3 am

This is an ambulance blog right?! So, you can imagine my surprise when I was asked to guest post for Big Fashionista! She is a powerhouse in the blogging world so it was a real honour to be asked to write for her ,but what about?! Fashion, beauty, lifestyle, her much vaunted Nom or Vom?! Luckily for me, and probably you too, it was none of the above! She just wanted a blog, about a job I've done, that I wanted to share with her many readers!


"18 year old male, fall from height, cardiac arrest"

3 am is a cold, dark, wet, blood soaked account of one of those nightmare jobs that stay with you. Go have a read on Big Fashionista's website and while you are there enjoy some of her fabulous posts!

3 am - view here

A big thank you again to Big Fashionista for inviting me on to her blog. I am not ashamed to admit that I did a happy dance when no one was looking!

The Circle of Life

Life is a funny old thing and if this job has shown me anything it is that. The general public of this fine country never fail to disappoint. I see incredible strength and incredible weakness, absolute joy and crushing sadness. Stupidity is rife, common sense is sparse and everyone loves a good drama. I get to see a snap-shot into people's lives, I get to see inside their homes, inside their bedrooms; see their photos, their prime and their squalor. The difference in people is truly amazing but the basics are the same. You are born; you are helpless and rely on everyone for everything. You grow up; work, live a life and occasionally get so drunk that you regress to the behaviour of an infant. You then grow out of it; retire, get old and eventually you are back to square one. You are helpless and rely on everyone for everything again. It is the circle of life. It is only ever going to start and finish in exactly the same way. It's how you act in the middle that defines you.

This night shift was no different to any other in terms of the length of shift, the crew mate and the type of jobs we did, but there were three jobs that stuck out, that got me thinking:

"1 month old male, crying, DIB"

Not the most exciting of headlines really! We headed round to the address expecting the usual 'walk on, walk off' type of job. They are our bread and butter jobs; no lifting required, from start to finish it would take an hour, the patient probably not that ill but a trip to hospital regardless. We arrived and headed inside. The doting parents were stressing, the baby was indeed crying. He way lying on his back, massively distressed about something. What? No one knows; they can't communicate and it's a case of 'best guess wins'. Try cuddles, try music, try food, try toys, try Calpol. Clearly in this case it was then 'try ambulance'. Unlike most other mammals, human babies are helpless. For years they can't really do anything for themselves. They need their nappies changed, they need to be fed, they can't explain what they are thinking; their frustration must be immense. This is how it all begins. Ahead are years of learning, years of making mistakes and years of paying obscene taxes, working for the best part of 50 years and if they are lucky having a reasonable retirement. We checked him over, walked to the ambulance and off we went to hospital. I love the innocence of them. Yes it's annoying that this is a complete waste of time, an arse covering exercise if you will, but babies go to hospital. I'm not risking it! I also remember how I felt the first night I came home with my son. I just stared. 'Has he stopped breathing?', 'Is he ok?', 'Why is he crying?' The fact is I was still learning and so are they! Handover complete, I ran to the shop to buy my nutritious dinner of a BLT and a coffee; a pretty standard diet. Next!

"26 year male, lying on pavement,  intoxicated"

This is the regression I mentioned. Having had 2 bites out of my pre-packed BLT sandwich and a few slurps of coffee, we arrived on scene outside a pub in the heart of the city. Lying on the floor in what appeared to be a very expensive suit was our patient. He was conscious but plastered. Apparently he had been drinking all night with friends and something went array after the last Jaeger-train & Sambuca chaser. Binge drinking seems to be the hobby of choice for most 16 - 30 year olds. They can never handle it; loose all sense of decency and end up lying in a pool of  their own vomit in front of the group of girls they had been trying to impress with their power-drinking prowess. Oh how the mighty have fallen. We got him on to the bed and onto the ambulance. His friends were very well spoken. Apparently he was a hedge-fund manager, whatever that is. Rich people investing in hedges? I genuinely have no idea. I can barely afford a tea fund. Job title regardless, he was now back to being helpless, just like he was 25 years ago. He needed positioning so he didn't suffocate, his face needed wiping and at hospital he would need undressing and dressing again. I have no doubt that once fixed he'll be mortified and full of regret. En route to hospital the regression was more than evident. Remember boys when they are born? Remember the nappy change horror? The arch of pee?! Yes... Half way to hospital this guy whacked out his crown jewels and did his best impression of being back on the changing table. It's amazing what 25 years, a degree and a bottle of Jaegermeister does to one's sense of decency. True to form, my solution was simple; chuck patient's Hugo Boss suit jacket over his crotch and swiftly avoid the golden river heading towards me. We dropped him off, cleaned out the vehicle and I got back to my BLT. Next!

"93 year old female, fall, can't get up"

The address was a care home. The word 'care' is meant to be ironic or sarcastic I think because, despite an army of 8 carers on scene, they left her without blankets until we arrived.  Obviously, for health and safety reasons they cannot help their patient, a patient in their care, off of the floor. Silly me. Unless there is an injury we are not supposed to be called, but in all fairness due to her advanced dementia she was unable to tell them. This is where life reaches full circle. Ok, so I don't imagine that in 1944 she was binge drinking her 20's away, things were different then, but I'm sure in her own way she had a raunchy dinner and dance or two. She has lived her life, a good life if her photos were anything to go by, and was now back at square one. Lying on the floor unable to do anything then herself; she needs her nappy changed, she needs to be fed, and can't explain what she is thinking or feeling. The frustration must be immense. This is how it all ends. Depressing?! Kind of. I don't want to end up like that, I want better care and more dignity but we cannot change the inevitable. We will end how we started. We checked her over and put her back to bed. There were no injuries or anything untoward going on. It was another bread and butter job, a pick up and put back to bed. I knelt down beside her. I felt something strange. A weird sensation; one I have felt before but one I promised myself I wouldn't feel again. It was the all too familiar feeling of urine seeping through my trousers and onto my knees. Joy! Next!

Stop, Look & Listen

This week marks Child Safety Week so to that end this is the first post of three to highlight areas of concern that I have come across in recent months. The theme this year is Small steps to safety to show that by changing only a few small things, a child's safety can be greatly improved. For example: putting hot drinks safely out of reach, teaching children how to cross the road carefully, strapping your child into their car seat each time, or fitting (and regularly checking) smoke alarms; these little things can make a huge difference. We all have our moments, sometimes careless, sometimes forgetful and sometimes doing things on autopilot; Child Safety Week aims to just raise awareness of the accidents that injure and kill children and how to prevent them. Writing those few words was chilling, but it does happen. I have seen it. You only have to read 'A Tragedy Laid Bare' to see how quickly lives can change.

This post is about road safety. It is simply a look at the basics. Stop, Look & Listen! Three words which all children are taught. The thing is, do we always set the right examples? Do we always cross at crossings? Do we always stop? Do we always look left, look right, look left again? Do we always listen to what is all around us? I have to admit I may be guilty of failing on occasions. I probably cross local roads with my son without going through the routine every time. I'm writing this post because I have been to the same type of job twice now and to me, twice is two too many. 

"RTC Car vs Pedestrian. 2 patients. Age unknown. Report for HEMS"

When someone is hit by a car it attracts attention. Normally it happens in a busy area with a large footfall and as such crowds gather. What you get with a crowd is a lot of mobile phones and a lot of 999 calls. This inevitably leads to confusion over what you are going to so I tend to just wait and see. The words Car vs Pedestrian can mean pretty much anything is possible. It could be bumps and bruises, broken bones, crushing injuries and at worst, a very public, traumatic cardiac arrest. We pulled into the high street and could see about 100 meters away the hordes of arms waving at us. The sheer number of them was daunting to say the least but the frantic nature of them was a concern. I may have said in the past I love a crowd, today I didn't. Why? Kids.

Lying on the floor, surrounded by people were our patients. A mother and her daughter. They had been hit by a car whilst crossing at traffic lights. The driver hadn't seen the lights change, nor seen them start crossing. He had probably been on his phone or something similar and was understandably shaken up. Our priority however was lying on the floor. Initially heads had to be immobilised so we used members of the public. We each assessed a patient. I had mum, my crew mate had the little girl. The mum was in huge amounts of pain and rapidly becoming more and more groggy but naturally her only concern was for her daughter. Until she knew her daughter was OK I was going to get nowhere so I promised to go and see. On this occasion mum had taken the impact. A basic assessment showed the girl had been knocked to the floor by mum, no direct impact with the car and no injuries other than bruising and grazed hands.

Mum wasn't so lucky. She had instinctively turned to face the car and protect her daughter from it. The impact had broken both of her legs. She also had a broken pelvis and a broken arm. She had possible spinal injuries and neck pain. She had a head injury. A bad one. Talking loudly across the gap between where they were lying, me and my crew mate had a very public, frank discussion and decided to leave the girl where she was, the police who were just arriving would deal with her. There was no other ambulance or resources available yet. The mum was a priority; her injuries were serious enough for us to request HEMS. The next 12 minutes flew by; by the time the helicopter was circling above we had 2 ambulances and a car on scene. It was a hive of activity, everyone was doing something; the bed appeared, IV access was being gained, dressings and splints applied and spinal board and straps in position. It was organised chaos. Once the orange jumpsuits were on scene they took over. She was whisked off in the helicopter and we took the girl. 

"Is my mummy OK?"

To be continued...

"RTC Car vs Pedestrian. 2 patients. 6 year old female unconscious. 35 year old female injuries unknown. HEMS on way"

Gulp. We go to 9-10 jobs a day, 4-5 days a week, 52 weeks a year. That's roughly 2500 jobs in a 12 month period. 99% of those jobs we don't bat an eyelid to. 1% of them terrify all of us. The anxiety is palpable en route to jobs like this. Read '7.9 miles' to see exactly what is going through our mind. The only difference between that job and this job is today we pressed 'on scene'. There is something very surreal about seeing a child lie on the floor. Maybe it's their size, maybe it's just the fact they are a child, maybe it's because I see my boy lying there instead. It's horrible. She was motionless; the mother was on her knees beside her crying. We ran over. There was no pomp and circumstance, nor was there any thought spared for the mums injuries. Today, the little girl took the impact. Take a moment to think of a child standing next to their mother. Think about where the bonnet of a car is on each of them. You can probably see why the mum in the last job had leg injuries. You can also now see why this girl was unconscious. 

The girl was alive, her airway was clear, she was breathing, her pulse way strong. Primary survey clear.  Due to the fact she was unconscious and so small we decided to get her on the ambulance as soon as possible out of the public glare. We fitted a collar and as soon as the second crew arrive we got her on a board and out of the public view. The mum came with us and was incredible. She let us do our thing. She sat in the front of the ambulance watching through. She didn't ask questions, she didn't distract us, and that is such a huge help. As a parent I can only imagine what  was going through her mind. Someone asked for an update on HEMS. Before the answer was given the back door swung open. Thank god! The sea of orange got on board. No helicopter this time, they had come in the car and would travel with us to hospital. We stood back and they did their thing. Once stabilised we left. It was a 20 minute drive to the trauma centre. Eyes fixated on the road I made my way through the traffic, all the time aware there were 4 people standing up in the back. Mum stared. She didn't say a thing. Just watched and cried. As we pulled in to the hospital she said:

"Is my baby going to be OK?"

To be continued...

Stop, Look & Listen. Both of these accidents happened at pedestrian crossings; the lights had changed to red, the green man had appeared, and they had crossed. The traffic had not stopped. Autopilot had kicked in. You see a car stop, the green man appears, the beeping begins and you cross. Unfortunately, where there was no car waiting on the far side there now is one; seconds later and there is nowhere to go and nowhere to move to. The impact is inevitable. All that remains is who will take the brunt? Both of these could have been avoided. The small step to safety is just to double check. Have the cars in both directions and both lanes stopped? Is it safe to cross? Drum this into your little ones. Set the example. Stop, Look & Listen.

Continued...

How do you say "Probably not" to anyone?

On The Buses

"45 year old male, unconscious, breathing unknown, life status unknown"

Public transport. We all use it at some point. Personally, I avoid it where I can. The price does not match the experience. If it's a train you have to pay an obscene amount of money to go minimal distances. For that money you get to stand up in a hot sardine tin, armpits in your face, rubbish on the floor, chewing gum on the seat, shoehorned in like battery hens and you are taken from A to B where you may or may not get pick pocketed. It's all part of the fun. Then you have the bus. It's still at least £2 just to go 1 stop up the road; again you have to stand, chavs aplenty line the aisle having conversations across the bus: 'yes bruvs', 'no bruvs', 'trust me bruvs', almost in three part harmony. The baby at the front is crying, the diva behind you is on her mobile phone and you sit there tediously moving through the traffic slower than walking pace. Then you have 33 sweaty school boys bundle on, block the exit and spend their entire journey throwing balled up paper at each other. On top of all of that you have the drivers. They have a warped sense of power and never smile. They think they own the road and I'm pretty sure they get their driving licence free with a Fisher Price 'My First Car' kit. And yes, we have to pay for these experiences. 

My feelings about public transport aside, it is my dealing with bus drivers at work which sends me into a blind rage. It's not the fact that they pull out on me without indicating, block the road when my sirens are blaring so they can continue their drop off and picks, or even flip me the bird because I cause them to have to move out the way for me. It's none of that. It's there bone idle, lazy abuse of the ambulance service every single day. 

6am starts are wrong; when you leave the house it is too early for breakfast and I generally ignore the alarm for so long that coffee isn't even an option. We checked over our vehicle, made a coffee and I put my toast in the toaster. JOB! Typical. About half a mile away the update came through:

"Patient on 84 bus in bus station"

I looked frantically around for something to throw in frustration. There was nothing. I suddenly developed fluent 'French' and filled the cab with all sorts of expletives. God knows what my blood pressure raised to but apparently my face was bright red. Admittedly I was pre-judging the job, but having done the same thing countless times I was fully prepared for what was about to happen. 

We pulled into the bus station and headed for the bus with its hazard lights on. In the cab was the driver, feet up on the dashboard, newspaper in hand and a COFFEE on the dashboard. As I approached, the door was opened for me. The moron behind the glass pointed upstairs and said:

"He's upstairs at the back"

"Can you take us too him then? Who's up there with our unconscious patient?"

The driver looked extremely put out but I didn't move an inch until he got out of his cab. I gestured for him to go ahead of us. As he started to go up the stairs the (not so fast) response car arrived. A patient unconscious and possibly not breathing gets a full works and highest category of call. The two vehicles have just cost the tax payer £1500. We followed the driver up and sure enough, at the back of the bus in the corner, was our patient, asleep.....

"When you called you said the patient was unconscious, he isn't"

"I thought he was"

"He's asleep"

The driver just shrugged his shoulders.

"HELLO, wakey wakey, rise and shine!!" I shouted whilst shaking his leg.

His eyes burst open with shock. What a rude awakening! He didn't have a clue what was going on! He had simply fallen asleep on the bus. He had been up all night and had waited for the first bus and had nodded off. Now he needed to go back in the other direction. He hadn't even been drinking! He was very apologetic for 'wasting our time' and headed off on his merry way.

"Don't worry fella, we all get tired, and it wasn't you who called us, apparently it takes an ambulance to say 'wakey wakey'!"

He laughed, I felt smug, my crew mate cringed and the bus driver frowned.

"It's not my job to wake people up, it's not my problem if they fall asleep"

"But it is the ambulances job to get your passenger off your bus?! Such a waste of resources"

"We are not allowed to, for health and safety"

"What?! You're not allowed to talk to people, say 'Hello' or 'Wake up'?!"

"No, they might be violent"

"True, best get a couple of girls to come and do it. Do me a favour; don't say unconscious and not breathing unless they are both of them. If they are unconscious and not breathing you should be looking after them, not reading your paper. Unbelievable"

With that, I grabbed my bag and stomped off.

Every single day these people are wasting time and money through sheer laziness and blatant lying. They don't even try. They look in their mirror and see someone still on the bus and call us. What if someone was actually dying? What if they were having a stroke, a hypo or worse, had gone into cardiac arrest and needed CPR?! Does health and safety mean they cannot help a member of the public, the paying public, when in need? This is not what an 'Emergency Ambulance' is for, this is not how the taxpayer's money should be spent, and most importantly, this is not a reason for me to miss breakfast and go without coffee. Now where in God's name is the nearest Costa?!!!

Priorities

What do you want for your kids? Success, happiness, good health etc, are all things that are top of the list. The dads may wish their son becomes a footballer or a golfer. The mums amongst us may wish their daughter becomes a dancer or a doctor (The chavs amongst us want them to be a WAG!). These aspirations are generally a flitting fantasy based on our own childhood wishes and realistically we just want the basics. We put a strong onus on them being good people with a good work ethic and to have a good character with good moral fibre and good manners. We just want them to be good! We are there to nurture their interests, guide them through the good and bad times and hope they leave with enough social nous to make their way in the big wide world. There will be slip-ups along the way, that is a given, parenting being the prime example. I have certainly made my fair share of faux-pas during my almost 5 years as the owner of a boy!

"5 year old female, fallen, bleeding from face"

It was a gorgeous summer evening, the kind of evening where all you can think about is being sat in the garden, a BBQ, a jug of Pimms, some music and the company of friends. There was the smell of burning charcoal in the air and the thought of sizzling meat and a token potato salad was frustrating and making me drool. Why? Because I was 4 hours into a 12 hour shift in an ambulance with no air-con and my lunch bag only housed a soggy tuna sandwich and a warm bottle of water. Yes, before you ask, I AM living the dream. The 'bleeding from face' appeared on our MDT and was met with all the enthusiasm you could expect. We now had a choice; drive 4 miles with windows open and risk losing our sense of hearing or drive 4 miles with the windows closed and risk melting to death. We opted for the former! Needless to say, 4 miles later we wandered towards the front door of our patient's house with a severe ringing in our ears.

As we approached the door we could hear the crying. All kids have their very own set of cries. There is the hunger cry, the pain cry, the tantrum cry, the ill cry, the fake cry, the overtired cry and the 'give me what I bloody want' cry. We all know them and deal with them in different ways. I could tell, as we were walking up the path, this was a pain cry. When our kids are in pain, what do we do? Comfort them, reassure them, play down what has happened: 'it's not that bad', 'shall I kiss it better?', 'you're being so brave' etc. It is natural; we will do anything and tell them any lie we can, just to make them feel better. It's called parenting. 

"Hello there, what's happened today?"

"She slipped on da wet floor gettin' out of da barf and smashed her face on the floor, oh my god, there is blood EVERYWHERE"

She ushered me into the little girl's bedroom but before I could say anything she had time to quickly berate her for mucking around at bath time. 

"It's OK, it doesn't matter, have you hurt yourself?" I asked the girl as I knelt down.

Before she could answer through the tears, mum interjected:

"Oh my god, it's really deep, it won't stop bleeding, oh my god, she's gonna need stitches and EVERYFING. It looks awful"

No wonder she was crying, poor little thing. I tried my best to assure her that it was OK and I was just going to have a look. The mum butted in again:

"Oh my days, her face is gonna be fucked up, she's gonna have a scar, she can't have stitches on her face, oh my days!"

Just out of interest, what exactly are you imagining here? A large cut across the forehead bleeding profusely? A fat lip and a nasty gash somewhere on the face? How about if I said it was a 3mm cut underneath the chin, not remotely visible if you were looking at her! Yes... I know. Why the drama?!

"It's not that bad at all, it's not even bleeding now, it won't need stitches and probably won't even need glue." I conciliate.

"It needs glue, it has to be glued, I can't risk a scar, tell 'em it has to be glued."

"The hospital will decide but it is so small and under her chin they probably won't bother to be honest." I continue.

"Nah, I ain't 'avin that, they 'av to glue it, I want her to be a model, I can't have her havin' a scar or a fucked up face, no way, she's gonna be a model, I ain't 'avin her let me down cause of a scar."

You can imagine what was going through the little girl's head and why she had a totally rational fear of me. She was crying, waiting for an ambulance to come and take her away. Take her away because her face 'looked awful', it was bleeding everywhere, there was going to needles and stitches, she was going to have a scar and if she failed at becoming a model her mum was giving off the impression she would love her less! THIS is not parenting. This is madness & I had to tell the mother that she was scaring her child for no reason. I spent a few minutes chatting to the kid, convincing her there would be no needles or stitches and a nurse was just going to look at it and probably give her a sticker for being so brave!

"Will I be able to go to school tomorrow?"

"Of course you will! What are you doing at school tomorrow? Anything fun?"

"I'm doing a dance in assembly and then there is a cake sale." she said with a grin.

Cue mum...

"But I've told you that you can't eat cake or you'll get fat. Also we don't know the hygiene in other people's kitchens, it could be minging"

Cue despair...

I have clearly led a sheltered life up until now. Obviously you see pushy parents on TV, but weight conscious 5 year olds? Mums obsessed with living their own fantasy through their kid's short childhood? Doesn't that only happen in American pageants? I really don't know what distressed me more, her inability to make her child feel better when distressed or her unhealthy obsession with her daughter's future. I just wanted to scream 'LET HER BE A KID'! Success? Happiness? Good health? They certainly appeared so far down on the list of priorities in this household. Aspirations of grandure are never healthy and the pressure and expectations can ruin a childhood.  The 'ambulance' in me wanted to tell her off about inappropriate use of the service. Kids fall over, they get bumps, they get bruises, they get up, they cry, you kiss, you feed, they smile. Simple. The parent in me wanted to tell her to calm down, comfort, kiss and hug her daughter, stop frightening her and make everything better. The foodie in me wanted to say 'just let her eat some bloody cake'! Instead, I kept schtum, blew up a rubber glove and made it look like an elephant. 


Cue the smile...