Opportunities
I’m about (but not straight away) to say something that probably makes me appear very selfish…
As a rule, I have in the past tended to be quite self-effacing (check definition) when it comes to being given opportunities. To be more specific, if there are not enough places to get to an event, I tend to be the sort of person who will offer up his place to another. I like to do things that help other people out, even if it inconveniences or harms me. On a number of occasions, this attitude has least that I have missed out on things that I particularly wanted to do, but there weren’t enough places.
We have a major duty coming up, the first of the season. As always, I said that I would prefer to cycle, but would do anything. Others have been less open-minded ( almost demanding that they be allowed to do whatever…)
As is probably to be expected from an organisation like this, we’re short-staffed. This means that people ( myself included) have been given roles that are less than ideal. Admittedly, I’m on a vehicle, which isn’t terrible, but I probably wont get anything, as is normal when I crew an ambulance… Nevertheless, I’m pretty nonplussed. I’ll do whatever is needed. I figure that at some point this might earn me brownie points, and besides, in my opinion it is the right thing to do…
Now it is possible that, at the last-minute, I’ll get reassigned to a bike. Its happened before, and rumor has it that it has been considered. Naturally, this hasn’t gone down well with some of the others. One person has even gone so far as to encourage me not to take my cycle uniform, so someone else can do it instead ( read: him).
Now I’m sorry. I appreciate that people are disappointed with their roles on the day. However, if I am given the opportunity to cycle, I’m jumping at it… I don’t often get to ride a bike, and I am usually very willing to go wherever I am needed. I see no reason to go against this, just because I’ve been offered a better position and someone else hasn’t.
Of cause, I’m far too tactful (read: timid) to actually challenge that other member on this. I just let it lie, and of cause this probably means he’s assumed I’ve agreed with him. It could be interesting if the situation actually comes up (though I doubt it).
Don’t Make Me Angry
It’s a schools rugby game. Not a small one either, the final in the local schools league, which means everyone is taking it that much more seriously.
We’re over by the side, well out-of-the-way, but close enough that we can see and hear what’s happening on the pitch. The windows are all rolled down, and we’re just lounging in the cab of the ambulance, enjoying the sun and chatting about everything and anything. In short, it’s shaping up as another Q word duty.
A loud yell. A thud, two bodies against the floor, and a groan from the crowd. Silence. Must have been a nasty tackle. We watch, waiting for the players to get up. One does. He’s a little scraped up, but nothing that’ll stop him playing. He looks down at his dazed competitor, offering a hand. And freezing, his face dropping. The crowd goes silent again, and then, through the breeze, “Medic!”
I slip through into the back of the truck while my crewmate jogs out to the pitch. Grabbing the gases and the response bag, I scoot out of the back of the vehicle and walk over. I’ve got all the kit, but there’s no need to rush. My crewmate is in charge of this one, and he doesn’t look that flustered. He certainly has yelled anything at me yet.
I can see from two meters off that our rugby player is in pain. A lot of pain. From a meter off I can see why. His shoulder is most definitely out-of-place. I look to my crewmate as I drop the kit down. ”What do you need?”
“We’re not going to get anything done here. I think shuffle to the back of the vehicle and check things out in the peace and quiet.”
“Spinal?”
We both look at him craning around, looking at everything that is going on and the crowd forming around him.
“Probably not.” We say together, and grin awkwardly. We’ve been working together a while now, we know each other too well.
“Right, so entonox, scoop, cot? Nah, scratch that, we can scoop him straight into the back, will be better on his shoulder.” I eye up the terrain, nothing particularly challenging. ”So straps, anything else?”
“Sounds good. Though, perhaps some crowd control?” The last bit is quiet, for my ears only.
I look around at what looks like both entire teams craning to see what is going on. “I’ll see what I can do.” I stand up and start in a reasonable tone: “Alright guys, let’s have some space to work please.” A couple of people shuffle back, but it appears that a dislocation is just too interesting to leave. ”Seriously guys, you aren’t helping. Give us some room.”
Slowly everyone backs off, far enough at least to let me get out and bring the kit back.
Someone who looks distinctly like a coach steps in front of me, deliberately blocking my path. ”What’s going on?”
I ignore the obvious answer of we’re treating someone, going instead for “I’m just getting some equipment, then we’ll get our friend back there moved into our vehicle.”
“How long’s this going to take?”
“As long as it takes. We need to be sure we don’t do any more damage.”
“Can’t you just put it back in and walk him off? We have a game to finish here.”
“Only if you fancy explaining to his parents why he will never use his arm again. Besides, you have three other pitches you can use, if you’re in a hurry.” I know that I’m skating the edge of being rude, but you’re annoying me and I have a patient to look after. He looks grumpy. ”Look, the sooner you let me get this kit, the sooner we’ll be out of your way.” I don’t think that’s an appreciated comment, but at least he does move.
A brisk walk to the ambulance, a brief argument with the scoop stretcher, and then I’m on my way back with magic pain killing gas in one hand and jack of all trades lifting equipment in the other. And yet again I’m facing a crowd, and this time I’ve got minimal patience left. ”GUYS!” A single syllable projected across the entire field. Even I’m a little stunned by the silence that rolls back. ”Move OUT of my way. Give us room so that we can do our job.” Youth Leader training kicks in. Act assuming compliance. I step forward purposefully and the crowd spreads out, dispersing before my eyes. Recognise good behaviour. ”Thank you guys.”
My crewmate looks at me, eyes wide and jaw lowered.
“Close your mouth, you’ll catch something.” The residual annoyance makes it a little more of a snap than I intended, but I soften it with a grin.
Our patient manages a strained laugh through the pain as my crewmates’ mouth snaps shut with a click. He takes the entonox from me, apparently grateful for something to do to cover the confusion, and I start explaining the lift and shift process to our patient. Once his pain has gone away a little (and he’s high enough not to care about what’s left), we scoop and scoot, and the rest of the job is a fairly routine transport.
As we’re packing up at the hospital, my crewmate looks at me over the cot we’re re-making. ”Are you okay? You sounded pretty annoyed back there with the crowd.”
I shrug. ”That was just lack of patience. You’ll know when I’m angry.” He looks at me questioningly, and I just smile.
Ambulance Frustration
You’ve broken your arm, and you have my sympathy. You were in quite a bit of pain, but the paramedic gave you a lot of nice drugs and you’re not feeling too shabby now. You now need a trip to the local children’s hospital, not a short journey.
Because the paramedic has given you some drugs, the paramedic needs to come along. Fair enough, one of the side effects of morphine is respiratory arrest, and so we need to have something like naloxone available just in case. This isn’t a drug I can give, so the paramedic is needed. Not a problem, we can take two in the back along with a patient.
Except, because you’re under 16, your mother also really needs to come along. Again, this wouldn’t be a particular issue, if it was just you, and about a year ago it wouldn’t have been an issue even with the paramedic along (at least, not officially).
Unfortunately, someone cocked up the weighing of the vehicle, and we’re not really sure if the weight limit can take three people plus a patient in the back. Counting a crew of two (driver and attendant), a patient, a parent and a paramedic, we’re over our limit, and only one person on the crew is expendable: the attendant. Me.
Off my truck goes, and I’m left stood in the primary treatment centre, and I’m in a bit of a fix. I can’t commit myself to a patient in the treatment centre, because I don’t know when my truck will be back and I’ll need to be available for that straight away. I can’t transfer to another vehicle, this will leave someone else without a ride. This leaves me unable to treat, unable to transport, and unable to really do anything.
My crew-mate eventually gets back, but it’s someone else’s turn to get a patient, and nothing else needs transporting. We get a 999 call, which I could respond to, but it gets given to another crew (who’ve already dealt with and transported a patient) and they ignore us when my crew-mate and I ask them to swap.
Now I know this was just bad luck. There wasn’t anything done that was unreasonable (though that last crew did annoy me), but that didn’t leave me any less frustrated. I hadn’t seen a patient all weekend, and still haven’t seen any patient on an ambulance that has needed me to use my advanced skills, and given my continuing track record it’s going to be a long time before I do. Combined with not being able to do NHS shifts any more, this leaves me wondering whether qualifying was actually worth the stress.
Of cause, this was then compounded by everyone else asking if I enjoyed my transport, and then overly lamenting when I tell them that I didn’t actually get to go on it. Oh, and a Control officer going ‘had we known (which they did), we could have sorted something for you’, which irritated me, a lot. Not to mention my friend going on and on and on about the people he’d treated that day, and not getting the hint that I had had a shit day and didn’t want to talk about it.
Still, I’ll probably be crewing during major duty season next year, so I might get something.
Or I might just get sat somewhere, bored out of my skull with an irritating crew mate. Listening to everyone else being kept busy, and wishing I was out on a bike, getting to do something…
Hitting the Speed Bumps
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…
Related articles
- Ambulance Excitement (walkingplasterdispenser.wordpress.com)
Ambulance Excitement
Okay, I’m really rather excited again.
First things first, it looks like I’ve passed the last bit of my ambulance crew training. This means I’m now fully qualified to crew an ambulance (eep!) and transport an emergency patient (ahh!). I have a year’s probation to complete, but that only limits who I can crew with (which doesn’t change anything, because I can’t drive). Given the number of sleepless nights the course caused me, as well as how long I spent training, this is really good news. It might mean I can’t cycle as much as I’d like to (which is sad
) but it will definitely open up a few new opportunities of events I can get to.
Second, I have just heard when I am getting my first duty on an ambulance: at the end of the week… I qualified on Sunday… In the upcoming three-day event, I am on an ambulance for two days (during which I’m almost certain to get something…) and am in charge of people on the remaining one. This is even more scary. I have never had actual responsibility at a major event. Well nothing more than “Keep an ear on the radio, I’m just going to the loo.” Being in charge of about one-third of the foot patrols present is not something I’d expected to do, not least because I’d expected to spend most of the days as a foot patrol myself, or in a treatment centre at best.
So yes, life is getting interesting in the Organisation at the moment.
Oh, and try not to get injured if you’re attending a three-day event this weekend. It might just be me taking you to A&E.
…
Well, try not to get injured anyway…
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…
Related articles
- 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)
Sirens
Just finished watching Sirens. In one word: brilliant.
I don’t normally watch comedies, they’re not really my thing. However, in this case, I’ll make an exception. I really loved Tom Reynold’s books (Blood, Sweat and Tea, and More Blood, More Sweat and Another Cup of Tea), and the his inspiration in the program is clear. And let’s be honest, I’m an ambulance geek, and likely always will be.
I can sympathise, a little, with the episode as well. Not the ‘up, horny, down’ bit so much, but definitely the adrenaline. When the hormones are thudding in your brain, it is a struggle to think straight, let alone try to remember precisely what it was I was supposed to be doing with this combination of signs and symptoms.
And, afterwards, when your system clears, and your hands shake, and you wonder whether what you did was the right thing. Perhaps I skip straight to the down…
Either way: I’ll be making a point of catching Sirens again next week. And if you missed it, it’s on 4oD:
http://www.channel4.com/programmes/sirens/4od#3200763
Watch out though, the language is strong and ‘adult themes’ is not wrong.
I Passed
I forgot to mention a few months back. I passed my Patient Transport assessments. It was a very weird feeling being on the other side of the deal, treating instead of being treated. I can certainly sympathise with all the people who make the silly mistakes. Nothing is half as obvious when it’s you who is being scrutinised…
My treatments were all fine, as was my dealing with the patient. We had to have two goes at the resus because my partner froze. The second time around I was told to step back, to allow her to demonstrate the competence we all knew she had. I ended up being held outside the assessment room an annoying amount of time ’getting equipment’, and then spending ages calling for an ambulance.
I understand the reasons, but having to stand outside while I can hear my partner struggling to get going had me climbing up the walls with the AED I had been sent to get. Oh, and doing that in the same room, watching my partner struggle with nerves, and spotting all the little mistakes that I could have solved without a problem, grated. I have never been so keen to do CPR in my life… Fortunately, second time was lucky.
My partner and I, two very slight people, were nearly referred on our lifting, but we got it right on the second go and it was put down to lack of confidence and over-caution.
Needless to say, I’m rather pleased. The second part of the course, the Emergency Transport section, is hopefully going to be mid next year, and I can’t wait.
Now all I have to do is work on my lifting, revise my First Aid Manual, learn my Ambulance Manual. Oh, and pass my Uni exams, get through this years group project work (which I already think is going to be a nightmare), and survive my new job. Could be an interesting year…
Unresponsive
You’ve volunteered to look after freshers this week, and had a good night out with the house you’ve been allocated. In fact, it was such a good night that they didn’t notice that you didn’t come back from the toilets, and went home without you.
I get called to you twenty minutes after the event closes, while we’re packing up. ‘Patient, unresponsive in toilets.’ Perfect. Grabbing a kit from where it had been put away, I walk swiftly out to find you. I have a bit of confusion when I notice that the route to the toilets is far from obvious, but get to you eventually.
You’re sat on the toilet, your boxers around your ankles, body lying on your knees. When I open the toilet door, which opens towards you, it presses against your head, stopping me getting in. It also stops me lifting your head up to properly assess you.
I bend down to speak in your ear, a far from pleasant prospect considering that this is a chemical toilet block, the floor is covered with vomit, and I don’t think you’ve showered in the last couple of days. Yelling loud enough to make security jump, I try and coax a response out of you. Nothing. Hitting you firmly on the shoulders, in fact very nearly slapping you, I try to reach out to a more basic level of your consciousness. Nope, you are indeed completely unresponsive.
You’re a big lad, and try as I might, I can’t get you sat up, not with the door in the way. With you like this, I can’t open your airway, and I can’t check that you’re breathing. This is a problem. I can’t even slip around the door so that I am in the cubicle with you. I’m just grateful that the door isn’t locked.
I have only one choice. Turning to the biggest member of security I can see, I ask him to break the door down. Indicating which way I need it to come, I stand back, and he takes great pleasure in forcing the door the wrong way. Outside I can see campus security eyeing up the door. They’ll be getting your name, assuming you are sensible enough to give it, and I hope you get sent the bill.
The crash of the door seems enough to wake you up, though you aren’t impressed. Twice you try to swat me away, but you’re moving so slow I can easily dodge. Besides, you don’t seem to be seeing straight, and only stay upright while I hold you. You are definitely in no fit state to go home tonight, and I’m not happy loading you on to the vomit comet for the easy ride to A&E (the vomit comet is an SU run minibus that takes all our minor injuries to hospital, saving on ambulances).
Up comes the local ambulance service, the crew not impressed that they’re having to pick up a drunk. I don’t blame them. I have no sympathy for you either, but we all know that it’s the safest thing to do. The last thing we need is for you to roll over in your sleep, vomit, and then drown in your own stomach contents. Once we’ve got the basic details out of you, we leave you in the care of the ambulance.
You’ll probably get put on fluids, rehydrated, and have no hangover the next day. You may even go for a repeat tomorrow. However, tonight at least you and your liver are safe from further harm. Perhaps you’ll learn. Can’t say I’m too hopeful…
A Bit of Excitement
(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…


