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Chaos. Complete and Utter Chaos

When I event manage, I like things to go to plan. I have spent ages developing a fairly standard way to run an event that works really nicely for me, and tries to anticipate everything that could happen. And nine times out of ten it works, and everything is nicely relaxed, and it’s all good. And then you get those things you just can’t plan for.

I’m running a student event, the basic night out with loud music and plenty of alcohol. I’ve planned for alcohol intoxication and poisoning, fights, stiletto injuries, even drug overdoses (thankfully rare at this University). I have eight first aiders, so plenty of staff, and so far all we’ve had is the usual run of drunk students who started the night a little too fast. I’ve got two people in the hall, being highly visible in high-viz, two caring for our patients, and four more ready and waiting for the next job.

I get a call from the team in the hall. They’ve been called to a patient in the toilets. I acknowledge, and send a team to cover their spot. Another call comes in from campus security. They’ve had reports of someone whose hurt themselves in the car park. It’s not technically our area, but I want security on side, so dispatch the other team I have with me. I go to peak around the corner at our patients, but draw up short when I hear the distinctive sound of vomiting. They’ll be tied up for a while yet.

The team at the toilets checks in, saying they’ve got to the patient and will advise when they know more. All normal. I try to raise the other team, but they’re not talking to me. Probably out of range, no great stress. They have my mobile number.

The first aid room is still, filled only with the quiet reassurance being poured out by the team with their patients.  I like it when it’s like this.  A gentle busyness that says we’re doing our job properly.

A static filled message fills my ear.  “Control, Control, 412, over.”

“Go ahead, 412”

“Control, we’re on scene at a *fuzz*TC.  We’re *fuzz crackle* a hand, and the *hiss*lice.”

I take a mental double take, looking at my radio in confusion.  “Sorry 412, say again.  Did you say you were at an RTC?”

“*hiss crackle* yes, Control.”

“Do you need an ambulance?”

“No *hiss crackle*nor injuries only, all *crackle*afe.  Need a couple more ha*hiss*s.”

“All received, 921.  Contact the police directly, I’ll warn security, and will send someone your way as soon as I can.”

“*hiss crackle*oger, control.”

I’m still a little confused, but make arrangements for the police to get on campus, and dispatch my team in the hall as backup.  In the back of my mind, I make plans about how I’ll deal with another patient, if they turn up.  In my head I have a wonderful idea of how I’ll pull a team back from the RTC, perhaps send one of my people treating in the room next door to replace them.  Hopefully the toilet call will just be another drunk who can be added to the group to be monitored.

“Priority, priority, control 922.”  My wonderful plans flee my mind.  Bollocks.

“Go ahead 922, you have priority.”

“One patient, male toilets, conscious  breathing, chest…”  The radio cuts off, and I have images of a first aider diving to catch a patient that’s just collapsed.  I’m around the corner to the treatment area in a flash, and grab one of the first aider’s attention.

“922, 922 say again.  Confirm you said chest pains in the male toilets, over.”   My colleague looks at me and I nod and point.  He’s off in a blur, stopping only to grab the O2 and AED bags.  I dive into my pocket for my phone.  “922, 922 from Control, over…  922, 922 from Control. Over.”  Silence.  “Nothing heard, 922.  Backup en-route   Control out.”  I curse under my breath.  This was not the time to lose contact with a team.  I want to phone 921, get them to send a team back to me, but don’t want to risk missing a call from 922.  I curse again.  Of all the things I had considered, the combo of an RTC and a chest pains was not one of them, particularly as I’m now completely out of staff.  Things have now officially gone to pot, and there’s nothing I can do except take a deep breath and roll with it.

“Control, Control, 922.”  This is a new voice, the backup I sent taking charge of the radio.  I grab my mic, other hand poised over the 9 key on my phone.  “Go ahead 922, Control over.”

“Stop. Stop. Stop.  Situation under control.  Returning to your location, over.”

“922, confirm that assistance is not required please, over.”

“That is a yes yes, control.  Mobile to your location.”

“Glad to hear it, 922, I look forward to it.  Control out.”  My sigh of relief is loud enough to get a smile from the last remaining first aider in the treatment area.  She grins at me over the head of a vomiting bloke.  I grin back and then look back at my phone when it buzzes a text.  921 was clear as well, and heading back to the first aid room.  I smile again to myself, everything was going to plan again.

I do like it when things go to plan.


This post was written from a prompt on The Daily PostComfort Zone

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Perspective

Now I’ve been qualified to crew an ambulance for more than a year, I’m able to go out and do shifts for the ambulance service.  I’ve been hoping to do this for quite a while, but equally been a bit nervous, as I haven’t really got that much experience working in the back of an ambulance.

I’ve managed to get on three shifts so far, and to say they are have been eye-openers would be the understatement of the century.  Aside from the tedium of quite a large amount of time waiting for things to do (apparently everyone had q word shifts those days…), I got to see a few things I would have seen as a volunteer at events.

Two particular patients stuck in my mind.  I’ll be honest, I can’t remember their names, or their faces, but their stories, as I saw them, will remain with me for a long time.

One old lady.  She had a stroke a couple of years ago, leaving her paralysed down one side, weak on the other, unable to speak beyond ‘yes’ and ‘no’, and bed bound.  She needed round-the-clock care, had a catheter in-situ and was peg fed.  She was going into hospital because she had developed a wheeze (which was not a good sign, as it could potentially be pneumonia).

She was obviously loved and cared for.  Her daughters (not young themselves) spent a huge amount of time looking after her and making sure she was as healthy as they could manage.

Still, I can’t shake the feeling that this is no real quality of life.  I can’t imagine being stuck in bed for the rest of my life, never to care for myself again, never even to speak properly again.  Stuck in my head with no way of getting out.  It’s certainly not something I’d wish on anyone.

My other patient was a 90-something year old man, the last job of the day.  Living on his own, he had been highly active, right up until the last month or so.  He had been experiencing complete lethargy, loss of appetite  and a whole host of other generalised symptoms, and his doctor decided that he would need to go in to be checked over in the ward.  In the past he had been diagnosed with some cancer or another, and his children feared this was a return of that condition.

Even getting him to the ambulance wore him out, and transferring him to the ward drained him so much he was practically asleep when he hit his bed.

My crew-mate and I made him comfortable, made sure he had everything he needed, handed over to the ward’s nurses, and then walked slowly back to the ambulance.  The depression over us was almost palpable, and at almost the same moment we both said, “He’s not coming out again.”

Normally, I meet people who are generally healthy, and just need a little patching up to move on their way.  Okay, I’ve seen the odd person with a serious medical condition, and the occasionally seriously injured patient, but almost everyone I had dealt with before had very good prognoses.  On these two shifts, I saw what is likely to be the end times of their lives, something I will hopefully never have to see when delivering event cover.  I just hope I was able to make what could have been one of their final journeys as comfortable as possible.

Slightly Surreal

It’s the end of the world, the zombie apocalypse.  BigCity is full of zombies and people trying to get past them to safety.  And what am I doing during at the end of the world as we know it? I’m sat astride my response bike, watching it all happen.

This is 2.8 Hours Later, and the aim of the game is to get from check point to check point without being caught by the zombies.  We’re providing first aid cover, ready and waiting for the inevitable slips, trips, falls, and out right head on collisions.  Needless to say, the event is hilarious to watch, and it appears the players are loving it as well.

We get a patient, one of the zombies.  We ask the typical questions, get a medical history (‘so how long have you been dead?’), all while keeping an eye open for the next batch of players to sprint down the high street.  In the corner of the square, a busker is setting up his guitar and amp, another person going about his business while the world ends around him.

We here the next group running, so we cyclists dodge out of sight, while our zombie friend lurches to hide in a phone box.  The running steps slow and stop, and we can just see the group looking down at their map to work out where to go next.  They wonder down the high street, paying far too much attention to the piece of paper in their hands, and not their surroundings.

A groan, a blur of speed from the zombie, and then screams as the group scatters, desperately keeping out of his reach.  The whole group races past where CycleGuy and I are hiding, barely missing the posts we’re propped up behind, intent only on avoiding the zombie on their collective tails.

And in the background, music drifts over from the corner…

What the Hell!

I was cycle responding at a music festival.  It’s crowded, there are lots of jobs, and my partner and I are responding right left and centre, 999 calls, shouts for backup, the works.

So after a couple of interesting jobs (which I may or may not post about later), we’re sent on to a 999 call to a collapse.  Full emergency conditions, which for us bikes means sirens, whistles (normally get us much more attention than a siren), blue lights if we have them (for all the minimal good they do) and dodging and weaving through people as quickly as we can (without hitting anyone).  We’re making good progress, given the crowd density, and most people are fairly willing to get out of our way.

I’m trying to keep an eye on everything around me, hunting out a route that will let me progress, and so not really concentrating on what’s happening behind me.  It’s a closed road, and we’re easily the fastest moving objects on it, so I’m not expecting anything that I’ve passed to affect me.

A bunch of people wonder in my way, and I can’t swing around them, so I stop briefly (I can impress one of my friends by  briefly holding my bike at a stop without falling off), giving them a blast of my whistle (which is loud enough to make my ears ring) and my siren (which is a little pathetic) and then pulled away as they jumped aside.  Almost immediately, I felt my bike swerve out underneath me, and I jumped off, trying to give my bike a graceful landing.

Turning around to get better leverage on the bike, I saw a girl holding on to my panniers, apparently helping me stabilise the bike.  With it back upright, I thanked her, turned back around, mounted up and tried to go.  And instantly feel my bike try to go out from under me again. This time I jumped off before it went, and swung around to find that girl still holding my panniers, laughing.

“Let go!”  She just laughed again.  “I said, let go.  I’m busy.”  She let go, but went to grab it again as I pushed my bike away.  “Grab it again and I’ll call the police!”  She continued to laugh, not saying anything, until some burly guy came out of the crowd, shouting at her as well.  I took that as my cue to move on, fast.

Now I’ve heard stories of people chucking things at ambulances, and prank calls, and all the other things that waste ambulance time, and I’ve had people deliberately get in my way, but this is a new one on me.  I still managed to catch up with my partner pretty quickly, the whole incident probably only lasted about a minute or so, but seriously, what the hell…  It was fairly obvious I was in a hurry (the blue light and siren was a bit of a hint), and the markings saying ‘Ambulance’ are hardly subtle…

I just don’t understand what would possess someone to do something like that which would knock me off of my bike, particularly when I could have been going to a very unwell person.

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.

Pain Scores and Young Children

An important lesson I learned today while on duty.  There is very little point asking a small child for a pain score.

This particular little person had fallen down a couple of steps, and had been brought down to be checked over.  He didn’t have any pain anywhere significant (like the back of the neck), and neither did he seem to be in any particular distress.  Normal practice suggests that I then try and have him quantify his pain level, so that I can work out if there’s something more going on.  I go through the rigmarole of explaining ‘where 1 is next to nothing (as I gently poke him for demonstration) and 10 is the worst thing you have ever felt’, and his first answer “9”.  Now in my experience, people who have 9/10 pain and and show no signs of it have either been really lucky (and so 10/10 is relatively low), have an incredible pain threshold (but even so…) or might possibly be stretching the truth a little.  Looking at this little guy, his mother and I went for the latter.  So I asked him if he was really sure it was 9/10, and stressed how important it is to tell the truth.  So he now says 6, because that’s his age.  Cue much rolling of eyes from me, my crewmate and his mother, and I give up.

The important lesson here, I think, is that I had made the mistake of treating this child like a little adult, and tried to apply a technique aimed at adults to someone who didn’t really understand what I was asking, let alone why.  Children are not little adults, though it can be easy to forget this sometimes, and remembering this is important.

Why I Volunteer

One of the most common questions I am asked (along with ‘Are you paid for this?’ and ‘What’s the worst thing you’ve ever dealt with?’) is ‘How do you do this for free?’ This usually happens about the time when I’m trying to stop a drunk student from drowning in their own vomit, while avoiding getting vomited on myself, and their friend is on the other side trying not to vomit. My stock answer is ‘Because it’s fun!’

Even more often, when I’m knee-deep in the worst of the politics and fighting against the people who are too quick to tell us what we are incapable of doing and the people who don’t care and the people who don’t want to lose their power, I wonder why I do it. I spend hundreds of hours a year doing work for a cause I passionately believe in, and in return I get people try to work against me because I want to improve things and they don’t want to leave the happy little rut that they’ve dug themselves.

A short time ago, I dealt with a patient at a Half Marathon, while working on a bicycle. They weren’t particularly unwell, but they had fainted and were a bit shaken up. They hadn’t run anywhere near that distance before, and weren’t used to all the sensations of their body saying ‘that wasn’t such a good idea, let’s not do that again’. All put together, they got a bit worried, and worked themselves up in to what I’m pretty sure was a full-blown panic attack. And I don’t just mean a bit of hyperventilation that quickly cleared up. They were genuinely terrified, kept fainting from the unbalancing hyperventilation does to your body, which just kept making things worse.

In the end, I called an ambulance for them and got them shipped off to the main treatment center, where someone would have the time to care for them and help them calm down properly. As soon as they were sent off, I was sent to another collapse, and I put the entire incident out of my mind.

After the spending the rest of the day zipping up and down the course, I was stood down and headed to the main First Aid post to grab some personal kit and help pack everything up.

While I was there, I bumped in to my patient from earlier. They had just been discharged and were going home with their mother. They both stopped when they spotted me, and my patient asked if I had been the person with them out on the course.

“Yes, I think so. How are you now?” I replied.

“Much better now, thank you.”

“Do you know what was wrong?” The mother chimed in.

“I can’t say for absolute certain, but I think you had a panic attack.” I went to explain how a panic attack was a scary condition, but usually self-limiting and nothing to be overly concerned about. My patient nodded along with my explanation, and then commented that she couldn’t really remember what happened.

“I just remember being convinced that I was going to die, but I remember you being there, and talking to me, and holding my hand, and I knew that I would be okay.” I didn’t really know how to reply to that.

To me, the treatment didn’t seem that much. A simple, non-life-threatening condition that, even if I did nothing, would most likely pass on its own, which I passed on to someone as soon as it looked like it would take a long time to deal with. Fifteen-ish minutes on scene, before moving on to the next job, patient already out of my mind.

But in those fifteen minutes, I helped out a terrified person, taking away some of their fear just by being there. And to that person, I made all the difference.

This is why I volunteer.

Ambulance Excitement

An East of England Emergency Ambulance at West...

Image via Wikipedia

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…

Cycle Response

Okay, I’m possibly a little excited.  Actually, scratch that, I’m acting like a kid on Christmas morning.

The last parts of my cycle responder uniform turned up this morning.  This is (and yes, I say it again) extremely exciting.

I’ve wanted to join the cycle responders for years now.  The first time I tried to get on the course, it was cancelled two days before.  The next time, after I’d spent some quality time with the cycle response policy, I didn’t think I had a hope of meeting the fitness requirement. That, and the high price for the uniform, I nearly gave up on it.

Somehow I persuaded myself I could do it.  Somehow, we’d raise the money.  Somehow, I’d pass the fitness test.

And I did it.  I passed the tests.  I am planning fundraising with a fellow responder.

This just left waiting for the uniform.  It’s special purpose uniform, so doesn’t get ordered often, and usually has a long lead time. I fully anticipated having to miss some events because I didn’t have the right uniform.

It’s now here.  All of it, in its hi-visibility yellow glory.  Now I feel like a proper cycle responder.

And just in time.  My first event is in just over a week and a half from now.  I can’t wait!

This sounds a little sad, but it feels like a dream come true.  I never thought I’d get to do this.  This is so much more important to me than the upcoming ambulance aid course I’ve been invited to.  True I might be able to go around in an ambulance soon, but I can go out on a bike now.

So yes.  A little excited, I think.

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