AWOL

"30 year old female, stepping away from the madness"

Right, cards on the table! I haven't been publishing much of late as many of you have noticed! It isn't because I have nothing to write about. I have a list of almost 100 posts to write up. It isn't really in issue of time. I have plenty of it if I'm honest. It isn't that I don't enjoy writing. I do. This job is funny at times. Months can pass as if nothing has happened but equally, a day can pass and it can feel like everything has happened. I use this blog to share my experiences, vent my frustrations and in many ways, use it as a self help therapy to get some of the bad stuff off my chest. Sometimes though, you can share too much. 

The last few months have dealt me some pretty horrendous jobs and as much as I could write about them in detail, some of them I just don't want to re-live through. As someone who likes to reflect on everything that happens to me, it puts me between a rock and a hard place! I want to write about them, but I don't. When I try to write about other things, they don't seem as compelling as the things in the back of my head! So, the result is I don't post anything and just have fun for a while! 

I've finished work each day and not given work a moments thought until my alarm goes off the next day! My rest days have been filled with non-work related stuff, no blogging, and trips away! I celebrated my 30th birthday with friends and family and now feel thoroughly recharged. I always said from the start that this blog was for me, and I would write for as long as I enjoyed it. Well, I wrote a post yesterday and thoroughly enjoyed it! 

A prolonged break from time to time is what has kept me blogging for three years, so hopefully, all things considered I should be back posting with regularity! There are plenty of posts coming up, there is the matter of the MAD Blog Awards 2014 in September and as of last week, I found out I've been short listed for a Brilliance In Blogging Award for Best Health Blog! 

Talking of the BiB's, I NEED VOTES! Please go and vote for me! I'm one of 16 shortlisted and would love to be a finalist for the first time! 

VOTE NOW! 

Anyway, that's the begging out the way! Thank you for all your continued support! 

Much love

Ella xx

Memories

"74 year old male, back pain, feeling dizzy and weak"

I've met 1000's and 1000's of people through my job, some good, some bad, some made me happy, some made me sad. To be honest, as harsh as it sounds, most don't get a second thought. That isn't to say I don't care, but if I take the thoughts and feelings of every job home with me I'd be a jibbering wreck! Doing this job however, it is inevitable some things you see will stay with you forever. It's an unavoidable part of the job. That said, delivering twins is a memory I'm fond of, as is meeting a man whose life I saved, or seeing the child start breathing again who had been choking. These are memories that I will cherish. The flip side, is there are people, faces and events that I can't un-see or forget about. There are people who you share moments with who have a profound effect on you, who stay in your thoughts when you'd rather they wouldn't. 

I was called to this guy with back pain and dizziness. At one point I thought that I'd be cancelled as it wasn't a high priority call, but due to my proximity to the address and the fact the service was busier than normal I was on scene before a cancellation appeared. The door to the flat was unlocked so after knocking, I let myself in. 

Lying on the bed was my patient. He was smiled at me and I introduced myself. He was white as a sheep and pouring with sweat though didn't look in too much discomfort. He spoke very quietly to me, so much so, that I could hardly hear him. He had had back pain throughout the day which he scored at around 5/10. He was feeling very light headed and felt especially dizzy with blurred vision when he sat up. He had no other symptoms to mention but was understandably anxious. I set about doing his observations, already thinking that I'd probably want an ambulance sooner rather than later. 

His blood pressure was in his boots. In fact, it was one of the lowest, conscious blood pressures I'd ever seen. I raised his legs with cushions and then nipped back to the car to get my paramedic bag. I also used the opportunity to request an ambulance ASAP, without having to worry the patient.

By the time I returned, his breathing was notably faster, but he wasn't complaining of feeling short of breath. It was still just the back pain causing him concern. Due to the extremely low blood pressure, finding a vein was a pig! Eventually I found one and got some fluids running. Despite his protests that he was feeling okay, as far as I was concerned, he was deteriorating and I myself begun to get anxious about not having an ambulance. It is one of the perils of working on a car. Sometimes you get stuck in a waiting game and it is a pretty helpless feeling. Luckily, the ambulance arrived a few moments later so my anxiety was put to rest for now!

I was aware that the guy's abdomen was somewhat distended, more so than when I arrived. There was  still no pain but I was pretty confident in my suspected diagnoses. I had a horrible feeling that he was having an Abdominal Aortic Aneurysm (AAA) and that it was at risk of rupture. A ruptured AAA outside of hospital means death. A person can bleed out into their abdomen and die within minutes. We were all well aware that he needed surgery immediately if it was what we suspected. We also had to make sure of minimal movement and a very smooth, yet fast blue light run to hospital. 

We get the bed into the flat and carefully transferred him to the bed. Without any delay we left,  driving off almost the instant the door was shut. We put a blue call in to the local hospital on route. By now the patients breathing was visibly strained. His oxygen levels that had been 100% dropped rapidly so we put him on high flow o2. We were at the hospital within 3-4 minutes, his abdomen now distinctly distended. As we were wheeling him in I knew in my heart of hearts that he was going to die. I still really hope my face didn't show that.

We transferred him to hospital bed in resus and attached him to their monitoring. He turned to us and said:

"Thanks guys, you've been brilliant.......thank you.........."

At that point his eyes closed. 

"Crash call!" shouted the nurse as his breathing stopped.

Within seconds, he was surrounded by nurses, junior doctors, SHOs, registrar's, surgical consultants and us. CPR was started as I handed over to 15 people surrounding him. Five minutes later, he was declared dead.

His medical records will show a 74 year old, male smoker who died of a ruptured AAA. A relatively common cause of death in male smokers aged 65-75. It's life and not something anyone will be too concerned about. He had no family to speak of and lived what a appeared to be a very solitary lifestyle. He is however, one of the patients which will stay in my thoughts. 

There are some patients you create a bond with, not through common interests or friendship, but because you were there when they needed you most. You were the face that appeared when they called 999 for help. You were the person that reassured them when they needed reassuring. Yours was the hand they grabbed when they knew something was wrong. Yours were the eyes they starred into as they drew their final breath. And you were the person they thanked with that final breath. 

I'm not naive enough to think I can save everyone. When he picked up the phone and called 999 he was dead. Nothing was going to save him and I know that. No one is to blame, there are no fingers to be pointed but sometimes that is of no consolation. What I can take solace from is that he didn't die alone, and as much as I don't want to still be thinking about him all these months on, at least someone is. At least he isn't forgotten.

Don't forget, voting are now open for the MAD Blog Awards 2014. Please go and vote me by clicking HERE. Just select Trying My Patients from the list in the Best Writer category!
Thank you! 

A Heavy Heart

"31 year old male, chest pain"

I really am bored with chest pain. Historically people ignored it, and as such, people having heart attacks didn't get treatment and subsequently died. Cue the huge, expensive campaign to raise awareness about chest pain. It was hugely successfully and cardiac care in this country is now one of the best in the world. However, the increased awareness about chest pain has inevitably led to chest pain being overused as a symptom. It seems that any pain, anywhere on the torso and for any length of time must be a heart attack, and as such, the amount of people who claim to have just pain when calling an ambulance is huge! Some use it to get a quick ambulance because they know we will come immediately. Some, just can't cope with any pain, anywhere and assume they are dying. 

I would say that as high as 9 out of 10 chest pains that we go to are not genuine chest pains, which is quite remarkable. We go to them every single shift in some form or another, and very rarely is it a heart attack. As a rule of thumb, I find that chest pain in the under 40's is not genuine chest pain. More often than not it is a panic attack, chest pain caused by prolonged coughing, a stitch or any other common day illness which most normal people treat at home. However, 999 seems to be the first port of call! Obviously, there are exceptions to the rule and we wouldn't want to put people off calling if they are having a heart attack, however, what I can assure you of, is sharp chest pain that is only there each time you cough, is not a heart attack.

It was middle of the day and my shift was ticking away nicely when I got sent a job. I shook my head about a 31 year old calling with chest pain and headed off. There is nothing that can be done about filtering these calls. It is very black and white. 'Do you have chest pain?' 'Yes'. They get an ambulance. Find a solution which removes risk and you'd save all ambulance services millions of pounds!

Waiting at the door with almost a proud grin was the patient. I grabbed my bags, trying my best to avoid eye contact for as long as possible, as I'd seen his beckoning eyebrows dancing round all over the shop! Keep them still man! I eventually got to the door and headed in.

"Right sir, what's the problem today?"

"I have pain in my heart."

"Point with one finger where the pain is"

*points to right side of chest*

"Your heart isn't there."

"You sure?"

"Pretty sure."

"Oh, how odd, is that my stomach then?"

*facepalm*

Welcome to my world! Needless to say, he was left at home with advice and 2 Paracetomol! Another life saved!

Utter MADness!

Well, about a month ago a asked you all to nominate me for the MAD Blog Awards 2014! I was a finalist last year which was humbling to say the least, but this year things haven't run as smoothly! For various reasons I haven't been able to blog with the regularity I was last year, so when nominations opened I was asked out of hope more than anything! Since I posted my plea to the masses I didn't think about it again until the finalists were revealed!

In a severe case of Deja Vu, in a carbon copy of last year, I was working a late shift when I got a text message from @BigFashionista saying 'You're a finalist!'. I couldn't believe it! It really was shock! I am a finalist in the Best Writer category and Blog of the Year! I'm still completely speechless about the whole thing, but very much looking forward to it! I met some amazing people last year and can't wait to see everyone again! 

Now, as much as this post is a HUGE thank you to everyone that nominated me, it is also a war cry of sorts! Now I am a finalist I need your votes! I'm up against some seriously stiff competition so PLEASE PLEASE PLEASE take 30 seconds out of your day to vote for me!

Voting can be done on the MAD Blog Awards 2014 website! Select 'Trying My Patients' from the Best Writer category and that's it! 

Thank you all again for your continued support! It really is appreciated! 

Ella x

VOTE NOW!

A Spot Of Bother

It was a rather quiet morning on the car! I'd taken the temporary lull in jobs as an opportunity for coffee with a fellow FRU! It's nice when you get some company on the car as it can me quite a lonely place at time. It's been described as prolonged periods of boredom, occasionally interrupted by moments of sheer terror. I think that is pretty accurate! 

"New Road @ Station Road"

Not two sips into my coffee, a job! A road name @ another road name, usually means an RTC. It could be someone just outside by more often than not it's an RTC. I had no other details yet so just started heading in the right direction. One of the problem with the FRU is when you're driving on blue lights it is very difficult to see any updates that appear on the screen. A buzzer goes of and the message appears in red when the call taker gets more information. The next update was the determinant, which is the main problem, i.e.; Breathing problems, Chest pain, Stroke, RTC etc.

"New Road @ Station Road, Stabbing / Shooting"

Really?! On a tuesday-bloody-morning! Come on! I upped my pace slightly, because despite my shock and horror at a stabbing or a shooting so early in the day, I bloody love stabbing and shootings! I'm not weird, most of us love a juicy trauma really! I started making mental plans of what I might see, what I might need etc. 

"New Road @ Station Road, 17 year old male, impaled on metal fence, report on arrival"

IMPALED?! How did he manage to get impaled?! What is he impaled on?! What is he impaled through?! No time to come up with a plan though, I was arriving on scene!

There was a small crowd beneath the patient, supporting him up in the air. All the heads turned to face me as I got out of the car. That look of expectation mixed with panic on all of their faces! 

*cue emergency face*

They were looking at me as the 'specialist in impaled human removal'. Sadly for them I was far from it! I'd never done an impaling so I was about as experienced as all of them! The patient was panicking atop of his spiked metal fence and to be fair, I would be to! The spikes were about 8-10 inches long and by the look of things he was impaled on two of them, through his inner-thigh. It was hard to tell because he was 8ft in the air! 

His panicking was getting worse. I wanted him to stay still, and wanted everyone to continue helping to support his weight. It really was a logistical nightmare! I radioed into control and requested Fire, Police and HEMS. Fire to chop the fence and bring some ladders, Police to block the road, and HEMS to.....well, just do what HEMS do best! Unfortunately, hearing me ask for the entire world and his wife, the patient panicked further and despite my shouting at him not to, in one big burst of energy he lifted / prized his body off the spikes and fell into our waiting arms.

"Red base, patient is no longer impaled, cancel fire, update HEMS, patient has an arterial bleed from his femoral artery."

There was blood everywhere. The good samaritans moved back, some freaking out at the blood, others just starring. I put all of my weight onto his groin where there blood was coming from. It took an incredible amount of pressure to stem the bleeding. The problem was I now had no hands! I barked order at people to get me things from my car, to press the talk button on my radio so I could get an ETA for my ambulance and to use my scissors to cut up his trouser legs. It was organised chaos! 

Within a couple of minutes the ambulance was with me which was a huge relief. I was getting cramps through my arms, they were literally shaking with the amount of pressure being used. A pressure dressing was prepared, as was an extensive wound dressing. In a fluid movement I swapped places with one of the crew and we got the dressing in place. The patient was white as ghost and sweating profusely. He was in hyopvolemic shock and needed surgery very quickly. 

I set about getting lines in his arms. Luckily for me and the patient he was athletic and had HUGE veins which just popped up nicely for me. As I was setting up the fluids the helicopter appeared above us. What a relief! The bed appeared next to use so whilst waiting for the HEMS team to be driven to us by the police (*cough* not just crime fighters!), we got him loaded onto the bed. Based on where they landed we would have to drive him to the chopper and we didn't want to waste any time. His blood pressure was in his boots, his pulse was racing and he was becoming increasingly groggy. To help stem the bleeding we gave him some Tranexamic Acid which aids clotting. 

With HEMS with us they took over. They started giving him units of blood as we all started loading him onto the ambulance. I felt quite satisfied that that was all they could really do. We'd managed to do everything else before they arrived and that is always a good feeling! Within a minute or so we were next to the chopper and transferring him. Having to keep huge amounts of pressure over his femoral artery made moving him slightly awkward but he was quickly on board and taking off. 

His friend had stayed with him until take off and was awfully worried. 

"How did he get impaled in the first place?!" I asked him.

"He dropped a £10 and it blew under the fence, he tried to run up and volt over, but it went wrong he got stuck on a spike."

"All that for £10?! Couldn't he have just gone through the gate down there?!"

"Oh year, didn't see that."

I had to laugh! Even his friend begun to smile, despite being covered in blood. I was covered to! I looked like Carrie! It was a sight to behold! My arms were literally red! It was time for a shower, uniform change, a re-stock, a fair bit of paperwork and my cold coffee! Just another tuesday!