Medics should be seen but not heard

"Bunch of primadonnas acting like spoilt brats"

Doing the job I do, I get the opportunity to work an various different types of events for a number of different companies. Most recently I worked at Wembley for the England international match against Holland. Being a new stadium and one with a huge capacity, as expected it has excellent medical facilities. There is a mini hosiptal which has minors, majors, a resus, x-ray facilities and everything else you would expect from a hospital. There are doctors, nurses, consultants, radiographers, paramedics, EMT's and first aiders enabling it to be a self contained fully functioning hospital. Due to beaurocricy however it is not run by just one company. Wembley Medical staff the hosiptal, but they do not have the contract to take patients to hospital. This is done by another contractor who provides 3 ambulances and staff to man them. On top of this London Ambulance Service have to provide staff incase there is a major incident as neither of the other ones have the resources to cope. The problem is the 3 companies don't work in harmony. The whole operation can't go ahead without LAS presence, Wembley Medical don't welcome LAS and the transport are treated like a sub species by Wembley Medical. It does make for some interesting interactions which I have seen first hand from all sides, having firmly stuck my fingers in all the pies going! On this particular occasion I was working for the company contracted to transport the patients to hospital.

Each company has their own priorities regarding patient care. Up to 90,000 people cram into the stadium and all have the right to treatment free of charge. The NHS does still exist at the moment! There are mobile medical teams, first aid points on every levels and skill mix of staff to deal with everything. Once in the hospital they are treated for their illness or injuries and either discharged or taken to an NHS hospital by one of the ambulances. Unfortunately it appears only certain facilities are available to the paying public. If a precautionary x-ray is needed, rather than have it done on site by the radiographer the public will be sent to join the queues at the local hospital. X-ray is reserved for footballers only. If a patient is ill enough to be in the resus room they can only go in there if all 3 beds are empty. Resus is reserved for players only, they need privacy afterall. If a patient dies, the priority isn't to work on them and save them. Oh no. It's to get them off site as quick as possible because, and I quote:

"It's not good for PR if someone dies at Wembley, imagine the headlines!"

Forget about the fact that 'stay and play' is sometimes the best thing to do, we've got an image to protect. That's what's important right?!

When I said there are 3 ambulances, that isn't entirely true either. There are 3 vehicles but only one is for the public. It's the old one. There is a slightly newer one that can be used as a spare ambulance in case the players need 2, but they would rather it wasn't used. Then, there is the brand new ambulance. That is only for the players should they need it. And if they do, these are the instructions we have.

• Don't talk to them
• Don't speak unless you are spoken to.
• Don't ask them questions
• Don't ask for autographs
• Don't take photos
• Do whatever they want, no matter how unreasonable you think it is. They are the priority over anyone else. They get what they want.

Since when did these overpaid, untalented ADHD kids become royalty. Since when do they get to dictate and affect the treatment of the public? We were basically told, 'you are their bitch'. Why are we even there then? I understand the rules about photos and autographs, that wouldn't be professional, but 'don't speak unless you are spoken too'? I'm not a petulant child from the 1950's. I'm here to provide medical care to anyone who needs it regardless of social status or ability to do kick-ups. 

Another example of the needless pampering arose when I was bringing a patient from somewhere in the stadium to the hospital. The lady had a head injury from a fall, albeit a minor one. She wasn't well enough to walk so she was in a chair. As you can imagine Wembley is huge. The hospital is in the underbelly of the stadium. To access it there is an internal road over 1km in length that goes around the entire circumference of the pitch, just outside of public view. We were within 100ft of the hospital and were stopped my security. 

"Sorry, this way is now closed, there may be players by the coaches"

"We are going to the hospital with our patient"

"You'll have to go the other way, we can't have people getting near the players"

Fifteen minutes laters we reached the hospital. I simply do not understand the power these players have. The fact that Wembley Medical seem willing to allow this nonsense goes a long way to explaining. I understand that the players should be left alone by staff, we are not their to verbally abuse John Terry (as much as I'd love to) but if a paramedic and an EMT are wheeling a patient with an obvious, actively bleeding head injury to hospital, how can it be right, or medically responsible to make us walk 1km around the entire stadium just incase we get to near a precious footballer?! Can you imagine the headlines if she, or any other patient, died whilst going the long way round?! Probably not because 'it's not good PR if someone dies at Wembley'. 

The world has become obsessed with the celebrity culture. These 'role models' that are paid in excess of £100,000 a week (or 5 years wages as I like to call it) to kick a ball around. They are pandered to and yet there are no penalties or changes to their lives for drink driving, racism, violence & sexual assaults. Even on the rare occasion where they go to prison they come straight out back into their highly paid  privileged lifestyle. If the layman commits those crimes the fines and punishments effect them. If I was found guilty of racial abuse the £2500 alone would be a real struggle to pay. I would lose my job and would struggle to find another. If John Terry is found guilty of racism (which I suspect he will be) the fine imposed will be 2 hours 38 minutes wages, he will remain employed on £170,000 a week and will release some kind of sugarcoated statement to appease the masses. No doubt he will still represent our country as a convicted racist. What message does this send out to the youth?! 

The only reason the footballers and celebrities act like they can tread on anyone and do what they want when they want is because our society allows it and panders to it. Until a stand is made nothing will change and we can't really blame anyone but ourselves. I for one will not be working at Wembley again while that Mickey Mouse outfit is running things. 

(Unless of course, I'm offered double pay... slave to the wage and all!)

Buggies

Buggies. Some parents live by them, some detest them. I am the latter. I cannot bloody stand them! The second that the boy could walk more than four steps without falling flat on his face the buggy was put into retirement. Luckily for us he embraced this and like me, he is extremely stubborn. Even on the rare occasions it was offered he would insist on walking. If I was in a rush, he would be carried. Why don't I like them? Well, they take up so much room, they cost so goddamn much and when I wasn't using them they just annoyed me everywhere I went. They cluttered aisles in supermarkets while other mums chatted, they blocked my desired route while in shops and people seemed totally incapable of not driving them into my ankles everywhere I went. Don't even get me started with them on buses and trains or I will explode. From an ambulance perspective loading a mum and her 'ill' child onto an ambulance, complete with the bags, the other kids and a double buggy is a pain in the arse to say the least. OK, OK, they are a necessity but that doesn't mean I have to like them. The reason I am writing this blog though is one of safety and sheer stupidity. I see it every single day at work, I see it every day driving my car and if you haven't seen it you are clearly living in an area which isn't home to muppets!

"RTC Car vs Pedestrian, 2 year old male, injuries unknown"

Those words give a sinking feeling every single time. It is the sinking feeling of fear. A weird fear but a fear all the same. Obviously fear is usually associated with something that makes you jump; a moment of tension in a film or a phobia. It isn't that we don't know what to do, it isn't that we don't feel able to do what we need to do, nor is it the fear of working in front of a crowd; it is the fear of seeing a dead child. A dead child that will make me think of my son. A dead child in front of their mother. That is the fear. Each drive to these jobs is subdued; you are hoping it isn't as given, you are hoping a passer by has got it wrong, you are hoping you are cancelled 'No longer required'. We were not cancelled, instead we struggled to barge our way though the traffic caused by the RTC. As per usual with these type of jobs, it occurred on a pedestrian crossing on a busy high street with a high foot fall. We were first on scene and my heart sank as we ground to a halt. Lying in the middle of the road was a push chair. A contorted push chair. Contorted by the impact with the Land Rover sat at a 45 degree angle on the crossing with its hazard lights flashing. The usual sea of frantic waves greeted us but from where we stopped, all I could see was the pushchair.

I grabbed the bags, my crew mate grabbed the collars and a blanket and I tentatively made my way around the car. Lying on the floor was the little boy. He was wearing the same Thomas the tank engine t-shirt that my boy wears. At his head, kneeling on the floor was an off duty policewoman keeping his head still. At his side was his mother, crying and holding his hand. Surrounding them all was a 50 strong crowd, camera phones at the ready. This morbid practice has become customary every time there are blue lights in the vicinity. Could this be the next viral YouTube video, could it be the next malpractice story the Daily Mail would sink their teeth into? I just try to ignore it. I made my way over to the boy. His eyes were open. That was a good start! To cut a long story short, we checked him over from head to toe. Apart from dirty clothes and a small graze on one of his hands he was injury free. Thank god for kids being bouncy. We took the usual precautions but I was happy that he was going to be just fine. Now, what happened?

It didn't take long to establish the facts. The mum had walked up to the pedestrian crossing and pressed the button. Remember 'Stop Look and Listen'? This time she had! She had approached and waited until it was her time to cross at the edge of the pavement. The problem was, she was pushing the buggy and whereas she was on the pavement, the buggy was half in the road. The car, driven by another mum with her child onboard the Chelsea tractor (that's a rant for another day), had not been concentrating and had continued to drive in a straight line and failed to see the buggy in the road. Bang! Land Rover + Maxi Cosi buggy = Contorted mess + flying child. 

What... the hell... was she thinking?! Why do people do it?! It is your child, don't push them into oncoming traffic! Seriously! Like I say, it is not uncommon either! EVERY SINGLE DAY!! Walk down a high street, any high street and look at just how many buggies are edging out into the road! I have taken to stopping and ranting when I see it.  Most sheepishly reverse, some flip me the bird and some tell me to Foxtrot Oscar, but why take the risk?! Every time I see it, my hatred for them increases. Obviously, I am being completely unreasonable in my hatred for an essential item but that's just me! I see things at work that cloud my judgment and make me see red! Have you seen this happen?! Is it just me?! Do you hate buggies too?! Maybe it isn't the buggies, maybe it's the muppet in control of them but it is easier just to blame the buggy and be done with it!

I Shall Wear Purple

"76 year old female, dizzy spells"

There is one thing that never ceases to amaze me in this job and that is the characters that I meet. Sure, there are idiots in the world; there are also time wasters, hypochondriacs, grumpy people, angry people, rude people and ill people, but there are just as many people that make my day. They may not be ill, they may not necessarily need an ambulance, but they are polite, funny and interesting. I had spent the morning with the aforementioned  idiots; every single patient I had seen had been rude, ignorant and a complete drain on resources. I needed a pensioner to cheer me up. I think it's a generation thing. Their generation was formed on respect. They are more often than not happy to see you, grateful for your presence and forever apologising for wasting our time. Over and over again I tell them they are not and it is an absolute pleasure to be with them. 

We arrived at the house, let ourselves in via the key safe and shouted the usual 'hello, ambulance' as we entered. Our patient was sitting in her armchair, the broadest of smiles met us as we approached. To say she had a wacky outfit would be an understatement. She was wearing a green skirt with pink and white polka-dot tights underneath. On top she had a Mickey Mouse t-shirt and a purple suit jacket with shoulder pads. Her glasses were similar to that of Dame Edna Everage and her hair was a pale yellow, styled like GI Jane! I started asking the usual questions to ascertain what was wrong with her but she quickly changed the subject:

"Do you like my outfit?"

"It's certainly a lot more fun than mine!"

"There is no point in being boring is there?!"

"This is very true!"

"My daughter hates it, she is embarrassed to take me out! What a prude"

"I'll take you out then!"

"I'll hold you to that! I was so fed up of my clothes being boring, you see of these fashion sorts on the box, there are no rules saying that just because you are old you can't wear what you want"

"Very true, why the hell not eh?!"

"When my husband died I decided I would never look like a bore again, so I wear what I want when I want."

"Good for you!"

She pointed at the wall opposite and told us to have a read. On the wall, in a frame was a poem by Jenny Joseph. She told us that she read it, loved it and has lived by it ever since. We both stood and starred:

When I Am an Old Woman I Shall Wear Purple

When I am an old woman, I shall wear purple

with a red hat that doesn't go, and doesn't suit me.

And I shall spend my pension on brandy and summer gloves

and satin candles, and say we've no money for butter.

I shall sit down on the pavement when I am tired

and gobble up samples in shops and press alarm bells

and run my stick along the public railings

and make up for the sobriety of my youth.

I shall go out in my slippers in the rain

and pick the flowers in other people's gardens

and learn to spit.

You can wear terrible shirts and grow more fat

and eat three pounds of sausages at a go

or only bread and pickles for a week

and hoard pens and pencils and beer nuts and things in boxes.

But now we must have clothes that keep us dry

and pay our rent and not swear in the street

and set a good example for the children.

We must have friends to dinner and read the papers.

But maybe I ought to practice a little now?

So people who know me are not too shocked and surprised

When suddenly I am old, and start to wear purple.

As I turned back around to her she said:

"I've been practicing, now i'm a master of it! If you don't like me in purple, tough!"

This is why I love my job. You just wouldn't meet people like this stuck in an office. She wasn't that ill, she'd had a couple of dizzy spells and had called NHS direct. She didn't want to go to hospital so we referred her to her GP. Obviously that had to be done over tea and biscuits. She was an incredibly proud woman; proud of her appearance and proud of her home. Her look may not be everyone's cup of tea but it doesn't have to be. This was her time to rebel against the norm and 'step away from the mundane' and she was doing so in style and with a smile. As she said, 'two fingers up to anyone who poo poos me'! Priceless!

Right or Wrong?

"40 year old female, won't get off the floor"

Doing the kind of work I do brings with it some fantastic opportunities. I work for a number of different companies doing various event work ranging from sports events to concerts and festivals. This weekend I was lucky enough to be able to work at the Red Hot Chilli Peppers concert in Knebworth. For most of the day I was working on the cycle response unit but occasionally I was required in 'the pit'. The pit is the area between the stage and the crowd. When crowd surfers or people who can't stand the crush get to the front they are escorted back into the crowd by security. The reason I was there was in case anyone came 'over the top' injured. I have done a lot of festivals and you would be amazing what medical problems come flying over the top into the waiting arms of security; unconscious people, seizures, open fractures, neck injuries, crush injuries and 6 year olds! Nothing surprises me anymore! Being up front for the headlining act is a sought after place and people literally wait there all day and night! Saturday was no different. As soon as the gates opened people ran to the front to wait! One of the eager few was a woman in a wheel chair. 

She had arrived early, sat in the rain, queued like everyone else and had wheeled herself to the front and sat there all day. She was told as soon as she arrived at the front by security that she probably would not be allowed to stay there but she wouldn't move. The issues surrounding her being there are down to 'health and safety'. I can hear some of you groan already but in this instance I'm with the H & S bods (To a point!). A crowd, 80,000 strong, all crushing up to the barrier causes injury in itself. Stick a woman in an electric wheelchair in there and not only is there a danger to her but to others too. As the day went by the 'wheelchair in the pit' situation was monitored and despite every effort by security to get her to move to the disabled viewing platform she wouldn't. About an hour before the Chilli Peppers were due on stage the decision was made by the event organiser that for her own safety she had to be removed along with her very heavy chair. Against her will, she was lifted over the barrier, followed by her chair and moved out of sight of the crowd whilst a plan of where she could go was made. From here things took a turn for the worse. She refused to get back into her chair. Instead, she threw herself on the wet floor.

There she sat, refusing to be lifted, refusing to move and getting further soaked by the rain. She quoted legal legislation to prevent anyone from touching her and although, technically they could have moved her as she was causing an obstruction to an emergency route, they opted for diplomacy instead. This approach however was futile. She was livid that she had been moved and part of me understood why. That part was my heart understanding her frustration. My head however felt she shouldn't have put herself in that position and should have just gone to one of the three disabled viewing platforms. This was offered but she wasn't interested. Again, I get why, I can only imagine being on a platform would make her feel like a spectacle. She just wanted to be in the crowd, soak up the atmosphere like everyone else. After an hour she agreed to be taken into our field hospital to warm up. This happened just as the Chilli Peppers were starting. The event organisers offered for her to sit on her chair in 'the pit'. She would have had a perfectly good view, better than what she would have had stuck behind a barrier, but she wasn't interested. She turned down all viewing platforms and every offer that was put to her. Now, she was simply cutting of her nose to spite her face. Again, I get why! It had been a horrible, embarrassing experience and to be fair, I would probably have acted the same. She sat on the hospital bed for all of the concert and once it had finished refused to leave the hospital until she was given a refund for the entire concert. The problem was at 11pm on a Saturday night the security staff and the hospital have no power to issue a refund and the event organisers are busy! Sadly, she was taken away punching and screaming by police.

Should it have come to that? No. Could it have been avoided? I don't think so. I am all for disabled people doing everything they can to have a normal life; I have close friends in wheelchairs. Unfortunately, no matter how much will they have, there are some things people's injuries or illnesses will not permit them to do. That is life. No it's not fair but life isn't. A wheelchair has no place in a mosh pit. I'm sorry but it doesn't. Event organisers have to think about everyone there and to accommodate wheelchair users there are viewing platforms with an unrestricted view, toilets and clear pathways. The fact is, rules are rules, right or wrong. The argument over whether the organisers should or shouldn't allow wheelchairs in the crush is another debate. If a wheelchair user pays for a full price ticket then surely she has the right to go where she wants. Unfortunately, she can't, and was told so from the outset and as horrible as it was watching it unfold the ones taking the action did not make the rule. I felt guilty looking at her on the hospital bed, she looked like a drowned rat. I know being in a wheel chair was not her choice and she is trying to lead a normal life and do things that everyone else does, but in this instance I feel she was playing on her disability to make a point. She wasn't removed from the crowd out of spite or malice, it was done with her best interests in mind and I agree with that decision. Were they wrong? Were they mean? Should she have been allowed to stay? Please tell me because I am split on this one!

Hydration therapy

"28 year old male, severely dehydrated"

Isn't summer great!? Beaches, sea, sand, ice cream and sun! Days in the park, evenings in a beer garden and holidays! The only problem with summer is that it has been and gone! Yep... remember those three hot days in early June? That was it! The big drought, the hosepipe ban, the sunburn and the change of wardrobe gone for another year. Normally with the 'summer' we experience a spike in heat related illnesses; sun stroke, heat exhaustion and even sunburn. Yes, people do call an ambulance for sunburn! Obviously, with the heat comes dehydration; when people don't drink and continue to lark about in the sun. You can imagine my surprise when I got this call in the pissing rain, a bit muggy but still, dehydration, at that age?! I tried not to judge; people can get dehydrated at any time but it isn't something people normally call an ambulance for, it's something we find during an examination and it is normally the elderly. Anyway, we headed off to the 'outside' location that we were given. The rain was pelting against the windscreen, the wipers could not wipe fast enough. We pulled up outside the address to find it was a newsagents. Outside, under the cover, was our patient. My initial thought was 'you're outside a shop, you're dehydrated, buy a bloody drink'! I kept that thought in my head, opened the side door to the ambulance and let him on.

"Hello there, what the problem today?"

"I'm really dehydrated"

"In what way?" (He didn't look dehydrated, his lips were not dry and pursed, nor was his skin dry)

"I'm just really really thirsty, it feels like really bad dehydration"

'Feels like really bad dehydration'?! What is that?! I'm no doctor, but this was the first time I had been in this line of questioning?! Has he been dehydrated many times before and know the difference better mild, bad and really bad?! It wasn't like pain that we can quantify and score. It wasn't if we could score the dehydration out of 10! Or was it?!

"When you say really bad, how bad are we talking on a scale of 0-10. 0 being perfectly hydrated and 10 being having a mouth full of sand?!"

"A 10"

"So just to clarify, it feels like your mouth is full of sand?"

"Yeah"

"OK, have you been drinking plenty of water?"

"I've had some, but not much"

"Why not? If your mouth is dry, drinking water may help"

"Because I read that when you are dehydrated drinking water won't be enough, you need fluids and stuff"

*sigh* "Have you passed any water recently? Any problems with your waterworks?"

"I did a wee about half an hour ago"

"And what colour was it? Dark?"

"Nah it was really light, almost clear"

"To be honest, it doesn't sound like you are dehydrated, just thirsty. What makes you think you are dehydrated?"

"My flat is really hot inside"

What can I say? What can I do?! Seriously, thirsty is now a reason to call an ambulance?! What next? An itch someone can't reach? A mouth ulcer? Why can these questions not be asked over the phone?! I could keep asking questions but no one has the answers. There is no cure for stupid. Would education help? No! He wasn't born or schooled in this country. No one will ever say no to him because of the fear that on the one occasion they say that to someone, they will drop down dead and then a finger has to be pointed. At least if they send an ambulance and he drops down dead they can point the finger at us! And what can I say to him? Sure, I can lecture him but then face a possible complaint on my record. I don't want that, no one does. Instead, I just advise him what to do if he becomes thirsty again, get him to sign my paperwork and head off to satisfy someone's itch. Living the dream!