Super Strength Batteries

I've been blogging a few years now, and in that time I've had many a guest blog. However, I've never had one from a fellow ambulance blogger! To be honest I don't read many blogs, least of all ambulance ones. I just don't have enough time! However, I recently made contact with Binder, from not-on-my-shift.org after discovering his gem of a blog on Facebook! Despite having been blogging longer than me, I'd never seen it! I also saw his glowing recommendation for me, so felt compelled to make contact and say hello! (seriously, go and read ALL of his blog, it will have you laughing hard!)

To cut a long story short, a week later, I was in a harness, attached to a rope, and stuck 30ft up a wall hanging on for dear life. Far below me, was Binder, trying to convince me that letting go of the wall was a good idea. After a discussion with my inner psyche, I finally made peace with the fact I was sure to die, and let go of the wall. To my surprise, I didn't plummet to my death, I just hung there. Moments later I was back on the ground, stood next to a grinning Binder ready to go again. 

The afternoon passed with the exchange of war stories and as with most conversations between paramedics, it ended up being about foreign body insertions! EMS Rule #97 states that: 'Fellow paramedics always have a better story than yours.' Well ain't that the truth! I felt this story needed sharing, and who better to do it, than Binder himself! So, with all the pomp and circumstance it deserves, and without any further ado, I introduce my friend and colleague, Binder, author of not-on-my-shift.org.

Enjoy! 

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Super Strength Batteries

"You can feel it going . . . go on, have a feel" She said through tears and gritted teeth.

I placed my hand on her tiny stomach and sure enough, I could feel it . . . .

BZZZZZZZZ - BZZZZZZZZ - BZZZZZZZZ - BZZZZZZZZ - BZZZZZZZZ 

"Wow!" I said, genuinely impressed. I looked back up at our patient and smiled . . . not that this helped in any way. You see, our patient had managed to get a vibrator stuck in her rectum - and it was switched on at full speed.

She certainly was in a tizz. Tears were streaming down her face as she fought off vibrations from within and tried to bear down and force “it” out. Every now and then her hapless "partner" received a flurry of abuse and bore the brunt of her frustrations.

"You ARSEHOLE Peter*!! Super strength batteries!??? Super strength batteries!!?? Why'd you have to use SUPER STRENGTH FUCKING BATTERIES!! Oh GOD!!!"

We stood there slightly bewildered and somewhat superfluous to the poor woman's needs. Every time we'd try and calm her and make her as relaxed as she possibly could be - under the circumstances - she just burst out into a torrent of abuse aimed at her partner and then repeated another attempt at trying to get the vibrator out.

"Can you help me?!" she pleaded, squatting down and reaching round with one hand, "I mean, it's not going to go anywhere else is it?"

"No, I don't think so," I said, "you just need to relax more . . . sort of, let nature take it's course"

"I've drunk shit loads of the Colace, do you think that will help?"

"Um . . . "

"Look," she went red in the face as she bore down extra hard, ". . . I'm sure I can get it out, can you . . . Peter! PETER! PETER, you BASTARD!!"

Peter's muffled response came from within one of the cupboards, "What?!"

"GET THE FUCKING CRISP-N-DRY!!! I think I can . . . "

"Look," the other FRU said, "I think it's best we just pop you up the Hospital eh Tara*. We're not getting anywhere here are we. And I think it best a Doctor has a look yeh? Especially as you say Peter put in super strength batteries"

"Hospital?! Oh god no!" In between gritted teeth, a red face and streaming eyes, Tara gave us all wink and a smile, "I bet you lot are loving this aren't you!"

"No. Of course not Tara" We all shook our heads over theatrically.

Tara sighed deeply as if resigned to her lot, "Right . . . come on then! Let's go"

So, with a little assistance and a muffled BZZZZZZZ - BZZZZZZZ coming from her bellie we helped Tara onto the ambulance and left the crew to it. The Hospital were simply going to love this one.

Binder

*not their real names of course

Binder Smiff (2 f's)

www.not-on-my-shift.org
A Paramedic Blog
"When life-saving adventure meets fiction! . . . . well, definitely more fiction really"

Emergency Medicine - Part 2

'RELATIVES: Ignore any first aid advice you’ve ever been given and just throw a glass of water in your loved ones face. Works a treat.'

continued.......

“61 year old male, burns to chest.”

Burns to chest isn’t that common except in cases of major burns. Normally it’s legs and arms, either from spillage or stupidity. Burns kit in hand I headed inside. The air was ripe with the smell of burnt hair. The patient was lying on the kitchen island topless. He’d lent over the hob whilst it was on. He had been trying to change the bulb in the extractor hood and set his shirt on fire. Apart from being a candidate for a Darwin award he was also beginning to look like an entry in The Great British Bake Off! 

There he was, lying flat as if he was planking, being buttered. Yep! His wife was scooping handfuls of butter out of the pot and basically basting him. He was only a few steps away from being floured, rolled out flat and being put in a pastry tin ready for roasting. 

“No more butter!”

“But he has a burn!”

“I know, but no more butter! We need to get him into the shower room and run cold water over it and keep it clean, OK?!”

She un-trustingly nodded at me. I am only trying to help! 

Once he was out of his cold shower, I dressed the wound with aqua-gel and layered some cling film on top. He also got treated to some morphine and entonox. 

I was fully expecting his wife to say ‘I can’t believe it’s not butter’. 

Sorry! That was awful!

“27 year old female, breathing problems, ?panic attack”

On arrival I was greeted with what had become a very familiar sight. Patient hyperventilating. Relatives fanning patient and running around like headless chickens. Often it’s the relatives that need the most help! The patient was crying and wasn’t being quite about it. She was also full flow in her panic attack. 

“Why is she soaking wet?”

“We poured water on her head?”

“Why?”

“To calm her down.”

Almost as she said it a hand flashed past my face. Then in slow motion I watched a glass full of water empty and start making its way through the air towards the patients face. With unerring accuracy the entire contents hit her square in the face.

Sure enough, the crying elevated to new levels. I don’t think she needed the second glass…..

“Stop it! What are you doing?!”

“Trying to calm her down.”

“I don’t think throwing cold water on her face is going to do that. All it’s going to do is make her wet and cold. I am now also wet. No more water. She’s not on fire!”

“OK, sorry, she needs to calm down though.”

The classic home treatment and I’d had the pleasure of witnessing it in all its glory! I can’t think of any situation where this would be my first choice or treatment. No one like having cold water poured on their face. No one! Least of all those who are already stressed or panicked! It is just such a bizarre thing to do! I would love someone who frequently uses this technique to let me know their rationale! 

“25 year old male, burns whilst cooking”

I blogged about this job before at length in Getting Egged, but I’ll share with you the highlights once again!

This guy had been cooking for his friends. He had used an industrial sized saucepan to cook a spaghetti bolognese for his friends. He’d decided to cook wearing only his pants, as you do. During the motion of transferring the vat of bolognese from the hob to the table he slipped on the wet floor and poured the entire contents of the saucepan over his torso, arms, groin, neck and legs. Probably close to 50% burns. It was actually really bad! 

Anyway, his friends knew exactly what to do in such perilous circumstances. Crack eggs onto the burns. Not just a 6 pack or even a Waitrose 9 pack. Nope, a Costco 24 pack of eggs. Every single one, cracked over his burning body. When you combine eggs with heat they begin to cook. By the time I walked in to the chaos, it was basically a giant omelet with a head. 

What followed with one of the most difficult and painful scrambled egg removals I’ve been involved in. The poor guy was an absolute trooper and to get morphine inside of him I ended up having to cannulate his feet! 

As is always the case, before we left to take him to the trauma centre I gave some excellent health promotion and financial advise to his friends. Namely, by telling them to use tap water, not eggs in the future….

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This little lot would make an excellent sketch! TV producers, take note!

People really do the strangest things and never ever cease to amaze. I genuinely wouldn't be surprised if I walked into a house to find a patient in a bath tub full of tined mackerels for treatment of a sore throat! It seems to be the done thing! No doubt I’ll have more to share in the near future but this should keep you all going for now! Anyone else experiences any particularly bizarre treatments for medical emergencies?! Please share! 

Anyway, this has made me all hot and bothered. I must go and throw water in my face, crack an egg on my head, douse myself in vinegar, bathe in olive oil and rub myself with butter and apply my potato skin body scrum. It what all the cool kids do, right?!

Emergency Medicine - Part 1

'RELATIVES: Ignore any first aid advice you’ve ever been given and just throw a glass of water in your loved ones face. Works a treat.'

I laughed when I tweeted this the other day. I know it’s a poor reflection on myself to be laughing at my own jokes, but I was just reliving the countless times I’ve gone to patients and found myself asking ‘Why are they soaking wet?!’. Invariably, the answer isn’t that they’ve just been out in the rain but that they just had a glass of water thrown in their face. It’s like some mythical sick joke! ‘I know, this person feels sick, let’s chuck water in their face! That’ll make them all better!’ It’s absolutely bonkers! Anyway, to that end, I thought I’d share some of my favourite home remedies that I have encountered! They range from the bizarre to the outright ridiculous. I wonder if JRCALC would consider putting any in our treatment guidelines! 

“52 year old male, cardiac arrest”

I had finished work for day but on hearing a cardiac arrest on the general broadcast with no units assigned I offered up for it. It’s what we are here for right?! I rushed to the address and was bet at the end of the road by a franticly waving man. Once he had my attention he literally sprinted like Usain Bolt down the road and into the house. This level of urgency must mean it was as given. I grabbed every bit of kit I could possibly need and headed up the stairs. I could hear the wailing and the crying, everyone was stressed and despite carrying the payload of a jumbo jet I bundled my way past all the screaming relatives to the patient. 

He wasn’t in cardiac arrest. He wasn’t even unconscious. He was however laying on the floor having possibly had a faint or panic attack or a combination of the two. He was soaking wet and absolutely stunk of vinegar.

“Why is he wet, and why does he smell of vinegar?!”

“We poured a bottle of vinegar on his head.”

She said it like I was being the idiot for asking such a stupid question! 

“Why? Why have you poured a bottle of vinegar on his head?”

“Because he wasn’t breathing properly.”

Aaaaahhh, I didn’t realise that the treatment for dealing with breathing problems was vinegar on the head! This will be helpful for so many patients! My next VDI will go something like:

-Morphine  √

-Paramedic Drugs  √

-Tech Drugs  √

-EZ-IO drill and needles  √

-Diagnostic equipment  √

-Vinegar  √

-IV fluids  √

Good to go! Vinegar!! Amazing! Needless to say, I left this particular cardiac arrest at home with advise and some adjustments to their next Ocado delivery.

“15 year old female, burns to leg”

From what I could gather, she had spilt a hot drink on her legs. The history wasn’t exactly forthcoming due to the circus of panic that was surrounding the patient. If I didn’t know any better I would have thought her legs had just been amputated. A woman barged past me as I was trying to get closer to the patient they had called me to see. The woman had two handfuls of potatoes. I would go on to found out that these were extra potatoes on top of the ones that had been used prior to my arrival. 

Eventually I managed to fight my way through the crowd to get to the patient. Standing over her was a relative. Frantically peeling potato skin onto her scalded leg. Yep! Potato skin. Sod all that running under cold water lark! Who needs that, when it’s much easier to turn your daughter into what was essentially a giant human potato rosti! 

“What are you doing?!”

“She has a burn, we peel potatoes.”

“I can see that, but can we stop, and get rid of the potato peels please?! We need to run it under cold water! Not dress her like a hash brown!”

“No more potatoes?”

“No, no more potatoes!”

It was a minor scald. Once she was clear of starchy veg and cleaned I was able to put a burns dressing on. She was then taken to hospital. Again, shopping list and future treatment advise was given. Will we see potatoes joining aqua-gel and cling film any time soon?! Hmmmmm!

“47 year old female, collapsed”

I find that when jobs have very little information to go on, it’s a sign that the patient isn’t going to be that unwell. On arrival, the familiar signs of overreaction and panic were evident! I’m always amazed how many people can fit into such small rooms! When someone becomes unwell the entire world, their wives and extended friends of friends seem to congregate in the room when the invalid lies! As I entered the room I had to ask all non-essential well wishers to wait outside so I could have room to do my thang!

As it turns out, I wasn’t needed. They had it all under control. My under control I meant the patient was lying on her back, legs being held up in the air whilst having olive oil massaged into her feet.  And by massaged, I don't mean a relaxing spa massage with relaxing oils. I mean a frantic, verging on violent massage or some kind of weird, lubricated tickle torture. Admittedly, it wouldn’t have been my first choice of treatment for a panic attack but what do I know?! 

“What’s with the oil?”

“She faint, we oil her feet.”

“Ah, OK, how about we stop that and sit her up so she can breath, I imagine holding her legs over her head will be making breathing a tad difficult.”

Sure enough, once the room was less like the mosh-pit of a Slipknot concert and she was upright and not being contorted in an oily mess, her breathing improved. I left her at home, again, with advise on what to do should a similar situation arise again. Somehow, I don’t think Olive Oil will be joining Sodium Chloride and Glucose any time soon. You never know though…..

To be continued......

No More, No Less

"RTC, car vs car. Injuries unknown. Police on scene."

We happened to be on the road the RTC was on when we got dispatched to it. It was about two miles away but due to the nature of the relatively narrow and winding road, any RTC always caused absolute chaos in the area. The traffic was already building up, even where we were so it took a little while for us to get there. For every five cars that move out your way, there is one that just sits there and doesn't move. It's most frustrating! Ahead, we could see the blue lights of a police car and after a final push we were there.

As far as RTC's go, this was a minor one. Three car were involved all with relatively minor amounts of damage. There were five patients, all with pretty minor ailments, but all needed assessing and treating. Injuries ranged from minor head injuries to mild chest pain. Once we had parked our 3.5 tonne vehicle traffic was now well and truly blocked in both directions, but whilst the two of us were working our way between the three cars, that was what was happening. The two cops were having to take statements, try and clear the road, act as mediator between the feuding parties as well as making sure everyone was safe until we had arrived. I didn't envy them one bit!

Sat in the traffic, near the front was a brand new white Audi. A guy, mid 20s leaned his head out the window and spoke at one of the coppers.

"Oi, how about you clear the road."

"How about you don't refer to me as 'Oi' for starters."

"How about you just do your job."

"Can you provide me with more officers to assist us, because that is what we need?"

"Ain't my job, I pay my taxes, how about you clear the road like you're paid to do, fucking idiot."

"We can only do so much. There are only two of us. We would love more officers to help but there aren't any. You'll just have to be patient."

"Just move the fucking cars so we can get on our way. It's your job, it's not rocket science. Are you all as incompetent as each other?"

"Stop swearing at me."

"Or what, what you going to do. How about instead of wasting time whining about swearing you do your job and clear the road."

At this point the copper walked away and continued doing the huge list of things that needed doing. I just stood there open mouthed. Had that really happened?! Some people are so unbelievably selfish! And arrogant. And in this case, just a total arse!

"Oi, move your ambulance so we can get past."

Oh, he's talking to me now! I felt that warm feeling inside, one full of joy and excitement! I composed myself for a moment and walked over to his open window.

"You are a rude, nasty, LITTLE man. You will wait like everyone else is waiting. There is nothing you can say, or do to make me move my ambulance any faster. All that you stand to achieve with this attitude is ensuring you wait longer."

With that I begun walking away! 

"Go fuck yourself."

"Very intelligent response. Well done." I said with a smile.

"Fuck off."

Clearly, I don't have the same levels of self restraint that coppers do. I am often found guilty of taking the bait but someone needed to tell him he was being an arse! The police face this abuse on a daily basis and most people get away with it, because there simply aren't enough officers to arrest and process these morons.

I asked the police officers on twitter how many units / officers would be needed in an ideal world to deal with a 3 car RTC with 5 patients on a busy road. These were some of the responses:

"I'd like 6. However I think that 4 is probably all I'd get. And that's on a good day." 

"Ideal world an officer per car, 2 for the road block and 2 for the witnesses so 7. That would almost be my whole team!" 

"6 in an ideal world, but you should be so lucky! 4 would be safe and manageable" 

"Ideally 6, but safe with 4. No less than that." 

"4-6 for scene management, arranging recovery, taking witness statements etc"  

"Depending on the road 6-8 ideally, not less than 4, too much to do." 

"Probably 6 I reckon but that would be most of my team!"

So, I think it's fair to say that the one police car with two officers was not enough to safely deal with the scene. Unfortunately, there was no one spare to send. In previous blogs Please Sir, can I have some more? and A Special Relationship I highlighted what effect the cut of 16,000 front line officers was having. Those two posts highlighted extreme cases which is easy to get outraged about but RTC's like this are part and parcel of every day policing and there simply are not enough to spread around. What you're left with is two officers trying to mange 3 angry families, a blocked road, the irate public, 5 patients, 3 drivers to process and breathalise, vehicles to help arrange recovery for and an ambulance crew to ensure are kept safe! It simply doesn't add up does it?!

As a bonus, as the road was being cleared the chippy chav opened his abusive mouth one to many times! The cop went over to the car and asked him politely to get out the car. The driver don't take kindly to this and his threatening manor and verbal threats landed him in handcuffs. To top it off, due to a faint smell of alcohol he too was breathalised. In what was a beautifully poetic moment, he blew over the limit and was promptly arrested for drink driving. One more scum bag off the road! If only he'd kept his mouth shut!

Despite the pressures, everything got done. The abusive moron was ignored, then arrested! The road got cleared, the patients got treated and discharged and after a good hour or so all that was left was the two cops with an absolute mountain of paper work, an ambulance crew and a clear road. The upshot is though, the public are left blaming the police for not doing enough to ensure their smooth journey! It's not the cars crashing, it's the police not working fast enough to clear the road. That moron happened to voice it but you can be sure others with thinking it. The emergency services shouldn't be left in a situation to just cope and muddle through. These ill conceived cuts to front line services have a huge effect on day to day services and there simply are not enough left to keep the public safe. Then again, lets not forget police should "Cut crime, no more, no less". These non-police matters will sort themselves out, eh Terese May....

Dead Man's Hand

"25 year old male, playing cards, now not talking"

Call me a cynic, but I suspected this was going to be yet another waste of a resource. I may be wrong, he may well be having a stroke like the NHS111 triage system had determined, but at the age of 25, this was highly unlikely. There are always medical phenomenon, where teenagers have strokes, heart attacks and other conditions that are not expected to be a risk for at least 30-40 years. However, they are rare, especially when there are no risk factors. With no other symptoms listed, it was pretty staggering to the me that a) I was even going to it and b) it was such a high category or call! Anyway, who am I to form these opinions and question these decisions?! I'm just the Band 5 warrior who gets to see these people in their own habitat! I'm just the one who treats them. I'm just the ambulance driver who merely takes them to hospital. Questioning NHS111 is way above my pay grade! Anyway, only time would tell if it was NHS111 1 - 0 Me or the other way around. I suspected I would be taking home the points today! 

I pulled up to the house around 1am. It was the only house in the road with lights on so was pretty easy to spot. The door opened as I was walking down the path and a young guy came out to meet me.

"Thanks for coming, you really shouldn't be here."

"No problem, what happened tonight?"

"Between you and me, he's a friend of a friend. We have had a poker night and he has lost money. He kept buying back in over and over and now owes about £70. He collapsed to the floor, we got him up and put him in a chair and he hasn't said a thing since. Every now and again he opens his eyes but just closes them. It's a bit odd, I reckon he's putting it on to avoid paying but a couple of the guys were worried and called that 111 thing."

"OK, thanks for the heads up, let's go and see him."

I was led through to the living room where the perfect 'lads night' was on display. Sky Sports News on the TV, remnants of a curry lying around, poker table set up and a fair few empty cans of lager all over the place. They were actually a really nice group of guys, polite, courteous, offered me tea / coffee etc. 

"Coffee, milk and 2 please!"

Lying in the chair was the patient. I've seen a lot of unconscious people in my time and I've also seen plenty feigning unconsciousness and he was DEFINITELY not unconscious. I don't know what it is exactly, we just know! Unconscious people have a look about them.

"Come on James, open your eyes.......James, open your eyes."

Nothing. I lent forward and gently touched his eyelashes. Sure enough, they twitched. Shocker! 

"James, I know you can here me, stop playing around and talk to me."

Nothing. I pinched the muscle on the top of his shoulder as my 'pain stimulus'. Sure enough, he recoiled from it but still continued the pretence of unconsciousness.

"James, an ambulance is on its why. I'd like to cancel them so they can be used on one of the dozens of seriously sick people who are currently waiting for one. The reason they are coming here is because you are pretending to unconscious. Do me and them a favour and start talking to me, this has gone far enough.........James!"

Nothing. I went for the shoulder again and he slid himself down onto the floor and started 'fitting'. It was one of the worst fake seizures I've ever seen, complete with spitting and drooling. After about 20 seconds he stopped. I picked up his arms, held it over his face and let it go. Sure enough, instead of dropping and hitting him in the face he moved it to one side at the last second. 

"Red Base, this patient is not co-operating, could you request the police to attend this CAD as the patient is preventing the emergency services carrying out their duty." (Forgot to press the transmit button, oops!)

*cue the miraculous spontaneous recovery*

James started moving around slowly and feigning confusion. 

"What happened, what's going on?"

"You pretended to be unconscious and then pretended to have a fit, are you recovered now?"

"What do you mean?"

I could have continued in the same vein but it was easier to just ensure he was fully recovered so I could cancel the ambulance. AMAZINGLY within about a minute he was fully recovered, fully alert, fully cooperative and fully embarrassed. 

"Does he need to go to hospital?" said one of the guys.

"Nope, certainly not, he'll be just fine!"

"Excellent! Pay up bro! Mans have to pay their debts!"