Monday, 3 December 2007

Speak of the Devil

Six calls - two assisted-only, two conveyed, one dealt with by police and one taken by ambulance.

The underground is a common place to faint. The hot, crammed inside of a tube train does nothing to enhance circulatory flow and if you are feeling ill, weak or in any other way vulnerable your body might decide to shut you down for a short while until it gets a grip of itself.

My first call for a 25 year-old female ‘feeling faint’ was to an underground station but, as is usually the case, by the time I got to her she was already recovering. An off-duty doctor (another thing you can almost guarantee getting on the underground) stopped to render aid and the woman was being plied with food and water (she hadn’t eaten this morning apparently) to help her get better. It worked because she declined further aid and I cancelled the ambulance. She continued her journey to work. Next time I'm hungry I'm gonna faint on the tube.

I took a 61 year-old female with abdo pain and dizziness to hospital myself because she is a regular caller with nothing wrong with her (well, she has a long history of ulcer but apart from that nothing else). Staff at the hospital know her very well and are less than 100% sympathetic when she shows up but she lost her husband a few years ago and has never been able to accept it – now she calls us out whenever she feels lonely and unable to cope. She uses her ulcer to get an ambulance (the dizziness is added in for extra effect, as is DIB or chest pain, depending on what you've used up before).

A call to a 45 year-old ‘fitting’ at a bus station next and I found myself driving towards a man in a wheelchair. His friend (the man pushing the chair) was windmilling me over and pointed to his non-walking mate, telling me he had been fitting and was still ‘not right’. He looked post ictal and was behaving a little oddly. He kept getting out of his chair as if he was ready to do a runner (which prompted me to wonder why he needed the chair at all) and had to be restrained.

The man was an alcohol from the nearby hostel; alcoholics have withdrawal seizures brought on, ironically, by a lack or complete cessation of alcohol. I had to be careful not to confuse his condition, however, as he may have genuinely been epileptic. His friend confirmed that he wasn’t (that he knew of) and so I asked when he last had a drink.

‘Last night, I think’, said the helpful friend.

Usually it takes longer than 24 hours without a drink to cause fitting, so with the possibility of other causes lingering, the ambulance crew took him off to hospital, just in case.

A 23 year-old female with ‘DIB’ and described as having ‘heart problems’ turned out to be a panicking young French woman with hyperventilation who was recovering by the time I arrived. The MRU medic showed up too but it was unnecessary. She refused aid and felt very embarrassed by the fact that her manager had called us at all. As for her heart condition, she denied having one, although her boss was still insistent. We left her to work it out with him.

I had been talking about some of our regulars with a colleague at the station at the start of my shift and I happened to mention a particular menace that I hadn’t seen for about six months. He calls us out for ‘chest pain’ and then abuses everyone in his path. He is thoroughly convinced of his right to go to hospital every time he calls – which can be two or three times a day. By some fluke of chance or the cruel hand of fate or whatever you want to call it, he turned up on my next job, almost as if I had summoned him!

He was on a bus in the City. He was very drunk and very rude. The police were on board chatting to him but they were also around the corner at another call, dealing with an elderly lady who had fallen and sustained facial injuries. She had been described by the police as a 'woman with a smashed up face', which kind of simplified my version of her injuries. She had fallen very hard. Unfortunately, I wasn’t there for her, I stumbled on that call by accident as I approached the bus job.

I told the police officer with the woman that I would be right back to help her (after I had done a cursory check of her face). At this point I had no idea it was my regular friend on the bus but I weighed up the possibilities as I considered which call took priority. Drunk on a bus, woman with smashed up face...hmmm, difficult. The trouble was, I had been assigned the former and the latter was a running call.

I called my control and explained what was going on. They had just received the call about the lady with the facial injuries and were trying to assign an ambulance (but there weren’t any free) so I offered to deal with it after I had checked on the bus drunk. That’s when I walked onto the number 55 (or whatever it was) and saw his familiar and annoying face. The police were already onto him, so I agreed to leave him to them (after a quick check to see that he was just drunk and nothing else was wrong with him) and they took him off the bus and read him the riot act. He wasn’t arrested; he will never be arrested for this – it’s not worth the paperwork.

I went back to the injured lady and got her into the car, husband in tow and off we went to hospital. The last thing I saw of the annoying regular was the back of him as he shuffled off with the police watching him go.

I got the lady to hospital and found that there were no wheelchairs around, which is not unusual. She was too unsteady on her feet to walk and as I passed through the hospital corridor looking for something useful, I saw an item that shouldn’t have been there at all...a shopping trolley. It crossed my mind but I dismissed it.

Eventually I asked a crew if I could borrow their chair from the ambulance and they obliged. I handed her over and said goodbye. Then I made my way back to my own area.

We get messages direct from the police on our MDT’s now. I wasn’t aware of this because nobody told me but I discovered it when an ‘urgent update’ flashed up on the screen. It confused me at first because I didn’t know who had sent it or why but I read it: Drunk man back on another bus, been taken to hospital by ambulance crew.

The only thing worse than a time-wasting regular caller is one who knows exactly how to play the game.

Be safe.


Anonymous said...

Hi there.

I do not live in the UK but I will be coming over for christmas and new year and then leave on about the 7th of January to come back home. What I would like to know is by any chance would your book be out then, as if it is I would like to purchase it first hand as opposed to ordering it over the net and it arriving in the post, Could you let me know where I could purchase it if it will be out ? if not then it is not a problem I will order it over the net when it is out.

Anonymous said...

Out of interest what shifts do you work and how long are they, How often do you get days off ?

Anonymous said...

I am ninteen and have completed school, I am looking at pursing a career as a paramedic and am going to hopefully go and study at uni in the near future. I would like to know if the LAS takes students for work experience where they act as observers or volunteers ? where they can get a sense of what it really is like on the roads.


P.S. I love the blog

Anonymous said...

I have heard that in some instances Doctors or paramedics have had to conduct on scene operations in life threatening emergencies such as ampuatations, in what cases would you conduct such an operation and are you as a paramedic allowed to conduct any surgical procedures operations on site and if you are what ?

Anonymous said...

What is the law regarding death with regards to paramedics ? Are ambulances allowed to remove corpses and in what circumstances do the police need to be contacted. Can you sign a death certificate or declare someone deceased ?

Anonymous said...

I know that protocols in Scotland allow ambulance Technicians and ambulance Paramedics to Recognician of Life Extinct (ROLE) procedures. Meaning we can make the clinical decision to cease attempts at resusitation and to recognise when someone is dead. In all DOA the police are informed. Be it an old lady in bed, or an obvious murder.
Dead bodies are remved by the ambulance crews if they are in the public view or at the requst of other services to a place mutually agreed by local authorities, but i think this is a regional/local agreement.
Great posts big man


Debbie said...

I'm having some trouble getting my comment to show up! this is my third attempt but I do not give up easily! You must have the patience of a saint, surely it must be a job requirement. It would infuriate me keep getting called out by drunks when the poor old lady with the facial injuries was surely more in need of you. Also hope the poor sick lads at the station got sorted and home ok, how awful to be that sick on a train! Take care, love Debbie x

Xf said...
This comment has been removed by the author.
Xf said...


I work a five week rota of 12 hour shifts (mainly) either staring at 0630 or 1830, depending on whether I'm on nights or earlies.

I get days off, of course but I also run a business so I rarely have time to myself.

Xf said...


You might be lucky. LAS does take on observers but you will need to sign a disclaimer and have insurance. If you want to go out and have a genuine reason (such as work experience) then email me and I will speak to my bosses. No promises.

Xf said...

The book is out now but it trickles through the distribution system I believe so it may not show up everywhere for another week or so, especially at this time of year. You should be able to buy a copy in any branch of Waterstones or Borders.

Xf said...


We can carry out certain surgical procedures, such as needle cricothyroidotomy and needle chest decompressions but doctors open up chests (throcotomy) and do some of the more in-depth stuff! All of these can be done on scene, yes.

Xf said...


I believe my friend Yorkie has answered this for you (see comments above). The same guidelines apply to us. We do NOT sign death certificates, that remains the responsibility of a doctor.

Xf said...


Nice to hear from you again. Long time!

Your comments are getting through but I think there is a problem with the site, some of my counters and stats have disappeared for some reason.

Anonymous said...

How would you (or other ambulance crews) deal with someone who has fainted in the heat on the tube and was still out of it when you arrived i.e. what are the general ways you would try to revive them?

I have heard of someone in the distant past who woke up in a store after fainting on the tube (probably whisked away by staff - there were lots more of them at that time, BTP, or other passengers). However, I keep noticing from your blog that ambulances are called these days and this scares me. If it was me who fainted in the heat on the tube, I would not even want to be put in an ambulance let alone taken away in one. I also cannot see what busy hospital staff can possibly do that cannot be encouraged at the scene. PG Tips, Tate and Lyle, boiling kettle water and a mug come to mind.

Alison Ashwell said...

The french young woman probably said she had 'mal au coeur' which means she was feeling sick and the boss translated the phrase literally as "bad heart"

Xf said...


If you haven't recovered from a faint, we will take you to hospital.

Xf said...


Thank you for that. You are probably right.

Anonymous said...


Why would you not try to revive me with smelling salts or oxygen instead? It would save you an ambulance for someone who really needs (and wants) it?