrain from saying that Neighbours makes me feel like that too!)  He also said she had a heart condition, and that it was atrial fibrillation (AF).

Atrial Fibrillation is quite common in older people, and what happens is that the two chambers that receive the blood back from the rest of the body stop beating properly and just quiver.  This doesn’t normally cause a huge problem as up to 70% of the blood that is transferred into the ventricles to be pumped back out again is done so by gravity.

The AED (Automated External Defibrillator) showed me that the patient was in VF (Ventricular Fibrillation – like AF but the ventricles quiver – means that the heart has stopped pumping and if you could actually see the heart while it was doing it, it would look like a bag of worms.) VF is a shockable rhythm.  

As the defib charged to deliver the electric shock, I explained to the husband what I was doing and that he would see his wife twitch as I delivered an electric shock to try to re-start her heart.  I pressed the button and she twitched.  I found myself holding my breath as I watched the screen to see if it was successful.  It wasn’t – her heart was still in VF.  I delivered a second shock.  This time she went into asystole – flat line.  At this point, the crew turned up and we started CPR.  After a minute, the AED announced that it was re-analysing the patient’s heart rhythm and that we were not to touch the patient.  She had gone into VF again.  We gave 3 shocks this time, and although still in VF, we continued with another minute’s CPR.

In between salvos of shocks, we got her out to the ambulance, and I went with the crew in the back of the ambulance to help with CPR.  We gave 14 shocks in total, and she had another two in the hospital.  After we’d been trying to revive her for an hour, the doctors decided we’d done all we could.  She had been in cardiac arrest for far too long now and the chance of survival was minimal.  Returning to normal life was going to be virtually impossible as her brain had been starved of an adequate oxygen supply for far too long.
CPR is only 20% as effective as a normal heart beat.

Her husband knew she was dead.  He had offered to help us give her the “kiss of life” in the ambulance but I assured him that we were doing all we could for her.  He was glad she’d just “dropped dead” as he put it, as it meant she hadn’t suffered.  She’d just closed her eyes, gave a sigh, and passed away peacefully.

It was just her time to go.

At home in Lincs

I'm back in my home county of Lincolnshire for the weekend. As well as doing the obligatory visits to relatives, I'm also helping out on a St John Ambulance duty - a swimarathon.

From 8am to 9pm people of all ages are coming to swim for 55 mins at a time up and down lengths of a pool. Then there's a five minute interval for changovers & photos, then the next set of teams swim for 55 mins at a time. It's rather dull stuff just sitting and watching people swim up and down, so you get thankful for the odd person hyperventilating or feeling dizzy after swimming on an empty stomach.

Today it's my turn to go, but I'm only staying until just after lunchtime. Thankfully the organisers supply food and coffee, so I'll see how much of their coffee I can drink.

Drive back home this afternoon ready for an overtime shift tomorrow.

Broken MDT

Each time we touch the screen on the MDT, it beeps. Today, the MDT went nuts, and started beeping on it's own at random, and wouldn't let me press "At Scene" on a job so I had to ask control on the radio to book me on scene.

I finished the job, and decided to re-boot the MDT to see if that would fix it - you know, like when your computer at home or in the office goes potty, you turn it off, turn it back on and usually it works fine again. Well the MDT worked fine for about a minute, then it started doing it again, and this time I noticed that the cursor was jumping around at the bottom of the screen.

So off I trundled to the MDT menders. The engineer came out and had a look and a press around on the screen then said "It just needs re-calibrating." I have to say I wasn't convinced, but hey, he's the engineer and he knows more about the system than I do. So he plugged in his keyboard and ran the program to re-calibrate the touch screen.
Half way through, it started doing it again.

The engineer lost his temper and punched the screen. The screen protested at this treatment by rewarding him with a spiderweb type pattern on the screen. He'd broken it. Despite my best efforts, I couldn't stop myself from laughing. He shrugged his shoulders and said it had needed a new screen anyway, then spent the next half an hour fiddling in tight spaces to get the screen off it's mounting, and replaced it with a new one. Whilst doing this, he told me they'd had several MDTs with broken screens, but this is the first one he'd broken. I suspect he now understands why they came in with broken screens.

I took a picture of the broken screen with my phone, and as soon as I can work out how to get the bloody bluetooth dongle working on my computer, I'll copy it across and post it on here.