Saturday, 3 May 2008

Risk


Ten calls; one assisted-only, one treated on scene and eight required an ambulance.

More rain and more RTC’s, starting with a two-patient collision in which a moped hit a pedestrian. The moped rider came off onto the road and the pedestrian landed on the pavement. Both ambulances from my station were activated, as was I and a MRU was sent for good measure. Luckily neither man was badly injured. In fact, the pedestrian was more concerned about keeping his hair dry with a newspaper than any injury he might have.

The police arrived just as we were all packing up – each patient was treated separately and both were taken to hospital.


I went to see an 84 year-old man with a history of lung disease who was currently experiencing severe DIB. He lived with his wife at the very top of a block of posh flats in central London. They were so posh that they had no lift – thank goodness for the historical preservation of old buildings. I had to walk up every flight to get to him and by the time I got to the top, laden as I was with everything I needed to carry, I was puffing and panting more than he. Maybe I’m just getting unfit.


Then a driver went straight into a wall at a decent speed as he drove the wrong way down a one-way alley (see photo). The wall in question belonged to a school but there were no children around at the time and the witness, a young woman who had been feet away from the spot where the car struck, knew how lucky she’d been.

Apparently the driver and his wife, who was absent after running off, were arguing and he simply wasn’t watching where he was going. He approached a tight bend but drove straight on before coming to a sudden, violent stop, courtesy of one brick wall.

His wife had scarpered, probably because she didn’t want to be with the driver but she’d left a crack in the windscreen on her side. This concerned me because it meant she may have injured herself. An MRU and an ambulance were on scene and, despite a search, we couldn’t find her.

The driver was completely unscathed. The poor witness was a bit shaken – she would have been walking in front of the car when it hit the wall; a couple of seconds later and she would have been crushed underneath it and the job would have had a completely different complexion.


Another RTC and a 35 year-old man came off his moped after he attempted to drive in between a truck and a car. He must have made contact with one of the vehicles and it sent him wobbling off and almost into the path of a bus. He struck the tailgate of the lorry on his way down and ended up flat on his back in the middle of a busy road. The MRU was on scene and I arrived just after the ambulance did – I was given the wrong location and went around in a circle before finding it.

The patient had neck and shoulder injuries and was collared, blocked and strapped for his own good. Pain relief (entonox and morphine) was administered as the traffic cops controlled the heavy flow of vehicles around us and then he was taken away to hospital.



A 63 year-old woman with a history of CVA became dizzy and faint in a department store. I was called to help her recover and she was taken by a crew to the nearest hospital for further investigation.


Yet another call in which we out-resourced the needs of the patient. It had come in as a 65 year-old with chest pain at an underground station in the West End. When I arrived I thought it must have changed to cardiac arrest because there were two ambulances parked outside and the MRU was on scene. I saw the crews walking casually back towards me with a gentleman who looked none the worse for wear. It turns out he was just feeling dizzy. So were we.


I treated a 23 year-old woman for hyperventilation on scene. I had been called to the University campus building for an asthma attack but was cancelled when I arrived because apparently the first aiders there had decided they were going to deal with it and that an ambulance was no longer needed. As I got ready to leave, three first aiders came towards me and I asked them if I was still required.

‘Don’t know yet’, the tall one said. He looked fed up already and we’d only just met.

I decided to tag along and we went to another area of the campus, where a young student was sitting on a sofa, hyperventilating. The three first aiders had brought a lot of stuff with them; bags of kit, a nebuliser, a stethoscope. The tall man immediately took out his steth, even before asking the girl what was wrong, and pressed it to her chest. He didn’t refer to me at all and I was left standing like a lemon in the background as they huddled in around her.

‘Sorry but I need to deal with this now’, I said in my politest LAS voice. I had been called to her, so I had the statutory duty of care, regardless of their status and it had annoyed me that we’d been called on the 999 system just so that I could stand and watch.

The tall man said something sharply and they all stormed away. It was the most unprofessional behaviour I’d ever seen from first aiders. He had obviously gotten the hump with me because I had intervened.

It took me ten minutes to calm the girl down – she had become stressed because she was late handing in an assignment and they wouldn’t give her any more time. I understood her worry because that would greatly affect her grade.

She went off to her room, fully recovered, with a friend in tow. Meanwhile, I mulled over what had happened with the three first aid people from the University. Had they cancelled an ambulance, even though they weren’t sure if it was an asthma attack or not, just so they could ‘play’ with a patient? What if she’d been critically ill and their toys hadn’t worked? Somebody, somewhere needs to remind them that they have a limited capacity in the workplace.


I got called to a baby that had ‘stopped breathing’. I don’t like calls for dead or dying babies and I radio’d in to get further details. The baby hadn’t stopped breathing completely; he’d had a febrile convulsion and his breathing had stopped momentarily – it’s very common. When I arrived, the crew were behind me and the MRU paramedic was dealing. The child had a temperature and so did his non-fitting brother.


A 28 year-old with chest pain at a dance class next. He was in the middle of rehearsing a West End show when he felt a twinge. Again, we were a wee bit over-responsive and sent a MRU, and ambulance and myself. All he needed was a crew to take him to hospital.


My final job made me realise the risks we take just to get to a call on time. It was for a 50 year-old with chest pain. The traffic was at a standstill and I called Control to explain that I would be delayed because of it and would need to do some risky driving if I was to get there on time at all. They told me that no other vehicles were available and so I was to continue.

I had no choice but to drive all the way along the Strand on the wrong side of the road. There was simply no other way I was going to get to a potential heart attack on time. When I got there, he was genuine enough. He told me about his two previous heart attacks as the rain poured on top of us – his chest pain was similar to the others he had suffered. He was as pale as a ghost and very weak.

The crew arrived and he was taken rapidly to hospital.


I went home after that but I reminded myself of why that last drive had rattled me. We lost a paramedic recently, he was killed during mortorcycle training when he came off and a car struck him. I’m in a car and so I have more of a chance but it’s clear we are being pushed harder and harder and the risks are not being carefully considered. In the end, I expect they will say ‘it’s your choice to drive fast or not’ whilst in the same breath we’ll be reminded that our jobs are only secured by meeting Orcon’s eight minute target.


Be safe.

12 comments:

JackB said...

Nice, proffesional and caring attitude from first aiders there. Makes you seriously wonder whether they were treating it as an interesting exercise instead of a person with a serious condition. And how many first aiders get trained to use a stethescope? Its rare even with SJA.

Louise said...

I'm 7 months out of driver training and still very much only take risks where absolutely necessary, unfortunately I've been passenger when a work colleague has seem to take unnecessary risk at great speed, and scared the shit out of me!!

Don't get me wrong I love the feeling of blue light driving but those lights do not give us the right to put anyone at risk! As we were told regularly at training no emergency is so great that it warrants putting people at risk.

northern nurse said...

What bizarre behaviour from the first aiders! I can't say I've ever come accross something like that from one before (and I just hope that none of the workplace first aiders I've helped to train behave like this!).

miss emma said...

so sorry to hear about the loss of the paramedic. its sad to think that he died during training and im sure it was a great blow to the force.

I hope you wil continue to be safe whilst driving at speed.

emma x

gjmoomin said...

So sorry about your colleague who lost his life whilst training to help save others, so unjust. There ought to be a section in the driving test how to respond to sirens and a massive education programme for the whole country on what you guys have to do and the risks you have to take just getting there. I'm appreciative of your efforts.
Take care. Gill

Xf said...

Louise

Not to be patronising but I think once you've put in a bit more time you'll realise that your driving improves so that you can increase speed without necessarily increasing your risk or that to others but you'll also realise soon enough that what they say in training school almost never works in the real world.

I have colleagues who've quit their fast response roles because of the risks they have to take in order to meet targets for the bosses and to avoid sanctions against them for poor performance.

An what exactly constitutes a dire emergency? A few minutes can make the difference between life and death in heart attack calls - or you end up looking at a fool with a headache who claimed 'chest pain'. We have no way of knowing for sure just how imminent some of our red calls are going to be; thus all are treated the same - with urgency and speed.

In heavy traffic and poor weather, a judgement call is required and as long as it is still possible to drive safely, other ways of getting to the call on time need to be planned - or you call in a delay.

Sometimes its a no-win situation.

:-)

Robin said...

Yes, I read about the paramedic who died during training - he worked locally. Incredibly sad.
I think its criminal that the system ends up being a stick with which to beat people when targets aren't met. The people who are rushing to save lives should not be penalised for trying to avoid creating more work in the process. Hope those targets are changed to something more sensible and meaningful soon.

BeckyG said...

I'm sorry to read of the death of your colleague and can totally understand your subsequent wariness of fast driving. I know you have no choice but to respond to all red calls with urgency (as is the nature of red calls), but I'm sure it must anger you when the risks you take to get to some of these calls turn out to be unnecessary if the so-called life threatening situation turns out to be a twisted ankle, a drunk on a bus or a bit of a headache etc. I suppose the genuinely urgent calls make it worth while.

Sewmouse said...

Here in Illinois (near Chicago, USofA), we have a law that states that if an emergency services vehicle - Police, Fire or Medical - is approaching with sirens & lights, all traffic in BOTH directions must pull to the side of the road (if possible) and stop. At the least, stop. This allows the Ambulance, Fire Truck or Police Car to navigate safely through stationary objects, rather than trying to negotiate through moving traffic.

If we don't do this - we risk getting a "moving violation" on our license, and 3 of those within a 1-year period will net you a pulled license. (Moving violations include speeding, not using indicators properly, failure to yield right-of-way, failure to stop at sign, &etc.)

I'd do it anyhow, law or not - but knowing it is the law means the idiots who WOULDN"T do it, do it because they want to keep their license.

Sam Tyler said...

This has always intrigued me...what sort of driver training do you as the LAS get? If you wouldn't mind expanding for me Xf :-)

Xf said...

sewmouse

As usual, the Americans have got it covered. Typically here in the UK a law like that would probably infringe someone's human rights, so it won't be considered.

Xf said...

sam

We get three weeks advanced driving and highway code instruction. It's an intense course and brings us up to advanced driving and blue light driving standard.

The Motorcyclists are given even more training and I understand are taught by traffic cops, where as we are taught by our own people and sometimes civilian instructors using the police driving manual.

With no disrespect to anyone, however, it really doesn't make any difference in the end if one idiot out there ignores you and slams into you at speed.