There are certain jobs where you just can't figure out how or why. The info we get is sometimes, how shall I put it, sketchy and the first job was a good example.
 
"Man collapsed. Fractured jaw, fitted"

We looked at each other and went "Eh?" Off we went.

He was sat on the side of his bed with a look of determination about him, which if you think about it isn't surprising. His wife was flapping around. Once we had got her settled down we got the information out of her (Because he couldn't talk).

The chap had been having problems with his blood pressure recently. The medication he was taking was designed to lower it and they hadn't quite adjusted the dose properly yet. He'd got out of bed a bit quick and fainted. He had landed chin to carpet. It possibly wasn't broken, it actually felt more dislocated to me but only an x-ray will tell for sure. He hadn't fitted.

Then, as it is still the chest infection season, we did a few old people with breathing difficulties. Including one who didn't have breathing problems but was certainly brewing up for something. He didn't want to go to hospital so we arranged for a GP to visit him.

Then some carparks were visited. Including one where they were serving up a lovely bacon and egg role. Yummy.

Then the motorists felt left out. We were called to a lady who had rolled her car. The call had come from the police so naturally the accident wasn't where we were told it was. Eventually we found it, more by some fine detective work by someone in control than any help from the police. The car was on its roof but the lady had come out without a scratch

Just an aside here. The police have regional control rooms. I am more and more convinced that that is why they have such a problem with addresses. The government wants us and Trumpton to go the same way. I see a mistake on the horizon.

Then we went to another RTA. This time the chap had actually fallen out of his car while he was swerving to avoid another one. He'd landed on the back of his head and the top of his neck. At 30mph!!.

This is potentially very bad news indeed. A break in the neck, back and spinal cord gets more serious the higher you go. From just painfull at the cocxyx to lethal at the base of the skull. He had pain at that point.

We immobilised his neck with a special collar and immobilised his back with a spinal board. We got him to hospital and three hours later he walked out with a clean bill of health. Lucky man.

Then finally to a very pleasant lady who had been out shopping and had bent over to help somebody. She hadd fallen over onto her left hip.

She had fallen very hard and one look at her said to me that she had broken her leg. She'll be in hospital for a while unfortunately.

Haven't seen the man on the white horse yet this year. Still early days.      

Well. Ive just had two weeks off. Very nice and very unexpected. Nobody actually told me. I found out by looking at the next two weeks work and I wasnt doing any of it.

 If they did tell me I forgot.

Back to work today then with a distinct "Meh!" We were very, very busy. We used no equipment at all. That gives you a rough idea of how ill the people we went out to were.

A few doctors admissions. I actually don't mind doing  those although a lot of people do. First job was to a nursing home and an old lady with breathing difficulties. We arrived and discovered she was hyperventilating. Sorted her out. It takes a knack which fortunately I seem to have. Its either that or they sort themselves out because they are bored with me wittering on.

A few other jobs and then we went to a collapse. This was a good object lesson in things arent always what they seem.

Anyway: "88 year old female. Collapsed", was what we got. We arrived to find the lady on the floor with a blanket over her and her daughter standing over her looking worried. 

I spoke to the daughter to find out what had happened from her point of view. Then I spoke to the lady herself to find out how she felt. The first thing she wanted was to get off the floor. I checked her over and then we sat her up. Fine and dandy.

Now physically there didn't seem to be an awful lot wrong with her and with the sence of urgency withdrawing we chatted and it turned out she had a lot going on with her life and she was finding it difficult to cope. She was only sleeping a few hours a night if that. She really needed help from her GP and social services

This really wasn't a job for a & e but I asked her wether she wanted to go to hospital. She didnt really. The daughter had a different idea. She was quite insistent that her mother went to Hospital. We get this a lot and I don't know why. Is it because people don't think the process through? or is it because they just want them gone?

In the end we managed to get the doctor out to see her and hopefully she'll get the social help she needs. But what started as a collapse ended up with us hopefully assisting an entire family. Hopefully 

A lot different from yesterday. Quieter for a start, and we got through three vehicles.D

A lot different from yesterday

The third night out of four. I am very tired.

I should have known it wasn't going to be a stright forward shift when the first job started as a very drunk 6 foot 5 inch Latvian rolling down some stairs attached to 3 policeman. It had all started as a drunken party apparently, various bits of furniture had been punched and the police had been called.

 He had a lot of blood on his arms and they were concerned that he had injured himself. We checked him over while they sat on him and he growled and said things in latvian. A small cut on his thumb was the full total of the injuries.

Then he vomited. They moved him out of the growing pool. Then he vomited again and they moved him again. Then he vomited again. He was prescribing a nice arc of vomit on the pavement. I think he must have been hungry because he started licking it up.

Which was nice.

We weren't keen on having him in the ambulance for several reasons and as he wasn't seriously injured the police said they would take him to the hospital.

Then the madness started. I don't think any of them were seriously ill but I don't think any of them were the full ticket. If you see what I mean.

There was a trend about 2 am for punching windows. We were sent to one. As it turned out he was quite a pleasent old man who was under a lot of stress. He had had a few drinks and lost his temper. He then put his hand through a window.

The police quite impressed us on this job. Because control didn't know what was going on at the address they sent the police in first. We were told to hold off untill they made the area safe. Now we were holding off on the only road onto the estate where the address was. They didn't go past us but they arrived on scene before us. Are the police using stealth technology?  We should be told.

Lots of relatives running round in the garden smoking and shouting at each other. We  went in and found the patient sitting smoking, tea towel on arm soaked in blood, growing pool of blood on the floor. He had a couple of nasty lacerations on his hand. These we dressed and took him into hospital.

Various other patients followed. To be honest they are blurred into one.

Then to an old lady (this is about 4am). She had fallen at around tenish and she was very insistent that she wanted to go to Hospital. She knew that she had broken a rib and her shoulder  and wanted an X-ray. She almost certainly hadn't but she wanted to go. So....

Then, and by this time I had lost the will to live, we went to see a man who had had an episode of diarrhoea. Thats it pure and simple. He insisted on going to hospital. I explained to him (politely) that this wasn't an appropriate use for an emergency ambulance and that a & e wasn't really the place to go but again he demanded an ambulance. And as we are not allowed to refuse....

A twelve hour shift. Fifteen patients. 80 miles traveled. One ambulance broken. An almost typical night. One more to go.

Oh yes. My radiation detecter went off for some reason. Don't know why. Batteries probably.

Nice and quiet tonight although it didn't start that way.

First job was to a scalding. We just got it as a female poured boiling water over herself. It was in some flats that we go to quite a lot. We arrived on scene and my crewmate said:
 "It'll be on the ground floor"

Nope

First floor

Nope

Second floor

Nope

Third floor

Nope

Fourth floor

Yes. The man of the house opened the door and showed us upstairs. Upstairs in a flat. Who would have thought it. Then we heard the screaming.

 The poor little thing was 3 years old. She had pulled her little brothers baby bath of hot water over herself. She was bright red from the waste down.

 We have specialist burns dressings. They suck the heat right out of any burns so it doesn't hurt quite as much. After we had applied these she was a bit calmer but not much. Ironically the less serious the burn or scald the more painfull it is. With deep burns the nerve endings get burnt off and people feel no pain at all but with lighter burns everything is (relatively) intact so it hurts.

Then we went to a chest pain that when we got there was a chap who had fainted and banged his head. We left him at home.

Then to a chest pain which turned out to be a chest infection. He was wheezing like nobody's business. We took him to hospital for two reasons. Firstly we couldn't sort him out with the drugs we had and secondly he was litteraly a stones throw from the hospital.

And that was that. For the first time ever I fell asleep for about half an hour. That will never do.  

I'm a bit cross.

Alright I'm bloody annoyed.

Today the press has been full of the story of a man who died while heartless ambulance crews had a break.

As per normal the tabloids are sensationalising it and the ambulance service being the ambulance service is doing nothing to help itself.

Read it here:

http://news.bbc.co.uk/2/hi/uk_news/england/london/6237307.stm

I don't know the full facts behind the story and I'm sure the press don't either. We don't know what those crews were doing before they had their lunch break. It is entirely possible that they only had that half hour break in the whole of a 12 hour shift. I know I've done it.

My point is what do they want from us? Are we not allowed to have half an hour to ourselves? And also don't forget that we are not being paid for our lunch break so essentially those crews on break did not exist. Also there is no evidence to suggest that the gentleman died because he wasn't transported to hospital quickley enough. The first responder would have given him all the treatment possible on scene.

Lets get some of these journolists out to spend 11.5 hours a day sat in a 7 foot by 5 feet ambulance cab with brief brakes to treat ill and injured people then see if they are prepared to work unpayed through their only break in the day.

I think we all know the answer to that.

Three.

We had a young lady from Patient Transport Services out with us. I'm glad to see that the PTS management is keeping up with this. I think its a really good idea.

But as is normal "The curse of the third man" kicked in and we had very little to do.

It was almost a case of the jobs that weren't jobs.

A chest pains was the first one. But as the man opened the door himself we were immediately suspicious. We did the normal checks. Blood pressure, pulse and a 12 lead ECG but all it showed was that the man was in very good health. The symptoms he was describing were more that of a muscle strain than a heart attack but he wanted to go to hospital. So...

Then to a Road Traffic Accident 2 towns over. I'm pretty sure this came from the police as the address kept changing. When we arrived on scene the police were actually there but nobody was injured so we headed back to base.

On the way back we were given another RTA on the motorway. Unfortunatley we were on the one way system so we had to go all the way around the town. As we were just about to get on the motorway we were stood down and sent back to base again.
 
I shouted that I was getting dizzy but I don't think they heard.

Then to a man having a diabetic Hypo. He looked disconcertingly like the head bad guy in Lost. I'm pretty sure it wasn't him though.  

We checked out a few carparks in the afternoon and were then sent to a woman who had collapsed at work. She had cracked her head a good 'un on the floor and had a huge lump on the back of it. She couldn't remember it happening and seemed a bit confused. We took her in to hospital.

Now my crewmate has a good nose and so do I but this time I totally missed the smell. Apparently she reeked of booze. I couldn't smell it at all.

If we want to tell each other something with out the patient seeing then we tend to write it on a glove and show each other it. He was writing and showed me the word "Ethanol".

Ahh. That would explain a lot. I asked her 3 or 4 times if she had had a drink but she denied it. I don't know if she had.

Then home. 

 Somedays you are quite glad that you are where you are and not somewhere else. We came in this morning to the news of the bus crash on the motorway. You probably saw it on the news. A lot of my colleagues were involved with the operation and they were quite shaken by the whole thing. I won't add anything to the stories in the papers but to say that it was a truly heartbreaking event.

My day was a bit quieter. 3 jobs in total which is not many however you play it. First job was to a woman who had fallen off the toilet and now couldnt get up. She lived about 30 seconds away from the ambulance station but because of the one way system it took us about 5 minutes to get there. She was locked in as it was VERY early in the morning. This needed us to wake up an extremely bad tempered neighbour to get a front door key. I sent my crewmate off to do this.

Key got and crewmate unpunched we entered the flat. I quite often say my house is a mess but compared to this flat my house is sparkling.
 
We found the lady in the bathroom. It was a council flat and the toilet seat had broken off its fixings and she and it had landed on the floor. She had headbutted the floor and now had a cut just under her hairline. It was fixable but probably needed stitches. This was a bit above our skill level so we sent for one of the Emergency Care Practitioners. These are paramedics who have done a bit more training and can now do things like stitching etc. Its the governments idea so they don't have to pay doctors.

While we waited we got her off the floor. She was a bit big but we managed.. The ECP arrived and repaired the wound. She didn't want to go to hospital.

Then we went to sit in a carpark. A burger van had opened up for business so I decided to treat myself. Very nice. 

Then we went to a lady who had collapsed behind locked doors. The fire brigade were there to break in when we arrived.  They were heroes all right. 

The ladies family were there and as there wasn't anything physically wrong with her we left them to look after her  

Then to another town a few miles away. We were making good time when...

BANG!

Ka chunk

Ka chunk

Ka chunk

Then my side of the ambulance started to lean. Oh dear, flat tyre.

We called control and told them what had happened. They arranged for the tyre people to come and fix it. We settled down to wait.

And fell asleep.

An hour later we had still not been rescued and we were due to finish quite shortley. The tyre man arrived soon after and we set off for home. 

And got another job. Fortuneatly it was an old chap who had been hit by a cyclist. He wasn't badly injured and didn't want to go to hospital anyway. We tidied him up, he shook our hands and went on his way.

We went home, quickley. 

Today has brought up a few jobs and its got me thinking.

Most jobs today seemed to envolve mental health in one form or another. Not just with us but it seems with everyone else as well.

We went out almost as soon as we started. The responder coming off a night shift was on scene with a chap at an old peoples home. It wasn't one of the best homes we go to but not one of the worst by a long way. The last time I was there somebody slashed the tyres of my ambulance.

The chap had been unwell for a few days but had been found on the floor that morning by the staff. We arrived and he was covered in bruises and wounds and was very arguementative and punchy. He was shouting and made no sensce at all. His head was covered in bruises. Getting him out was a bit of an ordeal as he kept reaching out and grabbing things and people.

We got him to hospital. Whether he had a head injury i dont know although it is likely.

While we were doing this some colleagues of ours were at the local psychiatric hospital. They had been called out to a  young girl who had drunk some antifreeze. Now she hadn't been sectioned and refused their help so they had to leave her.
 
Another vehicle was called out to her a few hours later when the antifreeze had taken effect and took her to hospital.

We were at the same hospital at roughley the same time to a woman who had taken an overdose. And some other of our colleagues were there for the same thing.

Now to my point. In days gone by, up untill fairly recently, the mentally ill were kept in very large institutions. Segregated and confined. Then in the '80's came the advent of "care in the community" This meant that these people were turfed out of the hospitals and sent to live in small houses in the community. The emphasis is now not on confining the mentally ill but in letting them live lives as normal as possible.

Now in general this is a good thing. For most people it is right that they are given as much freedom as possible.

But is it the best way for everybody? Do people have the right to kill themselves slowly? Because all three of the people I mentioned will be cured and all three will probably try again. The longterm damage to their health will be immence.

I dont know what the answer is. I'm not an expert in mental health by any stretch of the imagination but I do wonder.