We got the job as "26 year old with all over pain. History of bowel cancer"

We were met at the door by her dad who led us up the five flights of stairs to her flat. He explained that her cancer had recently spread and she had started on her third round of chemo therapy. In the last few days she had deteriorated and they were concerned.

We entered the flat and were met by the rest of the family and the young lady concerned. She was painfully thin, struggling to breathe and obviously in pain.

Her mother explained that they were trying to get her into the local private hospital and had been speaking to the GP.

We did some observations on her. Her blood pressure was very low, her heart was beating very fast and her oxygen level in her blood was very low. 

It was at this point I think that we both decided, seperately and without talking to each other, that she needed to be in casualty. Now.

We carried her down the five flights of stairs and got her lying on the stretcher. Lieing flat and on oxygen seemed to improve her a bit.

Now we didn't cure her. I don't think there will be a happy ending here, all we did was make her a bit more comfortable for a while. I hope we made a difference to her and her family for a while. To be honest I can't ask for any more  

Sometimes this job is like peeing yourself in black trousers.

It gives you a nice warm feeling and nobody notices.

We were called to a doctors surgery to a 3 year old boy. He had had diarrhoea and vomiting for three days. Today he had fainted in front of his mum. She was worried and had taken him to the doctor.

The doctor was stumped and called us. We arrived to find the boy not really with it and sleepy. The doctor had booked him into hospital to find out what was wrong.

On the journey in I had given the boy some Oxygen and was talking to his mum about what had happened and also doing some observations to see if I could find out what was wrong with him.

She explained that he hadn't really eaten much recently and had had, what my sister would call, a runny bum.

Looking through the letter that the doctor had sent he hadn't actually taken any observations; or if he had he hadn't written them down.

I took mine.

Pulse: a little slow

GCS: Low

Blood sugar: 2.7

That'll be the reason then.
 
Blood sugar needs to be above 4.00 otherwise you can become extremely ill if its not corrected.
 
We carry satchets of pure glucose gel which we use to get people out of episodes of low blood sugar. They taste absolutely revolting but they do work.

I put one in his mouth and he virtually sucked it empty. That's the first time I've ever seen that. Normally we have a real job getting people to eat it.

Then he sat up and held his arms out for his mum.

I allowed myself a moment of smugness   

Boys playing football.

They are playing on a slope near some houses. One takes a big kick and the football heads downhill towards the road.

Another boy runs after the ball. Passing a low brick wall surrounding someones front garden he trips. On top of the wall is ornemental iron work with spiky bits. The boy finds that he is lieing across the wall and he can't move his right leg.

I think you can see where this is going.

The cast of characters is as follows: Me and my crewmate, another paramedic on a responder car, the patient, fifteen firemen in two fire engines with a watch commander, the patients family and various spectators and bystanders.

Most of the others were already there when we arrived. The responder was trying to get intravenous access so we could give him some pain relief. The firemen were gathered round the leg end of the patient pondering how to free him. His friends were holding him as horizontal as they could.

My crewmate went up to give the responder a hand. As they are both paramedics it made sence for them both to try and get a cannula into a vein

I went to the leg end to see what we were dealing with. If you can imagine a spade shaped piece of metal on top of this wall. This had gone through his leg and out the other side. There were many of these and they were screwed to the top of  the wall in a line. Fortunately it had missed the bone and all major blood vessels. We didn't know this at the time however. 

As there was a surplus of firemen a few were dispatched onto patient holding duties. I was busy with my scissors trying to get a good look at the wound.

The other two had managed to give him some pain relief and were giving thought to how to move him. The firemen had came up with two cutting options. One, a mechanical saw, I rejected as it would have vibrated two much. They set to with a hacksaw.

They did very well actually. The metalwork was cut through quite easily and the patient was manhandled onto the stretcher. We left the metalwork in the wound because it was best to remove it in a safe, sterile environment and not in somebodies front garden in the dark.

He's going to have a cracking scar but should be fine otherwise. 

Moodwise I'm back to normal. I slept well last night and it does make a difference. Unfortunately I think I'm one of those people that the depression isn't going to go away completely.    

 "Male running amock. Hitting people and cars with baseball bat. ? Injuries"

 We looked at each other. "Bloody hell" I think I said

 Off we went. In the town where I work there are two bridges that go across the river. This was taking place on one of them. Although we got the address as the other one.

 Still. I knew where it was and we went to the right one.

 Chaos. The bridges are the only route south to north and this bridge was well and truly blocked. The police were everywhere and more were arriving by the minute

We looked for a copper who might know what was going on and found one. Apparently this was all the result of a road rage incident. Two cars had been involved in a bit of a tussel and things had got violent.

One car had an elderly chap and his wife coming back from shopping. The other had 3 yobs from the local estate. Luckily the older man knew how to handle himself and although he had been the recipient of a few lumps one of the younger ones had had his hand broken and the other two had run off. The police were hunting them down.

We took the old chap to hospital with his wife who was very upset. The man with a broken hand was detained by the constabulary.

So in the end not much to excite us but I think the police enjoyed themselves.

I still feel a bit down but I'm pretty sure its down to tiredness. It should sort itself out when I get a day off.   

I think I am now free to talk about the job the other night.

We were called to a garage very close to the Hospital (its the same garage that the guy died at yesterday). An assault had taken place. A responder car was was already on scene.

As I've said many times this job sometimes involves a lot of detective work. Sometimes the detective work, erm works and sometimes it doesn't.

I'll describe the scene as we pulled in. The responder car was parked on the left, two police cars were parked on the right and between them was the patient lieing on the ground with his trousers at half mast. Our collegue was with him. The policemen were inside the garage taking statements.

The situation was this: The man was deeply unconcious. Not responding to any stimulous  that we could devise. Why? We had no idea. Because we had no idea what had happened we needed to immobilise his spine with a collar and spinal board. Doing this we noticed something strange. He was rigid. His legs were stiff and his arms were clamped to his side. His teeth were clamped shut.This done we got him onto the ambulance where we could examine him in light and privacy.

In situations like this we tend to move fast, clothing does not get in the way for very long. I cut his jacket off and noticed that he had three layers of clothing underneath. This might mean he was a person of no fixed abode.

My crewmate was putting a needle in his arm and our colleague was wireing him up to an ECG monitor. He was smelling quite strongly of drink but wasn't acting drunk. His pupils were enourmous. 

A policeman appeared and told us what the witnesses said happened. 

Apparently he had had a good kicking from his companions. One of whome had pulled his trousers down and stuck a finger up his bottom.

There are times when somebody says something and the only answer you can come up with is "What?"

Words fail me at this point. I don't know what was going on. I don't know why they did that and I expect I never will. To be honest I'm not sure I want to.

He had no I.D. so we don't know his name. We got him to Hospital and they did tests and did various scans but none of them found anything wrong.

The job was just odd. It was odd and a little disturbing.

I don't know the end to the story because we don't know his name so we can't get at his hospital records. My overriding impression that I came away with was "Life is very strange"  

The black dog is with me tonight. About half way through the shift I felt it settle on me like a damp, grey cloud. Never mind, I hope its just because I'm tired and hungry. We'll see in the morning.

Totally different from yesterday. We started with a young girl who was in a bit of a state. She had a psychiactric history and was a cutter. Today she had some sort of domestic with her partner and had cut herself. Unfortuenately she had gone a bit deeper than she intended and had opened up quite a nasty wound on her arm. She was very drunk and was feeling sorry for herself. We dressed the wound and took her in. What her story was I don't know. She told me bits on the journey in but while I lent a sympathetic ear the story didn't make a lot of sense. There is a councillor at the hospital who would help her I hope.

The rest of the night, for us, consisted of old ladies with chest pains including one who, we think, had probably had a heart attack a couple of days ago but hadn't noticed and now was feeling under the weather.

Elsewhere death stalked the land.

At least 3 cardiac arrests. One of which was at a local petrol station which I am begining to think is cursed. This was the 4th serious illness there in the last week. What is going on there?

Short post tonight as I am tired

The night started quietly enough. We went to see a woman with very severe depression. She had taken an overdose and was reluctant to go to Hospital. With a little persuasion we managed to get her there.

Then it started. It was almost as if the town woke up and decided to get angry with itself. Fights everywhere. In fact, jokingly I said to my crewmate "Blood's going to flow on the streets tonight. I can feel it". Its a quote from the film "Bringing out the Dead". Very good, I highly recommend it.

Two of note for us. First one was to a suburb up on a hill. "Male Assaulted. Unconscious". Now the information we get is a guide and as it is filtered from bystanders is frequently not that accurate but is useful as a guide.

When we arrived the scene was taped off with blue police tape. This makes you think "Ooh." The man was lying in the middle and was indeed unconscious, a large pool of blood was by his head. This makes you think "Ooh" as well.

We gave him a quick check over on the ground. He had had a good kicking and a nice shoe print was developing on his cheek. All the blood seemed to be coming from his nose. He was well and truly out of it though. We put him on oxygen and because we didn't know exactly what had happened it was nessesary to for us to treat the assault as "Worst case scenario". So we put him on a spinal board and immobilised his neck with a collar. He was still completely unconscious.

Now, there were two possibilities here. One, he had a major head injury or two, he was very, very drunk. There was no real way for us to tell which, so we went with the head injury.

We rushed him into hospital to a waiting team who would assess him.
 
We went back an hour later and they were still trying to assess him but he was too drunk. What the end result was I don't know.

By this time the department was filling up nicely, loads of assault cases. I think that there were almost as many police there as there was in town. I exagerate but that conjours up a picture I think.

Then we got called to a bar in town. to a young man found collapsed in the toilets. Now this could have been anything. But sure enough he had been assaulted as well.

We were met at the door by a man, presumably a security guard, who started with; "We've got an IC1 male...." I think some people get over excited and think theyre in The Bill or something. I have no idea what an IC1 means but I let him carry on.

We got upstairs and the young man was on the toilet floor unresponsive with a black eye and a cut on his head. The cut appeared to be mostly eyebrow and the man was easily rowsable. Again he was very drunk but the same rules applied. We had to take him into hospital. I don't think for a moment he was seriously injured but we couldn't take the chance.

A busy night for everybody, including us. Every time we ended up at casualty there was somebody else mopping out the back of their ambulance.

If somebody could develop a computer program that would predict what jobs we would get and where they would make a fortune. Well, they probably wouldn't because the NHS couldn't pay for it but its the very randomness that that keeps us coming back. You really don't know what tommorow will bring.        

I was going to tell you a very odd story about what happened last night but thinking about it the law might well be involved so I'm going to keep shtum till I know whats going on.

Sorry

He was back last night. The guy on the white horse had popped by for a visit.

Its never quite that simple though.

7.30 we got the call. 60 year old male. Cardiac arrest. Off we went. We arrived and were met by the mans son.

"He's dead", he said.

We went into the mans flat which was a tip to be honest. The man himself was up against the wall. It looked like he had had a heart attack and dropped dead on the spot.

He had been dead for a while. His colour was grey, verging to black and his stomach was huge.

Then the smell hit us.

It was the sort of smell that stuck to your clothes and crawled up your nose when you weren't looking.

He was very dead. Now that the urgency had gone from the situation we had time to properly take in the surroundings. It was fairly typical of many flats and houses I have been into over the years. This man was an alchoholic.

His son seemed very matter-of-fact about the whole thing as I explained the procedures that we had to follow. The fact that the police needed to be called as the mans death was unexpected. This done we waited.

More relatives arrived.

And waited.

And waited.

We called control to find out where the police were. A bit later control called us to find out where the police were.

And we waited

And waited

Eventually three hours later the police finally arrived. It was Saturday night and I imagine they were very busy but keeping a bereved family waiting for that length of time is not acceptable.

No drunks at all tonight. maybe its the weather.

A  job today was a virtual copy of one yesterday.

We arrived at the address and were met by the patients daughter. She didn't say a word to either of us, just pointing us to the front room.

The lady in question was sitting on the floor talking quite animatedly to someone else in the room. She wanted them to get off the furniture. There was noone else there.

Apparently she had been there since lunch time (this was about 2am). I introduced myself and asked if she would like a hand getting off the floor. This prompted a torrent of abuse which summarised was basically her saying that she was quite happy on the floor.

Time to turn to the daughter. I tried to get some basic information out of her. She replied in single word answers. This was starting to annoy me but I quickly realised that it was basically because the daughter was at the end of her tether caring for her mother.

The old lady didn't want to go though.

 She wasn't coping at home and her daughter wasn't coping looking after her. She needed to be in hospital. Now strictly speaking casualty wasn't the best place for her but its the only place apart from cardiac care that we can take her. As it was (very) early Saturday morning there wouldn't be a GP within easy reach so casualty was it.

But she didn't want to go.
 
As the imaginary visitors had gone I tried bargaining with her. I got her to agree to just visit and be seen by the doctors and then she could come home again.

I lied.

We got her onto the ambulance. She screamed at the top of her voice everytime the stretcher hit a bump. A lot of old people, when they become confused, get very "grabby". I think its a fear reflex. They try and hold on to anything thats in reach. The stretcher, walls, people, anything. She was one of these

So what was wrong with her? I don't know. I think it may well have been a urinary tract infection but she wasn't showing any of the "Classic" signs.

The important thing was that she needed to be somewhere else other than at home. She needed to be away from her daughter so both of them could have a rest. 

The snow had all gone by the time I got into work. Shame really

It was still really cold though and this had the effect of cutting our workload down considerably.

No drunks. Which was a nice change. Only one assault. I don't know the circumstances behind it but the result was one guy had a bit of a pasting. He wasn't badly injured but he had a cut just above his eyebrow. Just right for glueing.

We have recently been able to use, what is in effect, superglue on wounds. It works a treat. A few little drops and the wound is closed. Its tidier than stitches and is easier for us to do. It also means that sometimes we can leave people at home who we used to have to take to hospital.

We also got called to an old chap who had fallen out of bed. Normally, if he hadn't injured himself, we would have left him at home.

But in this instance there was a bit more to it. He hadn't injured himself and we got him off the floor quite easily. I must admit I was verging on leaving him at home but then we started getting more information from his wife and him. 

His wife was virtually at the end of her tether looking after him as he had been going downhill with a chest infection for the last few weeks. She actually broke down in tears as she explained this to us.

In the end we took him to hospital. He didn't want to go and I didn't really want to take him but in the end I think it was best for the health of both of them that he went to hospital.

Quite sad really.    

In the crewroom, on the ceiling there is a device cunningly designed to look like a smoke detector.

But I think its something a lot more sinister. I think its a moral sensor.

The evidence is overwhelming. Everytime that the kettle is switched on, everytime laughter is heard, everytime someone says "I like this film" or similer, a red light flashes in the control room and they are forced to send us out.

Nobody else belives me

Nights tommorow. With added snow

I would say that about a quarter to a half of our time at work is taken up by waiting for somebody or something to happen.

This was brought home the other day. We were trundling off to pick up someone who a GP had admitted when we were stopped by control and told to go and liase with the Police. Somebody was threatening to jump off a (quite) high building.

We arrived and went to have a chat with the WPC on scene. As the building concerned was in the middle of town quite a large crowd was gathering to watch the fun.

The man on the roof was shouting and waving and was showing no signs of wanting to jump. The police were taking no chances however and a couple of them were on a quest for a way up to the roof.

We settled down to await developments.

Ambulance people are a strange breed. Waiting for this brings out many mixed emotions in us. Annoyance at somebody being an idiot, trepidation at what happens if he jumps and exitement hoping he does jump.

The thing is injury is why we are there and deep down part of us looks forward to it.

While we were waiting for a splat or not somebody decided to faint on a passing bus. Lots of worried people ran over to us. We sorted her out, it was just a bad case of the flu.

He didn't jump. The police grabbed him. The WPC asked us if we wanted to take him to Hospital. We didn't. They took him....somewhere and we carried on with our day

I've been told by Ceebee that I have been to a dead person this year and she is absolutely right. We were backing her up as with cardiac arrests many hands make light work. But I can't really count it as one of my patients as she got there first. 

 Well. Breakages today.

 Early morning we went out to a small town a way to the east of where we normally work. The traffic, as is normal for that time of the morning, was horrendous.

 And as we drove along I thought about a conversation I had had a few days ago. When driving on emergency, I was told, we tend not to see the other vehicles. All we focus on are the spaces in between. I'd never thought about it before but its absolutely true. As I drove I just put this enourmous yellow van in the spaces I could see and ignored the rest of the world.

 The problem was that the world hadn't really woken up. People were getting in my way a lot. It made me angry.

Anyway we arrived without incident at the railway station. As we hadnt been told which platform I naturally chose the wrong one.

Guards came running.

My crewmate took the bits he needed and walked across the railway (by the bridge). I drove round. I arrived to find him tending to a 30 yr old woman who whilst running for the train had tripped up the stairs. Her ankle had a right angle in it.This is not a good look.

The ankle bone was pressing hard up against the inside of her skin. If it had been left the blood supply would have died in that bit of her skin and necrosis would have set in.

We had to pull her ankle straight and splint it. On the stairs of a railway station. In the cold. At rush hour. with lots of people rushing by. Oh yes and she was pregnant. It focuses the mind wonderfully

Station manager at the head end, husband holding her hand, me pulling and my crewmate splinting. We did it withe the assistance of lots of entonox.

Got her to hospital.
 
Then to a woman who had done the exact same thing. Same leg and everything. Hoovering had caused this one though. She tripped over the cord.

So I've decided that because of the number of jobs we go to caused by sport and housework (including a man who slipped backwards onto a toilet brush. But thats a whole other story) I am not going to do any sport or housework ever again

I expect to live to be 100