Night shift: Four calls; one declined; three by ambulance.
Stats: 1 RTC with minor injuries; 1 Fractured rib(s); 1 Fall with facial injuries; 1 Abdo pain.
Luckily I am in the habit (as I should be) of checking the tyres on the car before I set off into the world and tonight I spotted a huge screw sticking out of one of them. Oddly, the point was protruding, so either the head of the thing had embedded inside the tyre or it was pointy at both ends. Either way, I wasn’t taking the vehicle out until it was changed, so I found another car and the Hi-Q man was left to do his job. It’s the fourth tyre change on the vehicle in as many weeks.
Two people literally walked into a bendy bus as it turned a corner (I prefer to say meandering around corners ‘cos it takes them a week). They were tourists and were looking the wrong way by all accounts. They were knocked off their feet and one of them, the man, sustained a minor head injury amounting to a large bump at the back. The woman got a grazed knee as her reward. Neither wanted to go to hospital because they had other, more pressing things to do, so they were examined, their troubles and details documented and then let go by the crew.
A pub landlord slipped on cellar steps and lifted into the air for a second before crashing back down onto his back on the concrete. When I arrived there were two members of staff waiting for me but they weren’t pleased to see me. ‘You’ll need something a bit bigger than that mate’, the man greeting me said as he pointed critically at my car.
‘Its all you’ve got for the moment, I’m afraid’, I told him.
The initial aggression with which I was met was down to someone allegedly being rude to him on the phone when he made the 999 call. I wasn’t sure if that was the case or not but I was feeling the heat of it, as if I represented everyone wearing this uniform.
Inside the pub, the landlord sat on the floor with an ice pack on his back. He was having problems breathing without pain and when I listened to his back I could clearly hear the creak and click of a fragmented rib…or possibly two. He wasn’t in immediate danger because his intercostals were doing a good job of splinting his injury. He had no neck pain and no other significant problems but he needed pain relief.
The crew arrived after a failed attempt to get a line in for morphine; he wasn’t interested in trying entonox because he couldn’t breathe in with enough force to inhale the gas. His vein had cheekily come up for the cannula but then ran away once it was inserted – he wriggled a lot too, so those are my excuses for poor performance on this occasion.
I was back on my usual car soon after that – the tyre had been changed and I was no longer in danger of skidding off the road as the result of a sudden blow-out (I hoped).
The next call took me to Tottenham Court Road, where an 86 year-old man had fallen in front of a bus as he attempted to flag it down. He’d stepped into the road to signal it to stop and when it approached him, he panicked and tripped over himself in the rush to get back on the pavement. The fall was witnessed by a few people at the shelter and they were helping him when I pulled up.
The well-spoken gentleman had lost three of his teeth (well, a bridge and two supporting teeth either side) and he kept referring to the gap that now existed at the front of his mouth. Someone had picked them up and wrapped them for me and I was presented with them when I started my obs. They were handed to me like a prize.
There was some bleeding going on and his nose looked damaged. He had no memory of falling and kept repeating himself a lot, so concussion was a possibility. His pulse was irregular and when the ECG was done in the ambulance, I found that he had a Mobitz block. We don’t see many on the road, so it was an interesting graph to take away.
I don’t expect he stayed in hospital too long but at least the accident had given us the opportunity to spot a potential cardiac problem in the making.
Very early in the morning and I was heading out towards Kings Cross to help a 16 year-old girl who’d developed acute abdominal pain and vomiting whilst out with her friends. She had no medical problems and she didn’t drink alcohol. Her pain was genuine and she vomited while I was going through my obs as she stood, bent over, with five of her mates close by.
I sat her in the car but it took a long time to get her there – she was unwilling to walk or change her position because the pain was extreme. When the crew pulled up I gave her entonox but she barely had the strength to draw it in. I felt very sorry for her.
She was put straight onto the trolley bed and taken away to hospital. Her friends went home and she was left in a crumpled heap, crying out in agony. She would need something stronger than gas for this.
Be safe.
Sunday, 30 November 2008
Saturday, 29 November 2008
System failure
Night shift: Eight calls; all by ambulance.
Stats: 1 ?Fit; 1 Hyperventilation; 1 DIB; 1 Fall with multiple injuries; 1 Unwell baby; 2 eTOH; 1 Unconscious.
What a strange Saturday night. Maybe the cold, rainy weather is keeping the drunks at home or maybe everyone’s getting into the Festive Spirit by behaving themselves…or, more than likely, fewer people can now afford to go out and buy unlimited alcohol to poison themselves with. Whatever the reason, I found myself working one of the busiest weekend nights without visiting the West End on a regular basis to help scrape someone off the street.
The first call, given as a fall, was an 86 year-old man who had fitted and was now suffering shortness of breath (SOB). His family told me he had recently suffered diarrhoea and stomach pains and that he was normally fit and well. They had gathered in a posh hotel to remember his wife who passed away a few years ago – they do this every year.
His ECG indicated a left bundle branch block (LBBB) and there were other changes on it too, so he was taken to hospital for further investigation.
Choking provokes a Red1 because of the immediate life-threatening nature of the incident. I was sent to a University library where a 21 year-old was apparently choking to death, so every second counted and I sped there as safely as I possibly could, given the rubbish visibility. I arrived and got lost. Nobody was there to wave me down or direct me and the buildings are sprawled all over the place, so I couldn’t identify the right one. A MRU was arriving on my tail and he couldn’t work out the address either. We might get to your location within a short time but if the address is vague or there’s nobody to meet us, another minute could be wasted; it’s frustrating.
An ambulance pulled up just as I found the correct building, thanks to a passer-by who casually pointed around the corner – it was almost a ‘Yeah, your emergency is over there mate’ type of gesticulation.
So, three vehicles and four LAS bods were on scene – more than enough to cope with a choking person. We could save her life – well, we could if she was choking at all. A gang of students rushed out of the main door to meet me as I approached. One of them was carrying the girl as if she had been wounded by a mortar in a war zone; it was all too dramatic. I took one look at her, asked her to breathe in and out and decided that she wasn't dying. Neither was she choking.
The girl was hyperventilating. She’d collapsed in a heap outside the place and a mob of concerned students with absolutely no knowledge of basic anatomy or physiology decide she must be at death’s door. Obviously, because she was gasping, she must be choking. It all made perfect sense to them I guess.
A district nurse dialled 999 and asked for an ambulance to take a 77 year-old man with diarrhoea and SOB (another one) to hospital. He was in bed and certainly seemed to be having trouble with his breathing. The crew took over once my obs were complete and oxygen was given to help him out. Otherwise, he seemed stable for the moment.
Some calls contain so little factual detail that it’s surprising more people don’t die as a result. Sure, plenty of people exaggerate the information they give (as in the choking call earlier) but some play down the need for an emergency response. We’ll run around on Red3 calls for ‘not alert’ or ‘unconscious’ people who are just drunk and we know it but we fail to grasp the problems associated with mechanisms when we receive calls with scant detail but a high index of possibility for serious injury. It’s not the call-takers who are to blame; they do what the computer tells them to do – it’s the design of the system, the software and the uneducated non-clinical method we employ to associate cause with effect.
For example, I received an amber call for a 72 year-old woman who had fallen down stairs but had ‘no injuries except for a bloody nose’. Right; she’s 72 years-old, so no spring chicken (with respect). She’s gone down stairs (that are made of what?) and landed on something (a floor? A bed of nails?). The call detail also stated that it was a ‘long Fall’ which should sound alarm bells for anyone. When I got there I was shown to the patient by a tall man who is a friend of the family. They are Portuguese and the patient doesn’t speak English at all but the daughter-in-law does and she translates for me.
The flat is a complex of rooms in which there are multiple sets of stairs to negotiate, up and down. The hallway in which the lady landed is tight and narrow, cluttered with stuff, so moving her out of there was going to be a nightmare.
She had fallen from the top of six steps without touching any of them – she’d been launched in fact, landing with a thud that was heard from the back room, according to the daughter-in-law. She was found wedged in a small space at the bottom of the stairs with a head injury. I saw a huge bump on her forehead and good size pool of dark, congealing blood on the floor. She was sitting up now but complaining of neck and arm pain. Further examination revealed a broken nose, broken Humerus and multiple bruises around her limbs. Her neck pain was a concern but she had fair movement and refused to sit still so that I could hold her head in alignment.
I called Control and asked them to upgrade the call so that I could get a faster response but I learned that this wasn’t done and so an ambulance was sent on the amber code with no rush.
I can’t write about calls like this without sounding like I’m having a go at Control staff; I’m not – I’m against a system that ignores the clinical assessment of someone on the front line in favour of a grading system that satisfies ORCON.
When the crew arrived it was decided to take the lady out in a chair and not to board her; it would have been impossible and dangerous to do anyway. She consented to this and refused any sort of restraint in any case.
We need to re-think the way we remotely assess a call, based on the information given using mechanisms and a high index of suspicion. That means using clinically trained personnel to take the calls but call-takers do not receive much, if any training in pre-hospital care. HEMS and the MRU desk use this practice to send additional resources to a call and I use it when I look at calls on the Clinical Support Desk – the computer’s opinion takes second place.
New parents with new babies worry a lot about their offspring – even when they have been told that nothing is wrong with their child. A 3 week-old baby with diarrhoea was brought to my attention and I reassured the young parents that she was okay after a full set of obs. However, they thought she had fitted (she back arched when picked up) and I explained that babies do that when they have wind. Recent trips to hospital where a clean bill of health had been given did nothing to reassure them, however and I was reluctant to leave them at home, so they went to hospital for more support.
Club personnel who carry patients out to us because they are unconscious and drunk risk trouble for themselves if anything goes wrong, so I would recommend they leave the patient where they lie until we get there. I wasn’t surprised when my 18 year-old Portuguese (there’s a lot of them in town) patient was carted out as I arrived but I was annoyed. She had drunk way too much and her sobbing friend couldn’t understand why she’d just collapsed in the toilets. She had vomited and was floppy but conscious. In fact, she still had the sense to speak in full sentences to her friend. Every now and then she’d stop talking and slip into a drunken sleep, from which she was awakened by yours truly.
Off she went, friend in tow, to the nearest A&E.
Early in the morning I was despatched to a 32 year-old male who was unconscious and ‘had a bit to drink’. The word ‘bit’ is often the parody of ‘lots’, I find. Further details explained that the house had recently had a fire and so there was no electricity and that meant no light. This was going to be fun.
I arrived as the crew pulled up and we made our way up the dark, narrow stairway using our penlights to guide us – we do have torches in the vehicles but they rarely work. The smell of smoke was still strong and ironically, when we got into the flat, they were using live candles to light the room.
The man was in the recovery position on the floor and his wife and two friends were present. They had been drinking all night and come back here to party and dance around, as you do. While dancing, the man suddenly collapsed and lost consciousness. He had a fit and then his breathing became noisy and slow. When I assessed him his respirations were too slow for life and we got to work on him with the help of a little torch and one of the friends. I had to ask for the candles around him to be taken away – we were about to turn the oxygen on and this would have become a dangerous farce if we’d ignored the risk.
I’ve worked with one of the crew on several calls like this; we communicate well and things get done. He was bagged and I began the process of gaining as much information as possible about his medical history, drinking habits and possible drug use as I put a line in. He got Narcan even though his wife was sure he didn’t touch strong drugs and only smoked occasionally. I believed her but you never know, do you? His pupils were pinpoint and so going down this route to start was advisable.
We remained on scene for about 30 minutes because we had to wait for help, in the form of proper light, from the London Fire Brigade. They appeared as if by magic in healthy numbers and shone their torches where we wanted them. I’m willing to bet they were the same crew that put the fire out in this place.
His wife cried a lot but was able to keep herself together in order to help us. I think she feared the worst and there were a couple of moments before the LFB arrived when he stopped breathing and our support was the only thing keeping him alive. His pulse rate was dropping, so any interference with his airway, which was manually cleared several times, might have invoked a serious bradycardia.
Narcan didn’t change the situation and Oxygen didn’t make any difference to his state of consciousness, so it was time to get going before we had a bigger problem to deal with. I could imagine how difficult his removal from the place would be if he arrested on us, so it was a good idea to get him in a chair and go while he was drawing some breath for himself.
The LFB helped with light and guidance down the steps and my colleagues creaked and sweated as they carried him away. He was put in the back of the ambulance and everything we had was thrown at him; CO2 monitoring, 12 lead ECG, more oxygen, etc.
The quick journey to the hospital brought no change in him; in fact we had to wrestle with his airway a few more times to keep it clear. We also had to temper the bagging to balance his O2 and CO2…and pulse rate (over-enthusiastic bagging can disrupt the gas balances).
In Resus they worked on him some more, took blood, intubated and hooked him up to their machines but his condition remained the same.
I spoke to his wife as she waited. ‘He was always very difficult to wake up’ she said in an attempt to console herself.
I asked about him later and was told he’d been taken for a scan, which was negative. I was sure he’d been suffering a neurological insult. He was now in ITU and they’d taken two litres of urine out of him. I hadn’t given him fluids; he didn’t need any but the hospital, as part of their own protocol, had pumped a litre into him. I wondered if he had suffered renal failiure, although there are many causes of fluid retention.
I got back to a late job and was late home as a result. I still had two more nights to do, so the overtime wasn’t appreciated. The call was for a 38 year-old man who had walked into a bus. He was very drunk and I found him sitting on the cold, wet ground with a shoe off. The bus driver was annoyed that he’d nearly had to go home after potentially killing someone who was just stupid-drunk – I empathised with him.
The police arrived to help and they checked his immigration status (they are good with hunches like this). The ambulance arrived after 30 minutes and I left him to them (and the police).
Morale is very low in the service and pressure is increasing for all of us. Targets dictated by a lazy Government that believe in a nanny state give us no hope for the job sometimes. It’s made worse when human beings are removed from the exercise in the hope that prediction and submissive supposition can replace a good brain and common sense. I will never claim to be the best at what I do – there are better paramedics out there I’m sure but if you tell me your 20 year-old mate is vomiting in the gutter after drinking and he’s ‘unconscious’, I will replace paternalism with scepticism for the sake of the truly ill and injured out there.
Maybe a good scare is what’s needed for some of them so that they realise the risk they take has potebtial consequences and they stop being dependent on an ambulance service to carry their self-imposed burden all the way to an over-stretched A&E department. Or maybe I’m too harsh and unwilling to accept that people are essentially moulded into this reluctance to take responsibility for their own actions.
Be safe.
Stats: 1 ?Fit; 1 Hyperventilation; 1 DIB; 1 Fall with multiple injuries; 1 Unwell baby; 2 eTOH; 1 Unconscious.
What a strange Saturday night. Maybe the cold, rainy weather is keeping the drunks at home or maybe everyone’s getting into the Festive Spirit by behaving themselves…or, more than likely, fewer people can now afford to go out and buy unlimited alcohol to poison themselves with. Whatever the reason, I found myself working one of the busiest weekend nights without visiting the West End on a regular basis to help scrape someone off the street.
The first call, given as a fall, was an 86 year-old man who had fitted and was now suffering shortness of breath (SOB). His family told me he had recently suffered diarrhoea and stomach pains and that he was normally fit and well. They had gathered in a posh hotel to remember his wife who passed away a few years ago – they do this every year.
His ECG indicated a left bundle branch block (LBBB) and there were other changes on it too, so he was taken to hospital for further investigation.
Choking provokes a Red1 because of the immediate life-threatening nature of the incident. I was sent to a University library where a 21 year-old was apparently choking to death, so every second counted and I sped there as safely as I possibly could, given the rubbish visibility. I arrived and got lost. Nobody was there to wave me down or direct me and the buildings are sprawled all over the place, so I couldn’t identify the right one. A MRU was arriving on my tail and he couldn’t work out the address either. We might get to your location within a short time but if the address is vague or there’s nobody to meet us, another minute could be wasted; it’s frustrating.
An ambulance pulled up just as I found the correct building, thanks to a passer-by who casually pointed around the corner – it was almost a ‘Yeah, your emergency is over there mate’ type of gesticulation.
So, three vehicles and four LAS bods were on scene – more than enough to cope with a choking person. We could save her life – well, we could if she was choking at all. A gang of students rushed out of the main door to meet me as I approached. One of them was carrying the girl as if she had been wounded by a mortar in a war zone; it was all too dramatic. I took one look at her, asked her to breathe in and out and decided that she wasn't dying. Neither was she choking.
The girl was hyperventilating. She’d collapsed in a heap outside the place and a mob of concerned students with absolutely no knowledge of basic anatomy or physiology decide she must be at death’s door. Obviously, because she was gasping, she must be choking. It all made perfect sense to them I guess.
A district nurse dialled 999 and asked for an ambulance to take a 77 year-old man with diarrhoea and SOB (another one) to hospital. He was in bed and certainly seemed to be having trouble with his breathing. The crew took over once my obs were complete and oxygen was given to help him out. Otherwise, he seemed stable for the moment.
Some calls contain so little factual detail that it’s surprising more people don’t die as a result. Sure, plenty of people exaggerate the information they give (as in the choking call earlier) but some play down the need for an emergency response. We’ll run around on Red3 calls for ‘not alert’ or ‘unconscious’ people who are just drunk and we know it but we fail to grasp the problems associated with mechanisms when we receive calls with scant detail but a high index of possibility for serious injury. It’s not the call-takers who are to blame; they do what the computer tells them to do – it’s the design of the system, the software and the uneducated non-clinical method we employ to associate cause with effect.
For example, I received an amber call for a 72 year-old woman who had fallen down stairs but had ‘no injuries except for a bloody nose’. Right; she’s 72 years-old, so no spring chicken (with respect). She’s gone down stairs (that are made of what?) and landed on something (a floor? A bed of nails?). The call detail also stated that it was a ‘long Fall’ which should sound alarm bells for anyone. When I got there I was shown to the patient by a tall man who is a friend of the family. They are Portuguese and the patient doesn’t speak English at all but the daughter-in-law does and she translates for me.
The flat is a complex of rooms in which there are multiple sets of stairs to negotiate, up and down. The hallway in which the lady landed is tight and narrow, cluttered with stuff, so moving her out of there was going to be a nightmare.
She had fallen from the top of six steps without touching any of them – she’d been launched in fact, landing with a thud that was heard from the back room, according to the daughter-in-law. She was found wedged in a small space at the bottom of the stairs with a head injury. I saw a huge bump on her forehead and good size pool of dark, congealing blood on the floor. She was sitting up now but complaining of neck and arm pain. Further examination revealed a broken nose, broken Humerus and multiple bruises around her limbs. Her neck pain was a concern but she had fair movement and refused to sit still so that I could hold her head in alignment.
I called Control and asked them to upgrade the call so that I could get a faster response but I learned that this wasn’t done and so an ambulance was sent on the amber code with no rush.
I can’t write about calls like this without sounding like I’m having a go at Control staff; I’m not – I’m against a system that ignores the clinical assessment of someone on the front line in favour of a grading system that satisfies ORCON.
When the crew arrived it was decided to take the lady out in a chair and not to board her; it would have been impossible and dangerous to do anyway. She consented to this and refused any sort of restraint in any case.
We need to re-think the way we remotely assess a call, based on the information given using mechanisms and a high index of suspicion. That means using clinically trained personnel to take the calls but call-takers do not receive much, if any training in pre-hospital care. HEMS and the MRU desk use this practice to send additional resources to a call and I use it when I look at calls on the Clinical Support Desk – the computer’s opinion takes second place.
New parents with new babies worry a lot about their offspring – even when they have been told that nothing is wrong with their child. A 3 week-old baby with diarrhoea was brought to my attention and I reassured the young parents that she was okay after a full set of obs. However, they thought she had fitted (she back arched when picked up) and I explained that babies do that when they have wind. Recent trips to hospital where a clean bill of health had been given did nothing to reassure them, however and I was reluctant to leave them at home, so they went to hospital for more support.
Club personnel who carry patients out to us because they are unconscious and drunk risk trouble for themselves if anything goes wrong, so I would recommend they leave the patient where they lie until we get there. I wasn’t surprised when my 18 year-old Portuguese (there’s a lot of them in town) patient was carted out as I arrived but I was annoyed. She had drunk way too much and her sobbing friend couldn’t understand why she’d just collapsed in the toilets. She had vomited and was floppy but conscious. In fact, she still had the sense to speak in full sentences to her friend. Every now and then she’d stop talking and slip into a drunken sleep, from which she was awakened by yours truly.
Off she went, friend in tow, to the nearest A&E.
Early in the morning I was despatched to a 32 year-old male who was unconscious and ‘had a bit to drink’. The word ‘bit’ is often the parody of ‘lots’, I find. Further details explained that the house had recently had a fire and so there was no electricity and that meant no light. This was going to be fun.
I arrived as the crew pulled up and we made our way up the dark, narrow stairway using our penlights to guide us – we do have torches in the vehicles but they rarely work. The smell of smoke was still strong and ironically, when we got into the flat, they were using live candles to light the room.
The man was in the recovery position on the floor and his wife and two friends were present. They had been drinking all night and come back here to party and dance around, as you do. While dancing, the man suddenly collapsed and lost consciousness. He had a fit and then his breathing became noisy and slow. When I assessed him his respirations were too slow for life and we got to work on him with the help of a little torch and one of the friends. I had to ask for the candles around him to be taken away – we were about to turn the oxygen on and this would have become a dangerous farce if we’d ignored the risk.
I’ve worked with one of the crew on several calls like this; we communicate well and things get done. He was bagged and I began the process of gaining as much information as possible about his medical history, drinking habits and possible drug use as I put a line in. He got Narcan even though his wife was sure he didn’t touch strong drugs and only smoked occasionally. I believed her but you never know, do you? His pupils were pinpoint and so going down this route to start was advisable.
We remained on scene for about 30 minutes because we had to wait for help, in the form of proper light, from the London Fire Brigade. They appeared as if by magic in healthy numbers and shone their torches where we wanted them. I’m willing to bet they were the same crew that put the fire out in this place.
His wife cried a lot but was able to keep herself together in order to help us. I think she feared the worst and there were a couple of moments before the LFB arrived when he stopped breathing and our support was the only thing keeping him alive. His pulse rate was dropping, so any interference with his airway, which was manually cleared several times, might have invoked a serious bradycardia.
Narcan didn’t change the situation and Oxygen didn’t make any difference to his state of consciousness, so it was time to get going before we had a bigger problem to deal with. I could imagine how difficult his removal from the place would be if he arrested on us, so it was a good idea to get him in a chair and go while he was drawing some breath for himself.
The LFB helped with light and guidance down the steps and my colleagues creaked and sweated as they carried him away. He was put in the back of the ambulance and everything we had was thrown at him; CO2 monitoring, 12 lead ECG, more oxygen, etc.
The quick journey to the hospital brought no change in him; in fact we had to wrestle with his airway a few more times to keep it clear. We also had to temper the bagging to balance his O2 and CO2…and pulse rate (over-enthusiastic bagging can disrupt the gas balances).
In Resus they worked on him some more, took blood, intubated and hooked him up to their machines but his condition remained the same.
I spoke to his wife as she waited. ‘He was always very difficult to wake up’ she said in an attempt to console herself.
I asked about him later and was told he’d been taken for a scan, which was negative. I was sure he’d been suffering a neurological insult. He was now in ITU and they’d taken two litres of urine out of him. I hadn’t given him fluids; he didn’t need any but the hospital, as part of their own protocol, had pumped a litre into him. I wondered if he had suffered renal failiure, although there are many causes of fluid retention.
I got back to a late job and was late home as a result. I still had two more nights to do, so the overtime wasn’t appreciated. The call was for a 38 year-old man who had walked into a bus. He was very drunk and I found him sitting on the cold, wet ground with a shoe off. The bus driver was annoyed that he’d nearly had to go home after potentially killing someone who was just stupid-drunk – I empathised with him.
The police arrived to help and they checked his immigration status (they are good with hunches like this). The ambulance arrived after 30 minutes and I left him to them (and the police).
Morale is very low in the service and pressure is increasing for all of us. Targets dictated by a lazy Government that believe in a nanny state give us no hope for the job sometimes. It’s made worse when human beings are removed from the exercise in the hope that prediction and submissive supposition can replace a good brain and common sense. I will never claim to be the best at what I do – there are better paramedics out there I’m sure but if you tell me your 20 year-old mate is vomiting in the gutter after drinking and he’s ‘unconscious’, I will replace paternalism with scepticism for the sake of the truly ill and injured out there.
Maybe a good scare is what’s needed for some of them so that they realise the risk they take has potebtial consequences and they stop being dependent on an ambulance service to carry their self-imposed burden all the way to an over-stretched A&E department. Or maybe I’m too harsh and unwilling to accept that people are essentially moulded into this reluctance to take responsibility for their own actions.
Be safe.
Friday, 28 November 2008
Dark places
Night shift: Seven calls; one declined; six by ambulance.
Stats: 1 eTOH fall with facial injuries; 1 Faint; 1 Chest pain; 2 eTOH; 1 Sickle cell crisis; 1 Heroin overdose.
Here we go – four nights in a row and another phase of shifts after which I need, but rarely get, at least two days to recover and re-set my body clock. Night shift patterns are one of the main reasons for quitting the profession – love it or hate it.
And it starts with a 45 year-old drunken man who’s fallen outside the Waldorf Hotel and badly lacerated his thumb. The crew arrive with me and together we coax him to stand up and stagger (with support) to the ambulance. ‘I don’t want you guys’, he says. PCSO’s have been hovering over him since he was seen dropping to the ground by a MOP. Now he’s embarrassed that we’ve been called. He’s also useless to man and beast until he’s sobered up and got his thumb fixed.
Back to the Aldwych later on for a 46 year-old woman who fainted in a restaurant. She had a history of passing out in her younger days, she tells me but I don’t want to play down the significance of it until she’s had an ECG, so she’s taken to the ambulance and off to hospital by the crew.
One of our frequent flyers turned up at an underground station claiming he had chest pain. He usually goes for ‘I think I’m going to have a fit’ in order to ring the alarm bells of the general public but I know that he’s been in and out of hospital all week, so I expect he’s decided to change tack. I don’t mean to be unkind to him but he knows what he’s doing and he just doesn’t care.
When I got on scene the underground employees very concerned because he wouldn’t talk to them and seemed ‘floppy’. He soon perked up when he was in the back of the ambulance and assured a trip to A&E; the crew weren’t local, so they had never seen him before. He was happy with that.
A tall 20 year-old vomiting drunken female next – I had the pleasure of meeting her as she lay slumped on the floor of the ladies toilets in a bar. I met her weeping friend too. ‘Is she going to be okay? What’s wrong with her?’ I’m then informed that she’s had a ton of wine at high speed tonight, so there really was no medical mystery here. It’s just a shame they don’t have school lessons in which teenagers who want to grow up and drink like this can be educated in the ways of wine.
Some time into the wee small ones I went on a long drive across town to visit a 35 year-old woman who was ‘not alert’, which means all sorts of nonsense things. I arrived and made my way all the way up to the top flat and was greeted by a very drunk lady who immediately verbally abused me. Her friend was sitting on the floor, just as sozzled, being very quiet (therefore not alert). I asked her why she needed an ambulance and, eventually, she told me she didn’t. Meanwhile, the other lady is hovering over us, shouting and swearing - sometimes at her friend and sometimes at me. She just won’t shut up and I find myself competing with her volume in order to get sense out of the situation.
The quiet drunken lady tells me she doesn’t need an ambulance and that there is nothing medically wrong with her but her mate insists that I remove her from the house. I tell her I can’t force anyone to go to hospital and this makes the loud woman even louder. The quiet woman is just sitting there doing nothing.
I called Control and advised them of the situation and requested that the crew be cancelled. They must have heard the racket the lady was making as she continued her tirade of abuse towards me. The door was open and I needed no excuse, so I asked the quiet lady once again if she needed an ambulance – she said no, so I decided I’d had enough and left. I was followed by the angry woman and she stopped at the door as I stepped into the landing. ‘Excuse me, Officer, or whatever you think you are’ she said with an evil hate-filled look on her face. ‘So you aren’t going to help? You won’t take her away from this house?’
‘Nope’, I replied.
Then I made my way down stairs after receiving an earful of screamed expletives followed by the door slamming in my face. It’s bad enough being abused but it’s worse knowing that I’ve travelled miles out of my area to get it!
I had asked Control not to send anyone to the address unless the police were going too but later on I was told that a crew had been sent automatically by FRED without any warning to them about what had happened to me. They, of course, were treated to the same abuse and left the scene quickly.
I’ve said it before and I won’t be convinced otherwise; a good proportion of the calls we get to police stations for people held in custody are non-starters in medical terms. We are the excuse they need to get out of the cell and into a hospital bed. For some it’s even a chance to do a runner. That’s why the 31 year-old man who claimed to be suffering Sickle Cell Crisis was handcuffed as he was led to the ambulance. Right from the start I wasn’t convinced of his authenticity – neither were the officers escorting him, the custody sergeant or the hospital staff nurse. Pain, of course, is immeasurable and therefore easy to fake and a real crisis can be very painful but his sham behaviour poured scorn on the very real suffering of those who need help when they sickle.
The last call of the night took me to a narrow, dark alleyway, at the bottom of which lay a man’s body. I was led there by a drug dealer who’d run out of the shadows to get me as I waited at my RV point for the police to back me up. I wasn't supposed to be going in there just yet but it was too late now and I was on my way into that place without any protection. It was an uncomfortable experience.
The dealer told me that the guy had bought and injected Heroin, then slumped into unconsciousness. This is quite normal but if a dealer looks worried about the state of a punter, then something was awry. I was either being set up or the guy lying on the ground down there was dead…or close to it.
I drove down the alley and parked far enough away to get the space I’d need for an escape if I needed it. There was no way I could turn my car around in a hurry, so I’d have to use it as refuge...or simply run.
I went up to the body and saw that he was breathing but very badly. His respirations were slow, shallow and bubbly. There was foam coming from his mouth and he didn’t respond to me at all. I grabbed what I could from the car and saw that my colleagues were on their way down to help. The ambulance couldn’t fit inside the alleyway, so they’d parked up in the road and were on foot. I shouted for them to hurry because I don’t think they realised what was going on.
I turned the man onto his back and, with the help of the crew, began the routine of saving his life. He was ‘bagged’ and Narc’d, as is the usual drill in these circumstances. The police turned up just as we were getting serious and they assumed he wasn’t going to make it. The place was cordoned off and CID were brought in, which I thought was a little premature.
We got him on the trolley bed and rolled it all the way down to the end of the alley and into the ambulance, where he began to stir. Another bolus of Naloxone woke him right up and when I left he was sitting up and singing like a canary…well, you know what I mean. It was a bad-start job that turned itself around in less than twenty minutes. Sometimes you wonder why you take risks for this kind of stupidity.
Be safe.
Stats: 1 eTOH fall with facial injuries; 1 Faint; 1 Chest pain; 2 eTOH; 1 Sickle cell crisis; 1 Heroin overdose.
Here we go – four nights in a row and another phase of shifts after which I need, but rarely get, at least two days to recover and re-set my body clock. Night shift patterns are one of the main reasons for quitting the profession – love it or hate it.
And it starts with a 45 year-old drunken man who’s fallen outside the Waldorf Hotel and badly lacerated his thumb. The crew arrive with me and together we coax him to stand up and stagger (with support) to the ambulance. ‘I don’t want you guys’, he says. PCSO’s have been hovering over him since he was seen dropping to the ground by a MOP. Now he’s embarrassed that we’ve been called. He’s also useless to man and beast until he’s sobered up and got his thumb fixed.
Back to the Aldwych later on for a 46 year-old woman who fainted in a restaurant. She had a history of passing out in her younger days, she tells me but I don’t want to play down the significance of it until she’s had an ECG, so she’s taken to the ambulance and off to hospital by the crew.
One of our frequent flyers turned up at an underground station claiming he had chest pain. He usually goes for ‘I think I’m going to have a fit’ in order to ring the alarm bells of the general public but I know that he’s been in and out of hospital all week, so I expect he’s decided to change tack. I don’t mean to be unkind to him but he knows what he’s doing and he just doesn’t care.
When I got on scene the underground employees very concerned because he wouldn’t talk to them and seemed ‘floppy’. He soon perked up when he was in the back of the ambulance and assured a trip to A&E; the crew weren’t local, so they had never seen him before. He was happy with that.
A tall 20 year-old vomiting drunken female next – I had the pleasure of meeting her as she lay slumped on the floor of the ladies toilets in a bar. I met her weeping friend too. ‘Is she going to be okay? What’s wrong with her?’ I’m then informed that she’s had a ton of wine at high speed tonight, so there really was no medical mystery here. It’s just a shame they don’t have school lessons in which teenagers who want to grow up and drink like this can be educated in the ways of wine.
Some time into the wee small ones I went on a long drive across town to visit a 35 year-old woman who was ‘not alert’, which means all sorts of nonsense things. I arrived and made my way all the way up to the top flat and was greeted by a very drunk lady who immediately verbally abused me. Her friend was sitting on the floor, just as sozzled, being very quiet (therefore not alert). I asked her why she needed an ambulance and, eventually, she told me she didn’t. Meanwhile, the other lady is hovering over us, shouting and swearing - sometimes at her friend and sometimes at me. She just won’t shut up and I find myself competing with her volume in order to get sense out of the situation.
The quiet drunken lady tells me she doesn’t need an ambulance and that there is nothing medically wrong with her but her mate insists that I remove her from the house. I tell her I can’t force anyone to go to hospital and this makes the loud woman even louder. The quiet woman is just sitting there doing nothing.
I called Control and advised them of the situation and requested that the crew be cancelled. They must have heard the racket the lady was making as she continued her tirade of abuse towards me. The door was open and I needed no excuse, so I asked the quiet lady once again if she needed an ambulance – she said no, so I decided I’d had enough and left. I was followed by the angry woman and she stopped at the door as I stepped into the landing. ‘Excuse me, Officer, or whatever you think you are’ she said with an evil hate-filled look on her face. ‘So you aren’t going to help? You won’t take her away from this house?’
‘Nope’, I replied.
Then I made my way down stairs after receiving an earful of screamed expletives followed by the door slamming in my face. It’s bad enough being abused but it’s worse knowing that I’ve travelled miles out of my area to get it!
I had asked Control not to send anyone to the address unless the police were going too but later on I was told that a crew had been sent automatically by FRED without any warning to them about what had happened to me. They, of course, were treated to the same abuse and left the scene quickly.
I’ve said it before and I won’t be convinced otherwise; a good proportion of the calls we get to police stations for people held in custody are non-starters in medical terms. We are the excuse they need to get out of the cell and into a hospital bed. For some it’s even a chance to do a runner. That’s why the 31 year-old man who claimed to be suffering Sickle Cell Crisis was handcuffed as he was led to the ambulance. Right from the start I wasn’t convinced of his authenticity – neither were the officers escorting him, the custody sergeant or the hospital staff nurse. Pain, of course, is immeasurable and therefore easy to fake and a real crisis can be very painful but his sham behaviour poured scorn on the very real suffering of those who need help when they sickle.
The last call of the night took me to a narrow, dark alleyway, at the bottom of which lay a man’s body. I was led there by a drug dealer who’d run out of the shadows to get me as I waited at my RV point for the police to back me up. I wasn't supposed to be going in there just yet but it was too late now and I was on my way into that place without any protection. It was an uncomfortable experience.
The dealer told me that the guy had bought and injected Heroin, then slumped into unconsciousness. This is quite normal but if a dealer looks worried about the state of a punter, then something was awry. I was either being set up or the guy lying on the ground down there was dead…or close to it.
I drove down the alley and parked far enough away to get the space I’d need for an escape if I needed it. There was no way I could turn my car around in a hurry, so I’d have to use it as refuge...or simply run.
I went up to the body and saw that he was breathing but very badly. His respirations were slow, shallow and bubbly. There was foam coming from his mouth and he didn’t respond to me at all. I grabbed what I could from the car and saw that my colleagues were on their way down to help. The ambulance couldn’t fit inside the alleyway, so they’d parked up in the road and were on foot. I shouted for them to hurry because I don’t think they realised what was going on.
I turned the man onto his back and, with the help of the crew, began the routine of saving his life. He was ‘bagged’ and Narc’d, as is the usual drill in these circumstances. The police turned up just as we were getting serious and they assumed he wasn’t going to make it. The place was cordoned off and CID were brought in, which I thought was a little premature.
We got him on the trolley bed and rolled it all the way down to the end of the alley and into the ambulance, where he began to stir. Another bolus of Naloxone woke him right up and when I left he was sitting up and singing like a canary…well, you know what I mean. It was a bad-start job that turned itself around in less than twenty minutes. Sometimes you wonder why you take risks for this kind of stupidity.
Be safe.
Tuesday, 25 November 2008
Sats
Day shift: Eight calls; three declined; five by ambulance.
Stats: 1 Head injury; 1 Abdo pain; 2 Chest pains; 1 ?GI bleed; 1 ?EP fit; 1 Palpitations; 1 COPD with DIB.
A 59 year-old lady tumbled as she left a bus and hit her head on railings, causing a large swelling. Police were on scene and the crew was with me in five minutes, so all I had to do was gather my obs and hand her over for hospital.
Then I went to a local call and found a 19 year-old female sitting on a step inside her University Campus building, crying and nursing her painful abdomen. The security guy, who was just outside the entrance, took no notice of her and people practically stepped over her as she sobbed at the bottom of the stairs. She was on her period and its possible she was suffering a particularly painful episode but that doesn’t reduce the reality of her pain and it was a shame that nobody wanted to stop and ask her if she was okay. Maybe they were used to girls crying on those stairs.
A call given as a 42 year-old male was a female in fact and because I was looking for a man I almost drove past her as she waited outside a train station for help. She had chest pain and kept rubbing her breast to soothe it, something I haven’t seen done in this context. Again, she was on her own and nobody seemed to care. It was rush hour, so I guess there is a time and a place for caring.
After that I went to see a regular patient for whom a doctor had called an ambulance, stating she possibly had a GI bleed. When I arrived at the flat, she told me she didn’t have any problems and that her doctor ‘worried too much’ about her. In spite of her denials and because of the low blood pressure I was recording, I decided to call the GP myself and get the facts. The crew was on scene as I made the call and her own GP told me that she hadn’t been contacted at all. Then I tried the on-call doctor and this time the story became clear. She had been visited the night before when she became unwell and the doctor had told her that she was concerned about the low blood pressure and recent spate of malaena. She was advised to go to hospital but refused, thus the call to us the next day.
The patient spoke to the doctor on the ‘phone while I was there and pulled faces and made gestures that intimated her feelings for the professional on the other end of the line. Then she hung up on her.
She flatly refused to go and even though she had been warned that she could be found dead sometime soon (by her GP and us), she still said no. We had no choice but to leave her where she was and get the paperwork signed. No doubt I will see her again – dead or alive.
Another patient to refuse a trip to hospital had suffered a fit, according to witnesses. The school teacher was six months pregnant and had passed out but the description of the incident given by her colleagues in the Staff Room was closer to an absence (this used to be called petit mal). She felt fine when I arrived and insisted that she should carry on with her day.
The kids outside were extremely interested in what was going on and asked me if I was delivering her baby. On my way back to the car I told them it was a boy and it was to be called Brian. This caused a sudden upsurge of excitement and the rumour spread like wildfire before I’d reached the gate.
It was turning out to be an odd day with the third refusal in a row. A 40 year-old man with chest pain decided he wanted to continue his coach journey to Poland, despite collapsing and causing great concern among his fellow passengers. His father had died a few days earlier and he was on his way home for the funeral. His chest pain could have been the result of anxiety but there were changes on his ECG and he was strongly advised to go and get it checked out, rather than risk a long journey by road. I understood him though – I would want to be at my dad’s funeral if I had been away when he died. The poor man was working in the UK and sending every penny home to his mother so now he had no cash and no means of taking the trip later on.
He signed the PRF and was allowed to go on his way – he just about caught the coach as it pulled out of the station. I hope he made it without any drama.
A 27 year-old Soho prostitute suffering palpitations took 45mg of Valium to try and calm her heart down. She already had an anxiety problem and worried that she’d taken too many. I reassured her as she sat on the step of her bed-sit home and the crew took her for an ECG which, apart from the tachycardia, was normal.
I almost made it home but I got a late job and was off to see a 57 year-old man with COPD which had suddenly become exacerbated. I knew the man and I knew he was very fragile, so I tried to give him more oxygen but he didn’t want the mask on his face. His nasal cannula was only delivering 2lpm and that wasn’t enough. I couldn’t nebulise him either because, again, he refused the mask. I cranked up his oxygen to 4lpm on his home cylinder and hoped the crew would be there quick because his sats were very low and his condition was deteriorating. He was panicking. ‘I’m going to die’ he said repeatedly.
As his anxious family stood round I tried to calm him and prepared to do what was necessary if he stopped breathing – a strong possibility in these cases. The crew arrived and he was taken to the ambulance where he relented and allowed a nebuliser to be put on him. His condition improved slightly but he was still using accessory muscles to breathe and looked ready to give up, so he was taken to hospital for further treatment.
I take people with real breathing problems seriously; the look of a person, they way they posture and behave will indicate the severity of their condition, whether we gauge that through our instruments to be serious or not depends on how we see the human being that is trapped in the desperate fight to catch a breath. Until you have been there yourself, it’s dangerous to assume that a high saturation means they are ok.
Be safe.
Stats: 1 Head injury; 1 Abdo pain; 2 Chest pains; 1 ?GI bleed; 1 ?EP fit; 1 Palpitations; 1 COPD with DIB.
A 59 year-old lady tumbled as she left a bus and hit her head on railings, causing a large swelling. Police were on scene and the crew was with me in five minutes, so all I had to do was gather my obs and hand her over for hospital.
Then I went to a local call and found a 19 year-old female sitting on a step inside her University Campus building, crying and nursing her painful abdomen. The security guy, who was just outside the entrance, took no notice of her and people practically stepped over her as she sobbed at the bottom of the stairs. She was on her period and its possible she was suffering a particularly painful episode but that doesn’t reduce the reality of her pain and it was a shame that nobody wanted to stop and ask her if she was okay. Maybe they were used to girls crying on those stairs.
A call given as a 42 year-old male was a female in fact and because I was looking for a man I almost drove past her as she waited outside a train station for help. She had chest pain and kept rubbing her breast to soothe it, something I haven’t seen done in this context. Again, she was on her own and nobody seemed to care. It was rush hour, so I guess there is a time and a place for caring.
After that I went to see a regular patient for whom a doctor had called an ambulance, stating she possibly had a GI bleed. When I arrived at the flat, she told me she didn’t have any problems and that her doctor ‘worried too much’ about her. In spite of her denials and because of the low blood pressure I was recording, I decided to call the GP myself and get the facts. The crew was on scene as I made the call and her own GP told me that she hadn’t been contacted at all. Then I tried the on-call doctor and this time the story became clear. She had been visited the night before when she became unwell and the doctor had told her that she was concerned about the low blood pressure and recent spate of malaena. She was advised to go to hospital but refused, thus the call to us the next day.
The patient spoke to the doctor on the ‘phone while I was there and pulled faces and made gestures that intimated her feelings for the professional on the other end of the line. Then she hung up on her.
She flatly refused to go and even though she had been warned that she could be found dead sometime soon (by her GP and us), she still said no. We had no choice but to leave her where she was and get the paperwork signed. No doubt I will see her again – dead or alive.
Another patient to refuse a trip to hospital had suffered a fit, according to witnesses. The school teacher was six months pregnant and had passed out but the description of the incident given by her colleagues in the Staff Room was closer to an absence (this used to be called petit mal). She felt fine when I arrived and insisted that she should carry on with her day.
The kids outside were extremely interested in what was going on and asked me if I was delivering her baby. On my way back to the car I told them it was a boy and it was to be called Brian. This caused a sudden upsurge of excitement and the rumour spread like wildfire before I’d reached the gate.
It was turning out to be an odd day with the third refusal in a row. A 40 year-old man with chest pain decided he wanted to continue his coach journey to Poland, despite collapsing and causing great concern among his fellow passengers. His father had died a few days earlier and he was on his way home for the funeral. His chest pain could have been the result of anxiety but there were changes on his ECG and he was strongly advised to go and get it checked out, rather than risk a long journey by road. I understood him though – I would want to be at my dad’s funeral if I had been away when he died. The poor man was working in the UK and sending every penny home to his mother so now he had no cash and no means of taking the trip later on.
He signed the PRF and was allowed to go on his way – he just about caught the coach as it pulled out of the station. I hope he made it without any drama.
A 27 year-old Soho prostitute suffering palpitations took 45mg of Valium to try and calm her heart down. She already had an anxiety problem and worried that she’d taken too many. I reassured her as she sat on the step of her bed-sit home and the crew took her for an ECG which, apart from the tachycardia, was normal.
I almost made it home but I got a late job and was off to see a 57 year-old man with COPD which had suddenly become exacerbated. I knew the man and I knew he was very fragile, so I tried to give him more oxygen but he didn’t want the mask on his face. His nasal cannula was only delivering 2lpm and that wasn’t enough. I couldn’t nebulise him either because, again, he refused the mask. I cranked up his oxygen to 4lpm on his home cylinder and hoped the crew would be there quick because his sats were very low and his condition was deteriorating. He was panicking. ‘I’m going to die’ he said repeatedly.
As his anxious family stood round I tried to calm him and prepared to do what was necessary if he stopped breathing – a strong possibility in these cases. The crew arrived and he was taken to the ambulance where he relented and allowed a nebuliser to be put on him. His condition improved slightly but he was still using accessory muscles to breathe and looked ready to give up, so he was taken to hospital for further treatment.
I take people with real breathing problems seriously; the look of a person, they way they posture and behave will indicate the severity of their condition, whether we gauge that through our instruments to be serious or not depends on how we see the human being that is trapped in the desperate fight to catch a breath. Until you have been there yourself, it’s dangerous to assume that a high saturation means they are ok.
Be safe.
Monday, 24 November 2008
All fall down
Day shift: Nine calls; all by ambulance.
Stats: 6 Falls with head injuries (1 with broken nose); 1 Knee injury; 1 Hyperventilation.
This ambulance shift is with Emma and she is a good friend of mine from a few years back. Our first call is to a 45 year-old male who’s lying in the street with an ‘upset stomach’ – this was designated a Red3 and that was the description given. I get upset stomachs but I don’t believe it’s an emergency. When I arrive I realise why it’s been categorised that way; the call has come from the police.
I also know the man on the ground – he is a gel-drinking alcoholic and he can be very aggressive – not violent, just angry. He also smells very, very bad and often defecates into his trousers, leaving the mess there for days at a time. This was not the best breakfast start to the day for us.
Predictably he bemoaned his life and predictably he began to raise his voice as he became more and more frustrated with my crew mate’s questions. Emma has the patience of a saint; I don’t – so he was told to calm down and stop raising his voice.
‘I want to die’, he kept repeating, ever louder. I feel the same - the smell is overpowering at times.
When we get to hospital (police officer on board just in case) he is put into a secure room but he’s not happy at all. The last time I see him before I leave is on the CCTV monitor – he’s curled up on the sofa with a blanket around him - complaining about everything and everyone.
Our next call, soon after, is for another gel-drinker and the evidence is still on the ground next to him. A small bottle of orange, mixed with alcohol-gel is testament to his current condition. The 70 year-old man was seen to collapse and land on his head, opening it up at the back. Two helpful ladies from a nearby coffee shop tended to him until we arrived. He smelled the same as our previous patient. Perhaps the gel-alcohol gets into the urine and gives it that ‘special’ aroma. He hadn’t been incontinent, however, so it was a less stressful dilemma for the olfactory nerves.
He was semi-conscious and hypothermic (32c), so a couple of blankets, some warmed IV fluids (we don’t have a fluid warming system, so I use the ambulance heater) and a blue call to hospital were in order. By the time he reached Resus, he was a little more alert.
Then we went south to the aid of a 46 year-old man who fell in the street as a result of a ‘dodgy knee’ he’d twisted a few days before but ignored. One look at it confirmed that it was sprained at best – fractured or dislocated at worst. His leg was rotated at the knee so that it deviated from its natural line – it was obvious when he lay on the trolley bed. No wonder he’d been unable to walk on it.
We splinted it and gave him pain relief – entonox does the trick for this sort of thing. This time he would have to go and get it sorted.
We were sent on Active Area Cover (AAC)…or stand-by as we used to call it and, as if to prove a point, the next call came from just down the road. A 64 year-old female had fallen on a bus and had a head injury. AAC is fairly new and the idea, combined with call-connect, in which an ambulance (or solo) is despatched as soon as the address of the call is confirmed, is to speed up our response times to your emergency, perhaps saving one or two minutes. That’s all very nice and I appreciate that we need to be with you as soon as possible but a system based on prediction and human folly is bound to fail sooner or later. For the time being it seems to be doing its job. Either that or we are being sent to a specific location and calls are being setup for us. That’s too far-fetched and very cynical of me, I know.
Anyway, despite this wondrous technological advance, they still managed to get the wrong location and wrong bus number, so we wasted a minute trying to locate our patient in the heavy rush-hour traffic of Oxford Street. See? You just can’t knock human intervention.
The woman was fine; she’d fallen onto the back of her head when the bus braked hard to avoid hitting two kids as they darted across its path. Fair enough, the driver had to avoid the collision and maybe she should have been seated, as per the instructions for every passenger BUT I really wish he hadn’t said that he ‘broke’ hard to avoid hitting them. There was worse news for my ears, however, when the police officer attending the scene said exactly the same thing. It irritated me as much as seeing an apostrophe hanging over an S in a plural. Scottish and fussy about my English, that’s me.
We went back to Oxford Street later on to tend to an 84 year-old woman who’d tripped on a defective paving slab and fallen onto her nose. She had two hands full of shopping (and they say there’s a recession), so she was unable to stop herself landing full-force on that facial organ. ‘I heard it crack’ she said with a soft, smiley Irish tone.
The poor woman’s septum was deviated so far to the right that she looked like a prize fighter with a story to tell.
The strangest call of the day next and a FRU was on scene with an 81 year-old lady who woke up in the morning, had a bath, brushed her hair and felt something wet on her hands. She looked down and realised she was bleeding. The FRU pilot examined her and found a huge open bump at the back of her head. It looked like she’d been mugged with a cricket bat, yet she had no pain and no idea how this had occurred.
She had a GCS of 15 and all her obs, apart from her blood sugar, which was high, were normal. She wasn’t diabetic, so her BM was a little suspicious and we searched our minds for a connection. She hadn’t fallen, hadn’t been hit BUT she was taking Warfarin and that seemed to lead me to a reasonable possibility, although I needed a mechanism, like a fall or knock to the head to support it.
Obviously she was bleeding heavily from the wound and so it was dressed tightly and she was taken to hospital where no doubt higher paid people with more time on their hands would work it all out.
If you see an ambulance parked up with blue lights flashing and you are a multi-drop driver, keen to make that urgent delivery, please don’t park so close to the back of the ambulance that the crew can’t lower the ramp to take a non-walking patient on board. If the lights are flashing we are definitely working – not queuing for a coffee and cake at the local café.
A florist decided he’d unload what must have been dreadfully important plants directly behind our vehicle. He was so close that our ramp would have settled on his bonnet, had I been annoyed enough to go ahead and lower it anyway. Our patient, a lovely 85 year-old lady who’d fallen on the escalator at a John Lewis store, was being wheeled out with a head injury. To save us lifting her up the steps of the ambulance, my plan was to put the chair on the lift and gently (safely) raise her into the vehicle that way. She was unsteady on her feet, so it was the kindest thing to do. Mr Florist had other ideas and not even the sight of her having to be walked on wobbly legs made him feel guilty enough. Thank goodness we weren’t resuscitating someone.
We took the lady to hospital and she was directed to the waiting room because there were no beds. We wheeled her next to our last head injury patient, the Irish lady and they both got chatting. I suggested a game of cards.
A quick and easy hyperventilation next. A 65 year-old was having a panic attack at an art gallery and we spent no more than a few minutes calming her down after the MRU bod had started the ball rolling.
The last job came from just around the corner as we waited at hospital. A 12 year-old boy had fallen on his head. He was described as ‘dizzy’. That was under-selling it; he’d been aloft on his friends shoulders next to a busy road – they were larking about and he took a tumble onto the pavement. His tooth pierced his bottom lip, leaving a ragged tear and hole in it as he met the concrete with his face. He hadn’t been knocked out and his mates (there were a lot of them) could have walked him to the hospital but these days, everything is an emergency, right?
Be safe.
Stats: 6 Falls with head injuries (1 with broken nose); 1 Knee injury; 1 Hyperventilation.
This ambulance shift is with Emma and she is a good friend of mine from a few years back. Our first call is to a 45 year-old male who’s lying in the street with an ‘upset stomach’ – this was designated a Red3 and that was the description given. I get upset stomachs but I don’t believe it’s an emergency. When I arrive I realise why it’s been categorised that way; the call has come from the police.
I also know the man on the ground – he is a gel-drinking alcoholic and he can be very aggressive – not violent, just angry. He also smells very, very bad and often defecates into his trousers, leaving the mess there for days at a time. This was not the best breakfast start to the day for us.
Predictably he bemoaned his life and predictably he began to raise his voice as he became more and more frustrated with my crew mate’s questions. Emma has the patience of a saint; I don’t – so he was told to calm down and stop raising his voice.
‘I want to die’, he kept repeating, ever louder. I feel the same - the smell is overpowering at times.
When we get to hospital (police officer on board just in case) he is put into a secure room but he’s not happy at all. The last time I see him before I leave is on the CCTV monitor – he’s curled up on the sofa with a blanket around him - complaining about everything and everyone.
Our next call, soon after, is for another gel-drinker and the evidence is still on the ground next to him. A small bottle of orange, mixed with alcohol-gel is testament to his current condition. The 70 year-old man was seen to collapse and land on his head, opening it up at the back. Two helpful ladies from a nearby coffee shop tended to him until we arrived. He smelled the same as our previous patient. Perhaps the gel-alcohol gets into the urine and gives it that ‘special’ aroma. He hadn’t been incontinent, however, so it was a less stressful dilemma for the olfactory nerves.
He was semi-conscious and hypothermic (32c), so a couple of blankets, some warmed IV fluids (we don’t have a fluid warming system, so I use the ambulance heater) and a blue call to hospital were in order. By the time he reached Resus, he was a little more alert.
Then we went south to the aid of a 46 year-old man who fell in the street as a result of a ‘dodgy knee’ he’d twisted a few days before but ignored. One look at it confirmed that it was sprained at best – fractured or dislocated at worst. His leg was rotated at the knee so that it deviated from its natural line – it was obvious when he lay on the trolley bed. No wonder he’d been unable to walk on it.
We splinted it and gave him pain relief – entonox does the trick for this sort of thing. This time he would have to go and get it sorted.
We were sent on Active Area Cover (AAC)…or stand-by as we used to call it and, as if to prove a point, the next call came from just down the road. A 64 year-old female had fallen on a bus and had a head injury. AAC is fairly new and the idea, combined with call-connect, in which an ambulance (or solo) is despatched as soon as the address of the call is confirmed, is to speed up our response times to your emergency, perhaps saving one or two minutes. That’s all very nice and I appreciate that we need to be with you as soon as possible but a system based on prediction and human folly is bound to fail sooner or later. For the time being it seems to be doing its job. Either that or we are being sent to a specific location and calls are being setup for us. That’s too far-fetched and very cynical of me, I know.
Anyway, despite this wondrous technological advance, they still managed to get the wrong location and wrong bus number, so we wasted a minute trying to locate our patient in the heavy rush-hour traffic of Oxford Street. See? You just can’t knock human intervention.
The woman was fine; she’d fallen onto the back of her head when the bus braked hard to avoid hitting two kids as they darted across its path. Fair enough, the driver had to avoid the collision and maybe she should have been seated, as per the instructions for every passenger BUT I really wish he hadn’t said that he ‘broke’ hard to avoid hitting them. There was worse news for my ears, however, when the police officer attending the scene said exactly the same thing. It irritated me as much as seeing an apostrophe hanging over an S in a plural. Scottish and fussy about my English, that’s me.
We went back to Oxford Street later on to tend to an 84 year-old woman who’d tripped on a defective paving slab and fallen onto her nose. She had two hands full of shopping (and they say there’s a recession), so she was unable to stop herself landing full-force on that facial organ. ‘I heard it crack’ she said with a soft, smiley Irish tone.
The poor woman’s septum was deviated so far to the right that she looked like a prize fighter with a story to tell.
The strangest call of the day next and a FRU was on scene with an 81 year-old lady who woke up in the morning, had a bath, brushed her hair and felt something wet on her hands. She looked down and realised she was bleeding. The FRU pilot examined her and found a huge open bump at the back of her head. It looked like she’d been mugged with a cricket bat, yet she had no pain and no idea how this had occurred.
She had a GCS of 15 and all her obs, apart from her blood sugar, which was high, were normal. She wasn’t diabetic, so her BM was a little suspicious and we searched our minds for a connection. She hadn’t fallen, hadn’t been hit BUT she was taking Warfarin and that seemed to lead me to a reasonable possibility, although I needed a mechanism, like a fall or knock to the head to support it.
Obviously she was bleeding heavily from the wound and so it was dressed tightly and she was taken to hospital where no doubt higher paid people with more time on their hands would work it all out.
If you see an ambulance parked up with blue lights flashing and you are a multi-drop driver, keen to make that urgent delivery, please don’t park so close to the back of the ambulance that the crew can’t lower the ramp to take a non-walking patient on board. If the lights are flashing we are definitely working – not queuing for a coffee and cake at the local café.
A florist decided he’d unload what must have been dreadfully important plants directly behind our vehicle. He was so close that our ramp would have settled on his bonnet, had I been annoyed enough to go ahead and lower it anyway. Our patient, a lovely 85 year-old lady who’d fallen on the escalator at a John Lewis store, was being wheeled out with a head injury. To save us lifting her up the steps of the ambulance, my plan was to put the chair on the lift and gently (safely) raise her into the vehicle that way. She was unsteady on her feet, so it was the kindest thing to do. Mr Florist had other ideas and not even the sight of her having to be walked on wobbly legs made him feel guilty enough. Thank goodness we weren’t resuscitating someone.
We took the lady to hospital and she was directed to the waiting room because there were no beds. We wheeled her next to our last head injury patient, the Irish lady and they both got chatting. I suggested a game of cards.
A quick and easy hyperventilation next. A 65 year-old was having a panic attack at an art gallery and we spent no more than a few minutes calming her down after the MRU bod had started the ball rolling.
The last job came from just around the corner as we waited at hospital. A 12 year-old boy had fallen on his head. He was described as ‘dizzy’. That was under-selling it; he’d been aloft on his friends shoulders next to a busy road – they were larking about and he took a tumble onto the pavement. His tooth pierced his bottom lip, leaving a ragged tear and hole in it as he met the concrete with his face. He hadn’t been knocked out and his mates (there were a lot of them) could have walked him to the hospital but these days, everything is an emergency, right?
Be safe.
Sunday, 23 November 2008
Bad starts and funny bones
Day shift: Eight calls; one false alarm; one declined; six by ambulance.
Stats: 1 Knee injury; 1 RTC with minor facial injuries; 1 cardiac arrest; 1 sprained ankle; one faint; 1 fall ?cardiac; 1 fall with knee injury.
I’m doing my usual couple of shifts on an ambulance, so I have a crew mate each day and, for the first time in a while, I’m enjoying the change. Ambulance calls are much more varied; I never go to Green category calls in the FRU and I don’t do patient transfers. I also get to spend more time with my patients and that’s often the most satisfying part of the job.
My first shift is with Dave – I’ve never worked with him before but I have known him for a few years – he’s a thoroughly nice chap and totally professional.
We had a routine kind of start to our day with a 30 year-old Spanish woman who stumbled whilst running up stairs at work. She got a banged knee for her trouble and now she could barely walk on it. It was more than likely just bruised but knocks to the knees can be very painful, so I empathised with her misery and we took her to hospital.
This was followed by a 9 year-old girl who was on her way to school when she stepped out in front of a cyclist as he sped along the road. She ended up with cuts to her cheek, mouth, nose and hands. The handlebars of the bike struck her across the face and she was obviously upset. Her father had to be dragged out of bed to come to her aid when other family members called him. He was calm enough about it all but he told me that cyclists were notorious for speeding along that particular road, despite the fact that children use the route to get to and from school.
Some calls just aren’t what you expect or want in the early morning. A man had collapsed and was ‘unresponsive’ in McDonalds. We know the particular restaurant well and we know the locals who visit it, so our assumption was simple; it was a known alcoholic or drug user who’d lost himself on the floor. We would go in, wake him up and walk back out with him, arm in arm no doubt.
We walked in and I got to the man on the floor first. He wasn’t known to me and the staff members present weren’t too worried about him. A customer had a lot more concern on his face – he was the one who tried to get him to respond with no luck.
The man was on his back and he wasn’t breathing. I felt for a Carotid pulse and got a very weak, thready impulse against my fingers. He was peri-arrest.
As the equipment began to gather around his body, he arrested and his ECG showed asystole.
Nobody knew the man and there was no indication of anything untoward when he walked in. He sat down and then fell down by all accounts. The witness, who continued to help us as we started working on him, said that he’d gone to the toilet but there was no real historical information to help us work out what may have caused his sudden demise.
I asked the McD’s manager to call 999 and request a second crew (this is normal practice) and off he went. We continued to go through the sequence of actions needed to save the man’s life; CPR, drugs and more CPR but his rhythm didn’t change and no shocks were given.
The crew arrived but seemed completely surprised by what they were seeing. The paramedic told me that they had been given this as a ‘second patient’, so they thought they were simply coming to assist with another casualty. Right from the start, the verbal communication of what was going on in that restaurant was inaccurate. I even had to request that they clear everyone from the basement area because people were still munching their breakfast buns as we jumped up and down on the man’s chest. Then I had to ask for the cheery music to be switched off because a) I couldn’t hear the defib above it and b) it was entirely inappropriate and was cheering nobody up.
If you are a McD employee, please do a first aid course and learn how to relay messages. No offence if you are already switched on but it is all about communication.
We stayed on scene trying to stabilise the patient but nothing changed, so we blued him in and the work continued in Resus. Unfortunately, he was pronounced after twenty minutes and still nobody knew why he’d gone. He was only in his forties.
Green calls can wait a while before any help arrives and our next patient, a 19 year-old Danish girl had to endure two hours with a badly sprained ankle at the hotel in which she works. A heavy drawer cabinet was being pushed past her but the clumsy maintenance man failed to realise that an obstruction to his path was the young lady’s foot, so he pushed harder to clear it. She twisted herself to get free of it and damaged her joint in the process.
We arrived to find her sitting, leg raised, behind reception. She wanted to go by taxi but the hotel management decided an ambulance would be better. Not really…she would have been in A&E faster by cab.
She was a pleasant, chatty girl with excellent English and a love of texting that kept her pre-occupied during the journey to hospital. Opposable Thumb Psychosis I call it.
Comical calls are few and far between and the 999 request for a cancer patient who was not answering his door and was seen in bed not moving by a worried neighbour turned out to be one of those things. A MRU colleague was on scene with police and the door was being forced. The patient could apparently be seen in bed through a little window but he cared not for the commotion outside his door…apparently. When the door broke I went into the bedroom and approached the bed. A quilt was wrapped in a roll and I braced myself for the purple body it contained. Then I lifted it and saw…the sheet underneath. The bed was empty. Nobody was home and now the poor guy was going to return home to a smashed door. The police would inform him and he’d get a replacement but it would be a shock.
The shaken and very pale neighbour waited outside and fully expected us to come out shaking our heads in that ‘there’s noting we can do for him’ way but the shakes were contrary to his fears and we quickly reassured him that he’d done the right thing. Even I was convinced up to a point.
A 73 year-old lady declined to go to hospital when she fainted three times in a busy department store. ‘I’ve been fainting all my life’ she told me. We did all the necessary checks and pronounced her fit and well. She’d fainted, got up too fast, fell down again and repeated that action once more for the benefit of the worried staff who were lovely with her throughout.
Another elderly fainter was an 81 year-old man who tripped in the street, fell, was helped up and then passed out further down the road. He had a head injury and was confused about what had happened, although he had a clear memory of the events leading up to it. His ECG revealed a possible heart block and that would certainly explain the falls. We took him to hospital and his wife joined him a few minutes after we arrived. She looked resigned because, although he had told me this had never happened before, she told me that it had…several times.
Last call of the day and it was a cyclist who fell off her bike. She had a painful leg and when I examined it the bone seemed to be protruding. In fact, when I touched the area it clicked back into place and she got instant pain relief. She told me that this bone had done the same thing before but the location of her ‘loose bone’ was high up on her tibia, near the knee. Unless she was born with a deformity or the bone has been broken for a while, the movement was quite unnatural.
By the time we arrived in hospital the pain was virtually gone but she still couldn’t put weight on it. Good idea not to, I think.
Be safe.
Stats: 1 Knee injury; 1 RTC with minor facial injuries; 1 cardiac arrest; 1 sprained ankle; one faint; 1 fall ?cardiac; 1 fall with knee injury.
I’m doing my usual couple of shifts on an ambulance, so I have a crew mate each day and, for the first time in a while, I’m enjoying the change. Ambulance calls are much more varied; I never go to Green category calls in the FRU and I don’t do patient transfers. I also get to spend more time with my patients and that’s often the most satisfying part of the job.
My first shift is with Dave – I’ve never worked with him before but I have known him for a few years – he’s a thoroughly nice chap and totally professional.
We had a routine kind of start to our day with a 30 year-old Spanish woman who stumbled whilst running up stairs at work. She got a banged knee for her trouble and now she could barely walk on it. It was more than likely just bruised but knocks to the knees can be very painful, so I empathised with her misery and we took her to hospital.
This was followed by a 9 year-old girl who was on her way to school when she stepped out in front of a cyclist as he sped along the road. She ended up with cuts to her cheek, mouth, nose and hands. The handlebars of the bike struck her across the face and she was obviously upset. Her father had to be dragged out of bed to come to her aid when other family members called him. He was calm enough about it all but he told me that cyclists were notorious for speeding along that particular road, despite the fact that children use the route to get to and from school.
Some calls just aren’t what you expect or want in the early morning. A man had collapsed and was ‘unresponsive’ in McDonalds. We know the particular restaurant well and we know the locals who visit it, so our assumption was simple; it was a known alcoholic or drug user who’d lost himself on the floor. We would go in, wake him up and walk back out with him, arm in arm no doubt.
We walked in and I got to the man on the floor first. He wasn’t known to me and the staff members present weren’t too worried about him. A customer had a lot more concern on his face – he was the one who tried to get him to respond with no luck.
The man was on his back and he wasn’t breathing. I felt for a Carotid pulse and got a very weak, thready impulse against my fingers. He was peri-arrest.
As the equipment began to gather around his body, he arrested and his ECG showed asystole.
Nobody knew the man and there was no indication of anything untoward when he walked in. He sat down and then fell down by all accounts. The witness, who continued to help us as we started working on him, said that he’d gone to the toilet but there was no real historical information to help us work out what may have caused his sudden demise.
I asked the McD’s manager to call 999 and request a second crew (this is normal practice) and off he went. We continued to go through the sequence of actions needed to save the man’s life; CPR, drugs and more CPR but his rhythm didn’t change and no shocks were given.
The crew arrived but seemed completely surprised by what they were seeing. The paramedic told me that they had been given this as a ‘second patient’, so they thought they were simply coming to assist with another casualty. Right from the start, the verbal communication of what was going on in that restaurant was inaccurate. I even had to request that they clear everyone from the basement area because people were still munching their breakfast buns as we jumped up and down on the man’s chest. Then I had to ask for the cheery music to be switched off because a) I couldn’t hear the defib above it and b) it was entirely inappropriate and was cheering nobody up.
If you are a McD employee, please do a first aid course and learn how to relay messages. No offence if you are already switched on but it is all about communication.
We stayed on scene trying to stabilise the patient but nothing changed, so we blued him in and the work continued in Resus. Unfortunately, he was pronounced after twenty minutes and still nobody knew why he’d gone. He was only in his forties.
Green calls can wait a while before any help arrives and our next patient, a 19 year-old Danish girl had to endure two hours with a badly sprained ankle at the hotel in which she works. A heavy drawer cabinet was being pushed past her but the clumsy maintenance man failed to realise that an obstruction to his path was the young lady’s foot, so he pushed harder to clear it. She twisted herself to get free of it and damaged her joint in the process.
We arrived to find her sitting, leg raised, behind reception. She wanted to go by taxi but the hotel management decided an ambulance would be better. Not really…she would have been in A&E faster by cab.
She was a pleasant, chatty girl with excellent English and a love of texting that kept her pre-occupied during the journey to hospital. Opposable Thumb Psychosis I call it.
Comical calls are few and far between and the 999 request for a cancer patient who was not answering his door and was seen in bed not moving by a worried neighbour turned out to be one of those things. A MRU colleague was on scene with police and the door was being forced. The patient could apparently be seen in bed through a little window but he cared not for the commotion outside his door…apparently. When the door broke I went into the bedroom and approached the bed. A quilt was wrapped in a roll and I braced myself for the purple body it contained. Then I lifted it and saw…the sheet underneath. The bed was empty. Nobody was home and now the poor guy was going to return home to a smashed door. The police would inform him and he’d get a replacement but it would be a shock.
The shaken and very pale neighbour waited outside and fully expected us to come out shaking our heads in that ‘there’s noting we can do for him’ way but the shakes were contrary to his fears and we quickly reassured him that he’d done the right thing. Even I was convinced up to a point.
A 73 year-old lady declined to go to hospital when she fainted three times in a busy department store. ‘I’ve been fainting all my life’ she told me. We did all the necessary checks and pronounced her fit and well. She’d fainted, got up too fast, fell down again and repeated that action once more for the benefit of the worried staff who were lovely with her throughout.
Another elderly fainter was an 81 year-old man who tripped in the street, fell, was helped up and then passed out further down the road. He had a head injury and was confused about what had happened, although he had a clear memory of the events leading up to it. His ECG revealed a possible heart block and that would certainly explain the falls. We took him to hospital and his wife joined him a few minutes after we arrived. She looked resigned because, although he had told me this had never happened before, she told me that it had…several times.
Last call of the day and it was a cyclist who fell off her bike. She had a painful leg and when I examined it the bone seemed to be protruding. In fact, when I touched the area it clicked back into place and she got instant pain relief. She told me that this bone had done the same thing before but the location of her ‘loose bone’ was high up on her tibia, near the knee. Unless she was born with a deformity or the bone has been broken for a while, the movement was quite unnatural.
By the time we arrived in hospital the pain was virtually gone but she still couldn’t put weight on it. Good idea not to, I think.
Be safe.
Thursday, 20 November 2008
Remote control
A few months ago I was promoted to the role of Clinical Support Advisor (CSA). This is an off-the-road position and I’m proud to be part of the small team that mans the desk in Control 24 hours a day, 7 days a week. The role involves giving advice to crews and Control staff on protocol, guidelines, drug use and many other aspects of the job.
I work on this desk as and when I can and have so far found it to be very different to my ‘normal’ routine in that advising from a remote position can be a lot more difficult than being on scene. On one call a crew requested support in making a decision not to resuscitate a terminally ill patient who was about to go into cardiac arrest at home. Her family were adamant that no action should be taken to revive her and I waited on the line as the lady stopped breathing and eventually slipped away in bed. This sort of decision, as you know, is difficult for me because my instinct, like that of the crew on scene, is to carry out my perceived duty of care but it was somehow easier to deal with the problem from afar; the facts of the matter were clearer because I wasn’t in the unenviable position of having to feel the emotions within the environment.
The role is one of support and not superiority over crews and I’m comfortable with that – the decision-making process is faster and needs to be 100% accurate because the CSA’s head is on the block if the wrong advice or information is given to colleagues, so in that respect, we risk losing our jobs on a more frequent basis. Having said that, we too have a line of support if we are unsure and can refer a query further up until it reaches our Clinical Director.
Watching calls coming in and listening to how they are handled by the call-takers gives me another perspective and it’s healthy for me because I can see both points of view. I can also see how badly the system fails us when a patently obvious medical problem is overlooked by the press-button processes and how innocuous or just-plain-stupid calls are blown out of proportion and turn Red as the computer decides to panic. The CSA’s can upgrade or downgrade calls at the touch of a button but only if we can justify doing so…and we’d better be right.
I also hear the abuse levelled at the call-takers on ‘the nines’ – angry people, sometimes understandably, simply don’t realise that questions have to be asked and that time is needed to complete the data input. An ambulance will be on its way but a lack of information is one of the reasons my colleagues and I complain when heading to vague calls. This is the root of it all; quality of input and that’s mostly down to the caller. Although there will probably never be an answer to the human issue of 999 frustration, this blog and the others that exist should go some way to educating the public about the way their emergency system works.
Have a read at Nee Naw and other despatcher blogs for more insight.
Be safe.
I work on this desk as and when I can and have so far found it to be very different to my ‘normal’ routine in that advising from a remote position can be a lot more difficult than being on scene. On one call a crew requested support in making a decision not to resuscitate a terminally ill patient who was about to go into cardiac arrest at home. Her family were adamant that no action should be taken to revive her and I waited on the line as the lady stopped breathing and eventually slipped away in bed. This sort of decision, as you know, is difficult for me because my instinct, like that of the crew on scene, is to carry out my perceived duty of care but it was somehow easier to deal with the problem from afar; the facts of the matter were clearer because I wasn’t in the unenviable position of having to feel the emotions within the environment.
The role is one of support and not superiority over crews and I’m comfortable with that – the decision-making process is faster and needs to be 100% accurate because the CSA’s head is on the block if the wrong advice or information is given to colleagues, so in that respect, we risk losing our jobs on a more frequent basis. Having said that, we too have a line of support if we are unsure and can refer a query further up until it reaches our Clinical Director.
Watching calls coming in and listening to how they are handled by the call-takers gives me another perspective and it’s healthy for me because I can see both points of view. I can also see how badly the system fails us when a patently obvious medical problem is overlooked by the press-button processes and how innocuous or just-plain-stupid calls are blown out of proportion and turn Red as the computer decides to panic. The CSA’s can upgrade or downgrade calls at the touch of a button but only if we can justify doing so…and we’d better be right.
I also hear the abuse levelled at the call-takers on ‘the nines’ – angry people, sometimes understandably, simply don’t realise that questions have to be asked and that time is needed to complete the data input. An ambulance will be on its way but a lack of information is one of the reasons my colleagues and I complain when heading to vague calls. This is the root of it all; quality of input and that’s mostly down to the caller. Although there will probably never be an answer to the human issue of 999 frustration, this blog and the others that exist should go some way to educating the public about the way their emergency system works.
Have a read at Nee Naw and other despatcher blogs for more insight.
Be safe.
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