Life Goes On

So, there I was, in Costa coffee, in the middle of town on a hot summers day, people watching! Throngs of people were rushing past in both directions, most with their mobile phone to their ear, the rest starring down at them as they walked. People don't break their stride for anything. Nothing can come in the way of routine.

Inside was the usual hustle and bustle of a busy coffee shop. The symphony of mobile phones, steam from the coffee machine, the chinks of china and metal spoons, the scraping of chairs and the dull hum of many discernible conversations echoed throughout the room. There I was doing my thing, there they were doing their thing.

I was deep in concentration and very task focused. Perhaps I didn't take care not to leave my bag in the way of the thoroughfare. Personally I didn't think it was too much in the way but hey, I guess it's subjective! A lady in a business suit, made a real song and dance over having to step over it, tutting as she did. I apologised and moved it out of her way so she could rush out and join the drones. I remember thinking 'that skirt is WAY too short, who's she trying to impress?!'.

It appears it wasn't only my bag in the way! Clearly I'd positioned myself in the worst place possible as within a minute a mum with a double buggy was trying to get by! This was NOT my fault. This thing was like a small car. You can't drive a car through a coffee shop so you shouldn't try and drive a tank of a buggy either! Anyway, rather than get in an argument about the rights and wrongs of double buggies weaving between coffee shop tables, I moved myself out the way and let her be on her way. 

I looked around the room and everyone appeared to be in their own bubbles. Two people having in depth conversations, mothers talking to their babies, a few people reading their books or newspaper, others on their laptops and some starring at their phones, tapping away. Then there was the queue! We LOVE a queue in this country! It's all so ordered! The constant gaze at the menu and the perusing of the patisserie stand. the starring at the watches, the playing with the phone and the shuffle forward like a penguin when someone leaves! It's amazing to watch! This particular queue was gradually getting bigger and was now blocking the path to the toilets. Now more people had to come past me! That meant more tuts. Some people even knocked into me which I thought was a little off!

The chime of the door was constant, as people came and went. Their lives crossing with others for a few minutes and then going on their merry way. I wonder if they would recognise anyone that they saw in here! Would they recognise Costa's Baristas? Would they recognise the people they queued next to?! Would they recognise me?! That girl they nearly all bumped into! I wonder!

Oh, I forgot to mention....

"46 year old female, having a seizure, in Costa coffee"

I was at work! This woman's seizure wasn't going to stop itself. It was a very violent fit, you know, the full body shaking one's you see on TV! All my bags were open, and adding to the coffee shop symphony was the hiss of the oxygen cylinder, the beep of the Lifepack and the hum of the blood pressure cuff. Amongst the madness was me, cannulating and giving drugs and generally getting in the way! 

Is it weird that life goes on around us?! Sure, people looked up and shared a glance but generally, a woman having a massive, life threatening seizure was just an inconvenience to most. After all, we have routines, targets and deadlines to meet. Do you think any of the people who bumped into me or stepped over my patient and my bags will get home 9 hours later and think 'I wonder if that woman is ok'?! Do you think they will even remember it?! 

For the record, she died that afternoon. And when we moved her out of the shop, still fitting, we blocked the road for 5 minutes. How many people do you think cursed us?! Probably all the ones beeping their horns.

Life must go on after all, mustn't it?

Funny Patients and Funny People

"40 year old male, ? hypo"

Badly controlled diabetes, quite frankly causes havoc for ambulance services up and down the country. These patients are generally regular callers, but ones who always require treatment and intervention and as such, little can be done to reduce the constant flow of resources sent to them. With a reduced level of consciousness it automatically means an FRU and an ambulance are sent and quite often, takes a significant amount of time to deal with. This particular patient was very well known to me with a mix of good and bad experiences. The last time I dealt with him he was naked and extremely aggressive. Trying to cannulate or give an injection into a patient intent on swinging arms, kicking and spitting is a tricky business! I was hoping on this occasion he would be completely out of it, and thus, easy to manage. As if I'd get want I want.....

I pulled up, grabbed my bags and headed inside. This guy's housemate is less than sympathetic to his plight and as soon as he saw me, he slammed his bedroom door. Just how most 40 year old single men act, right?! 

Today, one blessing was that he wasn't fully naked. He wasn't fully dressed either but beggars can't be choosers! He was lying on his bed, thrashing around as per usual and spitting in sporadic intervals. Joy! Luckily for me the ambulance arrived a few minutes after me so there were three of us on hand to deal with his stray arms and bodily fluids! 

Working on the FRU, I meet a lot of crews, often crews I have never met before and to be honest it's a mixed bag. Some are friendly, some are indifferent and some are just plain rude. Tonight, the crew were awesome! A great sense of humour, both dry and toilet and enough sarcasm and cynicism to amuse anyone. Despite dealing with a man intent on covering us in saliva we had a great time. I know it seems strange, but in this job, it is possible to spend a long time with a patient like this and enjoy yourself. Bear in mind, we all generally have the same, warped sense of dark humour so if you mix three like minded people with a bizarre patient, even more bizarre surroundings and a housemate acting like a sullen teenager, you're going to have fun. Throw into the mix a collection of Viagra scattered around the flat and you're left seriously trying to hold on to a professional demeanour, despite the obvious urge to burst out laughing! 

The patient was quickly medicated and then it was a waiting game for him to come back to his usual, strange and eccentric self! Needless to say, that time was passed sitting on sofas getting to know a great pair of people discussing everything from triathlons to drawn-on-penises. Seriously, how it got to that I'm not sure. It just happens. Anyway, once the patient was back to normal, he declined hospital, signed our paperwork and I left in a thoroughly good mood!

This job has its ups and downs. It can be the most demoralising and the most fulfilling, the saddest and the happiest. There are great patients and truly shocking patients but what makes it infinitely easier, is getting to work with great people. Tonight was a prime example. I left the patient, needing to change my uniform due to being spat on but did so with a smile. Thank you to crew the who came to help me with the funny little man with a silly haircut and an apparent addiction to Viagra! It was a pleasure!

They probably got in there truck, looked at each and said 'what a bitch!'

Boredom, Terror and Celebration

Fate is a funny thing isn’t it?! I’m not a great believer in it. I’m pessimistic at the best of times so the thought that things happen for a reason is a little beyond my comprehension! I’m also as far from religious as can be, so the concept of a greater force intervening in life’s goings on isn’t something I buy into to. Personally, too much bad stuff happens in the world. There is just too much hurt and tragedy, but religion is not a debate  I'm going to get into at any point on here! Each to their own! The reason I brought it up, is that fate, by definition is the development of events outside a person's control, regarded as predetermined by a supernatural power. Obviously I don’t believe in it but sometimes, I’m left wondering. 

For the last few months, I’ve been working on the Fast Response Unit (FRU). It has been a change of pace and a new challenge but one that I've thoroughly enjoyed. Lone working and not having a crew mate to rely on and bounce ideas off has really helped me develop as paramedic. At times, it has been utterly terrifying, knowing the buck stops with you. The weight of expectation from the public, often at the greatest time of need can be daunting to say the least! But, with every tricky job that passed I found myself growing in confidence and stopped being daunted but the prospect of arriving on my own. 

On the FRU, there is a lot more downtime. 

'EMS Rule 10: EMS is extended periods of intense boredom, interrupted by occasional moments of sheer terror.'

We are only sent to the higher priority calls, so a lot of the time I’m sat on standby waiting. I have 3 or 4 places I hide out but today I fancied a change! I drove around and eventually settled upon a quiet road, off the beaten track, where I could read my book and wait. No sooner had I turned the first page, a job was sent to me! Typical! 

“18 month old female, choking” 

Well, to quote myself, “I found myself growing in confidence and stopped being daunted by the prospect of arriving on my own”. THAT was clearly a lie! I looked at the address and brought it up on the map. It was on the road that I was sitting on about 200 ft down the road. I was on scene within 30 seconds of the call coming in. I’d had no time to gather my thoughts or think about what the algorithm was for a choking toddler. Before I could blink, I was being waved at by a frantic parent, was holding all my bags including the Pediatric Advanced Life Support (PALS) kit and was heading into the unknown. Proper choking is extremely rare, normally in the 6-8 minutes it takes for us to arrive the obstruction is cleared, or partially cleared and there is nothing for us to do. I’ve seen 1 choking since I started and that was on an adult. That was cleared with back slaps! Pleeeeeease let this be the case here! 

As I rushed into the kitchen / diner the lack of crying, coughing and other noises associated with a distressed infant were worryingly missing. Her mum was frantically slapping the little girls back but to no avail. I took the child, who’s eyes were pierced with fear and started back slaps. There was no air movement at all and unless the obstruction was cleared quickly this little girl would be in a whole world of trouble. After just 3 back slaps, that ‘whole world of trouble’ was realised . She went limp in my arms. It was a feeling I'd never experienced. The life draining out of a child. My heart was racing, the mother was asking what was happening and begging me to do something. I knew the algorithm would tell me to start CPR. 

I ripped open the PALS kit and grabbed a pediatric laryngoscope. It was so small compared to the adults. I put it into her mouth and lifted it as I had done in training school a long time ago! The light on the blade lit up her mouth. I was now lying on my front desperately looking down her throat, manipulating the blade to try see something. Anything. Then I saw it. I blindly reached for the forceps with my spare hand, not wanting to move a muscle now I had the obstruction in view. How I managed to locate the forceps I'll never know but I just shouted ‘OPEN THEM’. They were taken for my hand and then returned, out of their sterile packaging. As carefully as I could I inserted them into the mouth and at the second attempt, I managed to grab the stray piece of apple. 

Amazingly, she still had a pulse so I just started ventilating her. In my head I was begging that she would start breathing. I radioed to control and quite rudely demanded an ambulance immediately! I think the tone of my voice said it all. For what seemed like an eternity I ventilated the little girl waiting for the ambulance to arrive. Then inbetween my ventilations she took a breath. Then another, and another, and another. I took the bag away and just starred.......she was breathing on her own. 

On cue the ambulance crew arrived. They looked at the bag I was holding, the open PALS kit and said ‘Ready to go?!’. They grabbed my bags, I scooped up the girl and as quickly as they arrived, we were gone! The blue call was put and we left. Mum was holding the girls hand and I was just starring still! 

Her eyes, slowly opened, she coughed and then started crying. I’ve never been so happy to see a child cry. Overwhelmed would be an understatement. We arrived at hospital and I handed over to the waiting Doctors. There was a total sense of relief as I walked away, back to the ambulance. I sat there starring at my blank paperwork and was physically shaking. All the adrenaline and emotion pouring out. It was a totally surreal experience. I sat there and didn’t write a thing for about 10 minutes. I felt validated as a Paramedic and was by far the proudest moment of my career to date. 

Will I feel calmer if I ever have to face that situation again? I very much doubt it. I could have parked absolutely anywhere in a 16 square mile area. I chose this road. I don’t know why. If I had been another minute away it could have been a completely different outcome and probably would have been. I’m just glad I’m not faced with writing about a tragedy. Instead, a rare success. I was just in the right place at the right time, and for that I am thankful. You can call it fate, divine intervention or just sheer luck. The result is the same! 

I’m still buzzing!

The Voice

"88 year old male, DIB"

I was extremely tired! I'd like to say it was because I had been working really hard saving lives but I hadn't been. In fact, the reason I was tired was because I'd hit the town with fellow bloggers @jooleroo and @babberblog and they'd forced me to drink too much gin two nights previously and I still wasn't recovered. I was still feeling slightly unhinged and not back in 'work mode' when I was sent a job 9 seconds into my shift. So, not only was I tired and irritable, I felt rushed and disorganised. It's not a good combination. Time to hope the first patient is easy going and not seriously ill!

As I pulled up on scene the call downgraded to a lower priority! DAMMIT! At this time of the morning (shift change over) it was now likely I'd have to wait a while for an ambulance. I also noticed the call came from a 3rd party caller so my patient might not even know I'm coming! I grabbed my stuff and headed on up.

After negotiating entry via the remote access people, which involved a military type interrogation, followed by a Crystal Maze kind of puzzle key safe and finishing with a Da Vinci Code themed coded instructions, I made it to the flat. Far to early for all of that! I let myself in and headed to the open door. 

Inside, my patient was lying in a cot bed. He didn't appear to be struggling to breathe which was a good sign. 

"Hello sir, what's the problem today."

"He's not well." a voice said. 

I looked around, baffled as to where the voice was coming from!

"Did you hear me?" the voice said again. 

Then I saw the phone lying next to the patient on the bed.

"Hello?!"

"My uncle isn't well, he can't breathe, can you take him to hospital please?"

"I'm not the ambulance, I'm the first responder, so I'll check him over and let you know the plan when the ambulance arrives."

"No, I want to stay on the phone so I can hear what's going on."

"OK."

I was miffed. It's an added pressure I didn't want or need and it felt like I was being scrutinised. 

I set about assessing him. He was alert and able to talk for himself. I was doing his obs while asking him questions on how he was feeling.

"What's his blood pressure?" said the voice.

"His blood pressure is fine."

"Right.....what is it?"

"126/84" I said and returned to talking to my patient.

"Have you been bringing anything up when you cough?"

"Yes he has" said the voice.

"I see you are being treated for a chest infection, has there been any improvement since you've been taking your medication?"

Before he could answer.....

"That's irrelevant, he's had a chest infection and it clearly needs more treatment."

"It is relevant. He's showing no signs of a chest infection, his chest is clear and is oxygen levels are normal. He seems fine to me so far."

The voice laughed.... "You haven't even checked his temperature yet!"

"Yes I have. It was normal."

"We'll you should have told me that." said the voice.

This continued for anther 10-15 minutes. I was repeatedly interrupted, questioned and argued with. Every now and again I managed to get some answers from my patient but in the main, 'the voice' did all the talking. 

Then there was a knock at the door.

"What was that?" said the voice.

I didn't answer! Oh the power! I went to let the crew in! I gave them a handover in the hallway and explained that they were on speaker phone so had to play the game!

"What was that? Is the ambulance here?"

"Yes."

"Right, can you take him to hospital now please."

I should probably mention now that during the handover to the crew we discussed an action plan!

"Hello there, I'm one of the paramedics on the ambulance."

"Hello."

"We've decided not to take your uncle to hospital. He doesn't need to go, he's expressed his wishes not to go and to be perfectly honest, he's still got 3 days of antibiotics for his cheat infection and is responding well to it. We'll refer him onto his GP so he can stay in the comfort of his own home."

I just smiled. 

"This is ridiculous. I called you to take him to hospital, now you WILL take him to hospital." said the voice.

"Sir, would you like to go to hospital?" 

"No, I want to stay here."

"Right, as your uncle is refusing hospital, we will be leaving him here."

"What is your...... Our patient picked up the phone and cancelled the call.

*sighs of relief all round*

We filled out paperwork which the patient signed and the crew referred him to the GP. I went back to my car in a foul mood. 

Why are some people so objectionable?! What do they think will achieved be being so rude?! I fully appreciate relatives being worried and sometimes worry becomes overbearing. However, I think a situation like this crosses the line and prevents us from doing our job. Do you agree? Am I overreacting?! Should I blame @jooleroo and @babberblog or would anyone have been grumpy in this situation? Discuss....

A Summer Break

Hello strangers! 

As most of you have noticed, about a month ago, I vanished! Well sometimes, it is necessary! I did so for a number of reasons and I won't bore you with most of them! I will however, explain why I stopped writing my blog for a little while. It isn't the first time I have disappeared and won't be the last. 

You've read about how we are always looking for the 'proper job'. We want the cardiac arrests, the trauma and the seriously ill. It may put us out of our comfort zone but the long and the short of it, is that is what we are there for. These kinds of job make the other stuff we do and go through worth while. In a warped way other people's misfortune is our job satisfaction. 

A few months back, I moved from ambulances, to working on my own on the Fast Response Unit (FRU). The FRUs are used for the higher priority of calls, so invariably you go to 'proper jobs' with more frequency. You see less mental health, less elderly fallers, less urine infections and less regular callers. What you do see is a lot more cardiac arrests, heart attacks and trauma. This, on the whole has been a good thing.

However, you can get too much of a good thing! I went through a phase, that seemed to never end, where every single day I was seeing death and distraction. I felt like the harbinger of death. Writing a blog about my working life is normally therapeutic, but I found myself not wanting to think about some of the days I was having. If I don't want to think about it, I certainly don't want to write about it! Some things should be left unshared! For now! 

I'm not sure if things have calmed down yet, I still seem to find myself in some of the most bizarre of situations with some of the most horrific injuries I have seen, but I think I am used to it now! 

The weather has also been bloody lovely so I've been enjoying the outdoors and avoiding some of the drama people crave on social media! It's been rather refreshing! 

Anyway, sorry for the sudden disappearance! Thank you for all your messages of concern! 

Ella x