Transfer

Our break had been finished for a couple of minutes when the Activation Phone rang on station.
"We've got a job for you - it's a transfer for a patient post cardiac arrest," said the dispatcher.
"Where's it going?" I asked.
"Dunno yet, the call's still in progress, but given the diagnosis I thought it best to get you running straight away."
"No problem," and we set off for the local hospital.

We were on one of the old white LDV ambulances because the nice Mercedes ambulance had developed a gearbox problem. There's not much room on LDVs at the best of times, and I knew it would be a squash in the back with me, a doctor and nurse, plus of course the patient, and all the monitors and syringe pumps that he'd be attached to.

The screen updated - he was undergoing Respiratory Weening* (initially it said respiratory whining - lol) and that he was going to a hospital about as far north-east of London as you can get - we were heading into the territory controlled by Mark on the north-east desk. My crewmate grumbled about having to drive all that way in the old truck and about having to lift the trolleybed. I couldn't blame her really - we were working in a heap of junk.

At the hospital, we had a little wait while the staff finished preparing the patient for the transfer. While we waited, I sent Mark a text telling him we were headed into his area, and would he kindly try not to use us when we greened up as we would be trying to get back to finish on time. He promised to keep an eye out for us and that he wouldn't use us unless it was absolutely necessary, like a cardiac arrest that we were right on top of.
As expected, our patient was attached to a wide variety of equipment, including a monitor, a ventilator, a couple of syringe pumps and a few other bits and pieces. Some of it would have to sit on the floor, so I knew I'd have to make sure everything I needed to do was done before we set off so that I wouldn't be falling over equipment trying to move around the ambulance whilst it was moving.

Our patient had suffered a cardiac arrest in the airport after arriving back in the UK from a holiday in the sun. He'd been successfully resuscitated and transferred to the local hospital, where they discovered he'd suffered a heart attack, where one of the arteries in the heart had become blocked. This had caused the cardiac arrest. He'd then been transferred to the hospital where we'd picked him up from, and he was now finally well enough to be transferred to the hospital closer to his home.

After a bit of a juggling act with wires, tubes and the other equipment, we loaded the patient onto the ambulance, connected the ventilator to the main oxygen supply on the ambulance, arranged the other equipment on the floor where it could be easily seen, the doctor sitting in the chair at the head end of the bed, the nurse in the side chair, and I settled in to the back seat. We set off on blue lights. Even on blues, it was going to take us about an hour. After about 50 mins, Mark sent me a text. "I can see you on the mapping screen!" he told me. It was a bit of a relief really - I had no idea where we were.

We finally reached the hospital. This is where after making our way from one end of London to the other, things started to go wrong. This is because some idiot decided to build the hospital in the middle of a shopping centre. Either that, or some idiot built a shopping centre around the hospital. Either way, we managed to get lost in the car parks, and had cars beeping at us as we floundered around trying to find the entrance to the hospital. Mark tried to help by giving directions - all of them in one text. "Go right, turn around, turn left, straight on," I read. I couldn't help but laugh. After what seemed an eternity, we found the entrance, and did the reverse juggle to get the patient off the ambulance. A porter lead us to ITU where we transferred the patient onto a bed, and the doctor did the handover.

After our long journey, we were delighted to find the staff were really friendly. A cup of tea was thrust into our hands, and we were invited to help ourselves from a packet of Wagon Wheels - I haven't eaten one of those for years!

We set off back to our own area - under advise, we returned via the M25. Just as we pulled out of the hospital however, the MDT rang with a job - a green call in Dagenham. My crewmate muttered. I waited....and sure enough, we got cancelled. "Thank you," I sent Mark.
"I couldn't resist teasing you with that," came the reply. Little sod!

We almost made it back, but as we got close to home, we were sent to a panic attack. It was a load of rubbish - the patient didn't want an ambulance - she suffers from panic attacks regularly, and knows how to get herself out of them, but a Police Community Support Officer (Plastic Police I call them, cos they have no real powers) had called us despite her begging them not to. We left her where she was to recover, and got back to station. We were only a few minutes late finishing.

Thanks Mark for ensuring we didn't get stuck in the north-east sector.

* Respiratory Weening - this is where a patient who is being ventilated is encouraged to start to breathe for himself again, with the ventilator still doing most of the breathing for him. The number of breaths per minute being delivered is gradually reduced until the patient is breathing fully for himself.

PS: Just a little tease - there's a cross-blog post with Beaker coming up soon

Corrie

The call was to a diabetic patient "behaving strangely".

Mary* is an elderly lady, whose sister was visiting from Canada. She'd woken up, shouting something about a daughter. The sister knew she didn't have a daughter, and couldn't understand what she was talking about, so fearing that the patient's blood sugar was low, she called an ambulance.

"Who's there?" shouted the patient as we trudged up the stairs.
"Ambulance service," I replied.
"I don't want the ambulance, it's the police I want. I've got information about a girl that's gone missing - my daughter, Rosie...." and she went on for a few minutes. Her sister told us she hadn't got a daughter. I tested her blood sugar while we talked - or rather, I listened while she talked. The reading was normal, so we'd ruled out a hypo. I still had no idea what this woman was talking about, until my crewmate told me she was talking about a storyline in Coronation Street that involved a girl going missing. I don't watch soaps, so I had no idea.
"....so I want the police to come so I can tell them the information I've found out," finished Mary.
"Mary," I ventured, "do you think you might have been dreaming about Coronation Street?"
Mary paused for a moment to consider that. "Maybe you've been watching too much TV," I suggested, smiling.
"Do you know, I think you're right," she said. "I do feel foolish."

I reassured Mary it wasn't a problem, and told her sister she'd done the right thing. I recorded her blood pressure & pulse.
"My son works for the ambulance service - you won't tell him will you?" she asked, looking worried. I assured her that her secret was safe with me, and we left her drinking a cup of tea.

The computer system in control that sends calls down to our screens in the ambulance had been taken offline for some maintenance, so we were doing everything "the old fashioned way", so I had to tell control the outcome of the call and let them know we were available again.
Much to my amusement, Beaker was the radio op. I pressed the button on the radio that let her know I wanted to talk to her.

"Go ahead," she said.
"You're going to love this," I said, and told her briefly what had happened, and that we'd left the patient at home in the care of her sister. There was a long pause. I knew she was laughing. Beaker was still laughing when she had finally gained enough control of herself to acknowledge me and confirm that we were available again. I managed to keep a straight face as I told her not to laugh as it was unprofessional.
"Sorry, I'd answer you but I'm too busy laughing!"

We drove back to the ambulance station - still laughing. I love it when we get funny calls like that - Mary brightened up what was otherwise a very boring week as far as calls go.

*not her real name - I never use a person's real name, but if I don't write this, I always get an e-mail from someone accusing me of identifying the patient

Good Week

I've had quite a good week this week.

I started working with my new crewmate and we were working as an EMT crew as my registration hadn't been processed yet, so I couldn't work as a Paramedic unless we went to a job where another Paramedic turned up, then I could have. We had a new student paramedic come out observing with us for a couple of days, and my HPC registration finally came through yesterday.

We took our new student up to EOC (Emergency Operations Centre) as I always try to do with new students so they get an opportunity to have a look at the desk that's dispatching us. The bonus for me when I do this is that I get to meet our dispatch team face to face and have a chat so that I can put a face to a voice and a name to the initials. Who should be there when I walked in? Beaker. So I've finally met her, and we had a good chat for a while. As for our student, it turns out he used to work there, so knew more about it than I did - infact it was he that trained Beaker on dispatch! Small world eh?

Mark from Neenaw was there too, call-taking again. He was having a better day than the previous time. He showed me the new Gazetteer, which can give the full address from the minimum information, such as "It's outside Tescos in Purley". I was quite impressed, although I gather not many call-takers are using it as it's still got some bugs.

Jobs this week included an old lady who'd fallen down an escalator and grazed her knee and elbow, and a man with a nasty gash on the back of his head who couldn't remember how it happened.

I've decided our student is a blood magnet. We went to a delivery man who'd had a cage fall on him and virtually amputated his index finger just below the nail. It was hanging on by a small piece of skin (this had originally been a Green call - lowest priority - and had been sent up to our clinical advice desk!!). It wasn't too badly mangled and there was a possibility that the finger could be saved, so we moved the finger back into its normal anatomical position, bandaged it up, and although we didn't put in a blue call (alert the hospital), we did push through the traffic on blue lights. The last we heard they were debating whether to re-attach or remove it. The job before that had been a man in his early 70s who had a nose bleed. It had been bleeding for 2 hours, and it was literally running out of him. He'd tried to get a taxi to take him to hospital, but they'd refused to take him. After going through three large dressings and counting, we bit the bullet and blued him in.

Our student's second day started with an RTC. We were going as a second vehicle to a motorcyclist who'd collided with a car and fallen off his bike. The first crew had been forced to abandon their ambulance in the traffic queue that had resulted, and walked some distance to where the patient was. As our ambulance station was in the other direction, we'd been sent to transport the patient.
A few run of the mill jobs after that, then after visiting EOC, we finished the day with a lovely lady who'd gone to help her mum who was being robbed. She'd been dragged along the floor by the robber for a few feet, and had a number of bruises and grazes. I gave her grazes a clean, and patched them up, and as she didn't want to go to hospital because she was trying to get through to the bank to cancel her cards and cheque book etc, I told her that she'd be a little sore for a few days, and advised her to go to the local Walk-In-Centre later on if she got worried.

And then yesterday afternoon, I got a text from my other half.
"Put your Paramedic slides on!" She'd checked the HPC website to see if my registration had come through, and told me my registration number. I think she'd got fed up of my moaning that I'd put my application in ages ago and still wasn't registered. I'd been frustrated cos we'd been doing jobs that I could easily have used my new "tricks" on (as Mark calls them).
So I finished off the shift as a Paramedic - but to save confusing the control desk I didn't tell them, as I didn't have a Paramedic drugs pack. Needless to say, now that I could use my new tricks, we didn't do one job where I could have justified so much as a cannula.

Oh well, there's always next week.