Not so green and not much peace

This is the melting ice bear on Traffy Square - read all about it on the WWF website at wwf.org.uk/icebear. This, in my mind, is how to make an effective point.

Day shift: Seven calls: One treated on scene; four by car; two by ambulance.

Stats: 1 Gammy leg; 1 ? Dislocation; 1 ?PE; 1 Faint; 1 RTC; 2 Head injuries.


Trafalgar Square is playing host to a number of things in the run up to Christmas. The tree is there, of course – and it’s been straightened up at last (probably as a direct result of this blog); there’s a melting Polar bear on show (which isn’t melting fast enough) and the main attraction but only because it’s littering the area below Nelson’s Column, is a scattering of coloured tents containing various bodies, all contending to save the world. They call themselves ‘The Climate Camp’ and they are okay but I prefer the bear.

The first call of the day was to attend a cantankerous 70 year-old man who had wandered in to the ‘camp’ and made himself at home. He was given a cup of tea and lots of sympathy by the people there. He lived rough and had a pair of disgustingly infected legs – the direct result of long term abuse of his health. The legs became the focus for the campers and so they called an ambulance and I was asked to check him out. For the entire twenty minutes or so that I was there, he subjected me to a rain of spittle, verbal abuse and reflected anger. His legs were so bad that it was entirely possible they’d fall off if he stood up but he wasn’t interested in my help, except to demand that I bandage them.

I put a couple of dressings on the worst areas – a completely ineffective treatment but it was all he would accept – and tried to persuade him to go to hospital. ‘I don’t want your medicine’, he shouted in my ear. ‘I don’t believe in Western medicine, I use Eastern medicine’.

The campers stood around looking concerned and neutral at the same time and one of them, a bearded fellow that, in my youth would have been labelled a ‘Hippie’, spoke to me about how worried they were about him but that they didn’t know him. ‘So, he just came in here but he has nothing to do with you?' I asked.

‘What do you mean? We are a collective’, came the reply and I found myself being looked upon as if I was the enemy of something or somebody. I had no idea why my question had aroused such suspicion or why such a large chip had been thrown onto his shoulder out of the blue, so I decided, as he began his lecture about ‘us’ and his collective, to walk away from him and seek out an adult. I went back to the lady who had originally spoken to me about the man with the dodgy legs – she was standing with a police officer.

‘I’ve put dressings on his legs but keep an eye on him and if you need us again, just call us back’, I said. Now, I thought this middle-aged lady was a sensible type but she said something that made me realise I might be standing in the middle of a mini-conspiracy.

‘We have a policy of not contacting the authorities if we can help it.’

‘Authorities?’ I replied, rather taken aback, ‘Madam, we are the NHS – not the police.’

I know we have to save this planet of ours and I am 100% behind the efforts to do so but protests that come in this form – where everyone is the enemy if they don’t share the same opinion with an aggressive passion and where every uniform is seen as authoritarian, puts me off the very cause being fought for. The best way to dissuade the majority of law-abiding people about any argument is to act and talk like that. I got abuse and arrogance and all I did was show up and try to help. I didn’t even get a cup of tea!


A 25 year-old building site worker fell from some steps and twisted his knee, repeating an injury that he’d suffered a few days earlier but this time it looked like he’d dislocated the joint. I gave him entonox, man-handled his leg so that the knee was more aligned and got him into the car for the short journey to hospital.


The next call sent me to a private GP surgery in Poshville, London, W1. A 77 year-old lady had chest pain and shortness of breath and her doctor decided she might be suffering the effects of a Pulmonary Embolism (PE), which can be life-threatening. I didn’t realise that the GP had called 999 and asked for an ambulance to take her to hospital then promptly left the poor woman standing in the corridor while he attended to another fee-paying patient.

The receptionists had no idea what was going on when I arrived, then I was taken upstairs to the doctor’s surgery, only to be told that the patient was downstairs and had been abandoned there. The doctor didn’t even have the courtesy to come and give me a hand-over. I was simply a taxi for the patient and to make matters even more infuriating, the patient thought I was going to take her to a specific hospital miles away!

I’ve said it before but some doctors are as abusive of the ambulance service as our ‘regular’ callers – especially in the private sector.


At a coach station an 84 year-old lady became unconscious and I was convinced I was running to a possible suspended but when I got there I found her sitting with her friends, smiling and chatting. She had been unconscious, according to her buddies and the station manager, for about ten minutes apparently, so I was concerned that something serious was going on but the lady didn’t realise it. She looked well enough, if a little pale and she was animated and aware. We shared a few jokes as I got on with the obs but I’d already decided that an ambulance was more appropriate than the car. Her medical history included a brain aneurysm so there was no way I would risk less than full monitoring.

She’d had a few ‘turns’ recently and, although she wasn’t worried, her friends were and when we did her ECG on the ambulance, it revealed a first degree heart block – something she could live with but that could also explain her recent faints and spells of unconsciousness, alhtough this is rare, so she was taken to hospital.


In the west a motorcyclist braked hard and skidded under the wheel of a taxi as it u-turned in the road. This is a relatively common type of RTC involving these two vehicles and I’m not sure if it’s the taxi drivers or the motorcyclists who are to blame but it won’t be long before I go to one of these and the biker is dead or dying after being crushed. This 45 year-old guy was lucky, however and got away with a leg injury after sliding along and breaking his visor on the road as he fell. The impact would have been moderate because it wasn’t a fast road he had been riding on. The cab was relatively undamaged and it looked like only the front wheel had taken the brunt of the force.

A crew was on scene, as well as another FRU, so I was just an extra pair of hands and it took us no more than twenty minutes to assess, collar, board and move him onto the back of the ambulance.


A cheeky little 6 year-old girl whose parents were abroad and who was being taken care of by her auntie, fell from a playground roundabout and got clunked on the head as it spun round. She had a small cut to her scalp, which had bled dramatically enough for an ambulance to be called. The bleeding was under control when I got there and she was bundled into the car with a carer (she was with a school group) for the trip to Children’s A&E.


Compared to the last call, the only difference here was the age of the female and the mechanism of injury – oh and the drama being played out as a result. Another fall and another scalp wound – this time, it was 21 year-old woman at a college who’d been sitting on a cantilever legged table with her friends. When her mates got off, the table became unbalanced and she was propelled backwards, slamming her head against another table as she fell to the ground. When I walked in the tables had been labelled by the staff of scene – ‘Do not sit on these tables’, the signs read. Horse, door, stable, I thought.

The cut to her head was minute; almost microscopic, and she hadn’t bled much, if at all but she was lolling around in her friend’s lap like a wounded animal. Clearly this young lady had never been exposed to injury beyond a broken nail before in her life. I had to ask her repeatedly to lift her head so that I could talk to her. If her girlfriend hadn’t been there I bet she would have been absolutely fine – she was getting a bit old to be milking sympathy.

This injury could have gone home and helped itself to recovery, or taken itself to A&E but no, in today’s enlightened intelligent society, it’s all about service, so she had to go by ambulance. She got the car though because I was not going to get a hard-working crew down here for this.

She continued to feed herself with the human kindness pouring from her friend all the way to hospital and when we got there and I was booking her in, her mate came over and interrupted me to let me know that she (the patient) had a headache and was in ‘real pain’. The hope being that I would drop everything and rush over with heavy-duty analgesics. Meanwhile, fifty other people sat waiting with their own ‘real pains’ and Resus was full of critical patients, some of which were actually in real pain.

Be safe.

Drugs are bad

I dont think they'd mind the publicity...I thought you'd want

to use your imagination here though :-)

Day shift: Seven calls: one assisted-only; three by car; three by ambulance.

Stats: 1 Drug o/d; 1 Abdo pain; 1 Chest pain; 1 Dizzy spells; 1 Head injury; 1 Cardiac problem (probably drug induced); 1 Unwell adult (probably not).


A beautifully mild, clear-sky morning and an early job to get me going for the day. A man was found ‘fitting’ in a car park basement by a driver who’d just parked up and when I arrived and was taken down to meet my patient I could tell that he was on something – probably GHB. His trousers were around his thighs, exposing him to all and sundry and his mobile phone lay at his feet, alongside a bar of chocolate.

He writhed around and made smacking sounds with his mouth, alternating with rapid clicking noises as his head moved from side to side. The MOP was leaving me to it and I couldn’t get anyone by radio or mobile because there was no signal, so I had no idea how long an ambulance would take or if one would come at all. I was stuck in the basement with a dolphin.

I asked the MOP to call 999 again when he got to the surface and he must have done because, thankfully, a crew arrived ten minutes later. There was nothing I could do for the patient and he was stable enough but I needed the extra hands to get him out of there. He was off his head a bit on drugs and would dry out eventually.


Half way through washing the car (so one side is still dirty) and I am sent on a call to a tube station around the corner for a 24 year-old female with abdominal pain. She is fine when I get there; it’s all getting better and she felt a bit faint on the train, so no worries. She might be pregnant though because she couldn’t definitively tell me she wasn’t and she’s not on any form of contraception. She doesn’t want (or need) to go to hospital, so I give her two bits of advice before I let her go back on the train – (1) get a pregnancy test done if she’s late and (2) try to get a seat on the train this time by pretending she is pregnant. Well, you never know.


Normally 18 year-olds with chest pain turn out to be nothing more than hyperventilating souls and I can quickly sort it out but this call to a female working at a beautician’s training centre, had a very recent history of palpitations requiring ablation treatment to resolve, so I conveyed her in the car with a colleague. Her pain was gone by the time I arrived but it may be significant, so best she is checked out. I thought my MRU brothers would be interested to learn that I had two beauticians in the car with me and so I had a wee smile on for the trip... and I was offered half price nail work, so it was a good call all round.


The next call was for chest pain but he actually only had dizziness when standing and when raising an arm. However, the 51 year-old man’s medical history included a heart attack last year in which, according to his doctor, 25% of his heart muscle had died and his blood pressure had dropped to '15 over something', which, considering he was conscious throughout, is unlikely – he either misheard the doc or someone needs to go back to med school.

He was resistant about going to hospital but, given his medical history and his current new episodes of headiness, it was wise to accept the crew’s offer.


I parked up in Mayfair, as you do, and wound down my window when something caught my ears – a cheery, very tuneful whistle was coming from somewhere. It wasn’t a song-type whistle, wolf-whistle or habitual whistle, it was like one of those warbling hi-lo things you often hear on Disney cartoons and films, so obviously I thought I’d be seeing a Christmas stall or something similar. Instead, I located the person making the sound – he was walking down the street, with all the other folks, ignoring everything and everyone but whistling in perfect tune as he went, until he saw something in a shop he obviously liked and he stopped, shut up and went inside. It’s not funny unless you are there I guess.

Anyway, after that little excursion I was off to see a 27 year-old woman about a bump to her head. She fell at work, landing on concrete with just her forehead to stop her descent. She had a huge, watery lump in the middle of her head and she told me she’d heard a ‘crack’ when it happened, followed by the feeling of liquid rushing into the lump that was forming. Quite creepy when you think about it. She wasn’t knocked out and she was fine otherwise – just a bit wobbly on her legs, so I took her to A&E in the car, with a colleague in tow.


A 30 year-old man in a van had ‘shaky limbs’ and felt generally unwell. He has a history of heart murmur but had also been drinking the night before and taking cocaine. This, I suspect, was the cause of his current problem. His ECG was anomalous; Tall R waves, U waves and PVC’s all over the place and his blood pressure was high at times. Considering his age, he was on his way to bigger health problems if he didn’t knock the drugs on the head.


Finally, after a stint of standby in Trafalgar Square, an 83 year-old gentleman collapsed in the doorway of a shopping arcade and confessed to being a diabetic with kidney and heart problems, although he couldn’t specify what those problems were or what drugs he was on for them. Hmmm, I thought. Well, he went in the car because there was no reason to take him by ambulance... and he was perfectly well all the way there. In fact, he positively cheered up at hospital. I suspect he used this to combat loneliness.

Be safe.

Another skinny tree year

Day shift: Four calls: Two by car; Two by ambulance.

Stats: 2 RTC; 1 Faint; 1 Abdo pain.


The Christmas tree on Trafalgar Square is leaning worryingly to the right – it will only take a decent wind to push it over I think. They’ve put 500 white lights on it and it still looks bereft of character compared to other trees in the neighbourhood. Still, it’s free.

A RTC in the grey, rainy rush hour involving a white van and a foreign pedestrian who stepped out from between buses on a busy road kicked off the morning. Her scarf was trapped under the wheel of the van but she got away with a knock to the leg that was going to put her in hospital for about 10 minutes. She was lucky and the poor old van driver was shaking like a leaf when I left the scene – not that he should be because it wasn’t his fault (according to witnesses) but the shock of it left him reeling a bit.


The rain stops for a while and I am sent to the aid of a 25 year-old female who has fainted on the tube. This is a very common occurrence and she is in the correct gender and age group for it. So, I don’t need an ambulance and I go through the routine as usual – her obs are fine and she has recovered. She gets a copy of the PRF because she’d rather not go to A&E and promises to get herself checked out after work and I drop her off, as a courtesy, near her workplace.


Minor RTC’s shouldn’t really tie me up for long but because the police were being so thorough with the motorcyclist who collided with a taxi, I waited for almost an hour before taking the patient to hospital. He only had an injured wrist and a cut lip, hardly worth the trip but he would probably need an assessment to appease his insurance company.


A certain supermarket chain needs to sort its first aid cover and the attitude of those trained to be first aiders out before they have a major problem. A staff member with abdominal pain and a history of Ovarian Cyst collapsed in agony and one of her colleagues was on hand to call an ambulance. When I arrived, not only did I have to find my way to the Customer Services desk because nobody was outside to guide me but when another member of staff was asked to show me where the poor woman was, she said ‘No, you show him’, as if I was a visitor looking for the loo. This kind of disgraceful behaviour is unacceptable and makes the company look shoddy and uncaring. We are an emergency service and that means you let us know where we are needed; don’t call us and then wander off so that we can find our own way around your store.

When I finally managed to get someone to guide me to the patient, the 31 year-old lady told me that the first aiders in the store ‘didn’t care’ and wouldn’t attend her. This is their duty – that’s why they train to be so-called qualified first aiders.

I spoke to the store manager about this and he was genuinely shocked that nobody had even told him that a staff member was ill. She would have been taken to hospital, disappeared from work and he wouldn’t be any the wiser. Poor show I think.

An ambulance arrived to take her away, despite my calling in and advising Control that I didn’t need one.

The rest of my day was taken up with the FRU Co-ordinator’s conference – an annual(ish) event held primarily to discuss concerns over issues that have arisen among the fast response pilots all over London. There was also an opportunity to do some training and updating. It was a fruitful meeting and things should change for the better, in terms of how we are despatched, the vehicles we use and the way we are utilised, in the near future. And I got a free lunch and they say there's no such thing...

Be safe.

How clean is your child?

Harry is doing well and he should continue to do well because we won't be molly-coddling him to protect him from his natural environment, read this:

This is something I've been saying for about fifteen years and have had lots of discussions about with school staff around the country. Asthma, anaphylaxis, skin problems, etc. are all, more than likely (but not always), attributable to our lack of respect for dirt and the fact that we live in a dirty world, not a clean one, so trying to scrub the planet into sterility is killing mankind.

There are individuals out there who will justify their obsession with cleanliness by citing the various germs that are around and how dangerous they can be, especially to our children but the point they miss is that those germs have always existed in, around and on our bodies and not always to the detriment of our survival - maybe keeping your child away from them when they are developing an immune response from age zero is not the wisest way of dealing with the issue.

This scientific debate will probably not result in the total reversal of narrow-minded stupidity and unfounded fear but it may help those of us who have always seen the logic of this to understand that we can continue with a common sense approach to our 'dirty earth'.

Xf

Down the drain

Night shift: Eight calls: One by car; Two Assisted-only; One treated on scene; Four by ambulance.

Stats: 5 eTOH; 3 Falls; 1 Chest pain; 1 Dislocation

I’m furious already and I’ve just started the shift. It’s Thursday night and that means we get very busy until the weekend finishes but we also have the added bonus of Christmas coming up and, notwithstanding the normality of pseudo-religious connotations for peace and goodwill (cos I guess it exists somewhere), we have the usual regular ‘players’ coming out of the slime.

I was asked to pick up a MRU colleague so that he could be returned to his bike and I got stuck in very heavy traffic on The Strand. I wasn’t going anywhere and when a call came in for a 50 year-old female who had DIB I tried to get going on it. This was an Amber call and I found that odd because DIB should be a category A, although I’m sure there are criteria which reduce it’s importance somehow. An update told me that she was now unconscious and that was very ominous, so I tried even harder to cut through the traffic; but even using the other side of the road, which I normally do, was out of the question as it too was packed solid and not moving.

I was then updated by radio and told that the patient had suspended (gone into cardiac arrest), so I began working seriously hard to get through it all. I climbed onto the meridian pavement and drove along it until a lamp post stopped me going any further, so I was forced back into the dead-stop traffic. There was no way I was going to make this call in time to save anyone. Hopefully an ambulance was there or on its way but it didn’t sound likely to me.

Then I saw a motorcycle colleague attending to a ‘collapsed’ man in the street – I’d heard this call go out to him earlier and he was standing over the man with a PCSO, so I stopped, rolled down my window and asked him if he was dealing with anything important. I knew from the look of it that he wasn’t, so I suggested a swap – he could run on the suspended patient and get there much faster than me. And that’s what we did; he got going and I stayed put, trying to keep an angry drunken Lithuanian man out of my face as he rolled around in pretend agony demanding an ambulance.

When the crew arrived, he was taken to hospital and that, I’m told, was his second trip in today. Now I don’t care how you judge me for this because I, like many others, am simply fed up with people coming into the country for the sole purpose of abusing our generosity and kindness. The cost of this man’s stupidity and selfishness may go beyond our taxes – he may inadvertently be responsible for someone’s death, it’s as simple as that. I wouldn’t want my mother to be left dying on the front room floor whilst ambulance crews, and particularly fast response units are tied up with rubbish like that. He drinks himself into his illnesses and yet he gets a Red category call and thus priority. Some poor woman can’t breathe, is given an Amber, so we can get there in 19 minutes if we want, and then promptly stops breathing, raising the category but all too late. When are we going to implement human intelligence into these calls and make sound clinical decisions based on training and experience? The chances of getting it wrong cannot possibly be greater that the mistakes made by the machines. If a call comes in for a 'collapsed' person and there is even a hint that alcohol is involved, we should consider the balance of what else is going on, so one collapsed drunk with a motorcycle responder on scene and one woman having difficulty in breathing and nobody available - re-assign the priority, like the cops do.

Rant over.


They send me south next because there was nobody available for a 57 year-old drug addict who was experiencing chest and abdominal pain – this was a Red call of course; you only have to mention your chest in any call and it’s virtually guaranteed that the machines will scream in panic and issue a category A. He had muscular pain and I guess it was all part and parcel of his decades of self-abuse. His cousin let me in to the flat and I thought he was the patient’s doctor – he looked so respectable; bespecled and smartly dressed. It threw me for a second.

The unwell man, a long-time morphine addict, was lying on a filthy sofa in a typically filthy abode. No drug addict keeps a clean house – it’s simply not a priority. His pyjamas were smeared with historical faeces and he looked like he hadn’t eaten for months. His methadone wasn’t helping apparently and he wanted me to give him...guess what; morphine. So I said no.

What he did need, however, was glucose because his BM was low, fluids because he was very dehydrated and metoclopramide to stop him vomiting his recent red wine dinner up.

He was in very poor health and, judging by the look of him, he didn’t have long to go. The pain in his side was a secondary problem compared to his general health and I could see why doctors simply gave up on addicts who’d come this far. A doctor had visited him earlier, obviously seen him in this sorry state and said she couldn’t do anything for him. Now the crew and I were here, we had no choice but to deal with it and I really wanted to try and make him comfortable but his future is bleak and others are dying and in pain, through no fault of their own, so I can’t reconcile this at all. I just treat and go.

‘Morphine’s good for me’ he said after my third refusal to give him the drug. I wanted to say, ‘Yeah, I can see that’, but I didn't.


As the night progressed I was sent to deal with a 50 year-old man who’d drunkenly fallen down steps on one of those party boats on the Thames. To be fair to him, he was no more than cheerily drunk – not irresponsibly wasted, so I guess his tumble was just one of those mishaps that occur when judgment is impaired. He had a history of brain tumour and his caring friends were concerned that there was a connection but I highly doubted it as he seemed fine apart from a nasty 2cm incision on his forehead. The skin was split deeply enough for a trip to A&E and a couple of stitches but he was resistant to the idea and it took all of my persuasive powers to convince him to go in the car. He’ll feel better about the decision in the morning I expect.


A patient for the booze bus next – he’d fallen as a result of having a proper skin full and the 'bus' was in front of me near the scene, so I asked if they could do the honours. His head was cut above the eye but he was okay otherwise so off he went to drunken heaven with the drunk-bus heroes.


After a quick coffee at Bar Italia in Frith Street, where all of the emergency services (armed and unarmed) go, I sped off to Charing Cross Road to help with a drunken 20 year-old female but she was beyond it. She was abusive and annoying, as was her potty-mouthed brother but they meant no harm; alcohol was speaking on their behalf. You might know what I mean - they swear, then istantly apologise to you for doing it, attempting to hug you as if you are their best friend. A crew just happened to be on scene with another drunken female, who’d fallen asleep in the underground platform. She was much more pleasant and continually smiled, although she wouldn’t give us any information about herself – off she went to hospital and the other one was left to the police.


A 30 year-old alcoholic woman fell through a half-open drain (see above) and sustained a nasty wound to her leg which bled through her jeans but which she adamantly refused to let me see or treat. She also chipped out her two front teeth on impact with the road and even when the police officer explained to her that she needed to go to hospital, as I had advised, so that she could be treated and then have evidence for a possible claim against the council, she refused. I was surprised to say the least but maybe I was misjudging the poor woman.

Her can of lager was of more importance than the prospect of compensation, possibly to the tune of a few thousand pounds. Anyone else would have been jumping at the chance to get some money for an accident like that. So, in this age of ‘where’s there’s blame, there’s a claim’, it was quite an exceptional thing to witness.

She wandered off after I had attempted, time and time again, to get her to come with me to hospital. She had sharks teeth and a decent wound under her jeans (which I had to dress over the clothing just so she could get on a bus home) but she didn’t want to know. All she did was cry and cry... oh and then go back to pick up the can of lager she’d left on the pavement. I think she was pregnant too but I didn’t ask.


This is the time of year when we frequently encounter normally decent people who have imbibed so heavily (‘cos it’s Christmas time) that they become rude animals with no respect for themselves or anyone else. The 30 year-old lady I was asked to help was asleep on a petrol station forecourt – oblivious to the comings and goings of traffic around her. The station attendant called us and rightly so as she was extremely vulnerable. Her handbag was lying next to her with her mobile phone and purse sitting on top of it. She could have lost it all in a second if someone had been nasty enough to consider robbing her.

She was obnoxious to begin with and refused to let me help her, so the police arrived and we spent the best part of 30 minutes trying to get her to go home. The first black cab the officer flagged down refused to take her as far as her address so I suggested a private taxi which had just pulled up into the station. I’m not sure of sending people like her in these cars but if black cabs are going to refuse to go distances then this is probably why they are being overtaken by private hire firms – sorry but if you won’t pick people up in the rain, take them ‘over the river’ or you have a preference for clientele, then the public, who have a choice, will go elsewhere.

She managed to stand herself up and flirt with the police officers and myself until we could get her to draw cash out for the fare – then I escorted her to the taxi and off she went but before she left, she sobered up enough to say this ‘you shouldn’t be wasting your time on a w**ker like me, I’m shameful’. Well, at least she could see what was going on from my perspective, although I didn’t think she was a w**nker. In fact, I didn’t think women referred to themselves like that at all (call me old fashioned).


Some calls are interesting for tame and mundane reasons. I was asked to attend a Greek man at a hotel that had ‘locked’ his knee when trying to stand up. I gave him entonox and straightened his leg whilst manipulating the patella gently so that it slid nicely back into its natural place. The click was audible across the hotel lobby I think and I felt it go in. The pain he felt initially was overtaken with relief and he was soon able to stand up and walk around on it – the more he did, the better it would be for him anyway. I advised him to consider hospital in case it slipped out again but he declined.

This sort of thing is outside my remit as a paramedic I guess but I’ve had a lot of training and experience with dislocations of this nature and sometimes just a little bit of movement is all it takes, so long as you know your anatomy well enough. I got a nice warm satisfied feeling out of doing that and it only took ten seconds, so no ambulance, no A&E and no hassle for anyone. I mean, all I'd done was straighten his leg for Pete's sake.


Further into the night, as 4am approached, I went to yet another drunken female but this one claimed DIB, or at least the person who dialled 999 did. She refused to go to hospital and rightly so because she was just drunk. The 25 year-old admitted that she was bipolar and this became evident from her erratic and changeable behaviour but then alcohol has the same effect; every drunk is bipolar to me.

After a lot of debating back and forth with her friends, who she loved and hated in equal measure during their conversations, I agreed to take her (with her mates) back to their hotel so that she could sleep it off. It was either that or get the police to prise her from my car because once she was in the back, she wouldn’t budge – even for a taxi that had been called for them all. It was a non-eventful journey and she will forget about the help I gave her and that’s okay because we are all used to such disaffection for our roles in society, especially when we are against a tidal wave of alcoholic indifference.

During the shift, I went into Resus and asked about the cardiac arrest lady from earlier. I was told that she died.

Be safe.

Damp squibs

Night shift: Six calls; one hoax; one false alarm; two by car; two by ambulance.

Stats: 1 Mental health issues; 1 Head injury; 1 Bumped elbow; 1 Allergic reaction; 1 Dizzy woman.

The heavy rain and consequent stupid traffic caused me to be late tonight and so I’d barely started my VDI when the first call nagged at me from the screen in my car. Apparently a 72 year-old female was ‘not responding’. This means she is either dead, dying or neither, depending on other factors. I looked at the details and made an assumption, based on experience - she was not dead and I wouldn’t find her dying.

I arrived to find her lying on the floor of the flat with her family around her. She had a history of depression and refused to open her eyes or play the game at all. She wasn’t ‘non-responsive’, she didn’t want to respond. She had issues that neither the crew (who arrived shortly after me) nor myself, would ever be able to resolve, so I left them all to it and ‘greened up’ for the next one.


Later on an assault call left me ambulance-less and standing with police, a 22 year-old Lithuanian with head injuries and his mate, in a cordoned-off area as I pondered the likelihood of seeing a crew. After confirmation from Control that I would have to wait, I made the only decision sensible when there was a fully conscious young man sitting in the road-soaked road – I’d take him to hospital in the car with a police officer to accompany him. His injuries were not life-changing but he’d been batted pretty hard a few times with a bottle that hadn’t broken, making the mechanisms a little more significant. His scalp had been torn open in two places but his skull seemed intact. He hadn’t show any outward signs of brain damage and we’d been waiting in the rain for 30 minutes, so I figured it was a calculated clinical risk if it was at all.

The trip was uneventful and he got a bed in the minor’s dept., so that counted for something in terms of my decision I guess. Why we were so busy is a mystery; it’s Wednesday, it’s raining and it’s no fun out there but obviously the young and dangerous of London town don’t mind.

The young man was accompanied by a young cop who was very friendly. In fact, he was the friendliest officer I’ve come across in terms of his empathy and patience with the assault victim. Not that other cops aren’t friendly – but there is a mile of a difference in attitude when you take someone’s hand to help calm them down.


A Red2 call – generated purely because the patient was described as ‘not able to move body; semi-conscious' – for a bumped elbow had me driving north and cancelling the ambulance mentally and then again in reality when I got there. The 62 year-old woman was sitting on a sofa with her family gathered around in sympathy. She had knocked her elbow on the door handle and the pain, caused by the nerves receiving a good kicking, made her want to faint (but she didn’t). If the system really believes that this type of injury, even associated with a bit of ‘wooziness’ afterwards merits the same category as a potentially dying patient, then we are all in serious trouble. No wonder there aren’t enough ambulances to go round.

I left her at home with her family, confident in my abilities to determine her prognosis without tying up an A&E department by taking her in because I feel doubtful in some way. It was what it was – a bumped elbow; it’s that simple.


A 51 year-old lady with a positive allergy to tomatoes ate some peanuts tonight and discovered she was also allergic to them. So she met me at the door of her apartment block, wheezy and puffy, feeling a bit rough as a result. The crew was on scene within seconds of me so I got no further than confirming that her throat was swelling but that she was in no imminent danger.


The next call, for a 48 year-old man with ‘stinging chest pain’ was a no trace because he’d made the call from a phone box and obviously decided to leave and go home... or somewhere else. When another crew asked me if I was on a 'tight chest' call, made in the same area from a different callbox, I knew we were dealing with a hoax caller. This dangerous game can tie up a number of crews in one location for hours, leaving less resources available to deal with genuine calls. We get idiots doing this to us every so often and they really don't care what the consequences of their actions might be. I doubt they'd care if there own mother was the one being put at risk. They truly are life's losers.

And to ensure I went home happy and contented, I was sent a last-minute call south of the river for a 71 year-old woman who was 'dizzy'. She was packed and ready to go and there was no ambulance available (of course there wasn't - that's why I was sent). This job was going to make me late home and I would have to race to the Euston Road if I stood any chance of returning free of charge, otherwise going home was going to cost me £8. So, either I waited with her until an ambulance arrived, which she didn't need because all she'd suffered was a minor dizzy spell, like we all do, or I could take her myself in the car and save myself an hour of waiting. It all sounds seflish, I know but, as I said, this was no emergency (an Amber1) and sending me on it so late in the shift was a little bit naughty, considering I have another night shift to do. I suspect it had more to do with clearing calls at the end of someone else's shift than it did anything else. No wonder morale is low and feelings run high between frontline staff and Control.

In the end I took her myself. She demanded I put her in a wheelchair at the hospital, even though she could walk perfectly well. I was her early-morning taxi and it cost me an hour's valuable sleep.

Be safe.

Car bomb

Night shift: Four calls; one by car; one false alarm; one left at home and one by ambulance.

Stats: 1 Fall; 1 Flu; 1 Vomiting baby.


I had a brand new, first day out Paramedic with me tonight and the hope was that she would get some practical experience in advanced skills under her belt. The first time out with your bag is always a little nervy and I guess a trip out in the car was thought to be the solution to this. It was, but not for the proper reasons – we had a night of nothingness and the only mishap she had to contend with was when the car decided to try and explode on us in Regent Street on the way to a call. The engine began to smoke and the clues had been there all night – the smell of burning was quite strong at times but we’d assumed it was something else for some strange reason. So, my colleague abandoned the vehicle rapidly and began to take off the oxygen and other explodable bits as I attempted to make the thing safe in the street. There was no fire but that didn’t stop the ‘go to the aid of an ambulance that’s on fire’ report going out to a Station Officer who was sent to our aid. He was, understandably confused as he drew alongside us, sitting sheepishly in the unburnt and unexploded car.

In the end, and with no solution to the problem, I drove the crippled car back to station in the early hours and got a replacement (by means of pilfering another Officer’s car) for the last few uneventful hours of the shift. It’s all fun and games out here.


The first call, to an 84 year-old woman who’d fallen, was highly entertaining. She was a lovely, chatty, almost blind woman who’d been stumbling a lot recently. She lives alone but really shouldn’t. She’s the independent type though and proudly told us of her love of penguins and her long-dead RAF brother. Sometimes there is no clinical need for us to be with someone but the fact that we can chat and get to know another human being’s life history is a privilege.

The crew took over and she went to hospital because she was genuinely concerned about her well-being and wanted to be somewhere safe.


A 4 year-old with Flu did not need to go to hospital but I could tell by the mother’s adamant responses to my questions that she wouldn’t have it any other way, so we took them in the car. The little girl had only just been diagnosed and given Tamiflu; her temperature was high as expected and she could have got over it at home with the proper care and attention. Instead she was taken to a busy children’s A&E where face masks are scary things.


Then a 2 year-old who had vomited milk while sleeping had his parents worried and we were called. This time I argued them round in favour of not upsetting him any more than he already was and letting him stay at home, unless the condition of the child, which was absolutely stable, deteriorated. They got advice and a copy of the obs.


A ‘trapped behind locked doors’ call that had us waiting with a crew for police turned out to be the chuckle call of the night. A neighbour had called 999 when she heard loud music and was unable to get a response from the flat next door after attempting to get some peace and quiet. The music continued to blare so I guess the neighbour gave up and said the person in that flat must be dead or dying to ignore such persistent requests for silence.

Seven of us went to the door once we’d gained access to the main building (the caller hadn’t bothered to stay up to let us in) and one of the officers shouted through the ‘dead’ woman’s letterbox. ‘Open up, police’, he said. The door opened immediately and a very short, wide lady made a strange and illogical demand before any of us could draw breath. Two tall, fully uniformed cops stood before her and she looked up and said ‘Sorry but can I see some ID?’ It was hilarious. The door was wide open and we all had uniforms on, so unless, as my colleague pointed out later, we were the world’s most inept burglars or had hired costumes from a fancy dress shop just to visit her at 3am, this was a most bizarre request.

Her sense of security included opening the door fully before checking who was there.
‘Is the uniform not enough? The cop asked. Obviously not because he still had to produce his warrant card, which she studied without knowing what a genuine police warrant card should look like.

She looked cagey and defensive and I think she and her neighbour have an ongoing dispute. ‘There was a complaint about loud music’, said the cop. ‘Yes but I’ve turned it off now. Can’t you hear?’ she replied. The sound of silence (except for muted chuckles from us in the background) was testament to that.

Still smiling at the audacity of it, we left the dwarf woman to go back to bed but only after the cops had gone in to check that there was nothing amiss in her flat. There wasn’t but I bet she will have something else up her sleeve for her poor neighbours next time.

Be safe.