Sunday, 22 May 2011

Help yourselves

Here’s some information for you if you are the type of person who calls for an emergency ambulance, especially on a very busy weekend night when we have important drunk calls to attend. If you think the call will just disappear because you decided you didn’t want to wait any longer and just want to go to bed instead – ignoring your ‘phone when it rings and forcing us to speak to your voicemail… then you are wrong.

An ambulance will still be sent to your door and will arrive at three, or four or five in the morning. The crew will knock on your door until you wake up and they will do their job, as required by you, the tax-paying patient with the broken fingernail.

Arguably, if your call wasn’t important enough for you to wait up for us to arrive, then I suggest it wasn’t important enough for a 999 call in the first place.

If it is an emergency then be there, ready and waiting for when the crew arrive. Answer your phone if we call you back to chat about delays or whatever is wrong with you… and feel free to ring us back and let us know that you no longer need us because you went to A&E by taxi in the end.

If you need a doctor and it’s late or it’s the weekend, you don’t need to call us because there are docs out there, contracted to deal with you at all hours, every single day. They are called Out of Hours doctors and to get to them, all you have to do is ring up your local GP and the answerphone message will tell you that they are closed (surprise) and that the Out of Hours Service can be contacted on… and Bingo, there’s your number. Call them and tell them what’s wrong with you unless you truly believe your condition is potentially life-threatening… then you should dial 999.

If everyone in London stuck to these simple rules, we’d have much less trouble and fewer delays when sending emergency ambulances to those who really need us – like the elderly who fall and need help getting up or need their wounds dressed. When you inundate your ambulance service with trivial nonsense and make demands and exercise your ‘rights’, someone’s mum or grandfather has to lie on a cold floor for hours (and I mean hours) until we can free up a crew to go and help them. If it was your mother, you’d be furious, wouldn’t you?

Of course, you could (and probably will) ignore this advice because you believe it is your God-given right to call an ambulance when you have vomited or have a slight temperature… or have just smoked cannabis and ‘feel a bit funny’. In that case, this post becomes no more than an oblivious instruction to your brain.

And I know that most, if not all of the people who read this blog already know this stuff and never abuse their emergency service. I’m aiming it at those for whom this will be leaked out and spread around. Maybe it’ll make a dent.

Be safe.

Thursday, 19 May 2011

Chinese food, recycled

Some people can fake unconsciousness very well; in fact they have turned their pseudo-coma into an art-form.

After a couple of NPCs - both because crews were on scene and dealing, so I wasn't required, I was given a very long run out to the east, where a man had been found lying on the pavement, apparently unconscious. The police had come across him and had tried everything to get a response from him.

When I arrived, there was a crew on scene and they were busily attempting to get the man to respond but failing. He was dead to the world, as they say. He lay on his back, with his shopping bag next to him and the contents spilled out on the pavement. This, of course, gave the situation more gravity than if he was flat out with a couple of cans of extra-strength lager nearby. The shopping was 'normal'; tins of food, milk... that sort of thing.

I tried giving the man deep pain for a response and got nothing. Using this technique, which is perfectly legitimate, should initiate some reaction if a person is rousable at all. It is not intended to harm... and it doesn't, but it certainly has the desired effect and those who are not unconscious will very quickly let you know they aren't. Sometimes this is signalled by a lightning fast punch to the face, so its best to stay clear of the patient when doing this!

His pupils were pin-point, so we though we'd try Narcan to reverse any Opioid he may have taken. The crew began to lift him onto the stretcher and there was something about his posture that looked abnormal for an unconscious person. The usual flaccidity associated with this state didn't seem to be there; he seemed to have some control of his balance.

When we got him into the ambulance I took another look at his pupils and, now that we were in good light, decided to try another trick for rousing the unrousable - the eyelash trick. It worked immediately - that is, he reacted, so there was no longer any doubt about the man's status - he was conscious.

One of the crew implemented the 'nasty smelly stuff' procedure and up he came, rising almost out of the stretcher and fully awake. Of course, he'd never been asleep in the first place.

'Why were you lying on the pavement?' I asked 'Why didn't you open your eyes and respond to us?'

'I've been drinking', he said.

'Well, these police officers have been with you for almost twenty minutes. They have better things to do'.

'I didn't call the police', he replied.

I left hi with the crew and, after ten minutes or so, I watched him leave the ambulance and stagger across the road, forcing cars to slow down for him as he walked against the lights.

He was unhappy and couldn't care less about the trouble he'd caused. He had an ambulance, myself and a police vehicle with four officers in it on scene. The cost runs into the high hundreds and in the time taken to get him to 'wake up', other patients had been waiting for an ambulance; other citizens had been waiting for police assistance.

It's not surprising that the entire shift, being that it was a Thursday night, kind of ran along this pattern. My next patient was a tall man who'd been seen slumped against a pillar outside a building near a main road. The calls had been coming in about him being 'unconscious'. This one was asleep. He had been drinking all day and finished his night off with a Chinese meal, the entire contents of which were thrown from his stomach and onto the pavement the moment I stood him up.

He was one of those 'I don't need you, I'm going to sleep now' types who couldn't understand that, if he wasn't taken to hospital, he'd choke, get robbed or suffer from hypothermia. We'd also get repeated calls if he was to be left where he slept. So, I explained all this to him as we danced together on the pavement.

A passing police officer came to help me out because the tall drunken man was going to fall through a window if he didn't stop pulling away from me and staggering aimlessly around. So, between us we got control of him and he puked up even more of his dinner. The pavement was spattered in three puddles of noodle-based something, none of which looked like digestion had even bothered to look at it. You could, technically, have served it back up on a plate. Alcohol slows everything down and that includes the digestion of food.

Eventually, we got an ambulance out to him and he was whisked off to hospital, a mere half mile up the road.

Next up, another drunken male. This one was lying on the pavement and didn't even try to get up. I basically baby-sat him until I could get an ambulance to him. With proper emergencies to deal with, my colleagues were nowhere to be seen but the Booze Bus was on the prowl and I got them to come and sweep up my new friend. I'd spent a good 30 minutes in his company and all he did was moan a few times and sleep.

A category A call south of the river for a male who was threatening suicide in the street. He told the call-taker he had a knife and he'd cut himself already. I was instructed to stay away until police arrived and I did but I queried it because I noticed on the call that when he was being asked questions, he told the call-taker that he didn't want his mum to know what he was doing. In my experience, people threatening suicide and harm to others - those brandishing knives in built-up areas, tend not to worry too much about the impression their parents will have of them. They certainly don't ask for clarification that mummy won't be told! On that basis, I felt it was probably safe for me to go and have a chat with him. I also believed he'd be standing there without a mark on him. Call me a fool for thinking that if you want.

The police arrived and I was given the 'all-clear' to mosey on in. I got a smiling reception from the plain-clothed cops when I went round the corner. They were standing with a young man and chatting to him like he was a mate. he was known to them; he has a habit of doing this sort of thing when he has a fight with his girlfriend.

I walked up to him and examined his injury. He had a graze on his neck. That's it. For that, police, a firearms team, myself and (soon enough) an ambulance had been scrambled.

'What did you cut yourself with?' I asked.

'A razor', he replied.

'What kind of razor?'

'A safety razor'.

'A safety razor?'


'You know they're called that for a reason?'

'Yep. Cos they're safe, innit.'

'And why did you graze yourself with a safety razor and then call us all out?'

'Cos my girlfriend disagreed with me'.

'This happens a lot?'


'Then maybe you should get a different girlfriend'.

I could actually see him thinking this over. He took no offence and none was intended but even the cops were of the persuasion that this guy and his girlfriend were probably ill-suited.

The last call of the night was for a very, very regular caller; a man so well known to us all, inside Control and outside on the streets, that he should get his own parking space here. He is singularly unpleasant and has obvious issues that are outside the remit of an emergency ambulance service. His problems are psycho-social and there are other agencies that can try to help him... but they aren't.

I spent twenty minutes with him and he meandered in nature from mild to obtuse. No matter what I said and how I tried to console him when he ranted about how everyone hated him, he ignored at all.

I don't personally have any axe to grind with the man and he clearly has long historical problems. He lies in his bed all day and calls ambulances three or four times every day for falls, or injuries that he doesn't have or has made happen. He told me he is an ex-soldier and I think that might be true but he is loose in the world now and his value has diminished as a result of his own actions. He can't see that.

In the end, after trying to keep him calm and dressing the smallest cut in the world on his leg, I left because he refused to go to hospital. This is what he does, over and over again. As I left and walked along the dark balcony from his flat, I could hear him shouting after me - swearing and blasting hate at me. I could also detect the shuffling sound of him attempting to come after me with his walking sticks. He does this and has been known to chase crews out of the door. I guess it's a sign of appreciation in his world.

Be safe.