Hitting the Speed Bumps

Image via Wikipedia

As an organisation (or, at least, in my part of the organisation), we are very keen at helping out the local ambulance service. By this I mean we will send out crews on ambulances (and occasionally on bikes) to help the service respond to 999 calls. Understandably, this could only be done by experienced members, and one of the criteria for the ambulance work was a certain number of hours third crewing on those shifts. This means working with two experienced members to build up some experience dealing with patients potentially more serious than anything I’ve ever dealt with before, which I’m strongly in favour of.  I don’t think I’d be happy going out on a shift without doing this first.

Unfortunately, since I qualified, it is no longer possible to third crew on any of our vehicles. Something to do with weight limits on the vehicles (which, given many of them are  transit vans modified into ambulances, not necessarily their original design role). This is very frustrating for me, as it means I can’t gain the experience needed to do NHS support.

To make matters worse, there are very few of us in this position (probably about 3 or 4), and so nobody at county level cares enough to do something about it. As far as they’re concerned, there are enough people to cover the shifts, and so there isn’t a problem.  This leaves me, and those few others, in a catch-22 situation: without having the needed experience, we aren’t able to gain the experience.

Needless to say, this is very frustrating.

A little while back, there was a possible solution. Our CRU lead sent us an email looking for interest in doing NHS cover on the bikes over Christmas. The roads get very busy in BigCity when everyone is doing their Christmas shopping, and the bikes can get around a lot easier than road ambulances. A load of us (apparently) applied, and it looked like it would go ahead. I even delayed heading home for Christmas around this.  A couple of us entertained the thought that this might count towards us getting some experience towards the ambulance work.

Of cause, it never happened. And we only found that out for certain a couple of days before the period was due to end. The reasons given was lack of  interest (yeah right), other duty commitments (*looks at depressingly empty duties book*) and lack of funding (*sigh*). Some of the more cynical amongst us suspect our useless County CRU lead is also to blame, but ho-hum.

All I’ve got to hope, in the nicest possible way to my patients, is that I get something interesting to do on the normal shift. Which, given my track record on a vehicle (nine or ten shifts, one patient transported for a minor injury) seems rather unlikely.  The only time I might have had an interesting job, someone kicked me off my truck (story to follow).

I think, as far as possible, I’ll try to stick with the bikes. At least on them I get something to do (and some useful exercise), giving me some experience treating, even if it’s not transporting someone…

My friend and I are already planning what out of county events we want to do.  Hopefully we’ll have a good yeah helping out our colleagues in the big city. At least there they know how well a bike unit can work…

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Cycle Response Run

We’re standing by outside the recruitment post.  Our bikes are attracting a lot of attention: a push bike with Ambulance blazoned across it is an unusual sight.

“992, 992 from Control.”

I turn away from the kids I’ve been explaining the bikes to.  ”Go ahead Control.”

“Respond under emergency conditions to romeo-one-five.  Collapsed child.”

I peer at my map, matching up R15 to where I currently am.  Bloody hell, we’re the other side the city.  I turn to see my partner already mounting up.  To the kids: “Sorry guys, got to go.”  I jump on to my bike, kick the stand away, and push off.

My partner pulls off ahead, and I slip in behind him.  I was good, and left my bike in a low gear when I pulled up.  We accelerate away, shifting up the gears until we’re racing along the road at a respectable rate.

It’s dusk, the perfect time for visibility.  What’s left of the sunlight makes our fluorescent jackets glow, while it’s dark enough for the reflective strips shine in every light.  Nobody should fail to see us as we race past.

We’re in luck.  Most of the route is a closed road. We have the tarmac to ourselves.  We make good time, getting half way to the far side of the event to the other before we know it.

We’re getting to the busy part now.  Slowing down a little, we weave between clumps of people, earning a few glares as we take a turn faster than perhaps people would like.  We shift down, cutting out speed to safely navigate around the dawdling obstacles.

The crowd thickens.  The spaces between the groups narrow.  We start to lose speed, stuck behind people wandering along, not expecting two cyclists to try to barge their way through.

On goes my siren.  They sound a bit weird, too high-pitched, but they certainly grab people’s attention.  People turn and stare.  A path opens up in the crowd, and we regain a little of our lost momentum.

One group turn and stare.  We approach, weaving left and right, trying to find a way past.  My siren is still going full blast, and it’s joined by my partner’s electronic buzzer.  The harsh sound cuts across the sounds of the crowd, making people wince, but still they stand, staring at us like rabbits in our headlights.

We’ve slowed to a crawl, nowhere to go.  Frantically we wave at them. “Make a path!”

Comprehension dawns.  They dawdle out of our way, and we pull off again.  Finally, a clear path opens, the crowd finally getting the hint that the loud, horrible noise means ‘we’re in a hurry, get out of the way’, not ‘everyone stop and stare’.

We career around the last few corners, the road finally clear again. We almost reach a sprint as we close in on our destination. I’ve been listening in to the radio as much as I can, in the hope that we get stood down, or someone got their first. No such luck.

We skid to a halt at the mouth of the road, screeching disc brakes announcing our presence better than any siren. The road is short.  If anyone was collapsed there, we’d be able to see them.

My partner circles up and down the road, scouting the area, while I hold a slightly breathless conversation on the radio, confirming the location of the call. Control tries to call back the original caller, while we lean up against our bikes, catching our breath.

Eventually they stand us down. Apparently our ‘collapse’ had got back up again when his parent’s didn’t give him all the fuss he wanted.  Of cause, they hadn’t thought to stand us down.

We took the slow route back to the first aid post…

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• Cycle Response (walkingplasterdispenser.wordpress.com)
• Cycle Response Training – Part 2 (walkingplasterdispenser.wordpress.com)
• Cycle Response Training – Part 1 (walkingplasterdispenser.wordpress.com)
• Four new cycle paramedics trained for Great Yarmouth (bbc.co.uk)

A Bit of Excitement

Image by Márcio Cabral de Moura, on Flickr (see Flickr page for license)

(Aside: The prose in this is a bit rough, but I can’t quite work out how to fix it so it’ll have to stay that way…)

I have just spent a weekend doing rugby duties. All the players were under 18, Saturday’s lot about 16, Sunday’s between 9 and 12.

The first day was simple enough. One person who had been booted in the chest and was in some pain. He might have broken a rib, we’re not quite sure, but even if he had there was nothing we could do for him. Even if we sent him to hospital, they wouldn’t do a lot (or so a doctor friend tells me).  He was otherwise fit and well, so we suggested pain killers (which he declined) and then he wondered off.

Sunday was a bit different. This time there was only two of us (instead of four adults, a youth member and an ambulance).  We started the day by getting lost, and heading completely the wrong way. We confused one driver by going around a mini-roundabout multiple times until we got our bearings.  Fortunately we still arrived in good time, and settled down on a cold, windy pitch to try to keep an eye on four or five games at once.

The first load of patients were simple enough, standard rugby injuries (bruised hands, heads and the like), though we did get three one after another, keeping us busy for a while.

Then it went dead, we had a very nice burger for lunch, and sat back down outside in what was improving weather.  Quietly, knocking on wood the entire time, we thought we’d had our rush and would coast until the end with the odd cut.

Then a boy walked up, saying that his neck hurt and he couldn’t really straighten it.  When we took a look at the back of his neck, the pain was mostly near the middle. Possibly muscular, but definitely too near the bone for my liking.  I asked my colleague to hold his head (to stop it moving), and I got ready to call an ambulance.

Then another boy turned up with a properly dislocated little finger. I am already on the phone to the ambulance service, so I just mention he’s here, and try to get on with the call.

At this point, someone claiming to be a doctor turned up, and wanted to put the finger back in place. This is against our protocol (we consider that a job for the hospital, in case surgery is needed), and I couldn’t be certain that they were a doctor, so I asked them to wait, as an ambulance is on its way.  Naturally they ignore me, then after demanding tape from my kit, and thoroughly disrupting my conversation with the ambulance call-taker, they demand paracetamol (which I refuse to give them without my own assessment, because I have to write-up that it’s given, and I didn’t think the ‘doctor’ would hang around long enough to fill out my paperwork), and promptly vanished (suspicion proven).

I’ll point out now that I put ‘doctor’ in quotes only because I couldn’t prove they were indeed a doctor, I don’t like taking people’s word for it (particularly when they’re a random bystander. What if they were a doctor of physics or something!), and because of the speed with which they disappeared. Not once did they stop to check on the poor boy whose neck we were trying to hold still (a coach did put her two-pennies-worth in by criticising my colleagues method of holding the head, which was correct, but we ignored her). I thought they had a duty of care!

When I was done with the ambulance call, and my colleague’s arms started seizing, it was my turn to hold the head.  This also freed him up to placate the other boy, and then deal with the two new patients who chose that moment to turn up with thankfully minor injuries.

The ambulance didn’t take too long to arrive (hurrah!), and when I handed over to the ambulance crew, they agreed that we should be careful and grabbed their long board (aka a spinal board).  We now had to put the poor boy through a standing take-down.

For those that haven’t seen or experienced a standing take-down, it is where the long board is placed behind a standing patient, they lean against it, and both are slowly lowered to the vertical. It is a highly unnerving maneuver, requiring quite a bit of trust on the part of the patient, as for the first couple of degrees the patient can feel as if they’re falling with nothing behind them.

My job was to hold his head, and after a bit of shifting to avoid trying to lower him through a tent pole, and to make sure I could keep my hold, we got him to the floor. Now I don’t like this process at all, to the degree that I refuse to have it done to me during training. Needless to say, this brave boy put me completely to shame, taking it in his stride.  After a strategic slide up the board, on my command (I had the head, so I was in charge… eek!) and the judicious application of head blocks and straps, he was safe and secure and ready to go.

During this entire process, my colleague had worked through each of the other patients, clearing each one in turn and leaving nothing left for us to do for the rest of the day (thankfully).

I’ve never done anything like this for real before, and it’s taught me a few things about spinal management, including good places to put hands and how to hold the head during a three-man standing take down. While I wouldn’t wish such an injury on anyone, and hopefully the boy wasn’t seriously injured, I am pleased I was able to get involved, and it was definitely good experience.  It has also maintained my enthusiasm to finish my ambulance training (whenever the second course comes around), when I can learn to do all of this properly for myself.

Now I just have to write this up for my portfolio…

Emergency Calls

It has occurred to me that on several occasions now I have responded to emergency 999 calls and dealt with the situation reasonably comfortably. It has also occurred to me that members of The Organisation routinely respond to such jobs, and handle them successfully until the statutory services arrive (if they’re even sent for).

We are, every one of us, volunteers. We don’t get paid. Very few of us are health-care professionals of any kind. While I have every respect for all the ‘real’ ambulance crews out there, I can’t help but to feel proud of this. Proud of what we as an Organisation are capable of, and what I as an individual have done. We’ve come a long way from summer fates and street parties (not that these aren’t just as important).

I can’t wait until my ambulance training starts, in about a month or so.

Request to Bystanders

A quick request to any bystanders who call 999, 911, or 112 or whatever while they’re out and about:

If you are not with the patient, please tell the call-taker precisely where the patient is.

When I’m off hunting for someone who is having difficulty breathing (more on this patient in another post) on a boat, telling them that the patient is by the bar you happen to be in doesn’t help. Not when there’s a tall fence and a stretch of water between them and me, and I have to double back to get down to them.

It doesn’t sound like much, and fortunately in this case it wasn’t a drastic problem, but getting to a patient half a minute sooner can make all the difference.

Oh, and it would have prevented two teams being dispatched to the same incident, each having a different bar as the patient’s location…

This has been a public service announcement from the Walking Plaster Dispenser.