Booze, Bangs and ODs

25 January, 2007

Watch out, watch out, the nutters are about

Last Friday night there was a new moon and, true to form, the nutters were out in force.

I kicked off with a ‘bottling’ at one of the local nightclubs; usual rubbish “no officer, I’ve no idea who did it” then “I’m gonna get that c*** tomorrow and show him what for”. This particular individual was one of a large family of yobbos who’ve been plaguing us for years – though to be fair I’d not had the pleasure of him before but the surname and the address were all too familiar. He was, as they say these days, ‘giving it large‘ and was having no truck with A&E, effing doctors, or needles. He did however, agree to keep his head still long enough for me to glue up the two lacerations over his eyes, even if he couldn’t keep his mouth shut; trying to impress the two scantily clad females he had in tow I suspect . He was last seen outside the club, waving his arms around and puffing out his chest, vowing to sort out the bastard “wot dun this to me” – what he really meant was “I’ve been in a bit of a scrape and mummy’s coming to pick me up”.

Next call was to an RTA – whoopie, a bit of trauma! Sadly not nearly as exciting as it sounded, but the young man involved was lucky not to have ended up crashing through the railing on the bridge and down on to the motorway below. He’d been drinking and admitted to ‘snorting’ something but wouldn’t say what. Although he appeared to have only minor injuries the bulls-eye on the windscreen (not wearing a seatbelt) suggested a possible head injury so the crew popped him up to A&E with a police officer to keep him company.

Meantime I backed up another crew for a patient with abdo pain, outside one of the local pubs. Sounded a bit like an ECP job so I asked Control if I could assist. What we actually had was a known depressive who’d been out drinking and wanted some attention. The abdo pain was a bit of red herring as she admitted that she was feeling ‘down’ and the pain was making her feel worse, but she couldn’t/wouldn’t take pain killers as she knew she would overdose on them, just as she’d done earlier in the week (and would do again in a couple of days). What she really wanted was to see the mental health team as she felt she couldn’t cope any more. What do you do? It’s Friday night/early Saturday morning and there’s no real help available. It was pass the buck time so the crew took her in and hoped the on-call psychs could help out – (ooh, there goes another pig flying past).

With all the local police gathered outside the town centre night clubs I got a call back to one of the working men’s clubs for an ‘unconscious male‘. He wasn’t when I arrived, though friends claimed he’d collapsed. His main problem was that his brain “was frying” and he had a stonking headache. His wife duly arrived and a more ominous picture emerged. This chap is only in his forties but has a drink problem – which he won’t admit to. He’s prone to ‘abscences’ followed by ‘crushing’ headaches and violent outbursts, which he admitted he can’t control. No, he wouldn’t go and see his doctor. No, the drink wasn’t the cause, it was all stress related. The Missus had had enough and wanted him to see someone. We convinced him that a trip to A&E was probably in order if only to sort out the headache and check that something more sinister wasn’t going on. Hopefully Missus is going to drag him kicking and screaming down to the GP next week in a vain attempt to get him some help for the drinking.

Then it was back to join the police at the night clubs. Two patients this time, both having been swiped around the head with the buckle end of a large, heavy belt. Of course it was all ‘unprovoked’ and they’d no idea who the perpetrator was. One had a nice neat laceration to the top of his head but the other had his top lip nicely bisected for about 1 cm – a job for the max-fax boys. I dropped him off and, as luck would have it, the max-fax doc was down in A&E and agreed to see the guy straight away.

Things quietened down after this – no more lunacy related jobs. Interestingly the following night, Saturday, saw no cases of booze, bangs or overdoses at all.

Roll on that full moon on February 2nd – I’m on nights again!

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Spare A Thought For The Dog

23 January, 2007

Both at the mercy of adults

“You were right”, he said, as I unloaded some kit from the car. Being 3 am, cold and miserable I really had no idea what he was talking about. He proudly displayed the ‘moonboot’ splint he had on. “I did break my leg”. Recognition slowly dawned, it was Kevin, who we last met back in mid December. That would explain why the address seemed familiar but the call was for a young child with ‘abdominal pain’ and there were no children at the property when I last called. I followed Kevin as he hobbled up the 5 flights of stairs to the flat. “Hey, look who’s turned up”, he hollered in the front door. I was already bracing myself for the putrid atmosphere and thick smoke and was relieved to find it wasn’t as bad as I feared. They’d had a slight clear up; the mushroom-farm mattress had gone, to be replaced by some rickety Ikea bed and the dog and been booted out of his corner – he was now confined to somewhere behind the television.

The two gorillas, who’d been present when I got called to Kevin, were in attendance but tonight’s call was for Emily. She’s only 3 and looked quite unwell, though she engaged with me happily enough, which was just as well as she was the only one who made any sense; luckily she had an I.Q. that outshone the rest of the them put together; particularly Mum who was struggling to string more than three words together. Mum, too, seemed familiar and it was only later that I discovered that I’d been out to her at her normal abode – the local women’s refuge. Now she was shacked up with the larger of the two gorillas who rents the flat. The place is hardly big enough for one gorilla never mind a vulnerable woman and a young child.

Emily told me her tummy hurt and it was painful when she went to the toilet – to emphasis the point she promptly vomited over the settee, the floor and subsequently Mum’s jacket. To be honest it would hardly be noticed, the floor was still littered with the remains of take-away dinners and fag ends and a set of dog bowls – just like last time. It’s the sort of place where you wipe your feet on the way out.

Now I’m no expert on children but I think it’s fair to say that 3 year olds spend a fair amount of time on the floor and are still at an age where they like investigating their environment by putting things in their mouths. Given the state of the floor goodness knows what Emily had found to sample and no wonder she was ill. I really felt for her – what a start in life. Mum’s already been through the refuge which is hardly conducive to bringing up a young child and now poor Emily finds herself stuck in what can only be described as a “shit-hole”.

I took Emily and Mum up to A&E, if only to get Emily out of there; but what about the dog? At least everyone else had the opportunity to leave if they wanted to but the dog was stuck there and it’s no place for a dog and certainly not for Emily.


Nothing Much

18 January, 2007


Lazing around and doing nothing much

Well, it’s been a few days since I posted anything so thought I’d better put something up just incase anyone drops by.

I’ve had a few days off and, quite frankly, haven’t really got anything of interest to blog about. I had a successful day at the Daily Telegraph Adventure Travel Show. I was hoping to find two different holidays for this year, one a photographic course/adventure the other a trip abroad. In the end I found both in the same holiday and have spent a lot of time since, sorting out the little incidentals that are commensurate with foreign travel. I also thought it was high time I checked the handbook for my Canon EOS 350D and found out what some of those other dials and buttons are for. I usually just have it set to ‘manual‘ and use it as I did my old Pentax K1000 (one of the best fully manual cameras around and still my favourite – even if it is a bit clunky).

I also found another Hilary Mantel book down at the library. I’ve spent a few happy hours immersed in Beyond Black. A story about nothing much – so far – but Mantel’s use of language keeps me riveted; like reading poetry. Reminds me of the books by D.M. Thomas I read years ago.

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There are some things that it’s acceptable to do when you’re single and one of my favourites is popping out to the cinema – I don’t go that often as so many films are of the “I’ll wait until it’s out on DVD” variety, though I end up missing out on the ‘big screen experience’. This year I thought I’d treat myself to an ‘unlimited’ card for my local cinema. It’s seems reasonable value, I only have to see 3 films a month and I’ve had my monies worth. It also means I can go and see all those films I would have waited for. So this week I’ve been out to see;

  • Apocolypto: not as grizzly as the press suggests – entertaining 4/5
  • Deja Vu: only coz I like Denzel Washington. Really two films stuck together. OK, but won’t be buying it on DVD 3/5
  • Night at the Museum: Jumanji part II. Lighthearted. Ricky Gervais is wasted (trying to recreate David Brent doesn’t work) Mickey Rooney and Bill Cobbs are wasted (they’re great and could have been used far more) 2/5
  • Miss Potter: Quintessentially English – maybe I’m turning into a sad, lonely old git but this was the best film by far; superb acting – by everyone, witty, great music and superb scenery (the Lakes). If this is the sort of production the UK Film Council is supporting then it’s money well spent in my view. 5/5 – see it

It’s back to work tomorrow – nights again- so perhaps something of interest will occur.


Comparing Notes

15 January, 2007

Hey, guess what I did today?

Having done a few years service, I take some pleasure in seeing new recruits, wet behind the ears and fresh out of training school, blossoming into full paramedics. Some take their first steps as nervous, naive EMTs and, after a few years, it’s a joy to see them confidently leading a cardiac arrest or a trauma incident. Others though, start out as arrogant snotty ‘know it alls‘ and progress to bullying, arrogant ‘know it alls‘ (who’ve actually learnt very little). We all know who they are; their idea of mess room conversation consists of regaling everyone with all the tricky jobs they’ve done and how good they are.

Last night I did an overtime shift on the RRV. As most of the service are on 12 hour rotas it normally means that I run with the same crowd every shift and hardly ever see some of my old chums. So, being on o/t meant I bumped into a fair number of colleagues that I hadn’t seen for a while; in particular three who’ve just completed their paramedic training and a couple who’ve been qualified as paramedics for nearly a year. I remember them when they first started and had the honour of working with nearly all of them in their first months on the road. Now they’re fully registered paramedics and out there saving the lives of ‘joe public‘.

It was interesting to hear them comparing notes; how many cannulas have you put in? have you tubed anyone yet? have you given tenecteplase? and so on. Some newbie paras seem to have done an extraordinary amount. One, who’s now been qualified for nearly a year, told me she cannulates 2 to 3 times a shift and has given benzyl penicillin 3 times (I’ve never given it). Another has lead a full cardiac arrest protocol on a trapped patient in an rta within his first fortnight as a paramedic and another gave morphine, metoclopramide, tenecteplase and heparin the first time he had to use his skills!

There’s a touch of envy on my part – I don’t seem to do anything like this. Tom Reynolds wrote in his book, Blood, Sweat and Tea:

I often bemoaned the fact that I tend not to get sent to many jobs involving ‘trauma’. If you’ve been stabbed, I’ll be down the road picking up a maternataxi. If you’ve fallen out of a second floor window, I’ll be one street over dealing with the sleeping drunk. And if you’ve thrown yourself under a tube train, I’ll be one stop down dealing with the twisted ankle.
(I’m sure this is in the book but I couldn’t find it, so here’s the blog link)

I confess that I suffer the same fate. Some people in the service seem to attract any ‘nasty‘ job that’s going; we call them Jonahs; it’s easy to tell who they are as they have nick-names which include adjectives such as deadly, dangerous, Dr Death, trauma Queen/ King, etc. Anyway, if there’s an opposite of a Jonah then I’m it. We don’t have an expression for paramedics like me but statistically speaking, the people in my patch are less likely to suffer major trauma or acute medical conditions when I’m on duty. That’s excellent for my patients but it does mean that I don’t get to use my paramedic and ECP skills very often.

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January 2007 marks 10 years since I qualified as a paramedic and I’ve kept a log of every time I’ve used my paramedic skills. So, if you want to compare notes, here are a few of my stats.

I’ve:

  • cannulated 129 times (approximately once per month) Only 1 was a jugular vein cannulation – My success rate is about 92%.
  • successfully intubated 14 patients
  • have only participated in 20 or so full protocol cardiac arrests in my entire career
  • got 2 patients ‘back’ – one lived for a few hours the other for 4 days. Neither lived to be discharged from hospital
  • thrombolysed 3 patients (only the first really made a difference)
  • only attended one fatal rta – and that was an assist for LAS
  • completed one paediatric cardiac arrest – the baby died – had a congenital condition that meant it had a haemoglobin level incompatible with life
  • sutured two patients ‘in the field‘ (one in their bedroom at 3 am, other in the garden)

Jobs I’ve never done:

  • a birth – cross your legs and don’t push
  • a drowning
  • an electrocution
  • a major burn

Skills I’ve never used

  • intraosseous cannulation
  • chest decompression
  • cricothyroid puncture

Motivational Management – Yorkshire Style

12 January, 2007

Um…, er…, sorry…you’re not fired after all.

So, having f**ked up everyone’s Christmas, Simon Worthington and chums at Yorkshire Ambulance Service have had a change of heart.

Union officials have said there is no immediate threat of redundancies at the Yorkshire Ambulance Service.

Having had all the festive cheer well and truly knocked out of them 5 days before Christmas,

The workers will now receive a second letter over the next few days, telling them to ignore the contents of the first.

Excellent. So that makes it OK then does it?

Hope you have a Happy New Year too Mr Worthington.


Loving Our Regulars

11 January, 2007

Can ya give me a lift home guv?

Anyone who’s done this job for a while will have string of ‘regulars‘; those callers who are forever requesting an ambulance for all sorts of ‘spurious’ ailments. They’re mostly a motley crew; alcoholics, druggies, personality disorders, depressives, people with mental health issues, etc. We know them; the hospitals know them; and perhaps, if we’re honest, we don’t treat them as well as we should. Of course some are a right pain-in-the-arse. One of our ‘regulars’ even has an ASBO for calling out the emergency services, particularly the ambulance, and then being verbally and physically abusive when we show up. Can’t say I’m sorry not to have her on the back of the bus any more. We also have another who’s been a ‘regular’ for over 15 years. He’s harmless; he’s an alcoholic, and a right pain-in-the butt to be sure but, when all’s said and done, he’s never been abusive; doesn’t swear, doesn’t lash out and just acts the ‘little lost boy’ when it’s all going wrong. Sometimes we take him in, sometimes we don’t. One thing we never do though is give him a lift home when he been ‘out-on-the-lash’: he’d catch on to that one pretty quickly.

It therefore came as some surprise to all of us on station to find out he was up on a charge of ‘assault’: and not just any old assault, an assault on an ambulance man no less? WTF? Are we talking about the same Harry? Surely not?

Seems we are; though the details are sketchy. A fairly new recruit, from another station – with a reputation for being a bit ‘full of himself’ – attended Harry for the first time. I guess if you don’t know him, Harry can seem a bit ‘odd’. Anyway the story goes that Newbie went into Harry’s house alone and found him sitting on the sofa (as he usually is when he’s at home. Goodness knows if he ever goes to bed). Newbie claims that Harry ‘feigned unconsciousness’ so he decided to stuff an OP airway down Harry’s throat. Next he claims he turned his back to get something out of his para-bag and Harry ‘thumped him one’. No witnesses; just his word against Harry’s. Harry told us later he couldn’t remember the incident. Newbie’s crew mate was out in the ambulance at the time and “knows nuffin’ “ and won’t get involved.

So Harry had to go to court. Whether this was a private prosecution or one ‘sponsored’ by the service we haven’t been able to find out. Newbie clammed up ‘good and proper’ when a colleague confronted him

And the result? Harry pleaded guilty! Why, oh why, oh why, did he have to do that? Just about every member of staff on the station said they’d have given a character reference in Harry’s defence if only they’d been asked. It’s been a real eye opener just how much we ‘love’ Harry. He might be a complete ‘waster’ but he’s our ‘waster’ so you lot leave him alone.

Needless to say Newbie is off everyone’s Christmas card list. We’re just waiting for him to f**k up big time: then we’re gonna take revenge on Harry’s behalf.


More on Meal Breaks

11 January, 2007

Have another cup of tea.

Meal breaks for ambulance crews are still hitting the news, and the blogsphere:

I posted about the meal break fiasco the other day. Tom Reynolds has, as always, posted an excellent article about the whole mess in London, while NeeNaw gives us his view of this nightmare from a dispatcher’s point of view in Tea Breaks Again. The popular press have been up in arms about the situation, led by last week’s edition of the Sunday Express.

Despite all the articles about this contentious issue I was, however, puzzled by one thing – Why didn’t this story get everyone steamed up last year?

Ambulance delay to death crash Pc

Pc Joe Carroll, 46, died from head injuries on 13 April when his patrol car left the A69 in Northumberland. An ambulance from nearby Hexham was not dispatched because the crew were on a meal break. A crew was sent from Prudhoe – 13 miles away.