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…

Yes, I Know You’re Fine

It’s the Sports Association’s Winter Ball.  Everyone’s a bit drunk, but mostly well behaved.  You’re not that bad, but you’ve had just enough to stumble and knock your head.

You’re fine.  You’ve got a bit of a sore head, but all the rest of our checks are clear.  You’ve not even got a lump.  I’m just finished off the checks, and you’re a little fed up.  “I’m fine.”

“Yes, we know.  This is just routine, just in case.”

I potter about a bit more with pen torches and other gadgets.

“I’m fine.”

“I know, I’m nearly finished.”

I start writing up, and have to ask for a load of details from you.

“I’m fine.”

“Look, Jane.  We now you’re fine.”  LittlePara (my partner for this expedition in the world of the drunk) interjects.   “But if you keep saying your fine like that, we’re going to start getting worried.  Please, just shut up, let us finish the paperwork, and you can be on your way.”

I give LittlePara a look.  I don’t really approve of telling patients to shut up, but I suppose if it works, I can’t complain too much.  I finish my questions, hand her a copy of the paperwork, and her friend a copy of our head injury instructions (just in case she isn’t fine).  “You’re fine. I suggest you go home, get some sleep, and you’ll feel better in the morning.”

“I’m…”  She starts

“I know.  That’s what I just said.”  Her friend grins.

“I think they got the message, Jane.”

How to Lose Your AAA Pass

You are an important person in the University, a Sabbatical Officer in fact.  It’s Freshers’ Week, you were involved in organising it, and you are pretty used to mostly getting your own way.  You’re also drunk, and have been issued an AAA Pass (AAA stands for Access All Areas).  This already is a bad combination.

I’m trying to treat one of the Freshers’ Crew (who are responsible for looking after the freshers in a specific area of campus accommodation).  He’s drunk, needs to sleep it all off, and I’m trying to gather enough information to arrange for him to get home.  He’s in his brightly coloured Crew top, so it’s fairly obvious that he’s a crew member, and I’m in my green and yellow hi-vis, so it’s pretty obvious I’m a medic.  It’s also very obvious that I’m treating you (or should be, to anyone vaguely sober).

“Is he alright?”  You come swaggering up.  “Bob?  You okay?”  (Yes, I know Bob is a very bad fake name!)

“He’ll be fine.  Are you his friend?”  I reply.

“Mmmwwaaa?”  Adds Bob.

“Are you okay Bob?”

“He’ll be fine.  He’s just drunk.”  I try to get your attention back to me.  “Do you know him?”

“He’s one of the crew members.  [As if the big words Freshers Crew on his T-Shirt wasn’t obvious enough].  What’s wrong?”

“He’s just drunk.  Are you friends?”

“No.  No.  He’s a crew member.”

I’m definitely getting the idea that you’re drunk now.  “Okay, in that case I need you to leave us some room, please go stand over there.”  I know there’s no point telling you to go away, but I hope I can send you far enough away that you leave out of boredom.  You standing right next to me is hardly good for patient confidentiality, particularly as you strike me the type to want to take photos, and anyway, I’ve always found that drunk + crowd = trouble.

“No, no.  That’s okay.  I want to make sure he’s okay.”

“Really, he’s going to be fine.  We’re just going to get him home, and he’ll sleep it off.  All he’ll have is a hangover tomorrow morning.  Please, just give us some space.”

“No, no. I want to make sure he’s okay.”

“Look.  There’s nothing you can do here.  Please, go away, you’re now getting in my way and preventing me from treating him.”

“I’m not going away.  I want to make sure he’s okay.”

I’m getting rather irritated now.  “Please.  Go away.  You are not helping, and I will have you removed if I have to.”

“Do you know who I am?  [I’m not making this up!]  I am a Sabb!  I have a triple-A!”

I’m now seething.  “Right.  And I have two.  [I do.  One as a First Aider, one as backstage crew.]  But that makes no difference.  I need you to go.  Now, before I call for security.”

“I can go where I like.  I’m a Sabb and I have a triple-A.”

“Right.”  I’ve had enough.  You have now held me up for too many minutes.  I might have had Bob on his way home by now, if you hadn’t turned up with your triple-A.  I turn my back on you, ensuring I’m standing between you and Bob, and get out my radio.  “Control, from 444 over.”

“Yeah, go ahead 444, over”

“Hi Control.  Can you send someone from security out to me.  I have a Sabb with a pass I need removing, over.”

“Err, say again 444, over.”

“I have a Sabb I need Security to remove for me please, over.”

“Err… All received 444.  They’ll be over in a minute, over.”

“Many thanks, 444 standing by.”

You haven’t heard what Control had to say, but what you get the gist from my side.  “How dare you!  I’m a Sabb!  I have a pass!  You can’t do this.”

Over your shoulder, I see the head of security (a diminutive Welsh lady best described as a force of nature), and her assistant manager (a bulky man twice her size) heading my way.  I nod at you, and they nod back.  “I already have.”  I turn back to Bob, who should have been the centre of my attention for the last few minutes.  Behind me I hear you being removed, and when I chance a look while moving around my patient, I see your AAA go in to one of their pockets.  Hopefully that’ll teach you not to but out next time when you are politely asked.

Needless to say, I had a lot of explaining to do once I got back to the First Aid post. I also got an apology from the Sabbs the next day, and even if I hadn’t, the look on your face when you had to hand over your AAA was well worth the aggro.

Sleep Fail

Freshers Week - Toga Night

 

For the past week, I have been tech-crewing and first aiding at my University’s Freshers’ Week.  The main aim of the week (publicly) is to allow the freshers to get to know each other and get settled in before starting lectures. Unofficially, some freshers, and some of the Freshers Crew that look after them, see this as an opportunity to get as drunk as possible as regularly as possible. 

From my point of view, this is a highly enjoyable week of rigging, first aiding and derigging. This year I also got the chance the run the lighting desk for an evening (and had a complete panic when it starting doing things I didn’t ask it to do…), as well as having a go being Assistant Stage Manager (more stressful than I’d like, especially as the main act turned up about an hour after they were supposed to be on stage.) 

From a first aid point of view, it’s dealing with drunks, drunks and more drunks. Oh, and the odd assault, but they’re usually drunk as well… 

This year we had three people drink themselves into unconsciousness, along with the normal round of alcohol poisonings and other drunken injuries (fractures, possible head injuries, etc.) 

As well as Freshers’ Flu, which seems to afflict anyone involved in Freshers’ Week, whether or not they are a fresher, the week successfully screws my sleeping patterns over for a month.  This year I caught the Flu early, and seem to have got over it quickly. However, it is currently 0040, and I’m still quite comfortably awake. This is extremely annoying, particularly as my lectures start tomorrow. 

On the bright side, it means I can get some posts written, but I have a feeling life (especially the bits of it that occur before 1100) is going to be a bit difficult for a while.

Punched Chat Up

“Hello. My name’s ****, one of ****’s colleagues. I’m just going to shine this light in to your eyes, is that okay?”

“Umm… Sure.”

“Okay. Just hold still for a moment.” … “No, keep your eyes open for me.” … “Just look straight ahead, that’s it.”

“****, you have very beautiful eyes.”

*Blink* *Blink* *Blink*

“Uh… Thank you.”

It takes a second for me to realise that I’m being chatted up by some bloke, who has not only been hit around the head so hard that he can’t remember the incident, but is also so drunk the alcohol is practically crystallising out of his breath.

I turn to my colleague. His face is carefully blank, but I can see his chest twitching as he tries not to laugh. Over his shoulder I notice the rest of our teams conspicuous absence.

It’s going to be a while before I’m allowed to forget this.

Summer Ball = Much Work + Much Fun

Last weekend was the University’s Summer Ball. This is basically a giant party for all the graduates to celebrate the end of their time at university, and for everyone else (if they can get tickets – it sells out in minutes!) to celebrate the end of the year. It is one of the largest events we cover on campus, in terms of area covered, and only the Fireworks Display in November has a larger number of people attending.

I am a member of the Technical Crew society at the University. Nowhere near as active with them as I am with my First Aid activities, especially over the past year where I have been on placement. I am more interested in the theatre style shows they run, but they clashed with my working hours, which basically ruled me out.

No matter what our interests are, be us lampies (like me, in an ideal world), noise boys (or girls), stage managers, or whatever, we all like to get to the big events. Not only does this make everyone’s life easier (they really are big events…), I find it gives a tremendous sense of achievement to see something I’ve been working on all set up and looking great on the night.

I can’t be as involved as some people. As I tend to be a First Aider at the event as well, I have to be very careful about the number of hours I’ve been working before I go on duty. This tends to mean a lie in on the day of the event, and no rigging that day, which does mean I tend to miss it all coming together at the end. However, getting to see the finished product, free, from a ‘punter’s eye view, means I don’t mind too much.

It was a q-word event this year. Normally we are rushed off of our feet in the post, and are forever ferrying drunks home or to A&E. This time we were mostly getting bored.

The one disadvantage of being both Crew and First Aider is that I get the late nights every night, instead of getting a night off like most people. I am still tired at stupid times in the day, and as I’m typing this at 00:40 in the morning without difficulty, my sleep cycle is probably going to be thoroughly screwed for a while yet. Slightly irritating after getting in to some fairly good habits while I was working…

Still, it was a thoroughly enjoyable weekend, and I was completely distracted from how screwed I am with my degree. Not a bad thing at the time. If only it hadn’t come back with a vengeance once I’d finished.

Scout Hike

This was one of the more unusual duties I have done, mainly because it’s a night shift with almost no chance of coming across someone who is drunk. Instead, I spent the night on the outskirts of town, treating various Scouts who were trying to hike around a twelve-ish mile course, consisting of fields, roads and, if the Scout’s clothes were anything to go by, muddy lakes…

As ever I arrived early to the event, and ended up waiting ages for someone else to turn up. Now this is a bit of an awkward one. If I arrive too early, I end up alone, and knowing my luck, treating, without anyone else around to back me up. If I cut it too fine, something goes wrong and I end up being late. This could leave someone else on their own, with nobody else around to back them up. This time I hit the former, though thankfully only had to twiddle my thumbs until the cavalry arrived.

The beginning of the event was, well, uneventful. No patients, and I forgot to bring anything to do. This is a recipe for getting completely bored. The first patient (brought to us by the ambulance crew, with next to no hand over, I might add) was a boy who hadn’t really dressed properly for the event, and got himself cold and generally uncomfortable. After administering a hot drink and a blanket, we sent him back to his friends, his tent and his sleeping bag.

Just as our pizza arrived, an incident broke out in the middle of a field. There was a bit of confusion at first over what was happening, leading me to take a slightly scary walk in the pitch black to find out what was going on. Eventually it was decided that my partner would head out to support the other team, and I would return to the post accompanied by a pizza, a torch, and myself.

Being on my own doesn’t bother me too much (I have a post about this up my sleeve), not when there is support just around the corner if I need it. However, sometimes I get a casualty that makes my heart race.

I got a call in for a patient with breathing difficulties. There is a reason that the ambulance services consider these calls to be Cat A. Sometimes these are nothing more than a panic attack, but sometimes this is a major asthma attack, or something worse.

The patient was a mile out, far nearer to me than the other post. This gave me no choice: I had to leave the post unmanned and respond.

A pair of scout leaders drove me down to the team, and, after a bit of a hike to get around a really irritatingly placed fence, I met the scouts by the side of a road. It was clear that this girl was having some difficulty with her breathing, but didn’t seem extremely distressed.

Getting a history, it turned out that she had been diagnosed with cancer about two years ago. After a couple of rounds of chemotherapy, she was given the all clear no more than six months ago. She had done no real training since.

I had a little worry when we helped her back to the car. However, as soon as we got her sat down and warmed up a little, she immediately began to improve, and my initial snap decision to call an ambulance shifted to transport to my post and observe.

My best guess (as I’m not qualified to actually diagnose) is that this was a case of exhaustion (understandable, under the circumstances) exacerbated by a mild panic attack. After a period of observation in the First Aid post, I was happy that she was okay to return to her friends. Considering what she had been through over the past year, and the lack of training, she had done amazingly well, and she was keen to get back to things, so, after making sure everyone was happy, we let her go.

Arriving back at the post, I found all hell had broken loose. It appeared a bunch of casualties had arrived, fortunately after the other team had returned, and I had caused a bit of worry because I was nowhere to be seen. The last that they had heard was that I was responding to a patient with breathing difficulties, and they were worried that I was still stuck with them.

Once I had resolved this minor worry, I was set to take a look at someone with a sore leg. This was a previous injury exacerbated by the walk. He also wanted to do the Ten Tors challenge not long after, something that I strongly advised him against. I think he understood my reasons, something that I find rather rare in this sort of circumstances, and I can only hope that he will be sensible.

Finally I had a bit of an unusual patient. I was asked to go and have a chat with one of the scouts who was acting a little strangely. He had been brought back early because he had been scared of the dark, and had sat very quietly on his own ever since.

After having a little chat with him, and with his supervising adult, I discovered that he had both a history that explained the fear, and was very fond of energy drinks. His behaviour and his attitude when we spoke matched what I would expect from someone coming down from a caffeine and sugar high, and after satisfying myself that the scout leader was working on the problem, and telling the lad that if he wanted to have a chat he could come and grab me, I left him to wait for his friends. Hopefully, when back in the company of people he knew and got on with, he would brighten up, and in time, get over his fear.

Another Night in the Town

Another night on the First Aid post in BigCity city centre. This time I was at the event with NewDoc and Organiser, as well as a couple of other people I know from around the County. We were lucky, it was nearly just NewDoc and I (not that I’d complain too much 😉 ¹), which, all things considered, would have been hard work.  

Organised and I walked to HQ together, to get a lift to the post. Ideally, this is the way it should work every time, as it means we all arrive at the same time, and those people who drive have a safe place to park up. unfortunately, it required someone qualified to drive the minibus, and these people are rare at the moment. This also means a relatively long walk from the train station to HQ. A walk that nearly took us half as much time again as it should have done. Thankfully, we got to HQ just in time, and met our lift.     

This time around, there were members of the Organisation in Ambulance Control. This meant they knew exactly what was going on when we logged in, and we got jobs sent our way when they were appropriate (as in, needed a response, but not an ambulance). I discovered through this that we are considered more than First Responders, as they get automatic ambulance backup, but they wait for us to consider it necessary. I’m not sure if I should be pleased that we are trusted with this responsibility, or scared…     

This time, we had enough people for two response teams, as well as two more to man the post. Along with our contacts in dispatch, this meant we received and responded to more 999 calls than we got people turning up at our door.  Along with one partner or another, I responded to three casualties, one where we were called directly to the scene, and the other two received as emergency calls.   The first was someone who had collapsed in a doorway and was fitting. As far as we could tell it was a bad reaction between some powerful painkillers they were taking, and alcohol. Fortunately an ambulance car was heading past at exactly the moment we wanted one, and he summoned a full ambulance shortly after. With a bit of a lift, our patient was on a cot, and then in the back of the ambulance and out of our care.   

Next was my first visit to a local hotel, accompanying NewDoc on my first 999 call.

We arrived, well within eight minutes (not that any of our calls are Cat A, in fact, all our patients are considered dead for time-keeping target purposes…). It then took us ages to be let in (despite being in hi-vis, clutching response bag and oxygen set).  We were met by a friend when we were most of the way there, and got most of the details of what had happened. This included a comment that the patient had taken off their fancy dress and got in something more comfortable (hush there, at the back!) Filing that note away (or so I thought), we continued to the room.  

Arriving, we met one lady, dressed in a modest red dress. To my surprise, NewDoc immediately started on his treatment routine, assuming this was our patient. Cue one confused look from the lady, and a quick redirect to the real patient, lying in her bed looking pretty flustered.  

Turns out, she had had a very stressful past few weeks, and she, her husband and a couple of friends were on a hard-earned break to relax.  She seemed stable, if a little uncomfortable, and we had no cause for concern. Giving her the stock phrase of ‘if things get worse, or if in doubt, call 999 again and get help’, we left her with what, as far as we could tell, was a cold or ‘flu caught after getting run down stressing over whatever it was she was doing.  

After a small break on the post, complete with complimentary chocolate bars from a local friendly store keeper, NewDoc and I were sent back again to the hotel.

This time, after getting in much faster and reaching the room in double-quick time, we arrived to find a lady lying on her bed struggling to breath.  With a bit of coaxing from her boyfriend and I, we managed to get her set up, which immediately helped her breathing a little. Then, using what I hope is my most confident, soothing tone, and the boyfriend holding her hand and rubbing her back, we managed to get her breathing under control.

Fortunately, it seemed to be a panic attack. Note that I don’t say ‘just a panic attack’. They are minor, and in many cases self-limiting (as in, the patient either calms themself down or faints, both of which solve the immediate problem), but they can also be very scary, and this patient was obviously quite distressed. 

 We never found our why she was so upset, but whatever it was she had a huge amount of support from her boyfriend. With nothing physically wrong with her once her breathing was under control, we gave them both some advice on how to deal with it themselves, got the paperwork finished, gathered our gear and returned to base.  

This last patient took us quite a time past our anticipated stand-down time. However, she was the sort of patient whose treatment brings relatively fast, obvious results with a very simple set of techniques. I find treating these people very satisfying, and left the hotel feeling that we’d achieved something, instead of just holding the fort until the paramedics arrived.  

This was my first time dealing with real emergency calls. Twice we responded, dealt with a patient from start to finish, and saved a paramedic a call out to a patient who didn’t need that level of care, saving them for the person who collapsed at home with chest pains.  

Funnily enough, I was feeling pretty pleased with myself by the end of the day. Makes a pleasant change.  

---

 1 I might possibly have a little bit of a crush on NewDoc. Unfortunately, it is unlikely to be reciprocated…

Night in Town

This isn’t as glamorous as it sounds, though it was reasonably fun. I spent the night in BigCity centre on our mobile First Aid post, working with four others to provide First Aid to the people who spend their night drinking themselves silly at the local clubs and bars. It is a long night, starting at 2200 and finishing at 0300, providing we’re not treating at the time. We’re also logged on with the local ambulance service as First Responders, so we could get sent to anything in the local area, aiming to get there before the swiftly following ambulance.

The night began with a train journey to BigCity, not a bad trip, I go further every morning on the train to get to work.

I met a PCSO on the station platform in UniTown. We were both on duty that night for the same reason, to keep an eye on the drunks. fortunately, most of the ones that were his problem would only become mine after they’d been arrested.

We had a friendly conversation until my train arrived, along with a fresh load of intoxicated students for him to keep an eye on. He did have one bit of luck, however: he could clock off just after the last train. I would only be halfway through my shift by then, if that. Though, I don’t envy him his job. Taming drunks is not a fun job.

I arrived at the post to find nobody there. I was a little early, but still expected someone to be around. Then when someone finally arrived, we discovered nobody had a key for the post. Brilliant. It was an hour before everyone arrived and we could get in. It definitely shows that this was only the second week of this operation.

The night wasn’t particularly busy, but enough to keep us all from getting bored. We did get called to a collapse once, though I didn’t respond, and then was left alone when everyone else went to deal with it. Fortunately it turned out to be nothing serious. 

I suspect that Ambulance Control had forgotten we existed. They were surprised every time we called a patient in to get a job number, especially when we emphasised that we didn’t want an ambulance to respond. We also received all of no calls from them sending jobs the other way.

Memorable casualties included a lady who received damage to her foot from a stiletto heel (the amount of pressure exerted on one of those heels, even by a skinny woman, still boggles my mind). Thankfully, this was just a bruise and a quite literally tiny cut. A quick clean, a plaster to keep the dirt out, and advice to rest the foot was all that needed.

Then there was the especially drunk guy who arrived at the post, only to ask where the strip club was. Even if I was interested in the same sort of clubs he was, I am rubbish at given directions. And even if I wasn’t, I wouldn’t have pointed him in that direction. We weren’t a tourist information centre, after all. A polite but firm dismissal sent him on his way, probably in the direction of the police post nearby (sorry guys…).

That just left the guy who had been arrested, and was brought to us by the police. Now this helps everyone out. It meant the police didn’t have to bother the NHS to get a minor wound dealt with (reducing NHS workload is why we’re out there), and gave us something to do just as we were about to get bored. Though watching someone get treated with his hands in cuffs was interesting: it made getting at the wound particularly awkward. Eventually they had to release one hand, though I’m don’t think they were strictly necessary with this guy. The burly police officers, one with us in the post, and a couple just outside, were more than enough to keep him under control.

Once we were rid of him, it was clocking off time. Aside from a bit of a hassle getting home, the rest of the day was spent catching up on my sleep, and getting ready for work the next day.

While fun, this event did eat up my entire weekend.