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

Can I Go Down There?

It is with great pleasure that I open the floor to my first Facepalm Friday guest post! This week I welcome the award winning, much revered, mental health guru that is @MentalHealthCop from MentalHealthCop! It occurred to me that all the emergency services interact with the public and therefor, we all come across candidates for the Darwin award on a daily basis! This comedy gem from Inspector Michael Brown is from his earlier days as a police officer. At a guess, it was probably in the late 1870's! ;-) 

"Adult male, wanting to go down there" 

I found the Friday Facepalm idea intriguing! - 999 services see human stupidity on an epic scale and we've all got these stories, but my blog doesn't lend itself easily to letting off the necessary steam around them.  Thanks to Ella, I have offloaded some major stress from my early career.

Well over ten years ago, I was a front-line PC in Birmingham.  My partner and I were called to a gas explosion on a very small traffic island where four approach roads intersected.  A engineer for a telecoms company had been working on underground pipes / cables, on the pavement which rounded the corner of two of those approach roads and had managed to ignite gas by cutting electrical wires.  The subsequent blast singed his hair without causing major injury and sent a thirty foot high flame into the sky.

An early Facepalm! for the engineer - but this is merely incidental to the stupidity that followed.

All three 999 services went down there: Ella's lot were helping the engineer change his underwear whilst Simon and Dennis were using their hoses to put out the fires caused to trees and bushes as the gas plume licked back and forth in the wind, torching anything within it's reach.  The only way to stop the plume of burning gas was to get the gas company to dig up the road around fifty metres away and isolate the supply - this would take hours so we were asked to support cordons on the roads and pavements for public safety.

The fire truck blocked one road, the police car another and the two less frequently used approaches were taped off.  There were two cops and a few fire officers to keep saying "No" to the question that always gets asked on these occasions -

It's been the since human pre-history that when you put a cordon on something, some members of the public will still ask "Can I go down there?"  It's important to understand I'd managed nearly two hours of "Can I go down there?" whilst sweating profusely on a what was already a very hot day, underneath a thirty foot plume of burning gas and we'd had to get another patrol to drop cold drinks up to us because it was quite demanding.  So to say I was a bit tetchy about "Can I go down there?" is to understate things.

The clue is:  my police car is across the road with blue lights flashing, we've taped off the road and you can see highly dangerous flames burning brightly and gently toasting us all.  They're licking backwards and forwards fairly unpredictably and there are fire personnel putting out fires as quickly as they can each time one starts.  You've probably seen other people approaching us who ended up heading back the way they came, so what do you think the odds are that you can "just go down there?"

Then happened one of the most unbelievable things I have ever seen - I will remember this until I die:  on the less often used approach, which was taped off and kept in view, but where no-one was permanently standing, a suddenly saw a young boy approach the tape and lift it in the middle. There was a Mercedes in the road, facing me and the boy looked like he was attempting to allow the car underneath the tape. Hang on: that car is slowly moving FORWARD!!

Stop!! 

*Double Facepalm!*

I ran from the opposite, busier cordon shouting "No!"  The vehicle's bonnet was under the tape, the tape stretching across the windscreen and the boy trying to lift it higher as the car inched slowly forward. There was a hairy arm out of the driver's door also attempting to force the tape higher and flick it over the height of the roof.  "Stop!"  The vehicle was approaching the roundabout on the side where the plume of flames was nearest.  Surely he can see it?!  The fire engine was to the right hand side and he could see it from where his car was and both Simon and Dennis were waving frantically in between planning their second jobs and having a snooze.

"What on earth do think you're doing?" I enquired.  "I live up there." he said, implying outrageous unreasonableness on my part.  The wind blew the flames towards us and I felt the temperature really increase before subsiding as the wind dropped.

"Can't you see the tape, the explosion, the blue lights?" 

"But I live up there!"

"It doesn't matter,  Sir - this road is CLOSED!"

"But I live ... just there!!"

"So find another way around, but this road is closed."

"This is ridiculous - I can just drive on the opposite side of the roundabout.  I'll be home in seconds."

"No you won't - because THIS ROAD - IS CLOSED!"

"You're being obtuse, officer."

"If we're offering viewpoints - I have one about using your son to lift police tape without permission and pushing him into demarked areas of extreme danger.  Shall we talk about that?"

"It can't be that dangerous ... they're letting you move about in it."

"They also let me arrest violent criminals, Sir - I'm guessing you don't want your son doing that either?"

"Fair point."

It took the threat of prosecution to get him to reverse and find another way.  I walked up to his house - it was just fifty yards beyond the opposite cordon and gave the appropriate advice.  I think I had hoped he would have realised the main learning opportunities from this encounter.  It amazed me to find he was still furious for the extra five minutes on his journey.  He informed me of that he would be complaining about my attitude and would like to speak to the duty inspector in respect of the complaints procedure.  Fortunately, Carlsberg do make duty inspectors - a man on whom I've modelled my very own approach to that job.

*Triple Faceplam* - the scale of fail.

Climbing for Little Angels

"28 year old female, climbing a load of mountains"

A few days ago I posted a blog called 'Little Angel'. I wrote it a long while ago but it never seemed the right time to talk about what is a very difficult and distressing subject. 

'Sudden Infant Death’ is the term used to describe the sudden and unexpected death of a baby or toddler that is initially unexplained. The usual medical term is ‘sudden unexpected death in infancy’ (SUDI). Some sudden and unexpected infant deaths can be explained by the post-mortem examination revealing, for example, an unforeseen infection or metabolic disorder. Deaths that remain unexplained after the post mortem are usually registered as ‘sudden infant death syndrome’ (SIDS). 

In February this year I learnt about Matilda Mae, who was the daughter of @Edspire and at the age of just 9 months tragically died due to SIDS. Jennie wrote some brave and heart breaking posts, none more so than 'Dear Matilda Mae: The night we found you sleeping'. Please, please read it to see SIDS from the families perspective. 

In the UK alone, each year there are 300 unexplained infant deaths. It was seeing  this number and seeing the amazing work Jennie, her family and her friends have done to raise money for The Lullaby Trust that made me want to do something. The Lullaby Trust provides specialist support for bereaved families and anyone affected by a sudden infant death, and it is this support which is invaluable to the many families affected by SIDS.

On the 1st August 2013, me and a friend are embarking on a challenge to raise money for The Lullaby Trust. We will be climbing the 4 highest peaks in Great Britain and Northern Ireland over 2 days. Starting in London we will drive to Northern Ireland and start with tackling Slieve Donard (850m). From there we will drive to Scotland and haul ourselves up Ben Nevis (1344m). Once Scotland has been conqured, we will drive to the Lake District where Scaffell Pike (978m) will be awaiting us. After that it's just a case of nipping into Wales, staggering up Mount Snowdon (1085m) and driving home.

Unlike the traditional 3 peak challenges, we have no support team to do the driving while we rest. We will sleep when we can and where we can. There is 1451 miles of driving which will take about 30 hours and about 24 hours of climbing (at best)! We expect to reach the summits of all 4 mountains within a 48 hour time window! 

Please, please, please sponsor me. The petrol costs, ferries and any accommodation will all be self funded. 100% of sponsorship will be going to The Lullaby Trust to help continue their crucial work. It costs them £1.6 million each year to do the work they do so anything that can be raised will help. 

This is my Just Giving page:

http://www.justgiving.com/EllaShawFourPeaks2013

I will of course be showing proof from the top of each mountain so you know I actually went up there! Please dig deep! Anything is better nothing. 

Thank you :-) x