24 - Season 2: Episode 2

continued......

The following takes place between the hours of 8:41am and 12:18pm

08:41

"27 year old female, 24/40 pregnant, feeling faint"

So, second breakfast will have to wait! Never mind! It was turning out to be surprisingly busy for the car! Normally there is some down time between jobs because on the car you only go to the higher priority of calls and are generally kept in your area. Today, everyone in my area seemed to be falling ill on an all to regular basis!

Again, I found myself at a supermarket. This time I was on scene within 90 seconds of the call coming in, so when I arrived at the cheese aisle, the patient, surrounded by store staff, was still on the phone to the call taker. I always enjoy the looks of amazement that I'd been able to drive 200 meters so fast! What they don't know, is that the very second they dial 999 the nearest available unit is dispatched by a computer. If its a mobile phone, you are dispatched towards the co-ordinates of the phone mast where the call originated and are then redirected when the address is confirmed. In this case, the mobile phone mast was on top of the supermarket, so when I got the address I simply turned off the engine and got out the car!

The patient was a really sweet young woman who was expecting her first baby. It had been an uneventful pregnancy up until now, but today she was experiencing some profound dizziness in spells. Dizziness in pregnancy isn't uncommon at all and she would need a check up, but really, she was fine. I checked her over, shared my war stories of parenting and generally talked babies, surrounded by cheese, whilst waiting for the ambulance. Mmmm cheese! Those second breakfast gremlins are coming back! 

Eventually the crew arrived, we said our goodbyes and once I'd put by bags back in the car I returned to the cheese aisle with a basket! 

09:35

"General broadcast, all mobile, holding a cardiac arrest, 1 month old baby, limp and floppy, gone blue, please go green or come up on priority if you can assist"

"Red base, I'm green, happy to run on it." I said as I dropped the basket and RAN back to the car." 

As I opened the door the job appeared on my screen. I accepted it, looked at the address and shot off. 6.6 miles to go, through the city, that's 9-10 minutes on a good run. I hope to god another vehicle is coming from closer than me. 

I could feel the adrenaline kicking in, I was driving at mine and the cars limit and fixated on the road ahead of me. I could hear the job updating repeatedly on the screen, but I daren't look at it whilst driving at speed, never worth the risk. As the miles were ticking down, I started to go through a vague plan in my head. I was recalling the resus guidelines for a 1 month old in my head just so I didn't flap when I arrived. I'm not going to lie, I am new to the car, new to this 'lone working' thing, and the thought of being solely responsible for this kids life scared the living daylights out of me. 3.1 miles to go......

I was weaving through the traffic at a rate of knots. Fast acceleration and rapid breaking, to take into account other drivers unpredictable actions. No doubt someone will say I shouldn't need to if I'm driving properly but sod em'. As far as I'm concerned a baby is dead, and they will stay dead until I get there and I will drive as fast as I can do so, safely. The end. 1.8 miles to go.....

I had just over a mile to go, the cars still parting like Moses and the tide, eyes still wide open taking in everything ahe.....

'CANCELLED: No longer required'

WHAT?! Aaaarrrrrrggggghhhhh! Now I'm 6 miles out of area, my heart is pumping stupidly fast, my palms are sweating and I have no frickin' cheese! I pulled over to calm down for a few minutes! I HATE cancellations.....with a passion!

09:47

I sat in car, stereo on (Cheers Mr Buble), seat declined slightly and just laid there. I was hungry but wasn't near any shops and had no real idea where I was so took the opportunity to just chill out! It had been a pretty relentless start to the shift, so until I was told to do otherwise, this is where I would be!

After having my slumber rudely interrupted by a pedestrian wanting directions to a building 25 feet away, I decided that the urge for food was now too strong to ignore! I started heading back towards civilisation in the hope that shops would appear.

10:52

"51 year old male, unconscious, ? Low blood sugars"

And there we have law of the sod! I should have gone as soon as the opportunity presented itself but procrastination has always been my thing! 

I recognised the address when it appeared. If memory served, he wasn't a regular caller per say but someone I've met a few times, controls his diabetes well, but occasionally makes a mistake and has a hypo. It happens! At least it was back in area though, so I wasn't going to moan about the 7 mile run! 

Sure enough, when I pulled up outside, I recognised the house and once inside, recognised the unconscious patient on the bed! He was snoring away, pouring with sweat and showing all the signs that it was indeed a hypo! A quick check of his blood sugar confirmed it. It was 'Low' which means its too low to give a reading on our kit. I set about cannulating him, drew up some glucose fluids and set the drip going. Then it was a case of waiting for him to wake up, act confused for a few minutes and then start apologising for having wasted my time!

10 minutes later, having started a discussion about rabbits playing tennis, he froze, then said:

"I've done it again haven't I?!"

"Indeed you have!"

"I'm so sorry for getting you out, I don't know what happened, I had my insulin this morning!"

"No worries, hospital?!"

"I think you know the answer!" and I did!

"Red Base, cancel the ambulance if you have one assigned, the patient is declining hospital so I will discharge him to his own care, over"

"Rog, thank you."

After checking his sugars, I gave him some more glucose, then while I started on the paperwork, he got changed! During a hypo, people can sweat profusely and his clothes were saturated. Whilst he was upstairs I got his wife to make him some jam sandwiches and a sugary tea. We all sat chatting whilst I dotted the I's and crossed the T's. I even got a coffee for my troubles which was very much needed as I was starting to lag! I'd been up for 7 hours or so and was yet to have more than half a bowl of cereal! 

Have you noticed how much I'm thinking and talking about food! It's a problem. I need help! Anyway, I got him to sign to say he was happy to stay at home, referred him onto his GP and left them to go about their day! I was in my 'break window' now so I made myself available and for once, relished a chance to stop for 45 minutes and eat some hot food! It really is a novelty!

To be continued.....

Materni-taxis

Ok, this may be a contentious issue and I don't mean to cause offence, but this is not just coming from the 'me' who works on ambulances. My opinion is partly geography biased, being in a city no one is ever more than 3 miles from a hospital, this means no one is ever more than a £6 taxi journey to a hospital, and this is where my frustration comes from. I fully understand that if you live in the middle of the countryside, 45 minutes from the hospital with no means of transport then yes, an ambulance is totally appropriate, but in the city I am sure any pregnant woman could save the cab fare over a 9 month period. By all means, call an ambulance if you need one but a contraction, waters breaking or a 'show' is not, and will not, ever be an 'emergency'! Please read this post in the spirit in which it is meant, an ambulance girl fed up with playing 'taxi' to expectant mothers whose partner follows in the car and lives 400 yards from hospital! If you need us, call us!


“27 year old female. In Labour”

So what! It’s an all too common job. A woman in labour calls an ambulance for a lift to hospital. She isn’t ill, she isn’t dying, she is going to give birth. Giving birth of a function of nature, thats’s what we do. Women have been giving birth since time began and I can assure you, that was long before the invention of the ambulance. Despite our obvious displeasure at being sent we drove there, lights and sirens and ‘save’ another pregnant woman too lazy to arrange her own transport. 

You don’t suddenly give birth. There is a 9 month pregnancy leading up to it. During that time you would have thought a lift could have been arranged. If not, a taxi?! A saving of just 25p a week throughout the pregnancy should be enough to cover it. Failing that, most people know someone or have a neighbor who transports their litter in a Chelsea Tractor. Bug them. Not us! Obviously, if something is wrong, or you have the urge to push, then that is a different matter but don’t take the piss.

We arrived on scene, grabbed all our kit; response bag, oxygen bag, maternity pack, entonox, Paediatric Advanced Life Support kit, inco-pads (yes, it weighs a ton) and headed to the front door. It took some negotiating to get us and our stuff past the 3 cars on the driveway but we made it. Mum-to-be was dressed and ready to go, bags packed and in the hallway, Dad-to-be clearly to excited to drive was fretting about everything, as was various other family and friends who were going to follow in the car. Contractions were coming along nicely, every 6-7 minutes, no show, waters not broken. This really was a life threatening medical emergency. Oh, and they hadn’t phoned the maternity unit or midwife. It’s OK though because we can do that for them too. Anyway, all aboard, boxes ticked, i’s dotted and t’s crossed we drove the 1.6 miles to hospital. Another life saved.

As mind boggling as this is, and as annoying as I find materni-taxis this isn’t why i’m blogging about it. Shortly after the job I tweeted the following on twitter:

“You’ve had 9 months to plan, call a taxi, get a lift from another mum in a Chelsea tractor. It’s labour. You’re not ill. You don’t need 999”

Within 3 minutes of this tweet I received the following message via my Facebook page, which quite frankly, made me seethe. The message was as follows:

“A woman in labour has every right to call an ambulance. The ambulance has all the medical equipment and the paramedics have the medical knowledge to deal with a birth, a taxi does not and neither does a neighbour with a 4x4. Show me where it says a woman in labour cant call an ambulance. Also while you’re at it show me the HPC code of ethics, as i think your statement is way off and to discourage any woman in labour from calling an ambulance is medical negligence. I would invite you to prove me wrong, if you can fine, but bet you cant??? A woman in labour without a way to get to hospital is hardly a sprained wrist and she much more in need for an ambulance than an elderly person who has just fallen over. I suppose you’re going to go onto long term illness and tell me i cant call an ambulance when my daughter is in DKA.”

Are you serious? What a deluded, self-centred fool. It is people like this which cause all the problems in this country. People who think they have the divine right to an ambulance whatever the circumstance, it’s selfish and greedy and exactly what i’d expect if this vulgar human called 999. Yes, you have a right to call an ambulance, if its an emergency, but normal labour is not. You’ll also be reassured to know that the only training a paramedic has on maternity is a 2 day course. We are given a very brief overview on how to deliver a baby in an emergency. Admittedly taxi’s and neighbours haven't had the luxury of a 2 day course but they don’t need it to drive your lazy arse to hospital. They need exactly what we need. Money for petrol. No where does it say a woman in labour can’t call an ambulance, it isn't advised though. The following has been copy and pasted directly off my employers website:

“Please think carefully before calling an ambulance in pregnancy or normal labour. Call your midwife, birth centre or labour ward in the first instance for help and advice. Ambulances are needed for life-threatening emergencies, and normal labour is not an emergency. During your pregnancy, it is important you discuss with your midwife the signs of normal labour and plan your transport to your chosen place for the birth. Initially any pregnancy or labour concerns should be raised with your midwife or birth centre. This includes worries with foetal movements, or if feeling unwell, as they can advise you further.”

To be honest, a) I can’t be arsed b) I don’t have the inclination to and c) I don't care enough to trawl through pages and pages of codes of ethics to find a sentence that will make my point and appease you. Your comment on the elderly speaks volumes about your character too. You are ill informed about the medical needs of pregnant women and to even suggest that a woman in normal labour is more deserving than a 92 year old lying on the floor with a fractured neck of femur is laughable. It’s people like you that cause these genuine patients to be left on the floor for 4 hours +. And as to your snipe about my sick leave, you don’t know me, you’ll never know me and what my sickness has to do with your daughters DKA I don’t know. What chance does she have anyway when your archaic opinions are what she has as an example to follow. No wonder the NHS is in crisis.

Obviously, I wouldn’t want to deter anyone who is in need from calling 999. On the rare occasions where an ambulance is needed for an obstetric emergency I would want someone to call. If:

• You are immediately about to give birth with a strong urge to push.
• If there is fresh bleeding which is more than an egg cupful (or two changes of pads).
• If you have severe abdominal pain that continues and persists after a contraction.
• If the baby’s cord is noticeable.
• If you are suffering from other medical emergencies, such as breathing difficulties or chest pain.

Call 999!!!! If however, you want a free lift to hospital and you are in normal labour, please don’t. It’s an unnecessary drain on resources and is a massively inappropriate use of an emergency ambulance. Rant over. Be safe x