Why are we even talking about this? The Government thinks it's a great idea and an 'innovation' to make special ambulances and resources available for drunk people. Getting specialist ambulances in for the grossly obese should be no biggie.
I've noticed the rise in larger patients among the elderly and this is quite shocking, because it indicates a generation of obesity that is about to slam into our NHS budget, causing a crisis like no other. It is already a fairly regular occurrence for crews to call in and request a bariatric vehicle for a patient they simply cannot carry, even on the newest ambulances with the wider beds. Private ambulance companies, like the one shown, are investing millions because they can see the future.... and the future is FAT.
The whole concept of spending millions of public pounds at a time when we are all being told to 'tighten our belts', is laughable and crudely paradoxical. I know that many obese patients got where they are because it is not as simple as not eating as much, but it is still due to excess that most of them are in that position. why are we paying for it? Why, in fact, are we paying to help out drunkards by giving them special vehicles and facilities too?
The bottom line is this: we haven't got the money for this nonsense. It would be cheaper to have everyone with a serious weight problem banded without fee if they reach a certain weight. Many obese people want this done because it can save their lives. However, it costs the NHS and there is a bit of moaning about that. How ironic then that we send that money (the same money that would be spent on banding) into the private sector so they can be trundled to and from hospital many times before they succumb to their disease.
I can see another future. Those binge-drinking kids that think it's so cool. A proportion of them (not all of them) will continue to drink like that and they will become alcoholics. We will see that generation filter into the NHS purse as a direct result of their ignorance within the next decade or so. Check back here in 2022 and see if I'm wrong.
Oh, and I'm not having a go at the obese; I'm having a go at our complacency to deal head-on with our problems. It's ridiculous. There are plenty of people out there who were once obese but got their act together and stopped bemoaning their condition as if it was someone else's fault. They lost weight and saved themselves. Even those who elected to get a gastric band fixed have acted to stop the rot.
So, instead of supplying indefinite funding, why don't we just educate people properly? Spend the money teaching people how to eat and drink wisely. Poor old Jamie Oliver tried to do this and got slated in the USA because they didn't like being told what to do! I expect my views on this subject will get me a similar reaction from some of you. That's a shame because I'm simply saying what everyone else is thinking.
Xf
Saturday, 25 February 2012
Friday, 24 February 2012
Radio Gaga
This is the interview from the beginning of the week. Even the Beau, who came with me (cos it was Daddy day), enjoyed himself and sat in with the DJ, although he doesn't look too impressed!If anyone out there has software to record this as it streams, can you do it for me and send me a Wav or MP3 file of it? Thanks!
I'm still battling for the return of Mr Tonsilpus but I think I'm losing. Some people just have no soul.
I may send the original Mr Tonsilpus (the first one ever made of two) with a new passport, off to the remaining locations; Australia, New Zealand and Lebanon, if I don't get the little guy back from his last host by the end of March.
If you were a member of the old Mr Tonsilpus Facebook group, you'll need to apply for membership of his new group because FB has migrated the whole thing and now there are only two members! There were almost 300 members in the last one. Type in 'Mr Tonsilpus' on the search bar and you should find the group.
Xf
Monday, 13 February 2012
Man in pants skates for dog
Now this is just plain stupid. I'd do pretty much anything for Scruffs the cat but I don't think it would include leaving my family without a husband and father. There have been a number of recorded deaths as the result of humans putting their own lives before that of animals and it all seems poetic on the outside and, I suppose, should you successfully negotiate thin ice in your underwear and bring 'Tappy' the dog back from the brink, then you would feel proud, but very few dogs have actually drowned in these circumstances - many of them scrambled to safety by themselves... usually after the human drowned trying to get to them. Maybe the animals saw what was going on, realised that if they stayed much longer they'd end up just like the daft two-legged rescuer, and made a proper bid for freedom.... with their four able legs.
It's been very cold recently, so not only are the dog-rescuers coming to the fore, but the elderly are suffering as usual. Among those are individuals who fought in a war to entitle us to charge them exorbitant sums for the privilege of switching on the gas. I heard one old lady say she had a simple choice, 'eat or heat'. I feel a lot of shame for our society.
BBC Three Counties Radio have asked me to say a few words on the Jonathan Vernon-Smith show from about 9.45am on Monday, 20th February. Listen in if you can; I might say something pithy :-)
Be safe.
It's been very cold recently, so not only are the dog-rescuers coming to the fore, but the elderly are suffering as usual. Among those are individuals who fought in a war to entitle us to charge them exorbitant sums for the privilege of switching on the gas. I heard one old lady say she had a simple choice, 'eat or heat'. I feel a lot of shame for our society.
BBC Three Counties Radio have asked me to say a few words on the Jonathan Vernon-Smith show from about 9.45am on Monday, 20th February. Listen in if you can; I might say something pithy :-)
Be safe.
Saturday, 21 January 2012
Friday, 20 January 2012
For what it's worth
It was only a matter of time....
http://www.camdennewjournal.com/news/2012/jan/paramedic-biker-%E2%80%98fireball%E2%80%99-euston-road
This happened to a friend of mine and I've been saying for a while now that, sooner or later, one of us is going to pay the ultimate price. I for one do not want to be killed racing to an emergency toothache. In this case, the call was a genuine 999, and I think if I get taken out on the way to a life-or-death situation, then it will have been worth the risk.
Now people who call ambulances for nonsense might see what actually happens when one of us runs out of luck.
Get well soon Jim.
Xf
http://www.camdennewjournal.com/news/2012/jan/paramedic-biker-%E2%80%98fireball%E2%80%99-euston-road
This happened to a friend of mine and I've been saying for a while now that, sooner or later, one of us is going to pay the ultimate price. I for one do not want to be killed racing to an emergency toothache. In this case, the call was a genuine 999, and I think if I get taken out on the way to a life-or-death situation, then it will have been worth the risk.
Now people who call ambulances for nonsense might see what actually happens when one of us runs out of luck.
Get well soon Jim.
Xf
Tuesday, 17 January 2012
To beat or not to beat
I had compiled a few news stories that I found either relevant to my profession, worth talking about or just plain daft but I never got around to posting them, so now I'm making up for it, starting with this:
http://www.tes.co.uk/article.aspx?storycode=6003543
I grew up in the 60's and 70's, and corporal punishment was legal and quite routine. Teachers in my day used a leather strap; a thick brown or black thing that, when brought down hard on the palm of your hand, delivered a long-lasting stinging-numbing sensation that made you feel like your hand would drop off. I can actually remember the pain to this day. You had to stand outside the school office, or the head's office... or even in the middle of the classroom, with your friends watching, as you waited for the 'belt' to be brought out of the teacher's desk. The anticipation alone was punishment enough.
Then you'd be asked to stand straight, with one hand one top of the other, outstretched, as if begging for money. Every kid I saw getting hit with this thing bent their little elbows in to try and avoid getting hurt too badly as it flew down onto them. However, if you were seen doing this, you'd be told to behave and you'd get another, extra lash for your trouble. Trying to pull your hands away was futile because it often ended in farce, as the belt missed and instead, hit the teacher on the knees.. or worse, the groin. You'd get hit much harder for that. And if this didn't happen, you'd end up getting hit so hard on the tips of your fingers that you'd wish your hands had remained still. But, it's hard to stand there and watch as it comes down, without wanting to run away from it.
Sometimes the evil thing crossed the border of hand and wrist and you'd get a lot more pain than you deserved, as it burned into the softer, more vascular area of your lower arm. No matter where you got hit, you'd be left with a red mark that told of your evil character. One hand, then the other would be battered. Usually one or two blows were enough but some kids got hit four to six times. By the time that ordeal ended, they'd be crying or screaming in pain and would have to go and see the school nurse!
Every teacher could give out this punishment, and there were no rules or guidelines as far as I'm aware, for the meting out of it. I was once given a few lashes just for playing the school piano without permission. I had done no real harm and I was showing off. There was no damage done, except to the ears of those with a love for good piano playing. It was harsh and extreme. I got punished like this for going into the staff ladies' loo, just to see what it looked like. Mrs Cuthbertson, a very large teacher, caught me as I made my escape and I got a few lashes for trespassing... or curiosity as we call it nowadays.
But in those days something else was pretty endemic; physical abuse at home. It was almost normal for parents to beat their children with belts, fists and God knows what else, as a means of 'disciplining' them. Well, I can tell you, it didn't work. It made us fear adults but not respect them. It taught us that the only way to get someone to do what you want them to do is to hit them. Bullying was rife in my day.
I am all for discipline and I am passionately against this 'new wave' stupidity that came along in the 1980's, where children were told they had rights (yes they do but please, just stop telling them!) and that everything could be sorted out by letting them grow 'naturally'; in other words, they could do and say whatever they liked. It was their right to behave like that. Small children calling their parents by their first names is a dead giveaway for this relaxed attitude. Imagine soldiers calling their superiors by their first names.
"Corporal, take your men over that hill and kill the enemy immediately!"
"Yeah, righto Simon. I don't bloody think so!"
Rubbish! They are children; they need to be told what to do and to be guided in the right direction, otherwise they become feral little gits, with no sense of value or truth. Children are all inherently selfish, for good survival reasons, but they should eventually learn that others have rights too and that others have frank opinions. They should also learn that for every bad deed there is a punishment; a consequence for their actions. That punishment does not have to be physical. At least, not to the point of brutality, which is what I described from my school days and home life.
I have never hit my children and never will. I would spank Harry on the backside if he ever went beyond ridiculous but I've never had to. Physically, they need no more than that. I have the right to bring my child into line and to teach him that he just can't misbehave without consequence. More effective, however, is the naughty step. Harry puts me on it if he thinks I've done something wrong! That's how well it works. He believes in the concept and therefore understands that he is sitting on it because he's been naughty. He will learn the difference between good and bad.
Does beating a child make them better behaved? No, it doesn't. It provides shock and awe for school staff, so that they can get a moment of power back for themselves. It teaches the child nothing about leniency, respect, appropriate repercussions or love.
I have an idea. Why don't we just tell the parents of every child in school in the UK to stop bullying the school staff? Why don't parents, who think they know better than the teachers at their child's school, shut up and let these people get on with their jobs? After all, if it wasn't for them, none of us would be able to work because we'd be too busy taking care of and educating our little ones. They are doing us a favour and they are inspiring our children.
Stop going down to school and 'having a go' at some defenceless member of staff just because you don't agree with their policies. The old 'it's my child, so don't you be telling him/her/it what to do' BS has got to end.
When Harry goes to school, I want the staff to treat him with love and respect. I want them to hold his hand if he allows it and needs it. I want them to hug him if he's down or has fallen over and is sobbing. I want them to punish him, using the clever tools of psychology, if he has been bad. If he, for example, pushes another child in the playground, I expect a member of staff to stop him in his tracks, using a firm no-nonsense voice and to instill in him a sense of fear that what he did was so wrong there will be consequences if he ever does it again.
I will NOT march my prissy self down to the school, get in the face of one of the teachers or the admin staff, and bellow 'how dare you shout at my child? Who the f**k do you think you are?!' That, my friends, is bullying. That is someone with no sense of the scale of things and the possibility that their little cherub deserved it and is a little shit at times.
So, no to hitting our kids but a big fat YES to giving school staff the power back they need in order to stop the rot that is festering in our children.
Xf
http://www.tes.co.uk/article.aspx?storycode=6003543
I grew up in the 60's and 70's, and corporal punishment was legal and quite routine. Teachers in my day used a leather strap; a thick brown or black thing that, when brought down hard on the palm of your hand, delivered a long-lasting stinging-numbing sensation that made you feel like your hand would drop off. I can actually remember the pain to this day. You had to stand outside the school office, or the head's office... or even in the middle of the classroom, with your friends watching, as you waited for the 'belt' to be brought out of the teacher's desk. The anticipation alone was punishment enough.
Then you'd be asked to stand straight, with one hand one top of the other, outstretched, as if begging for money. Every kid I saw getting hit with this thing bent their little elbows in to try and avoid getting hurt too badly as it flew down onto them. However, if you were seen doing this, you'd be told to behave and you'd get another, extra lash for your trouble. Trying to pull your hands away was futile because it often ended in farce, as the belt missed and instead, hit the teacher on the knees.. or worse, the groin. You'd get hit much harder for that. And if this didn't happen, you'd end up getting hit so hard on the tips of your fingers that you'd wish your hands had remained still. But, it's hard to stand there and watch as it comes down, without wanting to run away from it.
Sometimes the evil thing crossed the border of hand and wrist and you'd get a lot more pain than you deserved, as it burned into the softer, more vascular area of your lower arm. No matter where you got hit, you'd be left with a red mark that told of your evil character. One hand, then the other would be battered. Usually one or two blows were enough but some kids got hit four to six times. By the time that ordeal ended, they'd be crying or screaming in pain and would have to go and see the school nurse!
Every teacher could give out this punishment, and there were no rules or guidelines as far as I'm aware, for the meting out of it. I was once given a few lashes just for playing the school piano without permission. I had done no real harm and I was showing off. There was no damage done, except to the ears of those with a love for good piano playing. It was harsh and extreme. I got punished like this for going into the staff ladies' loo, just to see what it looked like. Mrs Cuthbertson, a very large teacher, caught me as I made my escape and I got a few lashes for trespassing... or curiosity as we call it nowadays.
But in those days something else was pretty endemic; physical abuse at home. It was almost normal for parents to beat their children with belts, fists and God knows what else, as a means of 'disciplining' them. Well, I can tell you, it didn't work. It made us fear adults but not respect them. It taught us that the only way to get someone to do what you want them to do is to hit them. Bullying was rife in my day.
I am all for discipline and I am passionately against this 'new wave' stupidity that came along in the 1980's, where children were told they had rights (yes they do but please, just stop telling them!) and that everything could be sorted out by letting them grow 'naturally'; in other words, they could do and say whatever they liked. It was their right to behave like that. Small children calling their parents by their first names is a dead giveaway for this relaxed attitude. Imagine soldiers calling their superiors by their first names.
"Corporal, take your men over that hill and kill the enemy immediately!"
"Yeah, righto Simon. I don't bloody think so!"
Rubbish! They are children; they need to be told what to do and to be guided in the right direction, otherwise they become feral little gits, with no sense of value or truth. Children are all inherently selfish, for good survival reasons, but they should eventually learn that others have rights too and that others have frank opinions. They should also learn that for every bad deed there is a punishment; a consequence for their actions. That punishment does not have to be physical. At least, not to the point of brutality, which is what I described from my school days and home life.
I have never hit my children and never will. I would spank Harry on the backside if he ever went beyond ridiculous but I've never had to. Physically, they need no more than that. I have the right to bring my child into line and to teach him that he just can't misbehave without consequence. More effective, however, is the naughty step. Harry puts me on it if he thinks I've done something wrong! That's how well it works. He believes in the concept and therefore understands that he is sitting on it because he's been naughty. He will learn the difference between good and bad.
Does beating a child make them better behaved? No, it doesn't. It provides shock and awe for school staff, so that they can get a moment of power back for themselves. It teaches the child nothing about leniency, respect, appropriate repercussions or love.
I have an idea. Why don't we just tell the parents of every child in school in the UK to stop bullying the school staff? Why don't parents, who think they know better than the teachers at their child's school, shut up and let these people get on with their jobs? After all, if it wasn't for them, none of us would be able to work because we'd be too busy taking care of and educating our little ones. They are doing us a favour and they are inspiring our children.
Stop going down to school and 'having a go' at some defenceless member of staff just because you don't agree with their policies. The old 'it's my child, so don't you be telling him/her/it what to do' BS has got to end.
When Harry goes to school, I want the staff to treat him with love and respect. I want them to hold his hand if he allows it and needs it. I want them to hug him if he's down or has fallen over and is sobbing. I want them to punish him, using the clever tools of psychology, if he has been bad. If he, for example, pushes another child in the playground, I expect a member of staff to stop him in his tracks, using a firm no-nonsense voice and to instill in him a sense of fear that what he did was so wrong there will be consequences if he ever does it again.
I will NOT march my prissy self down to the school, get in the face of one of the teachers or the admin staff, and bellow 'how dare you shout at my child? Who the f**k do you think you are?!' That, my friends, is bullying. That is someone with no sense of the scale of things and the possibility that their little cherub deserved it and is a little shit at times.
So, no to hitting our kids but a big fat YES to giving school staff the power back they need in order to stop the rot that is festering in our children.
Xf
Sunday, 15 January 2012
ROSC and ROLE
I've dealt with a spate of cardiac arrest calls recently, where the patient has been in a state known as PEA - Pulseless Electrical Activity; in other words, there's little or no output, but there is still electrical activity within the myocardium. PEA produces waveforms that are similar to normal electrical impulses when the heart is beating, except they tend to be slower than normal because the heart muscle is struggling to cope with a lack of blood and oxygen, as is the brain and so there is much less electrical activity than normal.
However, in at least six cases over the past few days, where elderly patients have been in slow PEA for quite some time (up to an hour), with CPR ongoing and Adrenaline being given by extremely competent crews, and where the teams in question requested permission to terminate the resus on the basis of futility - not long after it was 'called' and given a time for Recognition of Life Extinct (ROLE), the crews reported a return of spontaneous circulation (ROSC). In other words, shortly after compressions ceased, the patient's heart began to beat. This occurred in every one of those patients despite every causative avenue having been explored prior to cessation of resus and a call, in conference to the Clinical Support Adviser and a senior doctor.
Adrenaline, of course, is a major factor here. This hormone can 'make a stone beat', according to one of my doctor colleagues, and I've seen this on many occasions myself (the effect of adrenaline that is), but what I'm thinking about is the possibility that something is happening that could be relevant to the difference between a loved-one dying on the carpet in the front room, or in a hospital bed, with enough time given to say goodbye.
Are we inadvertently creating a ROSC by NOT continuing CPR, or was there a pulse there at the time, during compressions? We continually compress the chest now; there are few pauses and rests, so could there be a reason so many PEA-ROSC outcomes are being recorded?
To be honest, I don't know and I'm hoping that someone out there has had more experience of this and can give me something more to go on than 'it's just one of those things'.
Be safe.
However, in at least six cases over the past few days, where elderly patients have been in slow PEA for quite some time (up to an hour), with CPR ongoing and Adrenaline being given by extremely competent crews, and where the teams in question requested permission to terminate the resus on the basis of futility - not long after it was 'called' and given a time for Recognition of Life Extinct (ROLE), the crews reported a return of spontaneous circulation (ROSC). In other words, shortly after compressions ceased, the patient's heart began to beat. This occurred in every one of those patients despite every causative avenue having been explored prior to cessation of resus and a call, in conference to the Clinical Support Adviser and a senior doctor.Adrenaline, of course, is a major factor here. This hormone can 'make a stone beat', according to one of my doctor colleagues, and I've seen this on many occasions myself (the effect of adrenaline that is), but what I'm thinking about is the possibility that something is happening that could be relevant to the difference between a loved-one dying on the carpet in the front room, or in a hospital bed, with enough time given to say goodbye.
Are we inadvertently creating a ROSC by NOT continuing CPR, or was there a pulse there at the time, during compressions? We continually compress the chest now; there are few pauses and rests, so could there be a reason so many PEA-ROSC outcomes are being recorded?
To be honest, I don't know and I'm hoping that someone out there has had more experience of this and can give me something more to go on than 'it's just one of those things'.
Be safe.
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