Friday, 26 June 2009

At risk

We are taking an average of 5,000 calls a day now; the weekend weather hasn’t helped and the spike in ‘Swine Flu’ callers, real or imagined (mostly imagined) has created a problem. Our system works in an osmotic way – vehicles can be taken from any complex and ‘loaned’ to any other complex and resources can be used for calls in any part of London – we are not community based; we are medical whores for all of London, so theoretically, I could be sent from Waterloo to a call in Croydon, or Sutton, or wherever they damn well please, just as long as someone is running. Then I’ll be cancelled eight miles in because they now have a ‘nearer vehicle’.

There seems to be no simple answer and I am in no way critical of my Control colleagues, who are simply doing as they are told by a mostly automated system that doesn’t give a toss, but when it comes down to the safety of crews who continually run on blue lights, dangerously increasing the risk of collision with traffic or human beings on the road, only to be cancelled and have to pull over, switch everything off and reset their buzzing brains for the next (and almost inevitable) wasted journey somewhere else – probably in the direction that they’ve already come from – something is seriously wrong.

We could just tell most of our callers (more than 80% of them I would guess) to get well soon and leave it at that because a Red2 for ‘chest pain’ and ‘can’t speak between breaths’ in an 18-year-old, is probably...more than likely, hyperventilation or absolutely nothing. The chances of it being a cardiac event are so slim that it is worth the risk so that we can send something to that poor 83-year-old woman who’s collapsed in her own faeces on the sofa at home because she’s had a stroke.

My colleagues and I spent tonight running to and fro in every direction, covering everyone else’s sectors but our own and there was something different about the way I was being utilised on the FRU. For a start, it seemed like every call I got was for chest pain and every one of them was under the age of twenty five. I was also being asked to drive well out of my own area, leaving it uncovered as far as I was concerned, to deal with these stupid calls. I didn’t make it to most of them of course, because I was just stopping the bloody clock and had no clinical value whatsoever.

My stress level rose suddenly and I became irritable and angry because I was risking life and limb to get to these calls – not driving like an idiot, but still moving through red lights at busy junctions and weaving around thick traffic where people and objects lurked. The more I do this without a purpose, the more I feel aggrieved about the risk I’m taking. If I have an accident, I may be killed or injured for some teenager who doesn’t know the difference between an MI and a sore throat, and a system that lacks the balls to say no when it is clear from the way the caller is speaking that he/she has plenty to say between breaths!

I worked on the Clinical Support Desk a few weeks ago and spent a couple of hours clearing the amber calls that had stacked up. I called back these patients and all of them, without exception, could be dealt with there and then – no ambulance required. One of them was just depressed because he had moved house recently! Now, if he’d added that he had ‘chest pain’ (anxiety induced), this call would have gone Red and I wouldn’t have seen it because a crew would have been sent on blue lights to find him crying into his tea at home. On behalf of everyone who is genuinely ill out there – people with real life-threatening problems, I apologise for people like this. Unfortunately, there are thousands of them and they just won’t stop dialling 999 when they can’t cope.

We do not have the resources to continue like this. If a major incident occurs while we are mopping the brows of the weakest people in society, many may die because we might fall short of supplying enough ambulances. It’s as simple as that. Not our fault because we are very well trained and are ready for large-scale incidents...and the people who will criticise us the most are the very people who have created the monster that we are dealing with every day - the upper echelons and the Government.

So, Mr and Mrs Londoner...the weather’s nice and it’s the weekend – here’s my advice. Go and enjoy yourself. Have a drink but don’t drink too fast or too much (don’t be an idiot all your life). Avoid drugs if you can and have a meal with your friends. Then go home and have a sleep – you’ve earned it.

DONT get pre-planned-pissed out of your head. Don’t take drinks or tablets from absolute strangers (yes, YOU girls, don’t be dumb cos he doesn’t like you, he just wants to get into your knickers). Try to eat before you start drinking and STOP drinking when you feel a little drunk – don’t wait until you can’t feel anything at all.

If you have depression or life issues, don’t even bother drinking unless you are clever enough to know what’s coming.

DONT even think about abusing me or my colleagues – we are sick of it and we aren’t there to pick up the pieces of your life. Let us get on with our job, which is to care for your mum or dad or granny when they become properly ill. We really are concerned about that and we’d rather not listen to your pathetic excuses for having vomit in your hair, or how your toothache has manifested into DIB when we could be treating a grown up.

I love what I do but I don't love most of the people I meet because they represent stress and possible physical danger to me and my colleagues. You'll see what I mean when you read the coming posts.

Be safe.


Anonymous said...

Well said. Do you worry about how the LAS will cope over the next few months? Or is this just normal for this time of the year..

There's always REAP 5 left to play with. There's still hope. Right?

PK said...

I know exactly how you feel, just done a run of 4 night shifts also and its been busy. I reckon we had about a total of 28 calls over the 4 shifts but we only ended up taking about 7 to hospital. The rest didn't really require an ambulance but nearly all of them were given as Red calls because of people who were so drunk that they were now unconscious, or they were hyperventilating and so had SOB. The trouble is people know how to work their way around the system and what they can say on the phone to guarantee a blue light response, whether they need it or not!

CFR - Aaron said...

Well said my friend!

(Round of applause)


MarkUK said...

Stuart said: "DONT even think about abusing me or my colleagues – we are sick of it and we aren’t there to pick up the pieces of your life."

I work in a school. I'm putting together an email for staff to remind "students" that a First Aider is not there to be threatened, assaulted or abused.

Last week a 14-yo youth (fairly big) was so abusive to one of my First Aiders that she asked him to go to another (male) First Aider. He then complained that he'd been refused treatment! The First Aider then got a bawling out from a member of the SLT.

She now feels intimidated when he comes for treatment for some non-existant condition.

Frankly, I'm not having it. My email states that co-operation is a condition of treatment, and those who are violent or abusive will be judged to have witheld consent.

Andrew Clark said...

Sounds like you've had a terrible weekend!

I just don't know what the answer is... The current culture of no one having to take responsibility for the own actions seems like the norm now and any free service such as the LAS is gonna be abused with that type of attitude common place.

It's a little scary to read given that I've just been accepted on the LAS student Paramedic scheme! I still think it's all gonna be well worth it, but I guess there might come a time when the best and brightest of the profession will all move to teaching and/or writing, or simply move abroad rather than risking their lives.

If that happens everyone suffers...

Anonymous said...

Well put - nothing more needs saying.

Anonymous said...

Amen to that!!!

Unfortunately I get the feeling those who abuse the system like this are not the kind of people with enough of a social conscience to read your blog and agree with it!

joan said...

Hi xf
2 right!! where did common sence go! Unfortunately this weather set to continue.
take care

Fee said...

Here's a thought - name and shame those who dialled 999 while in no way in need of an ambulance. Picture in the Metro, where everyone on the bus/Tube can see it, with a desciption of the pathetic bleating involved. Probably against umpty-billion clauses in the Human Rights Act, but I really don't think that was drafted to protect idiots from a red face. If that doesn't work, bring back the stocks.

After the revolution, when I'm in charge, it'll all be different, my friends.

Maybe the heat is getting to me already?

Anonymous said...

I agree with this completely but I wonder what you think about the NHS direct phone/online service? Does it help with this issue at all? Would it help if it was better publicised? After all everyone knows 999 but I don't know how many know of this service. I've used it twice, once regarding a young child with a sudden rash that looked like sunburn (but it was mid-winter in UK so that wasn't the cause!) and once for advice on a diabetic friend. With the child they told us to go to A&E anyway but with diabetic it saved us the unnecessary trip.

Anonymous said...

Well said.

Xf said...


I do worry about how LAS will cope but, unfortunately, this is par for the course during long hot spells. It happened before about five years ago and I don't expect anything will change. REAP 5 is probably coming soon.

Xf said...


Great idea but HNS would never do it 'cos we are too scared to offend.

Xf said...


NHS direct sometimes helps but even they have to make a decision remotely and if a patient insists they have 'chest pain' or 'DIB' then its a 999!

Anonymous said...

I live in a lovely hot climate and am perpetually amazed at what happens to Northern societies when it gets hot. It's as if people's brains get fried. Have they heard of drinking water????

Viking83 said...

Very well said Xf, I couldn't agree more.

Anonymous said...

"We could just tell most of our callers (more than 80% of them I would guess) to get well soon and leave it at that because a Red2 for ‘chest pain’ and ‘can’t speak between breaths’ in an 18-year-old, is probably...more than likely, hyperventilation or absolutely nothing. The chances of it being a cardiac event are so slim that it is worth the risk so that we can send something to that poor 83-year-old woman "

I do get what your saying in total but I dont understand this. Last I heard 1 in 120 babies are born with CHD so my son could seriously be the one you don't turn upto.

Xf said...


I'm not talking about NOT turning up but your point is taken. A year or so ago, I was called to a 17 year-old who died of an unseen heart problem, so I know what you are saying BUT unless people who use the term 'chest pain' just to get an ambulance, stop being selfish, then your son and everyone else with those problems will suffer delays as a consequence. It is for THAT reason that I rant and rage about them... and cases like the 17 year-old are still very rare indeed.