Friday, November 24, 2006

AMPDS Strikes Again

We were sent to a green call (one of our lowest priority calls) the other day for an old lady who'd fallen downstairs. That raised my eyebrow a little, but I assumed that she'd just slipped a couple of steps. Even so, I thought it ought to have been an amber call at least. We were just round the corner, so rather than waste time questioning control over it, we just made our way there, arriving literally just as the caller was putting the phone down from control.

It turned out the lady had lost her balance when one of her legs "gave way" and had fallen down eleven carpeted stairs. She insisted she wasn't hurt, but we didn't take any chances and examined her very carefully. Indeed, we couldn't find any tender areas, and she had full movement in all four limbs. She was adamant she hadn't hit her head and didn't have any neck or back pain.

We got her onto our trolley and took her out to the ambulance, where we did all the usual checks. The alarm bells started ringing when we took her pulse. It was 31. They were ringing loudly by the time we took her BP, which was very low. We were amazed the woman was conscious at all, let alone fully alert, and began to strongly suspect that these findings were probably the real cause of the tumble downstairs.

My crewmate took bloods and started a bag of fluid to try to raise her blood pressure, and gave her a drug to speed up her heart rate. It only raised the pulse by 10 beats per minute, so we "blued" her in.

That was a call that was categorised as none-life threatening. It was fortunate that we had been sent on it straight away, as it could easily have been held onto for half an hour or more while calls categorised as a higher priority got the ambulance.

Our next job was a Red 2. A male apparently unconscious. He was drunk, and not unconscious at all. We saw the irony that a very ill woman got a low priority category, while a drunk got one of the highest priority categories.

I don't know if it was the system or the call-taking. I assume it was the system, as I don't know enough about the call-taking to comment on that. Perhaps a control bod would like to comment?

As an aside, the young lady from a couple of posts ago had broken her arm - right at the joint with the wrist, and apparently a quite nasty break too.

Wednesday, November 15, 2006

Taking Calls The Old Fashioned Way

I've said it on here before, but I really quite enjoy it when the MDT system crashes or is taken off-line for maintenance, even though it is a bloody nightmare for those who work in control.

Yesterday started with the MDT's apparently off-line for maintenance, although I suspect there was more to it than that, because they were down for far longer than usual. The maintenance is usually done between 4am and 6am - probably because that's when the call-rate is usually at it lowest, but yesterday it was down until lunchtime.

Listening to crews green up reminded me how many staff have started on the road since the MDTs came in to use. There were rather nervous voices clearly not sure of what they should be saying. The way it should be done, is you press a button on the radio which highlights your callsign on the screen in control and adds it to the list of crews wanting attention. When the radio-op acknowledges and tells you to "go ahead", you tell them you're "Green at [hospital]* on scene at [scenetime]*", unless it was a doctor's urgent, in which case you just need to say your green at [hospital].

There is usually a short pause while they look to see if there's another call for you, then they either tell you to "return" or give you another call.

Yesterday it was more like "Y123, we're green at hospital and we've started returning."

Trainees already on the road tell me that their radio training consists of a couple of hours messing around with handsets that are crap and don't work very well. This has made me determined that when I'm TSing, I will make sure the recruits know how to take a call "the old fashioned way", and what to say when they green up afterwards.

* Insert hospital name and the time arrived on scene here

Bad News and a Broken Arm

As I thought, my paramedic application has failed. It was my own fault really, but they've changed the selection process for this round of applications and I hadn't realised. My training officer is steaming mad. Not with me, but because the selection process seems to keep changing from course to course. Still, I know what to do for next time now.....I think.

Anyway, it's been a while since I blogged about a job, so here's one I did yesterday.

We were called to a school where 11 year old Emma had been accidentally pushed into a wall when one of her friends fell over. She'd hit the wall with her hand, and heard a crack in her wrist. Emma was petrified because she'd never been in an ambulance or been to hospital before.

I reassured her, and gently felt the injured wrist. I thought I could feel a deformity in the bone, so I carefully applied a sling and we took her out to the ambulance. The school was having a job getting hold of mum, so they sent a teacher along with us. we stopped by reception on the way out to get a print out of the girl's details so I could book her in (she couldn't remember all the details we needed) and they told us they'd just got hold of mum, and she would meet us at the hospital.

On the way to hospital, I tried to distract Emma from her injury by talking about favourite subjects at school and television programmes. It was at this point I realised I need to watch some kids TV so I know what they're talking about!

At hospital, I handed over to the nurse, ensuring she knew that Emma was really scared of hospitals, then booked her in at reception. Just as I was finishing booking her in, mum arrived.
"What's she done now?" she asked irritably, rolling her eyes as if this was most inconvenient for her.
"She's had a bit of an argument with a wall and lost. It looks like she may have broken her arm," I explained, keeping my tone light.
"Was she pushed?!" She was clearly already looking for suspects.
"Yes, but it was accidental, as it was one of her friends who was falling over at the time."

I took her through to where Emma was, expecting her to start having a rant for making her leave work, but she didn't, so I can only assume she didn't mean to sound the way she did.

I don't know whether it was broken or not as it was close to the end of our shift, and our last job took us to another hospital, but I wouldn't be at all surprised if it was. I'll try to find out tomorrow.

Monday, November 13, 2006

Good News & Possibly Bad News

It's been a week of mainly good news for me, but there may be a cloud on the horizon.

It's been confirmed that I will be "TSing" a crew when they finish their initial technician training in three weeks time. TS stands for "Training Supervisor", which means I will supervise, guide and debrief them on every call they attend in their first 5 weeks on the road.

This will be my first time TSing, and I'm very much looking forward to this, as I hope to learn lots as well as help the "newbies" to develop their practical skills. I hope they're nice and are willing to learn.

The other bit of "good" news is that I'm going back on the FRU as soon as I finish the TSing. Don't get me wrong, I thoroughly enjoy working with my crewmate and we have a laugh, but the rota is rubbish, and as I've said before, the station is quieter than I'm used to. Going back on the car means I'll be working in the area I'm more familiar with and hopefully a higher rate of calls.

There is potentially bad news though - I've got to go and see the training officer about my latest paramedic application. Apparently there's a problem, and I'm stealing myself to be told that I can't be put forward for the pre-course assessments.

Still, I might be wrong - I'll find out tomorrow.

Sunday, November 12, 2006

Running Calls

I'm back online now - but on dial-up for now, so it's taking a bloody age to load my web pages.

Running calls are quite rare. This is where we come across an accident or somebody laying in the street etc without being called to them. Sometimes we're already on the way to a call, in which case, we get cancelled down and left to deal with the running call, while another ambulance (probably the one that was coming to the call we've stumbled across) gets sent on our call.

This week, we've done two running calls on two consecutive days, and both were RTAs. The first one happened right next to us. We were on our way back to the ambulance station after dropping a patient off at hospital when a car knocked a motorcyclist off his bike - with an almighty bang. I told control we'd got a running call, and where it was so they could send the police for us. Fortunately, it was right outside the fire station, so we had plenty of extra pairs of hands to help us. Thanks lads.

We were in the middle of dealing with the patient when the MDT (computer) in the ambulance started ringing. At first I assumed control had been trying to get hold of us on the radio, and getting no response (cos we were busy) sent a message down the MDT for us. We ignored it and carried on. We collared and boarded the motorcycle rider, splinted his broken arm, and with the help of the fire boys, lifted him onto our trolley and loaded him onto the ambulance.

It was then we were able to pause for breath and have a look at the MDT. It was a job. Our job. It was given as "RTA motorcyclist lying on floor, LAS on scene". I looked at the time the call had started. We'd been on scene and dealing with the rider for more than 2 minutes before the call started. Why do people do this? Why call the ambulance service to tell them there's an ambulance dealing with an accident? Barmy.

The rider turned out to be very lucky - with just his broken arm. We'd been concerned about his pelvis as he was complaining of pain in the bottom of his back and hips, but the x-ray showed it was all ok.

Our second running call was again on our way back from hospital. It was a 9 year old girl who had been riding her friend's bike, lost control of it, and gone into the road right in front of a lorry travelling at 30mph. Don't ask me how, but she got away with only a few cuts and bruises. Another very very lucky person, and extremely brave. The lorry driver was an emotional wreck, as you might imagine. There'd been absolutely nothing he could do. Even the girl's mum said that and comforted the driver while we looked after her daughter.

I hope we carry on finding the lucky ones....

Sunday, November 05, 2006

Observer's Curse Strikes Again

Mark Myers came out with us on a late shift earlier this week. He's been out with me a couple of times on the FRU, but this was the first time with us on an ambulance (South of the river anyway).

Unfortunately, the dreaded Observers Curse struck again. A pathetic 2 calls in the whole shift. My new station is quieter than I'm used to, but even that was ridiculously quiet. Even us saying the dreaded phrase "It's a bit quiet tonight" didn't work.

I had a laugh when he panicked when one of our patients said he felt a bit sick. The cupboard door took a bit of a beating, and for both calls, he jumped up and down shouting "Is it a suspended? Is it a suspended?" I worry sometimes!

Still, we've made up for it this weekend. We've been out all day both days, with genuine patients to be fair. I'll write more about them once I've got the broadband connected at the new house - which is wonderful by the way.

Oh well, maybe you'll get a better shift next time Mark.....