Please Sir, can I have some more?

Dear David

I'd like to start by wishing you and your family well in these tough economic times. You and Samantha's combined salaries of £400,000 plus shares and bonuses must be really getting spread thin. I empathise, I really do. Like you, I seem to work all the hours god sends yet that £25,000 seems to just disappears! Still waiting for my mileage expenses to come through though, so that will be an extra £42 in the piggy bank! I love expenses! Anyway, the point of this letter is one of a more serious nature. 

I have waited a long time to write this too you. Let me draw your mind back to your first assault on the Police service. In case you'd forgotten you cut 16,000 officers. Less is more! Quality over quantity! Needs must! Look at the bigger picture! We will all feel the pinch! No one is immune from cuts! All very very true. We must indeed all pay the price for the bankers and politicians sticking our country in the economical dark ages. But, there are consequences to your ill advised cuts. Let me share a story. A story that brings back painful memories. A story that still bears real scars. 

As a paramedic, one who has been through years of training and sacrificed friends and family for such a fulfilling salary, I understand that part of my job, in fact, part of my salary is danger money. Well, not officially, but being abused is part of the job, right? As the Right Honourable Ann Widecombe, recently said, "Public servants worry more about their own safety than that of the public, Britain has sunk to a new low". I'm guessing by your lack of condemnation of these comments you must agree wholeheartedly. So, as an 'ambulance driver' (yes, we are that low in the food chain), a bit of danger comes with the territory. One afternoon, I was called to a residential address to a man who had 'passed out'. 

When I arrived that man was lying on the grass. I approached him, on my own, and he appeared drunk. I went about my business, checking him over, when the ambulance crew arrived. We began to get the bed off the ambulance all the while making sure the member of the public was OK. We are public servants after all and serve we shall. Without warning the patient stood up and swayed a little, then staggered into a fence. Poor guy eh?!

He then beat me with a fence post. He also beat the other members of the ambulance service. Three of us in all. Do you know what it feels like to be helpless against a man beating you with a lump of wood? Despite all of our broken bones we managed to press our emergency button. Let me share a conversation with you.

Me: "Red base red base, urgent police, we are being attac......." I stop because the lump of wood has been broken over the back of my head and then broke my hand.

Crew 1: "Red base, my crew mate has been hit over the head, urgent police" he says with 3 broken ribs.

Red Base: "Getting the police for you now, are you all OK, can you get to safety."

Crew 2: "I'm now locked in the car, I think my wrist is broken, he's still attacking us."

Crew 1: "We are away from him but he's coming after us. Are the police on way?"

Red Base: "The police have no units to send, try and maintain a safe distance."

Crew 2: "He's trying to get in the car, he's hitting it with the wood"

Crew 1: "I think he's stopped, he's lying in the road but we can't drive off."

Crazy stuff isn't Dave! No units to send?! But aren't the police supposed to be there to protect us? Surely in a real emergency they have someone to send. Surely you didn't cut too many? It's OK, 9 minutes later two undercover officers arrived. Part of their job is getting abused too. I should probably mention now that in their efforts to protect us from the patient they too both got broken bones. They were struggling to restrain him on their own so much, that we all helped. We all restrained him for 10 more minutes until more help arrived. Guess what we did then Dave? We all took the patient to hospital for treatment. With our broken bones and bleeding wounds, we checked his blood pressure, he even got to travel on the bed. He is of course a member of the public and we are all their servants.

Now, do you still think less police is the right answer? What if you or your beloved family were trapped somewhere in real fear for your life? What if you called for help? What thoughts would go through your mind when you heard those terrifying words "No units to send." The officer who came to my aid told me that it used to be a team of 25 to police the borough on this shift. Today it was a team of 7. No doubt they got complaints from the public for not coming to their aid quick enough whilst 2 of the 7 were sat in A & E with me and my colleagues. Tut tut. We really must all work harder.

The good news from all of this, was our patient was treated professionally by us and the hospital. He was arrested and charged. He was sent to prison. However, because of your cuts to the prison service he has already been released and I could bump into him anytime of any day.  Oh wait....in fact, only last week, I was sent on a job to his house. Can you imagine the fear Dave, can you? Luckily he wasn't there. 

I am proud to say that in this country we have by far the best police service in the world. The things they do and the dangers they face without a gun on their belt. The professionalism they show at all times is nothing short of amazing. That is in the face of your assault on their salary, their pensions and their working conditions. Now you are making a career in the police as unappealing as possible by slashing the starting salary and rushing through the 'Eton Old Boys' to top ranking jobs without ever having to be spat at, kicked, punched, stabbed, shot, sworn at, had missiles through at them and put their lives on the line. It is plain and simple Dave. There are not enough of them any more. Not enough by a long shot. So, in the words of Oliver Twist, 'Please Sir, can I have some more?'

Just a thought, you know that publicly owned bank, RBS? You know, the one we all bailed out with our taxes. Well they are paying their staff £950,000,000 in bonuses this year. As they are PUBLICLY owned, why not use the money to fund the salaries for 38,000 new police officers on £25,000 a year. I think my maths is right. There are other banks to you know. Other ones we all helped fix. How about they now help fix us? I know, I know, I'm probably not looking at the bigger picture, but in that big picture I just see the words 'No Units To Send'. Silly me.

By the way Dave, this wasn't a work of fiction for effect. This actually happened. To me. Have a read. http://www.barnettoday.co.uk/news.cfmid=3449&headline=Man%20in%20court%20for%20paramedic%20assault

Good luck with the economy Dave, there are tough times ahead.

Your Sincerely

Ella Shaw (Public Servant)

Trapped in Darkness - Part 2

continued.....

"Male, U/K age, One Under"

Until now, I had been totally patient focused and hadn't noticed the commotion around me! There were about 6 Fire fighters under the train too with various member of underground staff trying to work out how to lift up the train. I'm guessing by the discussions that it isn't something that is done too often! In most One Unders they are either a) dead, in which case the train is driven off them or b) alive but trapped by a limb, in which case if a quick extraction is needed an amputation and dragging out will happen. Unfortunately, they couldn't drive off as it was his pelvis on the track and you can't amputate a pelvis for obvious reasons!

As minutes ticked by we got drugs flowing! In went morphine and ketamine and fluids. We cut of as much of his clothing as possible to examine what we could get to. There were minor cuts and abrasions but nothing major. All the while, the patient was getting more and more frantic so more and more drugs were given to numb the pain and relax him. Problem was there was no real access to his head. He couldn't see anything but  darkness and could only hear and feel what was going on, and for someone who is claustrophobic I imagine it was torture. I was starting to get very uncomfortable my self, the heat, the smell, the noise, the taste of air, it all made it a very uncomfortable atmosphere. Add to that the fact that realistically the patient could simply die and we would be powerless to do CPR, ventilate and remove quickly. It was a scary thought! 

"Sorry we're all talking about you. How are you doing?"

"Get me out of here"

"We are, it will just take a little while, I'm staying here right by you, if you feel any new pains or anything changes, please tell me."

"Get me out of here"

"We will, we will."

"Please, help me, I don't want to die" he cried.

Talking to someone who can't see you is bizarre. I could only imagine his facial expressions and the fear painted across his soot covered face. I felt totally helpless in all honesty. I tried to keep him positive but as the pain continued and the time went on and on he became more anxious. To be fair, so did I. 

Eventually, after about an hour they were ready to lift. I don't credit the fire service that often but credit where credit is due. They had been fantastic. The were working their nuts off, bringing us more oxygen, providing light and lifting 120 tons of train up! It wasn't a case of 1-2-3 lift! So, in a co-ordinated effort and a very detailed plan, the scoop was lowered down to the tracks and slid along, rope on 1 end. The pelvic splint was positioned and as many hands as could fit were placed on various parts of the patient. We are all told to stay away from the wheels as if the train drops we don't want to get trapped! 'Drops?' 'DROPS?' Encouraging! 

"OK, we are lifting......"

"He's free. Lower him down"

"We got him"

He let out a gut wrenching scream. Once on the scoop he vanished. Pulled the along the suicide pit and out onto the platform where the HEMS paramedic and my crew mate would take over while we crawled out. I shuffled backwards slowly, eventually making it to the platform where the light and underground breeze could be felt. The platform was full. Police everywhere, about 30 fireman, a few ambulance officers, a second crew and of course......HART team huddled together watching! The patient was being strapped up and wrapped in bubble wrap. Blood infusions were being prepared and he was being put to sleep by HEMS. I bet he wished he'd been asleep a long time ago. 

Within only 2-3 minutes we were ready to go. I took over the breathing for the patient and 8 fireman lifted him up and off we went through the maze of tunnels and escalators. FRESH AIR! Oh how I missed it. Behind us was the band of merry men and woman carrying all the kit. Everything was chucked on board, blue call placed and off we went. I was trying to take stock of everything that was going on. Suddenly, the doors swung open, we were at hospital, I hadn't even noticed we'd stopped. Into resus we went, a 30 strong team waiting for us. Luckily for me HEMS did the handover. I'd have probably starred blankly and said 'Hit by a train...erm...'!

We went back to the vehicle which  looked like a bomb had exploded inside. We tidied up and I started on the paperwork. Where the hell did that job come from! It really is true, EMS Rule number 10:

EMS is extended periods of boredom, interrupted by occasional moments of sheer terror.

Nothing can prepare you for things like this. It isn't for everyone. It is one of the few jobs that tests every part of you. The problem is you never find out if you passed the test. As all crews will say, he was alive when we got him to hospital so that's a win for us. It's a cover though. In reality, we are all desperate to know if he survived. We will probably never know. That's the reality of pre-hospital care....once you're at the hospital, your care is supposed to end. 

 My crew mate pointed at my face...

"You got a bit of dirt on your cheek!"

Back to Basics

“23 year old male, hand injury”

Right, the time has come to get back to basics. This blog is aimed at anyone who isn’t in the know or is confused about what’s what when it comes to getting treated by the NHS. So, first things first.

Hospital: A hospital is a health care institution providing patient treatment by specialised staff and equipment.

Accident and Emergency: Accident and Emergency is a department within a hospital and is a facility specialising in acute care of patients who present without prior appointment, either by their own means or an ambulance. Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum  of illnesses and injuries, some of which may be life threatening and require immediate attention. All A & E departments in the UK are financed and managed publicly by the NHS. As with most other NHS services, emergency care is provided to all, free at the point of need and regardless of an ability to pay.

Ambulance: An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury. The word is most commonly associated with road-going emergency ambulances which form part of an emergency medical service, administering emergency care to those with acute medical problems.

Triage: Triage is the process of determining the priority of patients’ treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate, sift or select. In a hospital setting patients are divided into three main categories based loosely around the old wartime triage process:

• Those who are likely to live, regardless of what care they receive;
• Those who are likely to die, regardless of what care they receive;
• Those for whom immediate care might make a positive difference in outcome.

Ill people go to hospital. Really ill people go initially to accident and emergency. If they can’t get there due to their illness or injury they get an emergency ambulance. Once at hospital they are triaged. That triage will determine the speed of their treatment. Those rules apply to everyone.

So, we were called to a young guy with a hand injury. Not a bad hand injury but a painful one all the same. He had managed to close his finger in a door. It was swollen. It was bruised. He couldn’t fully bend it. He was in pain. He didn’t take any pain killers. He called 999 and asked for an EMERGENCY ambulance. This was deemed to be one of the acute medical problems that we are there for. He lived half a mile away from the hospital. His girlfriend was there. She had a driving licence. She owned a car. Her car was parked outside. His brother was there. He had a driving licence. He owned a car. His car was parked outside. His mum was there. She had a driving licence. She owned a car. Her car was parked outside. His dad was there. He had a driving licence. He owned a car. His car was parked outside. On the notice board in the kitchen was a business card for a local taxi service. They did not use it. 30 yards from the front door was bus stop. The bus which stops at said bus stop also stops outside the hospital. The patient had legs. They were not injured. He could have walked to the hospital. He chose not to. 

After a brief assessment in the £750-a-call-emergency-ambulance we drove him the half a mile to hospital. His girlfriend and mum came with us. The brother and dad followed in the car and parked in the pay & display car park. We walked the patient into the accident and EMERGENCY department. We spoke to the triage nurse and gave her a detailed history of what happened, what we have found and how he has been with us. She then triaged him based on what we told her and what her cursory look at his finger told her.

• Those who are likely to live, regardless of what care they receive;
• Those who are likely to die, regardless of what care they receive;
• Those for whom immediate care might make a positive difference in outcome.

“Waiting room please”

The girlfriend with a driving license and car stepped forward.

“The waiting room? He’s in pain, you haven’t even treated him yet”

“He has a hurt finger. I have 46 patients in the department now, all of which are a higher priority. There is a baby in there who may die. There are 2 patients in there who also may die. There are 16 patients in here who NEED a bed and require treatment because they are THAT ill. There is 1 doctor on duty, 4 nurses and 2 health care assistants. There are no beds free at all. The fact you called an ambulance for a finger injury is a gross abuse of the NHS. The fact I am sending you all to the waiting room should tell you that his hurt finger never has and never will be an EMERGENCY, now go and wait for your name to be called like everyone else.”

With that, she walked off. I was in awe! She summed up in 30 seconds what I have wanted to say to every single patient who has called an ambulance for nothing and who has been sent to the waiting room.

Why do people think there are long waits in hospitals? 

Erm...because there are people who could wait to see a GP who are sapping resources.

Why are people surprised they sometimes have to wait a long time for an ambulance? 

Erm...because so many people are calling an ambulance for the most puerile of complaints.

Why are people surprised that they are send to the waiting room? 

Erm...because they don’t need to be there.

Why do people seem to want to spend night after night sat in a hospital? 

I have no answer to that. Maybe a hospital lover can enlighten me!

When I am ill I want nothing more than to lie in bed and feel sorry for myself. I will ONLY go to hospital if I absolutely have to. I would never called an ambulance unless it was a life or death emergency or if I was too injured to get myself into a taxi or a car. People seriously need to get a grip and stop expecting miracles from our free health care service. The NHS is being killed by its misuse. Accident and Emergency. THE CLUE IS IN THE NAME. Emergency Ambulance. THE CLUE IS IN THE NAME. When someone picks up a phone and dials 999 they are greeted with a question. ‘What’s your EMERGENCY?’. How anyone can hear themselves say ‘I need an ambulance because I have hurt my finger’ or ‘I have a headache’ or ‘I can’t sleep’ is beyond me! In London alone the call rate has doubled to around 1.7 million calls per year in less than 10 years. Of that, 1.2 million people get an ambulance. This jump is not down to an increase in population, nor is it down to a population that is more ill or more accident prone. It is because people are not using the services as they are intended to be used. They have become lazy and reliant on a free service and are abusing it.

Please please please people! Stop killing our NHS. Once it’s gone, it will not come back.

92 minutes earlier

My cup of Costa went flying as our brakes ground to a halt at the same time as the second ambulance. The patient was lying there motionless. A woman was doing CPR. Blood was trickling out of his ear.  We all rushed over (no ambulance walk today) and each started doing our thing. As the crowd began to gather, I began to suction his airway. It refilled with blood almost instantly. Where was it coming from? He was still alive.....just. We stopped the CPR, he had a pulse albeit very faint. It was a case of two of us managing the airway, a combination of ventilating, suction and draining. We just had to make do. He still had a gag reflex so without ‘grown ups’ we were powerless. There was now 6 of us swarming around him. IV access was gained in both arms, 2 bags of fluid were hung up. He was attached to the heart monitor, his pulse was fast but regular. His blood pressure was still in his boots. 

“Can someone raise his legs please?”

“On it”

“Right, lets get these clothes off him”

“HEMS are on way”

“More suction please”

“How’s the BP looking”

“Try some more ventilation”

“What’s the SPo2?”

“About 77 over 40”

“80%, did we have an ETA?”

“I’ve got decreased air entry on both sides, possible bi-lateral pneumothorax”

“More suction please”

“18 minutes” 

“Want some cannulas?”

“Yeah, you alright to do the right side?”

“His left pupil is blown”

“Yeah, no probs”

“Can you grab us bed, blocks, straps and a scoop?”

“Who’s conveying?”

“Think the pelvis is gone, can we get a strap on here?”

“What was the resp rate when you arrived?”

“Did anyone see what happened?”

“I’ve got a sheet, we can use that until HEMS arrive”

“About 4”

“No idea”

“That’ll do, we’ll get it underneath on the log roll”

“I’ve got no respiratory effort, how’s the pulse?”

That’s the conversations that were going on between the 2 crews, the FRU and the duty officer. It’s probably worth mentioning I only knew 2 of the 5 people who were there. That was the same for all of us. At one point I thought to myself that it was amazing how we were all task focused on different parts of him without ever discussing who was doing what. There were two of us solely on the air way, two were getting IV access and decompressing the chest and two were removing clothing, getting kit and monitoring obs. 

The crowd was getting bigger by the minute. My crew mate lent over to me:

“His entire family are over there watching”

That always adds an extra emotion to an already chaotic scenario but for now we just had to ignore that. 

“Are we ready to move him?”

“I think so, lets get the scoop in here?”

The scoop was split into two, I was on the head so couldn’t move, leaving 3 of them to do a log roll, 1 to slide the scoop in and the other to carry on suctioning. 

“OK everyone in position?”

“Yep, on your count”

“OK, one, two, three, roll.....hold it there....one, two, three down”

(Everyone swaps sides)

“OK, one, two, three, roll.....hold it there....are all the clothes clear?”

“Yep”

“OK, one, two, three down”

“Right, lets get some straps on”

“More suction please”

“Police are here”

“How long for HEMS”

“About 2 minutes”

“OK, how’s BP, pulse and sats?”

“BP is up slightly, lets get the bed over.”

The beautiful sound of HEMS sirens could be heard in the distance. Being early evening the helicopter was offline so they come by car. The three orange jump suits came bounding towards us. A handover was given by my crew mate and then they took over. 

“Right guy, lets get him on the bed and move him over here. We need all round access”

We followed the instruction, all the while bagging and filling up our 4th suction unit. They were going to perform a Rapid Sequence Induction (RSI) which would basically put him into a coma. Once under, he would be able to be intubated and his airway would be protected. Whilst one of HEMS were setting that up, the other two were playing with scalpels! Two incisions were made in each side of his chest, fingers were inserted into the holes to see if his lungs were inflating properly. I could still sense the family watching from afar as well as the eyes and expectations of the crowd baring down on us. It was quite a scene, 9 of us standing around him, some performing procedures, some drawing up blood transfusions, some ventilating and others just doing.....stuff!

The drugs were administered and they managed to intubate. Now we could think about leaving. Or not......

“We’ve lost him, CPR please”

I started compressions and after a minute or so, couldn’t help but look over to the shocked faces 20ft away. Hands were over mouths, some people were crying. I could feel the hairs on the back of my neck stand up. 

“OK, he’s back with us, well done guys, let’s get moving”

In all honesty, I had zoned out, I don’t know what was done in those 4 minutes, I just know I was doing CPR and now I didn’t have to. The guy was loaded on. In the ambulance was the patient, 2 of HEMS, me and my crew mate and a copper. In the second ambulance was the other crews and all the kit that was lying where we had been. The police followed with the family and the HEMS car and another police car drove up front. Off went the convoy. 

24 minutes later we arrived at hospital. The bed was rolled out and onto the ramp. The door swung open revealing the long corridor ahead of us. The huge trauma team was waiting in resus and the now 8 of us did a rapid walk towards them. Some pushing the trolley, some holding fluids, 1 ventilating, others carrying monitoring equipment. He was transferred to the hospital bed while a handover was given. We then left to clean up the bomb site that was the back of our ambulance. About 25 minutes later HEMS came out to us.

“How’s he doing?”

“Not great, he’s got a sub-dural and extra-dural haemotoma, bleeding on the brain stem, a depressed skull fracture, a shatter jaw, fracture spine, bi-lateral haemo / pneumothorax, bleeding into the abdomen, a shattered pelvis and a broken mid shaft of femur.”

92 minutes earlier......

A man was celebrating his 75th birthday in a pub with his family. They had had a sunday roast. He had treated himself to a few whiskeys and why not?! He’s 75, he can do what he liked! He was with his wife of 55 years, his two sons, their wives and his 5 grandchildren. I can only imagine the joy he was feeling seeing all that was important to him sat with him smiling and laughing. It was time to go home, but before he got in his sons car he wanted to nip into the shop to grab a paper. He left them all getting into cars in the car park, he went to cross the road.

“RTC, car vs pedestrian, 75 year old male, cardiac arrest, CPR in progress”

In that moment, the joy was gone. In that moment 75 years was over. Maybe it was the alcohol that made him cross without looking on a bend.  Who knows? He’ll never be able to answer that. 

I remember looking down as his 3 piece suit was being cut off and his pocket-watch fell to the floor. I remember thinking to myself:

“I bet he was a lovely guy”

I never found out his name.

R.I.P

A special relationship......

"22 year old male. Unconscious and bleeding heavily"

A weekend in the city wouldn't be the same without drink, drugs, violence, vomit, blood and blue lights. More often than not, all the above are on the first job of the night. Today was no different. We were on station but our shift hadn't started yet. In a garage that holds 8 ambulances and 8 cars, our truck sat alone & being a Sunday night there was no management around and no admin staff. It was just us doing our VDI when the phone rang. We had already spoken to control to give our fleet number and skill level so they knew we were there so we had to answer! It was a begging phone call pleading for us to start early as there was a Cat A call and no other resources to send. Obviously we obliged, so not really knowing if we were missing anything we shot out the garage. It was only 3 miles we had to travel but doing that at 18:00 on the day of a Spurs vs Arsenal match and heading to Tottenham causes bit of a tricky drive. That aside, we arrived about 15 minutes later to a sea of blue lights. In the road was a guy lying on his back surrounded by police. As I stepped out the vehicle I could see a considerable amount of blood on the WPC's hands. The closer I got, the more blood I could see on all of their hands. What a mess!

The guy had been stabbed numerous times in the leg and once in the stomach and he wasn't in good way. He was pale, sweating and very drowsy. The police were applying fantastic pressure to the wounds so I took a moment to come up with a plan whilst listening to a vague handover. No one was exactly sure of what happened but what they did know was that a large crowd of 'anti emergency service' youths was gathering and were shouting abuse at us and the police. I called for HEMS back up or an FRU. In fact I believe I actually said "send me anything". If ever there was a reply which summed up David Cameron's reign of terror on front line services this was this:

"Sorry, we a spread thin. HEMS are tied up and there is nothing else available at the moment. We've got A & E support running from 13 miles away but until then you'll have to make do. As soon as something comes up I'll send them. Sorry guys"

Still think cuts to emergency services is wise? Hmmm! I wanted someone who could assist in major trauma. No disrespect to A & E support but they are not even aloud to do an ECG or give Calpol. They would be as useful as a chocolate teapot. It was us and the police. I started cutting the guys clothes off. He was panicking but we were far to pre-occupied with his life threatening injuries to be able to talk to him. Cue the police. Not only are their 12 officers trying to keep the crowd back, trying to protect us from some missiles that were being thrown but were applying pressure to wounds, opening dressing, passing us kit and constantly re-assuring our patient. No instructions needed. They just did it. The main source of bleeding was his groin. It was an arterial bleed and was taking all of my energy to apply the pressure needed to slow it down. My crew mate was placing orange cannulas (wide bore cannulas for trauma) in both his arms and drawing up fluids. It was a real mess. 

I was aware of two things. Firstly, the crowd was becoming angrier by the minute and things were getting rather volatile between them and the officers who were now almost making a cordon around us. Secondly, our patient may well die where he lay if we didn't move soon. Again, without prompting the trolley bed appeared. The police knew we had no hands to do it our self. Normally we'd use a scoop or sheet to lift someone but with the number of bodies we had at our disposal it was just a case of lift and run. We got him on board and put in the blue call to the trauma centre. As we were about to leave an FRU turned up. He dumped his car and at our request, drove the ambulance. In the back was me and my crew mate and three cops. The three who had saved our patients life. We arrived at hospital and bundled into resus. The guy was transferred and hospital staff took over from us. Off we went to the blood bath that was our truck. There was blood everywhere, everyone was saturated but it was a good job done by all. 

This job itself would have stood up well as a blog in it's own right but for me it was a great example of the special relationship between the ambulance service and the second best emergency service; the police! (sorry guys, couldn't miss out on the banter). No matter what the job is, there is a respect and admiration between the two of us. We wave as we pass each other on the road (take note fire brigade) and there is always a welcoming look of relief when one of us arrives at the others scene. This was a perfect example of two public services working well together for one purpose. The police come under a lot of stick and put up with much more abuse and violence than we do and normally shrug it off as being part of the job but that isn't good enough. They are a fantastic bunch of people who do the toughest job in the most difficult of circumstances. This country is lucky to have such an outstanding force and the sooner that is recognised by the mindless minority the better. This guy WOULD have died, I have no doubt, if the police hadn't done what they did but it won't gain them any respect or thanks from the idiots who abuse them. It wasn't their job. It was ours but they did what they had to do. I wrote a letter of thanks to their police station, only knowing their shoulder number. I hope it got to them. That's the funny thing. There are so money different police and so many different ambulance crews, most of the time we are working along side officers we have never met yet the respect and professionalism never wavers. Time after time, we call them when there is even a hint of danger and they come running. I'll always be in their debt and as such will always be more than willing to give my call sign, even on the ninth time of asking. Bless 'em!

Diminished Responsibility or Bad Policing?

 "18 year old male, going out of his mind"

In my line of work I often get the opportunity to work at various events as a medic with private companies. I mainly work at festivals as it's a good chance to see some good music whilst getting paid. Win win! Last year I worked as a medic at Bestival on the Isle of White. It was a great weekend, I got to work with new people, got to work on an array of different vehicles and although the majority of jobs were drink and drug related it was pretty easy stuff. Pick 'em up and drop 'em off at the field hospital where they were monitored then discharged. It worked pretty well. At about 9pm on the Sunday evening, which was the last night, and while the headlining act was on I was sent to one of the campsite hubs to attend a girl with breathing problems. We jumped in our 4 x 4 buggy and headed over. It was a panic attack. Nothing special. Whilst talking to her however a steward came running over.

"Can you come and help us, there is a guy just up the hill going out of his mind, I think he's on something"

I radioed it in and headed over. I left my cremate who was a first aider to stay with the panic attack and went with the steward in the buggy to the space cadet. It was about 200m from wherer I was and about 20m into the campsite. I clambered over the guide robes and tents and eventually got to the guy. He was about 6ft fall, skinny and clearly wired. His friends were all stoned and laughing at him and said he'd taken a 'molly' of MDMA. MDMA or Methylenedioxymethamphetamine to be flash is basically ecstasy. A 'molly' means that instead of a tablet it's in crystalline or powder form. This was the drug of choice for this years festival. Last year it was Ketamine but MDMA was the order of the day this year and by all accounts it was a pretty potent batch. 

I gathered that the patients name was John. I tried talking to him but he was indeed out of his mind. He was hallucinating and begin to get quite panicked. I wanted to get him out of the campsite and onto the path but when I turned round to get assistance from the steward he had gone. I was on my own. As I turned back to John he punched me in the face which knocked me to the floor and then proceeded to jump on me and try and strangle me. His friends came to my aid and between us we sat on him. I was able to press the emergency button on my radio and after a few minutes stewards came running over and we got him to the buggy. He head butted me and spat in face numerous times until the police arrived and handcuffed him. I had a fat lip, a swollen face, cuts to my neck and general bumps and bruises. He was arrested and taken to the hospital. Once at the hospital the Dr gave him a hefty dose of Midazolam to subdue him. My boss made it clear the company would fully support me to press charges and were absolutely fantastic about the whole thing. I was told  by the police to come back in a few hours to give a statement. 

In the hours that passed, I returned to work and John came to. He was taken to the welfare tent to sleep it off and had been rather apologetic by all accounts. Too little too late! At about midnight, after my 12 hour shift I went to give my statement. It started off as all statements do, blah blah blah but then the following conversation occurred.

"So do you want to press charges?"

"Yes, definitely"

"Why? Don't you think that's a bit selfish?"

"Pardon"

"Well he's only a kid and it will stay on his record, that'll ruin his life, besides he had diminished responsibility because of the drugs"

"So, he assaulted me, drugs or no drugs, it's no excuse"

The other officer in the room then came wondering over and pulled up a chair as if I was being interrogated. I was only a desk light in my face away from a scene from Law and Order!

"I know it's no excuse but be realistic. If you press charges we have to provide officers to take him back to mainland, what a waste of resources, especially when he won't be charged with anything?"

"Why won't he be charged, he assaulted me?"

"Yeah but you've got no lasting injuries and at the end of the day it's your word against his"

"So what!! Look at me"

"Well if you do press charges we won't be recommending it goes any further, you'll just be wasting everyones time for no reason. At the end of the day, it's a festival. Things work differently"

"OK, this statement is ending here, it will be continued after consultation with my bosses and your inspector in control. I have both of your shoulder numbers. Goodbye"

With that, I stormed off to the office. A expletive filled rant ensued and my boss marched me off to see the inspector. A long conversation followed and at 2am the inspector decided to take be back for my statement and to press charges. I waited outside while the inspector had a very heated discussion with the officers. He then came out to me with an awkward look on his face.

"I'm afraid that since you left here earlier your attacker has been released without charge. We have his details but don't know if they are correct. I'm very sorry, we can take your statement and if we make contact with him charges will be pressed."

I just walked away. Since when did the police show such disregard for the law and for procedure. I wrote a 2000 word complaint letter but just received a pathetic standardised response. John wasn't caught, not that I believe any attempt was made to find him. Am I over reacting? Do drugs provide a reasonable defence for violence to emergency services? Was it really diminished responsibility? Or was it just a lack of willingness to do paperwork and put in the time? I hope the latter. If copious amounts of drugs is a reasonable defence then that gives all drug user carte blanche to assault who they like, when they like with no repercussions. Shameful policing.

Claim Pain

"RTC, Cars vs Car, 3 patients with neck pain"

Over the past decade, a culture of claim has slowly developed in Britain. Advert slogans like 'where there's  blame, there's a claim' encourage people to claim for absolutely anything. A woman made a claim for £1m because her chair 'farts', gamblers sue casinos for loosing money, McDonalds were sued because someone burnt their tongue on hot coffee. The growing litany of ludicrous litigation needs to end. We now live in a country where kids can't do a sack race, can't play with conkers, where every injury costs companies money and where even burglars can sue for injuries sustained while 'on the rob'.

The fear has gripped every council and business and the introduction of absurd rules, regulations, signs and labels have become common place but one of the biggest areas abused by the public is that of whiplash. England has become the whiplash capital of Europe. Over 1300 claims are made every single day and accounts for over 75% of all injury claims in the country. This huge amount of claims has in turn led to a huge amount of companies encouraging people to claim. Just type 'claim' in to any search engine and see just how many there are.

We were called to the above job. When we arrived there was a big black BMW, a man, a woman and a child occupied the seats. Behind them was a mini cooper. Standing next to the mini was a mother and child. They were both fine, and the reason they were fine, was the it was a 2mph impact. Not a mark on either car. The police who were on scene had requested the incident be reviewed on CCTV. It was and the following came of the radio:

"No more than 2mph. The front vehicle didn't even move"

Case closed? No. I had 3 patients. The eastern european family in the BMW all had neck pain. Even the 2 year old. (I couldn't confirm this as he didn't speak english but the parents assured me that despite the fact he was laughing, the child had neck pain)

"Ok sir, stay nice and still, we are going to arrange to have the roof cut off your car"

Like a jack-in-the-box he leapt out of the car, as did his wife and the child was removed. Amazing recovery. They made it clear they needed to be checked over and needed a copy of my paperwork. 

"I'll give my paperwork to the hospital"

They declined hospital. They wanted to go and see their own doctor. Totally fed up and frustrated I completed the necessary paperwork and off they went. And here lies the problem. They will put in a claim. The lovely lady who bumped them will be financially punished with an increased premium despite there being no damage OR INJURY! The family will probably be awarded £2500 each for whiplash injuries as they are hard to prove and the doctors who assess them don't care. Doctors are there for diagnosing and treating but they are being used to alleviate social conditions and perpetuate a compensation culture. If you’ve got a doctor who is being paid £200 for every report he stamps, there is no incentive for him to turn around and say ‘I don’t believe you’.

I don't know what is being done by the government but something has to give. These idiots got 2 police cars, an FRU, an Ambulance and no doubt 3 GP appointments. For emergency services alone you are looking at a net bill of £3000 to the tax payer. Multiply that by the 1300 claims a day and its evident that 'claim pain' is not sustainable. Stop it and that 'national deficit' may become easier to wipe off.