24 - Season 3: Episode 4

continued……

The following takes place between 03:26am and 12:00pm

03:26

Despite that sudden burst of energy that the RTC had yielded, 03:00 in the morning is a friend to no one. As quick as the energy and invigoration arrived, it was gone again, leaving two, very sorry looking individuals left slumped in the cab of an ambulance. I could feel myself slipping into that place between being awake and being asleep, where your dream kind of starts but you eyes are still kind of open. The piercing noise of the MDT soon erred me towards my eyes kind of being open.

03:49

“21 year old female, chest pain. From NHS 111”

“On a scale of 0-10, 10 being central crushing chest pain, pouring with sweat, ashen in appearance and an impending sense of doom, and 0 being……..whatever.”

“ A 1. Panic attack. Fully recovered. Said the words chest pain. Likely car and ambulance.”

Off we went. The conversation wasn’t as bubbly as it had been. We were both staring at the road ahead, struggling to keep our keeps open. I did however summon the energy to make a joke about me not wanting to drive any more! 

When we pulled up on scene, as predicted there was a car there. We took a walk, similar to that of a zombie up the garden path and into the open door. Sitting on the sofa in the living room was our patient. She looked perfectly happy, not in any pain, not hyperventilating. The handover from the FRU went something a little like this……

“Hi guys, this young lady thinks she may have had a panic attack this morning. It has fully resolved now and she has no symptoms. She called NHS111 for advise on medication and they insisted on sending an ambulance because she said that during the panic attack they was tightness in her chest whilst breathing. Because of the ‘chest pain’ they said she had to go to hospital. She told them she didn’t want an ambulance and here we are!”

*little high-5 behind our backs*

Well, this going to be simple! All her OBs were completely fine, as you’d expect them to be and her ECG also resembled the perfect heart of a 21 year old. Needless to say, we did our paperwork and left! 

As you can see, NHS 111 causes a monumental waste of resources on an hourly basis. It’s not the people who work there’s fault. They follow a computer and the computer tells them what to do. When the computer says jump, it also tells them how high. Or in this case, it told them an FRU and an ambulance would be needed to deal with a 21 year old female who had had a panic and din’t want to be seen. 

Just for the record….. 21 YEAR OLD FEMALE DON’T HAVE HEART ATTACKS. OK, so maybe one did once because of having other medical problems and all the risk factors one could have, but surely this doesn’t mean that for ever more any 21 year old with pain in or near their chest, jaw or arms is having a heart attack?! Seriously! 

Anyway, off job time! 

04:27

Luckily a job came down pretty much straight away. Well, I say luckily….I hadn’t the patient yet!

“48 year old male, chest pain, ?intoxicated. At bus stop.”

“On a scale of 0-10, 10 being as blind drunk as they come, vomiting, urinating and requiring carrying, 0 being sober as a judge, how intoxicated is he?”

“6. Drunk, probably an alcoholic, the smell will make your eyes water, but sober enough to answer questions, walk and swear at me.”

My crew mate chuckled. It was knowing chuckle! Mainly because she knew I’d be correct! Social drinkers tend to be drunker and are normally scooped up and hospitalised by 3am. Angry, smelling alcoholics tend to be perms-drunk and therefor somewhat more capable of being encouraged to walk. They are generally much more abusive and tend to sit on benches or at bus stops which are near the 24/7 off-licences! Call me sceptical but this particular bus stop was right outside a 24/7 ‘Food and Wine’! Finally. he was 48. Generally 48 year olds don’t get blind drunk and call themselves ambulances at this time of the morning! The binge drinkers are the young ones, the alcoholics are the old ones. Normally! I may be proved completely wrong. 

I wasn’t. 

Sitting at the bus stop was a regular patient of mine. A vile, abusive drunk who calls an ambulance because he lives near the hospital. I was correct on every single count.

*little high-5 behind our backs*

“What’s the problem today Sir?”

“I’ve got fucking chest pain, I already told ‘em that.”

“Well you hadn’t told me that. How long have you had the pain?”

“Stop asking me fucking questions and just take me to hospital.”

“If you have chest pain, we need to do your ECG and check you over.”

“I don’t want one, just take me to fucking hospital.”

This could work one of two ways. I could say exactly what I was thinking about his abuse of the service for a lift home, probably wind him up further and end up with him being arrested, or I could open the ambulance door, let him on, drive to the hospital and let him run off to his house. There would be no winners for doing the right thing, but at least by giving into his whim, we’d be off on time. You could try and argue the morality or this with me, and tell me it just encourages that behaviour, and you're probably right. But at 5am, I am right. The end!

Off we went, conversation was hardly flowing and all inane questions were responded to with a battery of swearing. Sure enough, the back door opened, he staggered out, and wondered off down the road. Paperwork done, slurp of coffee and we were done. Finito. Fine. Time for bed! 

05:30

Free from the risk of another job we begun driving back to station. I took the opportunity to double check my rota for tonight's shift. Doing so much overtime means it’s easy to forgot where and when you were working. I had booked a late shift somewhere which would mean a relatively short turn around but it was my choice so I couldn’t moan…….

12:00!!! 12:00!!! I had mad the ultimate shift fail! I booked overtime thinking I was in at 18:00 but no! I was due in at 12:00 on a core shift, not overtime! I was due back in work for a 12 hour shift in just over 6 hours! Factor in travel, eating and showering time and I’m left with no more than 3 hours sleep. I felt sick. I had that pitted feeling in my stomach. My crew mate simply laughed, out loud, in my face! What could I do?! It was no ones fault but my own. I couldn’t change or cancel my core shift at short notice because I’d done overtime the night before. I’d just have to suck it up! 

We got back on station and I rushed everything away and headed off on my bike! 

06:20

I finally got into bed. Needless to say I laid away for ages, panicking about having to be up in a few short hours! I set my alarm for the last minute possible but that didn’t alleviate my fears!

10:40

THAT NOISE! Urrrrrgggghhh! I felt like I’d been hit by a bus. Nothing could console me. I was a wreck! I did everything as quick as I could, no time to make lunch and dinner though! Today was going to be a McFried Kingway kind of day! 

11:52

I arrived at work. Here we go again.

*Faceplam*

24 - Season 3: Episode 3

continued……

The following takes place between 00:00am and 03:26am

00:00

It was fair to say we had broken the back of the shift! It’s always nice on nights when you consider yourself to be on the home stretch! We tucked into our cold dinner as the clock ticked down to when we had to green up for the next one. Sadly, that time arrived far to quickly and once again we were off. I was also starting to yawn which with 6 hours to go, isn’t ideal! Again, I tentatively suggested we swap round but the only thing I got was laughter in return. Worth a shot! 

“30 year old male, DIB, Asthma. From NHS 111”

You’ll be shocked to hear I was sceptical! As far as I’m concerned, people who have asthma no what an asthma attack feels like and know what to do when they have one. They also know exactly when they need to call 999 so I find it odd for an asthma patient to call 111 for advice. As had been the theme of the evening, my cremate posed me a simple question:

“On a scale of 0-10, 0 being breathing so perfectly it makes me feel positively wheezy and 10 being unable to breathe, requiring ventilations, a silent chest, tracheal and sub-costal tug all needing immediate inspiration and a blue call, how bad is his DIB?”

“I reckon a 2. Possibly a 3. He’s probably got a cough. In fact, change that to a 1. Normal everything, no wheeze but thinks A & E will be some kind of great adventure!”

We pulled up at the block of flats. The address details said ‘4th floor’. There was no lift. Can you imagine the joy that was flowing through my veins?! By the time we got to the top, both of us were breathless and therefore, by my prediction, more in need of an ambulance than the patient. 

BINGO! *takes a bow*

There was our treasure of a patient, sitting on the sofa grinning away. There was no cyanosis, no increased respiratory rate, no obviously distress or difficulty, just a big grin. The grin itself was mildy unsettling! 

“Good evening Sir, what’s the problem tonight?”

“I’ve had this awful cough and cold. I think I’m wheezy with difficulty in breathing.”

“How long has this been going on?”

“Since the afternoon.”

My crewmate, complete with wry smile, did all of his OBs. All normal. Oxygen levels were 100%, there was no temperature, blood pressure and heart rate were normal. I couldn’t find anything wrong with him other than being sniffly. 

Despite my sound medical advice and suggestions of alternatives to accident and emergency he wanted to go and get ‘Antibotics’. I didn’t think he needed Antibiotics but there was definitely no indication for ‘Antibotics’. Rest assure though, he had taken ‘Paretomol’ and ‘Buprofen’. 

*Facepalm*

Anyway, overnight bag packed he headed back down the stairs to the ambulance and headed off. On route I had a fascinating conversation with his wife about diabetes. She had been diagnosed with type 2 diabetes a year ago at the age of 26. I can’t say I was surprised, she must have been in excess of 20 stone and rather short. Diabetes was somewhat inevitable. However, she assured me that she’d ‘caught it’ of her mum. Yep, that nasty contagious strain of diabetes mellitus was at it again, jumping from host to host, catching people unawares. It was just sheer coincidence she happened to be morbidly obese, a smoker and didn’t exercise. But yes, blame the parents! 

What these two need is the health promotion version of the ‘birds and the bees’ chat. An actual in depth conversation about lifestyle, risk factors, causes, what constitutes being ill and PRONUNCIATION of very common medications! Every time someone says ‘Buprofen’ a puppy dies. Spread the message and help cure the madness!

01:15

Thoroughly frustrated and now verging on irritable I no longer felt on the home straight. It felt like there was absolutely years to go until the end of the shift. Urrrrrgggghhhh!!

“23 year old female, tearing abdo pain, From NHS 111”

Really?! ‘Tearing’ seems the new buzzword that NHS 111 seem to be asking patients. Tearing abdo pain is a symptom of a very dangerous, life threatening Abdominal Aortic Aneurysm. (AAA). These patients often die. Unfortunately, if you ask someone who is ringing for advise if the pain is ‘a tearing pain’ it is highly likely a fair few will just say yes. Cue the Red 2 response of FRU and an ambulance. 

“On a scale of 0-10, 0 being calm, relaxed and whistling ‘ Always Look On The Bright Side of Life’, and 10 being the worst abdo pain since records begun, causing eventual loss of consciousness and a necessity to anaesthetise immediately, how bad do you think the pain is?”

“Definitely a 2. No more. But I want a bonus if she says 11 or 12 then laughs.” 

Up ahead of us were blue lights, we slowed down by the police car and saw the wreckage of a car. 

“Evening! Need a hand at all?!” 

“Yes please, we’d just requested you, got 1 trapped”

“RUNNING CALL: RTC, Car vs Tree, 26 year female trapped, injuries unknown.”

Pulled over and the road was subsequently closed. In the passenger seat was a young lady very distress and upset. The wouldn't open and her leg was trapped. A second ambulance was on scene within a minute or so and one of them got into the back, much to his annoyance! Everyone else claimed seniority so it was he who hat to sit in the back, holding her head for probably an hour whilst we got the fire brigade to cut her out. 

As I’ve said before, the fire brigade are great at what they do and we can’t get these patients out of the car without them. They arrived on mass much to the amusement of the police and myself. A sea of daffodils bundled out of all 3, yes 3 fire engines plus a specialist rescue unit. There was at least 24 of them around this tiny Nissan Micra. 

“I can’t stand around here watching them all swinging their bollocks around in some blue light mating ritual. I’m taking the driver to the truck and see how he is!”

Well, that was my cremate gone! And she had a point. Despite explaining that I just wanted the door off they seemed determined to take the roof off! My patient had no neck pain or back pain but was trapped and her leg was hurting. I wanted to get her out with as little faff as possible but that was proving an impossible task. The ‘white helmet’ ( 1 of 3) attempted to patronise me with phrases such as ‘Look here luv…’ which went down a treat. They didn’t need to take the roof off, the door would surface so much to their annoyance I pissed on their parade and stuck to my guns. Rolled eyes and head shakes followed but I didn’t care. It was freezing cold, raining and my patient needed to be in the warm with some decent pain killers. This wasn’t the time of the place for a training exercise. 

With the door off we got her fitted into a KED (fancy extraction devise) and promptly pulled her out of the car sideways onto the bed. She had escaped with minimal injuries so was taken in the other ambulance. We took her husband to the same hospital and left the 24 deflated egos having a collective bitch about that stupid paramedic! Ooops!

This encounter had woken me up somewhat! By the time we were fed and watered and ready to go again it was approaching 03:30 so time for 1, maybe 2 more depending on the customer! Winning!

Time to press the button again…..

To be continued…..

24 - Season 3: Episode 2

continued……

The following takes place between 22:12pm and 00:00am

22:12

Partially caffeinated and well snacked we green’d up for the next one. We had to wait the all of 5 seconds!

“? drunk, ? at a bus stop, ? fall. NFDA”

Call me a cynic but this sounds like a drunk at a bus stop. I know, I know, you mustn't pre-judge a call before you get there, blah blah blah. Sure, it could be a confused diabetic patient having a hypo, who has collapsed to the ground by a bus stop and hit his head. The resultant head injury could have caused him to have a seizure and due to him being crunched up against the bus stop, the resultant positional asphyxia and subsequent hypoxia has caused him to go into cardiac arrest. At this point a member of the public has seen him, phoned 999 and started resuscitation.

Anyway, we were on our way to a drunk at a bus stop! If it wasn’t, I’d eat my hat!

We pulled up and I was disappointed that there was no one lying on the floor. Had I been wrong?! The disappointment did not last long when we were suddenly treated to the member of the public that had phoned us! And believe me when I say ‘treat’! Picture Dr. Emmett Lathrop "Doc" Brown, Ph.D, from back to the future barring down on us walking like John Wayne! Now, keep the hair and facial expressions of the Doc but add the glasses of Garth from Wayne’s World. Now dress him in a Christmas jumper, a Columbo trench coat and some rather fetching white leather snake belly cowboy boots! Across the top of the boots, drawn in marker pen was his name! Nige! It was a sight to behold! My cremate almost choked on the dried mango she was chewing. I just starred in amazement and wound the window down! 

“Good evening ladies!” he said with a letchy grin!

“Good evening, is it you who has called us?!”

“It sure is!”

“What’s the problem tonight?!”

“Well, I think someone needs your help. There was a homeless Polish man who fell over. I think he was drunk. I chatted to him and gave him £5. He seemed very cold so I offered to go and fetch him the spare duvet from my house. Can you believe it, he didn’t want it?!”

“You.Are.Kidding!”

“I’m not! He just got up and walked off! He’s going to get so cold!”

“How long ago did we wonder off?!

“About an hour ago maybe.”

“So what would you like us to do tonight?”

“Well I’ve invited you here, and the police too, so we can have a group discussion of how best to proceed. It’s not normal behaviour to refuse a duvet when it’s this cold.”

“So you want us to wait here for the police arrive, so we can discuss with them, and your good self, how best to provide assistance to a drunk, homeless, Polish man, who doesn’t want any help and who we have no idea where he is?”

“Yep, I think it’s important, especially as it is so cold.”

A.M.A.Z.I.N.G! I know I moan about being sent to utter nonsense with worrying regularity, but jobs like this make a night shift thoroughly enjoyable! I could happily have played along with Nige for hours and hours. Unfortunately, they were holding calls so I had to gently let Nige down and tell him that the multi-agency conference would not be happening and that we would be leaving! I wished him a merry Christmas and complimented him on his taste in footwear! 

What a great experience that was! Now, back to the mango!

23:00

“50 year old male, chest pain”

Why can’t we ever just be left alone for 10 minutes to enjoy exotic fruits in peace! It’s as if they think we are an emergency service and patients come before dried mango! Anyway, we had to travel a bit of a silly distance to this one so I had time to eat on the run!

We pulled up outside a block of flats and my crew mate instantly recognised it. She didn’t know why, or who but recognised the flats, which was ominous to say the least! We got to the front door and just as I was about to knock the door swung open! Standing there was our patient, dressed like he was about to brave the arctic circle and very much ready to go! He looked a bit like Stanley Hudson from The Office US! As we ushered him towards the ambulance my crew mate lent over to me and said:

“Have fun with this one!”

“Wheeeeeeeeeyyyyy!”

Once on the back of the truck, the rigmarole of removed the 847 layers of clothing begun. Conversation wasn’t forthcoming despite my best efforts and the history was rather vague! He was also rather drunk and a tad creepy! 

“What’s the main problem tonight?”

“I have this funny old pain in my chest.”

“And how long have you had that for?”

“About two years or so.”

“Two year?! What’s different tonight?!”

“Nothing new.”

*facepalm*

I did all his OBs and everything was fine. He was keen to go to hospital but I convinced him that A & E probably wasn’t in his best interest. I started filling in all his personal details and realised I have completely forgotten his name! This often happens despite my concerted effort to always remember so rather than go through the embarrassment of asking their name again, I ask how to spell it. Obviously, more often than not I can get away with it, but names like Bill make me look stupid! 

“How do I spell your name?”

“K as in Kevin, E as in Evin, V as in….Vin, I as in Ivin and E as in Evin.”

“So Kevin then?”

“Yes.” 

Well, that was suitably bizarre way to dictate the spelling of a name, but then again, he called an ambulance for a two year history of chest pains. I won’t get him to phonetically spell EMERGENCY! If I did I have no doubt the joke would be lost on him! 

Eventually the paperwork was done, referral was made and all 847 layers were in position for the 10 meter walk back to his house! 

“Good night Kevin”

“Thank you.”

Another life well and truly saved! It's too early in the morning to rant about NHS111 and patients with 2 year histories of anything! He wasn't rude, provided some entertainment and didn't need carrying. I can assure you, that is all anyone ever wants on a night shift!

To be continued…….

24 - Season 3: Episode 1

For some it’s the season to be jolly. For other’s it’s the season to reflect on what an utterly crap year it’s been. For me, it’s overtime season. It’s the time of the year where I literally sell my soul to the ambulance service in the vain hope of affording a holiday at the end of it. Tonight was a self inflicted overtime shift, but with someone I very much wanted to work with so you won’t catch me complaining. 

I couldn’t write that with a straight face! Of course I’m going to complain!

The following takes place between the hours of 12:00pm and 18:30pm

12:00

Despite volunteering to work a night shift I wasn’t happy about it. I had given up a lovely little 8 hour day shift on request of my crew mate who going to be single on the night and wanted someone to do all the work for her. As requests go it was pretty outlandish! Asking ME to do a night shift instead of an early! Despite my faux protestations I was more than happy to and even offered to provide the grub. I’m nice like that!

So, instead of sleeping before the night shift I slaved away in the kitchen! Mainly because I can’t sleep during the day and also, because I predicted severe hunger throughout the night and didn’t want to leave anything to chance! 

Food made, washed and groomed, packed and dressed I was just about ready to head off in to the night. All we needed now was pleasant patients and we would be in for some easy money!

18:30

That ominous feeling that every night shift brings was well and truly upon me as I walked into a rather strange looking ambulance station. I chucked my stuff on the vehicle and headed for the kettle. Caffeine was going to feature heavily! 

‘Breakfast’ was prepared by my crewmate and we feasted like kings. It made a nice change from my usual routine. The bliss didn’t last long…..

19:00

“36 year old, asthma attack”

We headed off into the night. True to form, my cremate was driving and I was writing. When I suggested that maybe at some point she could write and talk to patients she laughed. And laughed hard! This was going to be me for the night!

We pulled into the alley way where we’d been sent to. It was in a particularly grotty part of town and the alley itself didn’t offer anything up, other than a bad smell and sludge. Up the metal staircase we trotted, full of unparallelled enthusiasm. The front door was open so we headed into the smoke filled hovel. It was like walking into a cloud of irony. Sure enough, sitting in the smoke filled room was our patient, wheezing away like a good’un. He had been treated in hospital that day already for his asthma and unsurprisingly, was having a relapse. They really didn’t seem to grasp that sticking an asthma patient in a smoke filled room would cause a problem. In fact, they blamed the bad treatment of the hospital for his current predicament! Gotta love the NHS! Failing patients at every turn….by not making them immune to cigarette smoke! The scoundrels!

Anyway, my crewmate handed out a speech, laden with sarcasm and health promotion do’s and don’ts whilst I gave him a nebuliser and off we all went to hospital like one big dysfunctional family! We handed him over to the nurse, making sure she was aware of the environment in which he was found and headed back to the ambulance to eat some dried mango. Yep. Mango. If you don’t like it, you have no place being here!

20:19

“66 year old male, chest pain.”

I’ll be honest with you. From the information we were given I wasn’t holding out much hope for this being a job that could hold my attention. Some chest pains read like proper chest pains, others read like chest pains for a quick ambulance. This looked like one of them. It had all the tell tell signs. Abdo bad, DIB, symptom after symptom, and eventually chest pain chucked on at the end for good measure. All was just itching to be revealed. 

We pulled up, grabbed our stuff and headed inside.

“Wheeeeeeeyyyyy.”

That is what we heard as we walked down the corridor. In the living room, sitting in the chair was a beard. Well, the beard had a rather large man attached to it, but the sheer magnificence of the beard was overwhelming. It made Santa Claus look like he only had designer stubble! I’m serious! It was most off-putting!

“Wheeeeeeeyyyyy.”

“Hello Sir, what’s the problem today?”

“Wheeeeeeeyyyyy.”

This could be a long conversation….. Luckily, I was quickly interrupted and told that he doesn’t speak any English. So, all history taking was done through a translating relative. I was dubious about some of the answers because I asked about the pain score the patient spoke at lighting speed for about 10 seconds only for the relative to say “8”. 

“Wheeeeeeeyyyyy.”

I muddled through and established he’d had chest pain for about 3 days but this evening it was much worse. I also learnt that trying to stick ECG leads onto someone who effectively has a mature weeping willow hanging off their chin requires a unique set of skills and preferably three arms! Eventually we were good to go!

“Wheeeeeeeyyyyy.”

*presses print and waits*

“Wheeeeeeeyyyyy.”

*’analysing ECG…….’*

“Wheeeeeeeyyyyy.”

*prints out ECG*

“Wheeeeeeeyyyyy.”

MASSIVE HEART ATTACK! Shit! My cremate quickly vanished to get the chair whilst I stuck a cannula in. We gave all the drugs, wheeled him to the ambulance, put in the blue call and headed off to the cath lab!

“Wheeeeeeeyyyyy.”

Once there, we handed over to the cardiologists and assisted transferring him to the operating table for the procedure. During the transfer my cremate was unfortunate enough to get an eyeful of old-man-penis. (“Wheeeeeeeyyyyy.”) I didn’t ask for details but going by the beard on his face and the pained look on her face, I imagine there is more to that encounter that met her eye. Poor lass. Bet she wished she was on the board! As if……

Despite the short period of excitement we’d just encountered, we needed coffee and some more mango so we quickly made our exit and headed back to the safety of the truck! As we wondered down the corridor all that could be heard was “Wheeeeeeeyyyyy.”. I'm still not sure what that noise was all about!

To be continued…….

Emergency Service

Well, it's that time again. Time to introduce Inspector Michael Brown, author of award winning and acclaimed blog, Mental Health Cop. Normally, I drag him out to discuss all things mental health. However, this time, my narcissistic side, just couldn't resist sharing his words with the masses. Namely, because one of the tails of heroism he refers to is me, and to be brutally honest, I dig that shiz! It's also confirmation that the ambulance service is indeed the BEST emergency service.

So, with all the fanfare it deserves, and a dosage of pomp and circumstance, I present to you, 'Emergency Service'! 

*          *          *          *          *

I sometimes remember to marvel at some of my colleagues and did so again over the Christmas period – ordinary men and women doing an extraordinary job, away from their friends and families whilst we were at home – (it was my turn to be off!) Their pay has been frozen for the last few years with their pensions being eroded compared to those they were promised when they joined up; there is comparatively little or absolutely no training for some of the functions that they are expected to undertake in their role; and sometimes they are patronised and misunderstood by senior members of Government who don’t really get their role at all.

CRIME, SAFEGUARDING AND PERSONAL BRAVERY

A while ago, one of them was at a job where a man had attacked his partner with a knife and the man was known to have a risk history that flags up whenever you attend the address. Back up was a distance away and consumed by an instinct to protect the woman and get to her aid, she went in to that unknowable environment on her own. What she did what she got in there meant the man fled with his knife, the woman was safeguarded from any further threat and it could be declared safe for paramedics to roll the ambulance up to the door. The man was arrested a short-distance away, but that early evidence meant we could prove that he *was* holding a knife during the incident. Crucial evidence, nicely preserved by a brave professional witness who put herself at risk.

You’ll remember this blog was prompted whilst I was off work this Christmas: I remembered what it was like working on the frontline last year – Christmas Eve in particular was a real bender of a shift and resources were so stretched that by about 3am (on Christmas Day!) I was first on the scene of a stabbing. A man so badly injured that his wound was an open chasm in his neck and there were half-pints of blood all over the pavement. I was soon joined by another set of blue flashing lights and before much else could happen, my colleague and I were rolling on the floor with this bloke, fighting him to let us apply pressure to his neck wound so he didn’t bleed to death in the road. We both got knocked about a bit, but nothing serious and wondered afterwards whether this man was as high-as-a-kite on cocaine? But the ambulance crew and more officers turned up and off he went to hospital.

Earlier this year, we had a very mentally distressed lady in police custody – a person in a condition of some particular agitation and obviously very unwell. As various medical professionals have suggested we should, I remember asking the custody nurse whether we could be sure that her basic obs indicated nothing was seriously physically wrong with her – was she actually safe in police custody? The nurse checked the custody record medical forms and admitted she didn’t know. She agreed she should do them again to be certain and saw what I was getting at. Was her heart rate OK, her blood sugar, etc., etc.. The nurse being there with all of her gear, you’d hope and think that a nurse would be able to reassure someone perhaps to a greater degree than someone in uniform that they wanted to check them out, to help make sure they’re OK? This lady couldn’t see that and I patiently watched two of my colleagues spent 90 minutes of constant patient and compassionate conversation turn this into a position whereby the obs could be done and we could relax that she was not potentially seriously medically ill, as well as distressed.

EMERGENCY SERVICE

I could go on and on – the point I want to make here is thatnone of the colleagues I’m referring to above are police officers.

They were all paramedics from our ambulance service. 

It was a paramedic first-responder that intentionally put herself at risk where a man had taken a large blade to his wife, to safeguard her and she unintentionally contrived to be able to provide evidence against him that helped convince the court he was a dangerous liar; it was a paramedic who got physically stuck in to a man who was bleeding heavily but fighting not to be helped; it was two paramedics who came into police custody and spent 90 minutes patiently persuading one of the most vulnerable, psychotic and distressed people I have ever met, to let them care for her.

I could still go on and on – the story of the paramedic in London who continued to provide care for a drunk man just after he’d been hit over the head with a fence post by that man; the paramedic in Suffolk this Christmas who ran into a burning building before the Fire Brigade could arrive to rescue a trapped woman and immediately give her respiratory support; the paramedic who accompanied three officers into a building where there was a risk of a gas explosion in order to assess a man inside – all were hurt when the building exploded, a risk that they knew they were taking.

It is my genuine privilege to work alongside these people – as we do every single day. Despite the very obvious differences between policing and pre-hospital healthcare, there are many overlaps and at the core of it all is dedicated public service at times like Christmas or during family birthdays and other events. It is my view that paramedics are paid peanuts for what they do and they are probably more messed about and taken for granted with the rubbish that is thrown at them, than we realise. The stories of people ringing 999 for an ambulance because they can’t be bothered to walk to hospital or see their GP; the Home Secretary contriving to refer to them as “ambulance drivers” in apparent disregard of the training and qualifications they must have and the media quick to pick up on paramedics not diving into a lake but aren’t mentioning the one who ran into the burning building.

It just beggars all belief that they aren’t considered an emergency service – I have certain views about that!

The practice guidelines for paramedics is a telephone directory sized book and it has four pages of information on about mental health, some of which is wrong! It probably isn’t as widely known as it should be, how many paramedics will say that they want to be able to do more for people in mental distress – they want to access NHS referral pathways, have options for removal to care settings that are more appropriate than A&E and be trusted to take pre-hospital clinical decisions. Let them serve us better, because they want to do it and are currently blocked from trying. We trust these people to get to grips with our heart attacks and strokes and to know what to do when time is of the essence – surely we can open up the mental health pathways and trust their clinical judgements?

So I want to circulate my admiration for my colleagues in green and help build awareness of the stuff they do for you and for all of us each and every day.

We would notice if they weren’t there to do it for us, trust me on that.