Heroes

Yeah, well these guys were part of a fancy dress cinema club. Batman and Robin were among a number of others whose costumes portrayed film characters but it’s not these guys I’m talking about – it’s the two young men who saved an old woman’s life when she toppled into the Thames. The two gentlemen, Dan and Mark (whose permission I have to name them incidentally) will probably never receive the thanks they deserve for what they did.

The call was to a 70-year-old female who had fallen in the river. No other information was given and, to be honest, on screen it looked like another tragedy and a fruitless search for a body. I arrived and there were a number of other colleagues already on scene. The woman had been fished out of the water by the rescue services and was being treated and kept warm by the medics attending. I was asked to check out the two lads who had also been in the river. This was news to me; the call had not described any others involved, so I wondered what kind of condition these two men would be in. I went around to the police office and found them standing in their shorts, drying themselves off. They both looked fine. I asked them what had happened and they described how they had seen the woman sitting on the embankment wall by the river when she suddenly frothed at the mouth and toppled in.

Dan immediately jumped in after her whilst Mark called the emergency services. I believe Mark then got in to help his friend, who admitted he had struggled against the strong (and lethal) current as he tried to keep the lady’s head above the water. All of this happened in broad daylight and in the most treacherous river conditions. You have to admire the sheer guts of these guys – there was no hesitation and they did this with no thought to the risk they put themselves in. It’s the kind of action we do not condone in our society, in fact, the more liberal minded among us tend to chastise risk-taking behaviour but how many of you have actually had to make such a choice? People who know me personally will tell you that I will take enormous risks for other people and many of my colleagues will do the same without a second thought but there are definitely things that take a lot more nerve to do. Jumping into that river is one of them.

So, I have named them and thousands of you now know their names, even though you will never meet them. Hopefully, the old lady will make a full recovery and will thank these lads personally – she definitely owes the rest of her life to them.

Last time I saw them they were walking along the embankment, on their way back to work, dressed only in their shorts.

My morning had started out as a calamity. The radio on the vehicle I was assigned to drive was malfunctioning (well, not functioning at all) and I had to go to the contractor’s depot to get it repaired. I arrived half an hour before they opened, so I waited until the engineers showed up. I explained my predicament - half an hour tops they told me and once again I sat and waited.

Three hours and thirty minutes later, they pronounced it alive and well. I got no further than back to base when it snapped, crackled and popped. Ominously, I could smell burning. I took the vehicle out of commission and found myself another, there were no managers around and so I managed it myself. I took on my usual vehicle and, after a clean out and a re-kit and a thorough wash, I was ready to earn my pay. I was five hours into my shift now and had not answered a single call.

When my first call came in it was for a 33 year-old female who had fainted at work. She was lying on the floor when I arrived and she made no effort to open her eyes for me, even though she was conscious and her eyes were probably working just fine. Neither would she speak above a whisper (I don’t do whispers very well) so it was difficult to communicate with her properly. It wasn’t until I stopped being so gentle about it all and hardened my voice a little that she responded. Now she was okay. All her obs. were normal and she was just a little emotional. The crew arrived and she was taken to hospital anyway. I think that’s what she wanted to be honest.

Then, an interesting call to a jewellers shop in the West End. A 60-year-old male had suddenly lost his peripheral vision in his right eye. He was working as normal when he became aware of his limited vision and a headache, which niggled him at the same time. I arrived to find him being taken care of by the shop staff. He was a bit pale and he was quite nervous about what might be going on. He had a slightly high BP but, apart from his visual deficit and his headache, he had no other obvious clinical (neurological) abnormalities. Neither did he have any significant medical history for heart attack or stroke.

The crew arrived to take him to hospital and I accompanied them to the street. I learned later that the man was thrombolysed because, although his CT scan was normal, the doctors suspected something abnormal was going on in his head. I couldn’t agree more.

A fainted female at another place of work but this time she refused to go to hospital to be checked out. My suspicion was that she had probably had a seizure; she was confused, vague and sleepy and didn’t really have the look of someone who had simply fainted. She looked post ictal to me and so I urged her to consider going to hospital but she just wasn’t interested. She had capacity to refuse and her colleagues were not happy to be left with her in their care in case something more serious occurred. Kind of selfish of her I thought.

A collapsed male next. He worked behind the security desk of a bank in the city. He had felt his legs go weak after a bout of pain in his side as a result of reaching over for something. The man’s colleagues were a hoot and kept making jokes about him but they were genuinely concerned and their banter was designed to keep him smiling, which it did - me too.

He looked very pale and I considered the possibility of a cardiac connection, although it’s not uncommon for people to semi-faint after a sudden crisis of pain, simply because the body releases adrenaline to cope. In fact, when the crew arrived and we looked at his vital signs and his ECG, he seemed to be in good shape, so I reckon the pain-crisis theory holds water in this case. I left the man in the care of the crew and I expect they let him get on with his day.

One minute away from this call there was a young woman lying in an alley after falling and cracking her head on a concrete window ledge. I was sent the call as soon as I greened up and off I went. There was a small crowd around this lady, who was eight months pregnant, and they were propping her up and tending to her bleeding head with a handkerchief. I took my usual position next to the lady and we chatted about what had happened.

I noticed on my short walk towards her that the street was very steep and the paving very uneven. I also noticed that this lady was wearing high heels - not really a good idea in late pregnancy. I presumed the combination had made her stumble and from what she told me, it sounds like that was the case. No loss of consciousness, no complications with the baby, no anxiety required. Her head wound had stopped bleeding, thanks in part to the beautifully white handkerchief (now available in crimson) and she was fully alert and aware. She was also very worried and tearful.

Once I had calmed her nerves (she was worried about her unborn child) and assured her that there was enough cushioning in there for her baby to be just fine, I walked her the few yards to my car. She was quite cold, so a blanket or two and a warm car were just what she needed.

The ambulance arrived and I thanked the gentlemen who had helped the lady when she fell, especially the one who lost his nice hankie.

My last call of the shift was to a block of flats not far from my station. I was attending an elderly lady, in her late 80’s, who was generally unwell after treatment for bowel cancer. Her neighbours were milling around her and I could sense their anxiety. She was a very frail woman but also quite independent; she lived on her own and relied on a once daily visit from a carer, otherwise she fended pretty much for herself. Her neighbours told me that the last time she went to hospital, her house was broken into and she was robbed. The lock had never been repaired since, despite the council being asked to do it repeatedly for the past few months. Disgusting. The lady had lived in the flat since the blocks were built in the 1930’s. I looked out of her window and wondered what she had seen from that view over those decades.

The crew arrived and gently carried her down the stairs and into the ambulance. A couple of kids were outside and they asked what was happening (estate kids always ask what is going on or who is ill). Then they saw the old lady being carried into the ambulance and one of them said, “I hope she gets better”, and you know, I think he meant it.

Be safe.

Dead or alive?

It was lovely and warm today. The wind kept me from being too hot in my uniform and stab vest (the shirt tends to stick a little to the vest at the back, which is unpleasant). Central London was busy with traffic, as it always is, and drivers were getting edgy. This was compounded by the many holes being dug around the place by men in yellow tabards whose aim is to re-lay something like a thousand miles of water pipe to replace the old Victorian ones - they lasted over a hundred years, I'll bet the new ones need to be replaced in a decade.

Strangely, as I sat in the car in the traffic and contemplated this, I heard the Python song, 'Always look on the bright side of life' floating in the air as a Royal Mail van passed. It seemed to parody the actual mood of the streets.

I was busy today. The amber car is dead (for the moment), so I am on a CS call sign day or night. That means only red and amber calls; mainly red. So, it all kicked off with a call to a male 'fitting. ? cause'. I arrived and the ambulance was already on scene and the crew were dealing. The man wasn't fitting at all, he was shivering.

Then a man who was described as collapsed and unconscious. He was sitting in the street with a little gang of his friends - all Czechs and none speaking much English, so it was a challenge from the start. Although my first thought was that he was just drunk, his friends assured me, in pidgin English, that he had not been drinking today/ He certainly didn't look well; very pale, quite confused and disorientated. I set about my obs. and all seemed normal, apart from his demeanour. The crew arrived and the paramedic on board - a good friend of mine from my old station, found his temperature was high. My thermometer had read normal but there you go, it just shows you how important a second opinion and a working thermometer are. There was also a familiar smell, which had become noticeable on moving him; the smell of bad urine, so a possible UTI. He was packed off to hospital and I drove back to my usual patch.

On the way I received a call for a RTC involving a motorcyclist and a van, only seconds up the road from where I was. I weaved around the queue of traffic and found the scene of the collision. The injured motorcyclist had been clipped by a van and thrown from his bike, luckily at low speed (sometimes the Central London traffic is a saving grace). He had nothing more serious than a sprained ankle, which he twisted on his journey from saddle to tarmac. An ambulance arrived before I could cancel it and the crew took him on board for a trip to A&E.

After a couple of cancelled calls that had me driving in a circle, I was sent to South London for a multiple stabbing. A rendezvous (RV) point was given and I had to wait there with the police until the all-clear to attend was given. Now these RV's can be tricky things to arrive at safely. I have, on one or two occasions, driven right past the incident address en route to said RV, quite embarrassing and possible dangerous. Receiving an RV and getting to it without crossing the actual danger zone is a distinct and nowhere near precise science. Rarely have I received the address of the incident, so that I can avoid it!

I arrived at the RV point, this time without getting confused and there was nobody there to meet me. I wondered if I had got it wrong and called my Control desk for more information. They told me that the police wanted me to move to another location, where I would find my patient. It was around the corner (literally) and took me all of 5 seconds to locate.

The police were up on a balcony in an estate and I was guided to a young man who was lying on the floor, his lower body covered in blood - at least his clothes were. Bizarrely, I was told that he had been stabbed hours earlier at about 5am and had only just been discovered when a couple of PCSO's had come across him in the street. He had been making his way home after the alleged assault.

I had a look at his injuries, which seemed confined to his lower limbs and could see at least one deep stab wound to his right leg. I dressed it and then found other, less significant wounds in other parts of the leg. He also had a few to his right hand, where he had been protecting himself from the onslaught. He was allegedly set upon for no reason by a gang of youths who had taken a dislike to him.

The man was still fully clothed, except for the ripped right trouser leg and I had him moved carefully into his flat so that I could examine him more thoroughly. It's important not to assume that the wounds you see are the only wounds around, even if the patient states he has no others, so his clothing was removed and I checked his head, neck, chest and pelvis. Nothing. Then I asked him to take his trousers off and there they were...at least five other stab wounds, two of which were very deep; one in this thigh and the other through the shin bone of his left leg. Surely he must have felt that one?

Many people claim to have been punched and this is what he thought had happened. He also had a wound to his eye and it was clear that the assailants had tried to stab him in the face too. He was very lucky, a couple of inches in the wrong direction and he would have staggered home whilst bleeding from an artery and I wouldn't be patching him up.

No rest and another call - an epileptic who had been fitting and was now recovering. When I got there the ambulance crew were already dealing. Not required.

After that I had a few minutes to myself and soaked up the sun by standing outside the car for a bit but that leisurely punctuation was disturbed by a call to a 30-year-old female who was fitting in the street. I arrived to find her lying on the pavement with helping hands on her. She was very confused and tearful. She kept repeating that she was a nurse and could I tell her what her BP was. She had fallen hard enough for witnesses to hear the thud of her skull on the concrete, so she was at least concussed and she was definitely post ictal. Her confusion was magnified by her repeated requests regarding where she was, who I was and if her BP was normal. I think she had experienced her first seizure and had been unfortunate enough to have it where the landing zone wasn't soft enough.

And the best call of the day, for sheer stupidity, was to a one month old baby, ? suspended. The worst kind of call for me and no doubt for a lot of my colleagues. I really don't want to be holding someone's dead child and explaining to them that I was "doing the best I could" because that's a rubbish deal.

The call description stated 'not crying' and this was all the information I had when I set off. I called Control and asked them for a little bit more info. In fact, I asked them if I was going to a suspended baby or not. They replied that they were still taking the call so had nothing else to offer yet, except that they were treating this as a Red1 - suspended.

When I arrived, an ambulance had just pulled up at the address and there was a motorcycle solo paramedic already inside. I felt that this must be a genuine dead baby - why else all the fuss? I went upstairs to the flat and entered the living room. I saw a very emotional mother, a worried relative, the ambulance crew, the solo paramedic and a baby lying on the floor...hiccupping.

I'm not even going to bother elaborating on this call.

Be safe.

Movies, bomb scares and gumballs

Sunday.

Busier but still not as busy as usual. There were lots of things going on today. If you walked in a straight line from the Strand to Pall Mall, you would have had plenty to see. They were filming a movie, set in the 1930's I believe, on The Strand. There were actors and actresses dressed in dapper costumes, there were old buses and cars on the street and the famous Savoy Hotel was part of the scenery. In fact, the scenes were being shot in there. I bet they put the room prices up for this occasion.

Traffic was still flowing up and down the road but, every now and then, the police would stop it and 'action' would begin for a few minutes. Then the road would open again. Nobody seemed to mind the inconvenience and there were dozens of tourists out to watch the spectacle.

Meanwhile police started to arrive at the Waterloo Bridge end of the Strand. They sealed off the road and a cordon was put up. I got a call from Control informing me that there was a suspect vehicle on the bridge and that it was shut for the time being. Since I was only a few metres away, I found myself in the middle of the operation. Soon there were other vehicles arriving, including our own HART team.

After twenty minutes of probing and investigating from a safe distance, the white van on the bridge was deemed safe and everyone was stood down. The area cleared as quickly as it had clogged.Filming carried on as this little drama unfolded and a member of the support crew came over to me and asked if a set of ladders, which were standing in a bus lane, belonged to me. At first I didn't answer because I felt sure she would come to her senses but eventually I had to capitulate and give her the bad news about new ambulance equipment, a tall ladder and a short car.

On Trafalgar Square, the Sikh festival of Vaisakhi was being celebrated. Thousands of people were expected to turn up to take part or to watch the proceedings, which included music, speeches and free food all day! The food queue went on for about half a mile at one point I think.

I sat on stand-by in between calls and watched this colourful gathering of different people progress through the day - many were Indian Sikhs, many were not. Nobody cared. The atmosphere was upbeat and only marred when a small contingent of the Darfur demonstration march cut through the Square, chanting and banner-waving through the music, on their way to Whitehall. We had been briefed about this demonstration and were expecting hundreds of protestors to descend at some point in the morning. I only saw this small group of about a dozen until later on, when they were already opposite Downing Street en masse.

Then there was the famous Gumball Rally which was being held on Pall Mall, a few minutes’ walk from Trafalgar Square. I went over in the afternoon to check it out but was sent away by LAS officers who were there officially. I hadn't been told it was covered and I was curious to see it but I didn't see much and I had a flea to remove from my ear!

My first call of the day was to a male with chest pain. He had a previous history of three heart attacks and a triple bypass. He didn't look well when I arrived and his pulse was thready and irregular, so he was taken to hospital without delay.

An emergency call for a 'male, cannot walk, foot locked up' sent me to a block of flats but as I pulled up, the ambulance arrived. The only reason this was a ‘Category A’ call was the addition of a vital but probably nonsensical piece of information - 'difficulty in breathing'. Once again, the great deeds of the call takers are undone by the impurity of open questioning.

"What seems to be the problem?"

"My foot has seized up. I can't walk"

"Do you have any breathing problems?"

"Erm. Yes"

"Has your leg got gangrene and is it about to fall off?"

"Erm. Yes""Would you like a million pounds?"

Well, you know what I mean. It’s frustrating for all of us. The ambulance crew went inside to deal with that call, I was surplus to requirements.

Soon after, I was sent to the West End for a male who was coughing up blood and passing black stools - in the street apparently. This call also had me thinking about how fast the turnaround would be. On my way to this (it was a Red3 because it had included chest pain - obviously) I found my way blocked by a large 4x4, driven by a large man who could neither see or hear me - we simply must get the siren volume increased on all our vehicles. After a 20 - 30 second delay in which I sat directly behind him, in line of sight of his wing mirror, he noticed and moved to the left for me. As I rolled past I looked at him and he looked back at me. Then he dropped his mobile 'phone from his ear. Some people just don't get it and never will.

When I got on scene, I had to search, along with the ambulance crew who had arrived behind me, for this bleeding man. He wandered up to me after ten minutes and began to talk to me whilst standing in the middle of the road. Traffic was meandering around him until I persuaded him to move to a safer spot. The man was a known alcoholic and a regular caller. No sign of coughing or blood or tarry stools. I left him to the crew.

An emergency call to a male with acute epigastric pain led me out of area for a nice old gentleman who came out to meet me at the lift, even though he shouldn't have been on his feet. He was very unwell, pale, diaphoretic and had a very low BP when I checked. He was constantly trying to vomit but producing nothing. He needed to go to hospital as soon as possible and, as he retched over his toilet bowl in his tidy little flat, I began to plan my options for his collapse at any moment. Then the crew arrived and I had back-up. Luckily, he remained fairly stable (if that could be a fair description) when they moved him to the ambulance. Some jobs put you on alert automatically.

On the way back from this call, I was verbally accosted by an irate taxi driver who wanted me to push through a red light and into the busy traffic at a junction because he had been waiting too long to move. I told him I wasn't about to go through a red light for him or anyone else and he stormed off to his cab. When we did get through the junction, he drove through another red light at a busy pedestrian crossing. Nice.

An alcoholic who had been fitting sent me to Victoria where I found the man waiting for me. He was a little confused and a LOT drunk. The crew arrived soon after me and, with wry grins, took him to hospital to 'recover'. Incidentally, alcoholics do suffer seizures and they can be serious, so forgive me if I seem a little flippant about it today. I still look at it seriously when I know it is. This wasn't.

I stayed in that part of London to deal with a young man who was hyperventilating but thought he was having a heart attack - thus a Red3 for chest pain. He was concerned about a Uni assignment he had to hand in the next day. He hadn't yet started on it, so he was fretting about where he was going to come up with a thousand words. The word preparation sprang to my mind. He wanted me to call his mother. I wondered if she was the panicking type too. If she was, then I could imagine the conversation if I called her.

"Hello, Mrs X. I'm a paramedic with the London Ambulance Service. Don't be worried, I have your son with me and he is alright. He has just had a panic attack and wants to go to hospital".

THUD!

"Hello, Mrs X. Are you there?"

Ahh, bless. He continued to worry all the way to hospital and I kept an eye on him in case he tried to jump out of the car or something. He'll be fine until the next crisis looms in his life.When I booked him in I found that the hospital software had been updated to include a whole new raft of questions for us, including 'wheel stop time'. Eh? They want to know exactly what time my wheels stopped when I arrived at the hospital. Crazy.

I got back to base and was dragged away from my hopes of getting home on time by a last minute call - back to Victoria. This was for an ill child. I didn't get to see this patient, although I had been to the address before and suspected it would be the same problem; unwell child, nothing more. A crew was already on scene, so I turned around and headed back to base, late.

Nice to have had a trip out though.

Be safe.

All quiet on the Central front

An altogether strange weekend. The sun was out, it was warm and there were plenty of people around - in fact, Central London was extremely busy and yet I probably had the quietest couple of shifts I have experienced for at least four years. My usual callsign (the 'amber' car) had been suspended, for reasons not explained to me and I was on a 'CS' callsign, which means I dealt only with Red and Amber calls - no green calls.

I was the only FRU on duty out of my station but I still wasn't as busy as expected, especially on a weekend. I will probably regret bringing this up at some point in the near future!

On Saturday I melted into the Trafalgar Square crowds at a food festival (I think it was at any rate) called 'Eat London'. I stood by the car and waited for a call. I only got TWO all day. One of these emergency calls was to a male who had fainted in a bookshop. He had gone down quite hard and hit his head on the edge of a shelf, splitting his scalp open. There is always plenty of initial bleeding when that part of the body gets opened up, so his head was matted with blood when I arrived but the bleeding had stopped.

The gentleman refused to go to hospital and continued to refuse throughout my treatment and obs. He had a significant cardiac history and I suspected his BP was quite low, not that my wrist monitor was any good at the moment (its going through a moody phase). He was very pale and diaphoretic, although he tried to put that down to the weather. I wasn't convinced and neither were my colleagues when they arrived. At first I thought there was no point in having the ambulance crew here - the patient was adamant that he wasn't going anywhere. I had given him three opportunities to change his mind and was prepared to get my paperwork and let him sign it so that he could continue his day out with his friend. The problem, however, was that I couldn't convince myself that it was the right thing to do considering his condition and past medical history. There was a possibility of cardiac origin for his present status, chest pain or no chest pain but in a situation like this, where a grown man is refusing, you can only hang around trying to persuade him for so long - you can't harrass people into going to hospital and my gentle coaxing wasn't working.

Between us, the crew and I persuaded him to go to the ambulance for further checks. His BP was indeed low, which explained his faint but he hadn't recovered fully and that was of concern to all of us. Still he refused to go. I took the details I required and left it to the crew. I sat in the car and completed my paperwork. The attending paramedic came up to the car five minutes later and told me that the patient had finally agreed to go to hospital.

I guess it was difficult for him to make the decision to go because of the circumstances in which he found himself - a public place, people all around and a lot of pride to tackle. Or the fact that my colleague was female. Who knows?

As a 'CS' unit I am on the same radio channel as the HEMS team so I can listen in to the chatter between the helicopter pilot, the medics on board and the Control desk that activates and directs them to their jobs. They seemed to be busy today, unlike some.

My last call was to a very posh apartment (too posh to call a flat) in Mayfair. The lady who lived there had been experiencing a fast heart beat for over five hours. She had a history of PSVT and had gone through these episodes many times but this was lasting longer than normal and had not resolved when she used her usual techniques. It was giving her and her husband cause for concern. It is common for chest pain to be present during these episodes and she reported this to me when I arrived.

I had almost completed my obs. when the crew turned up. I explained the lady's history and gave them her pulse rate reading - 196 bpm. The heart is a strong muscular organ and can work very hard for long periods of time but this patient's heart will eventually tire and things could get complicated. She needed to go to hospital now. The crew wasted no time and she was in the ambulance and on her way in a few minutes.

I wrapped up my day on stand-by then made my way back to base, where I almost copped a call at five minutes to going home time! It was cancelled before I started rolling on it - maybe Control had only just noticed me and I had been invisible on the radar prior to that.

Be safe.

In the River

A man jumped into the river tonight. I was asked to stand-by on the Embankment while the River Police, LFB and a helicopter searched for him but, after almost two hours of scanning the fast flowing water, he wasn't found. He is unlikely to have survived.

The activity on the river drew small crowds onto the bridges and Embankment area where I was stationed. Some of them clumped around with their children hoping to glimpse a body so that they could join in the excitement of it all. People are strange like that but its natural I suppose. A number of logs and floating debris became drowned men as sightings were made by onlookers. The witnesses to the watery jump (from a bridge apparently) introduced themselves to me and said that they had seen a body floating downstream - they were quite convinced. I called it in and the search vessels were pulled away to the area where they claimed to have seen him. Nothing was found.

The current tends to pull objects under the many boats that are moored off the banks. Its likely that he is still underneath one of them and will surface with the next tidal change.

A group of young women kept me occupied in banter when the search was called off and dusk fell. They kept me company for a time, which is just as well because Control forgot about me and I had to call them to ask if I was required on scene any longer! Still, thanks for the pleasant 30 minutes ladies.

Almost as soon as I greened up I was sent to a female DIB at a hotel. I passed the location because it was obscured by scaffolding and nobody came out to flag me down (I sometimes depend on windmills to get to the right place). By the time I located the establishment an ambulance was pulling up, so I left them to it.

I went on stand-by at my usual spot on the Square and a young woman walked by with her friend and said "thank you for all you do". She was, of course, referring to ALL of us in the service and I had to smile. It was a nice and utterly spontaneous thing for her to say and a pleasant surprise. It made a change from the usual nee naw sounds or requests for directions to places I have never heard of, some of which are probably not even in London.

Then an emergency call to a well known pub in Soho for a waste of time female who had faked epilepsy to get the staff to call us. Just before I left for this call I was asked to help a woman who had fallen down a few steps in a pub. I was about to radio in but this call came through and it was a higher priority, so I had to leave and instruct them to call another ambulance. When I arrived a few minutes later in Soho, the 'epileptic' was wandering around, quite drunk, with her boyfriend. Both looked like drug addicts and she certainly looked familiar to me. She told me she was okay and that she was sorry I had been called out. Then she weaved off into the sunset with her strange boyfriend. The member of staff from the pub was very sheepish and he too apologised. Can't blame him though.

I requested a return to the running call in Leicester Square and was told I could continue, so I made my way back.

The woman had fallen down a few steps at the entrance of the pub and she was extremely drunk and extremely tearful. She wouldn't behave herself for me, so getting information was difficult, although her small group of friends were very helpful...and apologetic. One of them became very tearful herself later on at the difficulty she was having controlling her volatile mate.

After ensuring that she had no injuries, I moved her to my car, with the help of another FRU colleague who had arrived soon after me. She wasn't easy to help - she wouldn't walk and kept falling down. In fact she did a lot of falling down. A lot.

In the car, she calmed down but it took a ton of effort and quite some time before she was ready to see the light and get a taxi home with her group. All her obs. were normal and she refused to go to hospital. It wouldn't have done her any good, they wouldn't have the patience for her to be honest. She did hit her head when she tumbled down the steps and I was careful to advise her friends to call an ambulance if her condition changed. The last time I saw her, she was being propped up on a corner while one of the group waved frantically for a taxi.

Then off to a gentleman with severe DIB as a result of an exacerbation of his asthma. He was in a bit of trouble but I have seen much worse, so I wasn't too concerned when I got to him. The crew arrived at the same time and we all went to check him out. He was sitting on his front step with his wife. He was a pleasant man and he needed help.

His wife made a point of telling us that he had been to hospital and had been treated as if he was wasting their time. She stressed that they both worked and paid their taxes. She was obviously frustrated about the treatment he received. I had to agree; pay your taxes, get your money's worth...without attitude if possible. I also understand the view of the hospital staff. They see a lot of nonsense and sooner or later it becomes routine to assume you are having your time wasted yet again. Nevertheless, its the sponging alcoholics and drug abusers who drain our NHS and that's the real problem.

We took care of him of course. We nebulised him with Salbutamol and Ipatropium but neither had any real effect, so he was taken straight to hospital by the crew. No time to waste really.

I got my break and enjoyed a bit of a rest until a call came in for a ? meningitis. I went with the ambulance to the address and the three of us piled into the lift and made our way to the flat. Inside, a young girl was lying in bed with a temperature of + 38 degrees. Apart from that, she had no other sign or symptom of meningitis. She was taken, with mum, to hospital where she will be monitored for a while, tested and checked then sent right back home to get better naturally.

A long period of nothing followed, so I had a nap at the station. These twelve hour nights, coupled with my 1 (sometimes 2) hour drive to and from work, tend to wear me out. The days don't seem to affect me so much.

My last call was to a male with chest pain. I found him lying in bed with abdominal pain and a recent history of vomiting. He had been prescribed Augmentin for an ear infection and had become ill soon after starting them.That was it.

Augmentin has a nasty habit of making you much sicker than you were before you took them. I had toothache once and was given this antibiotic. I was violently sick for days after starting them. Never again.

I asked about the chest pain and his daughter told me (he didn't speak much English) that he had described pain all over his body. That's a standard phrase when English is not the first language.

"Where's the pain?"

"All over my body...pain all over"

So that equates to chest pain? I don't get it.

Someone in EOC will have an explanation.

All his obs. were fine. He needed to see his GP but, as usual, the LAS were going to taxi him to hospital where a doctor will do nothing except give him another antibiotic. The sort of thing his own GP would do. Its all he needed. That and bed rest...and fluids.

The Marathon seemed to have emptied London because it was quiet for a Sunday night. I guess after having spent all day watching runners the last thing you want to do is stay out drinking til 3am. We should have a marathon every weekend.

Be safe.

Nuts

I enjoyed this shift. A lot of people I like working with were on duty with me and so I was bumping into them frequently over the course of 12 hours. Its nice to work with good company.

My first call was to a hyerventilating man who had been seen just an hour earlier by another crew. He had been treated but the panic attack had started again and his friend was concerned, so she dialled 999 for the second time. The man was a mute and could only sign to communicate, something that takes a bit of getting used to. Its also quite bizarre to treat hyperventilation with a one-way verbal communication. Most of the time the length of the patient's sentences is a guide to how well they are recovering. I took him and his friend to hospital in the car. By the time he arrived, and after ten minutes of oxygen, he was almost fully recovered again.

My next call was to a female in a restaurant who was having an allergic reaction to nuts. The call description added 'she has taken her Epipen but it hasn't worked'. Its bad enough getting a call to what may be life-threatening anaphylaxis without the additional complication that the life-saving drug isn't working. I sped to the scene and arrived within a few minutes. A man was standing outside the restaurant waiting for me. He told me that the woman was in the ladies toilet (I find that a lot of females in trouble head straight for the toilets; men don't seem to do that so often - or maybe that's just coincidence).

I grabbed my bags and headed in the right direction - I had been to this establishment a couple of times before, so I knew the layout. I was expecting to see a collapsed, barely breathing person on the floor when I went into the toilet, if the call description was anything to go by. The man who met me also said that this was the worst reaction she had ever had. I walked in and she was standing in a cubicle with her friend. Her face was a little puffy but not the mass of swollen tissue that I had expected. Her breathing was fine - a little fast but she was able to speak in full sentences and she exercised that right a LOT as she panicked and demanded pain relief. She had abdominal pain, which can occur in such reactions but I wasn't going to give her any drugs at this stage, she simply didn't need them. I told her this and she seemed to understand.

As for the Epipen. She didn't have one. Hadn't taken one. Had never heard of it before. So, I wondered where that elaboration in the call had come from. This was NOT a life-threatening emergency, this was a moderate allergic reaction, mainly involving the gastro-intestinal system.
I walked her to the car and sat her in the back seat while I continued my obs. All of her vitals were normal. She probably required anti-histamine therapy and that could be done at hospital.

When the ambulance arrived I explained the situation to the crew and they took over from there. This call generated a Red2 and resulted in myself, an ambulance and the motorcycle paramedic attending. Elsewhere on the sector I was hearing of other calls getting over-the-top responses. Someone, somewhere was being a little too cautious.

Then off to another spectacular MOP call. This was for a 'male collapsed, caller thinks he may be deceased'. Now, the supposedly dead person was lying in a street at a busy bus station, so my first reaction was 'Yeah, right', but as I said before, I can't afford to be cynical, so I sped to the scene with the same determination as I would muster for a cardiac arrest. An ambulance was just in front of me as I left Leicester Square and I figured it was also going to this call. Together we headed to the scene.

This can be problematic. Sometimes the ambulance you follow is NOT going to the same call. There can be embarrassing consequences if you turn up at the wrong address. I decided to overtake the ambulance and keep to my own heading. I don't like doing this, it seems rude but I am supposed to get there first, so I went for it. In the event, the ambulance was on the same call. In fact, they took a shorter route and arrived on scene a second in front of me. Damn!

We arrived, jumped out of our vehicles and saw this lump of humanity lying in a corner with people hovering nearby, waiting for their respective buses. Of course the guy was going to be drunk. Of course he was. We approached, prodded and shook and he made non-death type movements and sounds. Even the police, who arrived soon after saaid he was very lively for a corpse.

The person who had made this 999 call had left the scene apparently. A lot of them do that. They call us, make frantic suggestions about death and serious injury, then they hang up and clear off.

We got the man, who was seriously drunk (and smelly) into the ambulance. His BP was very low, so I sorted that out with fluids. Then there was a tap on the ambulance door. One of the crew opened it and a voice said "Is he alright?" This was the 999 caller, who had returned to the scene and was showing concern!

Back in the Square and it was very busy tonight. Heaving is the word that comes to mind but not in a vomiting allegory. Plenty of people coming and going and standing. A little gang of 12-year-olds strolling by at 1am. Their parents must be so proud.

A man singing along, out of tune, to the music generated by his aged discman and delivered by his huge, floppy headphones "la la la, hey hey, la la la..." etc. I had no notion of joining in except to grin at the brass of it.

A beggar who uses his dog as a prop for gaining sympathy from passers-by, especially women. His dog, a lovely Staffordshire Terrier, lies like a big baby in his lap with a dummy in his mouth. The girls love it. Hats off to the beggar with an imagination - he gets to eat every night. So does his 'baby' I hope. Whenever he sees me, he nods, waves, gets his dog to wave a paw and then they both howl. I take all that as a compliment.

A call to a female, fallen down stairs at one of those 'school' clubs where middle-aged men and women can dress up as schoolies again but with the addition of legal drinking til you are sick. School was never quite like that...except for the drinking til you are sick bit. On the way, I was flagged down to attend a couple of doormen who had been assaulted. I called it in and asked to be cancelled for the school club job - I couldn't find the place anyway to be honest and was driving around in circles like an idiot. I checked the two doormen out - scratches really - then asked EOC if they wanted me to continue on the original call, since I was in the vicinity and the ambulance that had been despatched was lost too. They said yes.

Eventually I found the club and was met by one of the EMTs from the ambulance. She was about to get the board out of the vehicle because they were going to 'collar and board' the patient who had fallen down the stairs drunk. I went in and had a look. The stairs were dangerous and obstructed, very narrow and steep. The lady was at the bottom of them but was conscious and moving quite easily. No neck pain, no neurological deficit, no other injury - just a pain in her head where she had bumped it on landing. She was also very drunk and apologetic. I liaised with the crew and we agreed that she could walk up these stairs. So, we helped her to her feet, walked her to the ambulance through a crowd of barely dressed adults in school uniforms and pigtails (and that was just the men). :-) Then off she went to hospital, head in hands, still apologising.

I went back to my station and had a cup of coffee and a rest. Then I went back on stand-by because I was bored but the West End, particularly around Piccadilly Circus, was absolutely heaving with people and vehicles. There were traffic jams. It was 3am!

My next call came in while I tried to fight my way through the mess on the roads. I was going to a collapsed male. I arrived to find a little group of people gathered around a man lying in the street between two parked cars. They hadn't touched him or tried to rouse him - they never do. At least they hadn't called it in as 'possibly deceased'. Thank goodness we don't live in the bad old days of Burke and Hare. Unconscious drunks would be carted off and cut up for medical experiments every day of the week.

I gripped the man's shoulder tight and shook him until he made sense of the world. He was drunk and had been sleeping. He was now drunk and awake. The ambulance arrived and he got a bed for the night.

Immediately after that job, another call, This time to a police station I have visited a number of times (not as a criminal obviously). They had a young man in custody who was not responding. I arrived to find the police doctor (known as the Forensic Medical Examiner - FME) in the cell with the patient. He had carried out all my initial obs. for me and gave me a handover. I tried to get a response from the man but he was out like a light. Probably alcohol, I thought. He was in for being drunk and incapable so it made sense. He had also allegedly taken ecstacy and probably something else. I gave him oxygen and then used narcan to extract a possible cause but he didn't come round. All his obs. were normal so he was probably just sleeping it off. The crew arrived and he was taken to the ambulance where he began to wake up a little. By the time he got to hospital, he was on a higher plane of consciousness.

I went back to the station and made some more coffee. Two other crews were there and it was beginning to look like the end of the shift would be non-eventful. Instead the 'phone rings, dragging crew number one out. Then it rings again immediately for crew two. Then my service mobile goes and I am out. This call was to a male, unconscious on a bus. Whenever I get a call like that I know I am going to be waking someone up and telling them to get off a bus.

I arrived at the bus in question, walked on, woke the man up (he was a bit aggressive at first) and asked him to leave the bus...'sir'. I followed him out and the ambulance (from my station) arrived and went away again.

As the clock ticked by and I made my way to my base station across the river I got a call for another person 'unconscious' on a bus. I had to double back to New Oxford Street, where I was required to walk onto the bus, wake the patient up (a woman this time) and ask her to leave the vehicle. I did and she did.

Oh and in both cases I asked if they needed to go to hospital, I always do but on calls like these you wonder if you are tempting fate.

On my last attempt to get home, I was called to a drug overdose just South of the river. The call description added 'caller was aggressive and abusive'. Great, I thought. I'm going to get punched out before I go home to bed. I asked Control to send the police.

When I got on scene a large man was waiting for me at the door of the address. I become very cautious at this hour of the day with people like this. After a night of alcohol and class A drugs, they can be very dangerous. I smiled, remained friendly and put on my best 'not judging you' voice when I walked in. The young lad who had taken too much cocaine and alcohol (and dope) was not looking well at all. He was tachycardic, diaphoretic and very agitated - the latter is mainly down to cocaine. I found it very difficult to work with him, some of my obs. were incomplete because he moved and fidgeted a lot.

Then the police arrived. I had forgotten about them. This changed the atmosphere dramatically. All had been calm and I was hoping to hear an ambulance siren soon but when the police entered the big guy's house, he wasn't happy. I explained that they were here for my protection after abuse had been reported by my Control but he just wanted them out. The police, bless 'em, ignored the man and stayed with me while I finished what I had to do. Tense.

In the end, the young man refused to go to hospital. I have to tell you I was relieved, even though he didn't look good and probably should go, I can't sympathise, I'm afraid. It's drug abuse and self-abuse and when he gets hospital care he will simply go back to his drugs when he is better. He will end up in hospital of course - hopefully not via LAS but in the back of his mate's car. This is how a lot of them arrive.

I finished my shift, signed out and headed home. I noticed a lot of ambulance control vehicles around and there were dozens of motorcycle police arriving in town. I was leaving London on the morning of one of its greatest annual spectacles, the marathon. The sun was up and it was getting warm. Time for bed.

Be safe.

Night of the rubbish gloves

As usual, I hovered around the Euston area until the congestion charge time had elapsed (thus saving myself £8 in going to work costs) and made my way across the Euston Road at precisely 1801 hours and on to the drag South for Waterloo. Incidentally, we can claim back 50% of the congestion charge (they used to give us all of it) but you need to fill a sheet in every month and have it in by a certain time or you don't get a penny. I am very organised in this department, so I never get a penny.

On the way in I stopped to assist at a RTC in which a cyclist had run into the back of a car and been thrown over it, landing hard on his face - almost right in front of me. He had a cut to his chin that needed to be closed and he was shaken by the experience. I sidled over because I thought he may have needed help. As it was, he had an off-duty nurse attending to him.

"Can I help?", I asked

"No, we are fine here. I'm a nurse", she said without looking up at me once.

"I'm with London Ambulance, you sure I can't help?"

"Oh...didn't recognise you."

I cover my uniform up when I travel to and from work, so I guess I could see her point. I was 35 minutes from being on-duty so if I needed to do anything here I would call it in and get myself pre-shifted, so that I was effectively on-duty (and thus covered by LAS). Its all necessary I suppose. In any case, he had a cut chin and that was hardly a problem, even though the nurse seemed to be quite excited about the prospect that he might need a stitch. A colleague of mine turned up and I left him to it.

I wandered into work and went through my usual routine: VDI; drugs; paperwork; stabvest and jacket. Ready.

My first call was a Red1, to a suspended patient in a restaurant in the West End. That call got cancelled as I made my way there. Apparently, the patient was breathing and had a pulse. I wondered just how bad the food was.

Then, ironically, I went to a cyclist who had collided with a car and had, wait for it, gone over and hit the pavement hard, cutting his chin (and lip). He was also concussed - he kept repeating the same question "where did you come from?" over and over. Or maybe he was just curious about my accent - or trousers.

Another emergency call that got cancelled as I prepared to get my teeth into it was a Red1 for a man 'collapsed at the wheel of a car, ? breathing'. My first instinct was that this was nothing more than a drunk driver. Sometimes you can get things very wrong when you assume, so I put my cynicism aside, raced up towards the scene, along with one of the motorcycle paramedics and then shut it all down when the cancellation came through - that harsh ringing sound that says you aren't going to work on this call. The crew that cancelled it told me later on that he was nothing more than a drunk driver after all.

I spent a long time in Leicester Square tonight. I wasn't rushing around like normal for a Friday night, partly because EOC wanted to use the cars for emergencies only and partly because FRED kept sending calls and then cancelling them immediately. I got a whole string of calls that were cancelled as I prepared to run on them. In the end, I radio'd in to ask if I was required or not. It saved me the hassle of getting my gloves on and annoying other drivers by shutting down my lights and sirens (without apparent explanation) after I had forced them all to the side of the road and made Moses of the public highway.

And the gloves. Well, usually they are a bit of a pain to put on but tonight they seemed to fight with me every time. I struggled to get them over my hands without a finger or two sticking out at an air-filled angle. Sometimes I blow into them so that they are easier to put on but that can look bizarre to passers-by, so I don't always do that. They are powder-free things and they cause only one allergic reaction - frustration. I will get a fresh box tonight I think.

As I sat in the Square, I noticed three young lads, probably around 13 years of age, sauntering by, smoking a cigarette. At least I thought it was a cigarette until I caught a whiff of the smoke and then noticed how they were holding it and sharing it. Cheeky gits.

Then a gang of about 30 motorcyclists descended on the Square, driving, rather alarmingly, over the pedestrian area to park up at McDonald's for a healthy meal. They caused a lot of commotion - noise and excitement and the police didn't like it, so they were told to clear off. They did but only after making a fuss and almost getting themselves arrested. When they were gone, the only evidence left behind that they had ever been there was the pile of rubbish on the pavement. Nice touch.

A couple of young girls thought it would be fun to come up to the passenger side window of the car, lift their tops and expose their (covered) breasts to me. I didn't complain. That would be rude. Smile and wave, boy, smile and wave.

A run up to an underground station for a 'male fallen, with head injuries' led to me to the end of another fruitless call. A vehicle was already on scene and I was not required. I returned to my usual area of operation and a young woman ran up to the car, thumping on the window, asking for help. I asked her what was wrong and she said her friend wasn't well.

"Is she not well, or is she drunk?", I asked

"She's not well...and she's drunk", came the reply

I went over to where she sat, surrounded by her friends. I knelt down beside her and asked her what was wrong.

"I need hospital. If you are the ambulance I will talk to you", she slurred.

"I am the ambulance", I said, "what do you want me to do though?"

"I want to go to hospital. I'm ill."

If I didn't take her, she would have ambulances out to help her all night. When I asked her friend why they didn't just get a taxi home, her reply was the standard default. "There are no taxis". Not quite true, I thought, you still have the LAS at hand.

This girl couldn't (or wouldn't) walk so I said I would lift her to the car. Her friend looked me up and down and said "do you want a hand?". Cheek.

So I lifted her (yes, on my own) to the car, poured her in and allowed her friend to travel with her. I took them to hospital and the hospital staff were more than happy to receive them. I don't think I have ever seen such a look of disappointment on a nurse's face.

My last call of the night came in the early hours of the morning as I sat on stand-by. A man ran up to the car. He was covered in blood. He thumped on the window (they all do that) and then he opened the car door. Now that was a step too far and it worried me a little. I told him to stay outside the vehicle and asked him what was wrong. He explained that his friend had just been stabbed. I looked at the blood, looked again at him and decided he didn't have a knife. I hoped.

I called it in, requesting an ambulance and the police and asked Control to track me so that they knew where I was going with this man. I told him to get in the back of the car and to take me to his friend. I asked him twice if the attacker was still on scene - he said no, so I continued. I drove around the corner and his friend was standing in the street with a couple of PCSO's. His friend had no injuries, so it was quickly assumed that someone else had been stabbed, possibly the assailant.

I waited on scene until the ambulance arrived and explained what had happened. The police were now looking for someone with a stab wound, as well as a gang of youths in possession of a large knife, according to the man covered in blood. He told me he had felt the knife touch him when one of the gang had robbed him of his phone. His friend had hidden under a parked vehicle and the gang had spotted him. When the man ran, he assumed the gang had laid into and stabbed his mate. Scary.

I spent the last hour of my morning standing on Waterloo Bridge, looking at the water and the boats and the scenery. I do love London, its full of the strangest, nastiest, nicest people I have ever met.

Be safe.