I’m on nights this week and it has been CRAZILY busy. Usually, the East Central is dead by 2am on a week night. This week, I’ve still been juggling a screen full of calls at 5am.
So what do you think is responsible for the increase in call rate? Drunken people enjoying the good weather? Swine flu? No, it’s the pollen count. Our screens are full of young people having “severe difficulty in breathing”, brought on by hayfever. It’s the first time I can remember this happening, and from a Control point of view, it’s hard to tell how serious these calls are. Some people are undoubtedly calling just for bog standard hayfever symptoms, and as a sufferer myself I know how horrible that “pins in eyes, feathers in throat, corks up nose” feeling is, but I wouldn’t call an ambulance from it. On the other hand, in some cases, the hayfever triggers a full blown asthma attack and the patient really does need us.
In other news, our control room is being refurbished at the moment. They are ripping out all the desks and making them point in different directions. This means we keep getting moved around to different rooms, no one knows where any of the other desks are and management have not been seen for several days. The highlight of last night’s shift was finding a big box of Christmas Belgian biscuits in a hidden cupboard when they dismantled the East Central desk. We ate the lot.
A few weeks ago, a two-year-old boy was killed when he was hit by a rollercoaster after accidentally wandering on to the tracks. You may have heard about it in the media. This didn’t happen in my sector, but on the desk opposite, so while I was getting on with my work, I kept picking up snippets of information across the room.
“It sounded awful,” said one of the call takers. “Everyone was screaming. I couldn’t get any sense out of anyone.”
“DSO’s on the phone,” announced the radio op. “He says HEMS are working on him but it’s not looking good. Crews are going to have to go off the road afterwards. The FRU paramedic is really upset. Sounds like a really awful call.”
Seconds later, I had my own call to worry about. A tipsy teenage boy had fallen down a river embankment. His friends couldn’t reach him, but they could see that he was unconscious and had blood trickling from his ear. They couldn’t tell if he was breathing.
As we sent the crew, we asked them to report for HEMS, even though we knew HEMS were the other side of London, dealing with a critically ill toddler. We hoped they’d say HEMS weren’t needed, because there is only one HEMS team and they can’t be in two places at once.
“Perhaps it’s not as bad as it sounds,” said the radio operator dubiously. “He could just be drunk and it could be a scratch on his face. It could turn out to be nothing. Do we know how far he fell?”
I fired up the new “street view” thing on Google maps to get a better look at the river bank in question. Of course, Google probably didn’t intend their map system to be used for this purpose, and there wasn’t a good close up of the riverbank, but I could clearly make out that the river was well below street level and that there was a set of stairs leading down to it. It looked to me that it could be at least a fifteen-foot drop.
The crew arrived and found the stairs we’d seen on the map. As they arrived, the boy was coming round but was extremely confused and cerebrally irritated, lashing out at anyone who tried to come near him. This kind of behaviour (which is sometimes hard to distinguish from alcohol induced aggression) is indicative of a life threatening brain injury. The crew called up for assistance. They needed someone, anyone, down there to help them restrain the boy in order to treat him, and they really needed the help of the HEMS doctor. We sent the police and another ambulance crew…
The phone rang. It was the DSO.
“We heard the crew on the radio. HEMS have done all they can here; the toddler’s on his way to hospital, so they’re coming to you now. Where exactly is the call?”
I told him, and the HEMS team got in the car (the helicopter does not fly at night) and belted it across London. They were at the riverbank in fifteen minutes. They were able to sedate the boy and get him on board the ambulance.
As they got him to hospital, he went into respiratory arrest. The A+E staff all battled to save him, but it was no good. It’s likely he had fractured his skull and had a serious bleed into his brain, and if this was the case, nothing anyone did would have saved him.
Now both the toddler and the teenager were dead.
The next morning the papers were full of stories about the tragedy of the toddler and the fairground ride. Not one mentioned the teenager or the river bank.
I like old people, so I have a tendency to think they are all sweet and nice and try to send ambulances to them as quickly as possible.
The other day, we had a call to a seventy-two year old female with a nosebleed. I decided to send the ECP (Emergency Care Practitioner) – a paramedic in a car who has extra training, and can deal with a lot of calls at home. The ECP will always perform a full set of checks on the patient before deciding whether to call for an ambulance or leave the patient at home and perhaps refer them to a GP, district nurse, etc.
The ECP had been at the old lady’s house no longer than a couple of minutes when he rang me.
“I’ve had to leave!” he puffed. “I thought she was going to attack me?”
“The seventy two year old with a nosebleed?!” I said, confused.
“Yes!” said the ECP. “I turned up and she was there with her bag packed – and no hint of a nosebleed except a slightly bloodied tissue. I explained that I needed to examine her properly before we were going anywhere and that she might not even need to go to hospital, and she went crazy! She told me to Foxtrot Oscar, and when I tried to explain, she came at me! So I ran away and locked myself in the car!”
I don’t know what our ECP looks like, but he sounds like a strapping young man and the thought of him running scared from a septuagenarian almost made me titter as I made sure he was okay and assured him he wouldn’t have to return to the address and we would make alternative arrangements.
I wasn’t laughing five minutes later, though. Incensed by the fact that the ECP hadn’t done as she asked, the elderly lady in question had rung back twice and sworn at two call takers and one of the Telephone Advice paramedics. Not content with this, she had also rung NHS Direct, her GP, her careline, the complaints department and her local MP to complain. All of the above, with the exception of the MP, had rung in to find out what was going on. (I do not know why people always threaten to tell their MP when they do not like something the ambulance service has done. I have seen no evidence that any MP is remotely interested.)
I had no option but to send an ambulance crew to her to take her to hospital. I warned the crew what had happened to the ECP and asked if they wanted the police or a DSO (manager) to help them.
“Nah, I think we can just about outrun a 72 year old if she gets nasty!” said one of them.
The crew also had no success in examining the patient and decided to cut their losses and ferry her to the hospital, just as she’d asked.
At the hospital, the receptionist told our charming patient that there would be a three hour wait to be seen. She promptly muttered something about complaining to Gordon Brown and stormed out.
The hospital she was taken to was right next to her local shops. If I were the cynical type I might suggest this was behind her rather odd behaviour.
(This post will probably be boring if you do not work for the LAS, so please scroll past if you like!)
The East Central desk are seriously persona non grata with the East Central Ambulance Crews at the moment. No one wants to bring us Percy Pigs, in fact we barely get a grunt from some of the crews when they answer the phone. We are The Enemy, a bunch of saddos whose purpose in life is to make crews’ lives difficult. What have we done? Well, basically, we’ve been checking up on their every move. For instance, if a crew is at hospital for longer than 30 minutes, they get a message telling them asking them exactly what the delay is. If they are trying to avoid their rest break (to get their £10 missed break payment or an early finish), we have to report them to their managers. Not only are we watching the crews’ every move, our managers our watching us, so if we miss something, it’s not just the crew concerned who get in trouble - we get in trouble for letting them. So I’m there banging out the messages: “Report delays!” “Return for rest break!” “Go out on Active Area Cover!” I occasionally give out the odd emergency call, too…
The trouble is that contrary to popular belief, ambulance crews are adults. They don’t like being told when to take their lunch and they don’t like being told they can’t hang around the hospital for a five minute cuppa after they’ve booked their patient in. The more we treat them like children, the more they act like them. They twiddle their statuses, drive round in circles and backchat to us on the radio. In turn, we get irritated with them and think “well, if they’re going to be like THAT they are DEFINITELY getting their rest break. And then I will send them to Horace Halfpenny! Hahaha.” But crews don’t play up if we just let them get on with their job without all those annoying messages. Well, some of them do, but the bad apples stick out like sore thumbs, and I have no hesitance in reporting a crew who are genuinely slacking off. The rest of them are just playing up because they feel their professionalism is being called into question, and I can see their point. I also think that whoever thought of giving crews a £10 bonus (sorry, compensatory payment) for avoiding their lunch break is a complete idiot. Most people would gladly skip their lunch for a tenner, so what did they expect?
The sad thing is that there’s a real sense of “us” and “them” at the moment and it’s counterproductive, because we need to work together. I need the crews on side when I want them to do me a favour (work late to cover a call I that I really don’t want to keep waiting, for example). The more we annoy the crews, the more they annoy us, the less gets done and the worse service we provide to patients.
I propose that to solve this problem, we abolish all the current LAS targets and bring in a new rest break system where all crews get a break that they actually want. Who cares whether we meet all Cat A calls in 8 minutes when it is proven that most of the time they are not even life threatening? Who cares if all your crews get a break if they all claim “dirty uniform” and go home early anyway? Can’t we count the number of lives saved and the number of patients satisfied with the service we provide? Making a real difference to patients is an achievement, meeting an arbitrary target is not.
And while I am on the subject of regular callers, an update on some of the others who I have previously mentioned on this blog.
Horace Halfpenny, the exceedingly unpleasant man with protruding bowels who cheated death after setting fire to his new flat while he was in it, has not been seen for some time. He has moved on from the hostel in my sector where he was staying and hopefully is somewhere deep in the South West where my poor crews don’t have to get abused by him.
Ben Higginbotham, the aggressive depressive who likes to ring us to talk about Neighbours and Hollyoaks but turns nasty when the crew arrive, has been ringing a lot lately to ask us to contact his mother for him. One of the paramedics told us that his mother has, in fact, been dead over a year. I felt sorry for him – but my sympathy declined swiftly when he later threatened a paramedic with a scalpel.
Jimmy Smirnoff, the charming young alcoholic, has not been too well after two recent life threatening overdoses. Out of all our regulars, he is the one I think about the most and I really hope he pulls through.
Bananaman, the disabled teenager who put every call taker in the room through months of sheer hell by calling up to 200 times a night offering us bananas and telling us that his penis was itchy was never prosecuted (much to my annoyance) but HAS stopped calling (much to my relief, especially as the “address” he gave is in my new sector). Apparently Social Services have intervened and his social worker brought him to the control room to show him what we do and to make it more “real” to him. While I applaud this approach, I think if I had known he was coming I might have been forced to purchase a large bunch of bananas and chase him round the room with them. Angry Allocators do not forgive and forget easily.
Today’s tube strike in London made me really, really angry.
It wasn’t the fact that I had to get up at 4.30am and sit on a dirty, stinking nightbus just to get to work on time. It wasn’t the fact that at the end of my twelve hour shift, I had to walk the two miles to Liverpool Street to catch the overground train home. It wasn’t the fact that my arduous journey meant that I missed the start of the England football match. It wasn’t even the fact that the tube workers could all be watching said football match from the comfort of their local pub with loads of beer, safe in the knowledge they don’t have to get up for work tomorrow.
No, none of those things were what made me REALLY angry.
What made me really angry was the fact that by rush hour, the streets of central London - the streets that my ambulances need to get to critically ill people - were utterly gridlocked with people trying to get to work. There was just so much traffic that no one was going anywhere - not even an ambulance on blue lights and sirens. While people tried to get out of the way and the drivers are permitted to break the rules of the road when on lights, there just wasn’t room for the crews to get through. And, of course, ambulances are only supposed to use blue lights when they are on way to a call or when a patient whose condition is life threatening is on board. It took one of my crews AN HOUR AND A HALF to take an assault victim from the scene of the crime to the local hospital - a journey which should have taken around fifteen minutes.
It would only have taken one call for the tube strike to end in disaster for us. A car accident we couldn’t cover, a cardiac arrest we couldn’t reach. We do have motorcycles, bicycles and cars that can get into tight spots, but anyone in a life threatening condition needs hospital, and for that you need to be able to get an ambulance to them. I watched my screen and held my breath, crossing my fingers and praying that nothing would happen in those gridlocked areas.
It was my lucky day. Nothing did. We got ambulances to all the calls without too much delay, and the delays in getting to hospital were an inconvenience rather than a disaster. But it could have been different. And this is why the tube strike made me very very angry, and why I have absolutely no sympathy with the tube workers and in fact hope they DON’T get their pay rise. If anything, they should be penalised for inconveniencing and endangering the public.
(Sidenote. In the midst of the chaos, a man committed suicide by jumping in front of a train. I wonder if he got a certain bitter pleasure by putting a halt to one of the few means of transport remaining - a final two fingers up at the world - or if he was so disturbed he merely found the tube strike an inconvenience because there weren’t many trains to jump under. Either way, there is a certain irony about a “one under” in the middle of a tube strike.)
A comment on my last post inspired me to tell you about another of our regular callers.
George Lennon is in his forties. He’s an alcoholic who is prone to fits. He’s also prone to calling up when there is nothing wrong with him, and equally prone to telling the ambulance crew who have rushed over on blue lights to tend to him to Foxtrot Oscar. He is far more likely to let crews in if they are female. George likes the ladies. He likes them so much that he likes to snap them with his mobile phone and then print the pictures off and stick them on his wall. When one paramedic objected to this, he offered to let her take his photo too. She obliged, and now there’s a picture of George’s grinning face pinned to the noticeboard in the ambulance station mess room.
George has never been anything but delightful to me. He is less polite to my male colleagues, so maybe it is a good job that I am not really Mark Myers. Often, when George calls, we ring him back to gauge his mood (to help the crew decide if they need the police’s assistance – he’s never hit any of the crews but sometimes he looks like he’s just about to) and often just the sound of a female voice is enough to make George happy and make him cancel the ambulance. He calls us all “angels” and has asked me to marry him twice. I said I’d think about it. It’s the best offer I’ve had in some time.
George rarely travels to hospital and has never been blued in while I’ve been on duty. As far as I knew, there was nothing much wrong with him except a somewhat excessive love of the bottle.
Well, I was wrong. A comment on my last post, from one of the ambulance crews in George’s area, informed me that George recently suffered an out of hospital cardiac arrest. Against all the odds, he survived, but it could happen again at any time.
I’m halfway through Tom Reynolds’ new book, and a post where he talked about his regulars really struck a chord with me. As you know, since February I have been the allocator for the area where Tom works – but I didn’t recognise any of the individuals he talked about. Then I got to the bottom of the entry, where Tom explained that since he originally wrote the post a couple of years ago, they’d all died. I am coming to realise that this is the inevitable end of the story for so many of the regulars I have become fond of, and it makes me sad. Because we get so many calls from the regulars, plenty of which are not medical emergencies, it is easy to shrug them off and think there will never be anything seriously wrong with these people. But really, they are more vulnerable than the people we do not regularly hear from, and there will come a day when they stop calling and disappear from our view, and we can only guess what has happened – that they too have died.
I hope George is okay.
One of the paramedics told me that Enid Whiner, one of our sector’s most frequent callers, passed away in hospital some time in the last few weeks.
I hope this doesn’t make me sound cold-hearted, but my first reaction was one of relief. There were two scenarios involving Enid that I have been dreading since I moved to this section - one, that she’d be seriously ill at home and I wouldn’t take her call seriously and end up in Coroner’s Court explaining how my actions lead to her death, or two, that one day I’d send my last ambulance to her and contribute to someone else’s death and end up in Coroner’s Court explaining THAT decision.
On the other hand, I wish we’d found a better way of tackling Enid’s issues before she died. She may have died comfortably in hospital without causing any noticeable averse incidents, but there’s bound to be another Enid at some point, and what will we do then?
At least the pillow plumping services of our ambulance crews helped make a frail old woman’s last months a little more comfortable. That is a small consolation.
It was the middle of a boring, quiet midweek nightshift and one of our crews requested a service run to a nearby 24 hour garage. (A service run is when an ambulance leaves its normal area to run an errand of some variety. They are still available for calls.)
“No wonder they want to go to that one,” I remarked. “It’s got a Marks and Spencer’s Simply Food! I bet they’re after Percy Pigs.”
“I want some Percy Pigs!” said the radio op.
“So do I!” I said, rubbing my empty stomach.
“G602, your request for a run to the fuel station is granted,” said the radio op. “But only if you pick us up some Percy Pigs while you’re there. Over.”
We all giggled at her joke, mainly the fact she’d said “Percy Pigs” over the air.
A bit later on in the night, the same crew requested a service run to headquarters to “drop off some important admin”. We agreed - it wasn’t busy and we had plenty of cover in our sector.
“What important admin can an East Central crew possibly want to do at Waterloo at 4 o’clock in the morning?!” grumbled Management.
Fifteen minutes later, the crew marched into the control room and placed two huge bags of Percy Pigs on our desk! We couldn’t believe it! We’d only been joking and they had actually bought us the sweets and driven halfway across London to deliver them! I love ambulance crews sometimes!
Five minutes after they arrived, before we’d even had a chance to thank them (or share the Pigs with them), the South East desk received a call to a cardiac arrest just down the road from Control. Fortunately, G602’s Pig Run had put them in just the right place to reach the call quickly, and off they went. The patient was blued into hospital, and if he lives, it’ll be entirely down to those Percy Pigs.
Tomorrow morning I’m braving the pouring rain to run 5km round Regents Park for the Race For Life. I do this every year but it’s the first year I’ve been able to mention it on my blog - Race For Life is for women only and Mark Myers wouldn’t have been allowed to run!
Cancer Research is a charity I support because I know many people who have been affected by cancer. My dad died from cancer when I was seven and my friend Lisa died from cancer almost exactly one year ago. More cheerfully, my grandfather has just beaten cancer for the third time and is back out dancing again, despite being nearly ninety.
If you can spare a few quid to sponsor me, I’d be really grateful. You can donate online here.
In other news, I’ve just finished a block of nightshifts and have the next two weeks off to finish the first official draft of the book! Hopefully I should have time to make a few posts which I have been saving up too.
Dear Management
Unfortunately I am unable to come in for my night shift tonight. I am too upset about Katie and Peter’s break up. I have lost all faith in true love, not that I ever had much in the first place and need to spend the evening snivelling in front of repeats of Katie and Peter: The Next Chapter.
Love
Suzi Nee Naw (East Central Desk)
Here - thanks Elliott! - is one of the last pictures of Katie and Peter together - and THAT bandage.
(I will write something about ambulances again soon, honest. This isn’t turning into a Jordan blog!)
Some of you may know that I am a huge fan of Katie Price, aka Jordan. I have all her books, an underwear set and the exercise video. I even had a pet mouse called Jordan at one point. Some people think she is a rather odd choice of idol for me, because we couldn’t be more different (eg: She wears glamorous frilly knickers for work, I wear ill fitting bottle green combats. She is a wife and mum, I am a confirmed child free singleton. She fancies Peter Andre, I don’t. Etc.) but I think that is the whole point. I don’t look up to people who are like me because I am already the best at being me! I think Katie is a fascinating, bright and extraordinary person and I admire the way she just gets on with everything and always has a smile on her face. She can get away with anything because she just has that certain something - her wedding dress and her old breast implants, for instance, would have looked ridiculous on anyone else, but Katie can pull it off simply because she is Katie. Or because she is Jordan.
Anyway, you may have wondered what all this has to do with ambulances. Well, on Sunday I was first aiding at the London Marathon with St John Ambulance, as I do every year. But this year I was extra keen because I knew Katie and Peter were running and I hoped to be able to catch a glimpse of them.
Hours passed, Vaseline was handed out, runners vomited pure Lucozade in my direction, people collapsed, and still there was no sign. We’d been so busy dealing with casualties that I couldn’t be sure if they’d passed or not. I updated my Twitter feed desperately: No sign of Jordan.
Then suddenly, I was standing at the barrier admiring the fancy dress costumes, when a lady ran up to me and said “Excuse me, would you mind putting some strapping on Katie Price’s knee?”
“Strapping knees, no problem…” I began. “Sorry, whose knee?!”
And suddenly, there she was, resplendent in an orange t-shirt, with Pete wrapping a protective arm round her shoulder. Katie Price, limping towards our treatment station. Oh my god!
“Katie, over here!” I said, as if she was an old friend. “Just take a seat and we’ll get your knee strapped up.”
(Internal monologue: Must be cool. Must not tell her that I think she is wonderful. Must not mention that I named my pet mouse after her. Be professional at all times.)
“Thanks,” said Katie (oh my god - she spoke to me). “I think you’ll need to cut through my leggings.”
I got out my tuffcuts. And then I paused. I couldn’t defile Katie Price by cutting through her leggings! But she insisted, and I snipped away. Oh crikey, I was touching Katie Price herself! I would never wash my hands again! I would frame the tuffcuts!
“Oh no! I haven’t shaved my legs!” exclaimed Katie.
“They look fine to me,” I said, which would probably sound really sleazy if I was a bloke, but I think I got away with it.
Then I got out a bandage and presented it to a nearby doctor who obliged in bandaging Katie’s poor sore knee and prodding and poking her a bit. Meanwhile, my colleague Jayne was interrogating Peter Andre, who was jogging on the spot behind me, about his tattoos. I noticed that he had “Jade” written on his arm in eyeliner.
Katie was determined to carry on, despite the fact that her knee was killing her, so off they went, with all the St John Ambulance people wishing them well.
So if you see pictures of Katie finishing the marathon with a bandage on her knee, just think, “That’s Suzi Nee Naw’s bandage, that is.”
Just as I was preparing to leave work, there was a serious stabbing on my patch. The HEMS team sent the helicopter. I explained what was going on to the night turn allocator, and set off on my way home.
Just as I was leaving the building, I heard a loud whirr overhead and looked up to see HEMS flying low above me. My first thought is “Oh, I wonder where it’s going?” Then I remembered, of course, it was going to MY call. The call I’d handed over less than five minutes ago.
It’s funny, when you leave the building, you hand over the calls and the ambulances to the next person and you forget the world you are walking out into is the same world that you’ve been sending crews out into all day. Sometimes you switch off too well when you leave and forget that it’s still all going on. Of course, sometimes I don’t switch off as well. Occasionally I wake up in the middle of the night in a blind panic because I think I’ve fallen asleep at my desk and that no one has been watching the screen. Then I remember I am in bed and there is no screen.
HEMS must have finished with the stabbing by now. I wonder if the boy is alive?
The other day I was very kindly invited to join one of our local FRUs (ambulance car) for a day shift. I was, of course, fishing for juicy stories for the book, but sod’s law decided to strike and predictably nothing of the sort happened. Still, we had a busy day and I learned a lot about FRUs and what they are useful for, which will be very useful for allocating - for the last few weeks, the sector allocators (ie. me) have been responsible for allocating FRUs. Previously, they had their own desk and allocators and I don’t mind admitting that my use of them has been a trifle hit and miss.
We started the day with three little old ladies and two little old men who had some combination of chest pain, difficulty breathing and confusion. Only one of these turned out to be seriously ill - a lady in her sixties with a suspected stroke. She was practically unconscious (she resisted when we tried to open her eyes, but that was it), breathing very oddly and doing something very peculiar with her tongue. When the crew arrived, they took one look at her and said “Okay, let’s go”. I think they thought she was about to go into cardiac arrest. She didn’t though - they blued her into the hospital and we later found she had gone for a brain scan and been transferred to a ward.
While we were on this call the other FRU from our station got sent on a working suspended (ie. a cardiac arrest that they try to resuscitate). Typical!
Next followed the ubiquitous sunny day call - “Male collapsed in road, ? intoxicated”. We went to the location given, and like on many of these calls, there was no sign of the caller and no sign of the patient either. We were about to give up and go when suddenly we spotted a pair of feet sticking up over a low wall. On closer inspection, the feet belong to a youngish male who was asleep in the bush behind the wall.
“Wake up, wake up!” said Samantha, the FRU technician I was with. “What are you doing in the bush?”
The man woke up, looked disorientatedly around and then muttered. “I drunk. I sleeping. Please leave me.”
“You can’t sleep here!” Samantha told him. “If you won’t move we’ll have to call the police. People think you are dead.”
The man tutted and reluctantly accepted our assistance to get him sitting up on the wall. Shortly afterwards, his friend came to remove him. We cancelled the ambulance.
Then it was on to a 30something woman with backache which had come down as a “severe difficulty in breathing”. I suspected this call was not quite the life threatening emergency that it was cracked up to be and I was right. This was proved by the fact that a) the patient kept saying “I know I ain’t dying or nothing, but…” and “I’m not having difficulty breathing” b) the way her “concerned” relatives were sitting on the sofa opposite with a copy of “Love It” discussing Jade Goody’s funeral.
The day ended inauspiciously with a 30 year old female who quite clearly had a urinary tract infection and looked so healthy when she answered the door that Samantha asked her where the patient was. On the plus side, she had a cute cat.
While the calls could have been better, it was still a great day as it was nice to meet the crews and have a chat with them about how we do things in control and how we could do things better. There were the inevitable questions about boring old rest breaks but no one said “Ugh, you’re from Control, we hate you, go away” or anything like that. Also other highlights of the day included hearing all about the regular calls from those who have met them first hand and driving by the places where they live. It really brought those voices down the end of the phone to life!
Thank you to everyone at the ambulance station and especially to Samantha for having me!
We had a call yesterday that made me wince: “16 year old female states her tongue has split after having it pierced”. I actually have several body piercings myself (in my nose, lips and belly button - and no, I don’t wear them to work) but it still made me squirm. Fortunately, I managed to stop squirming long enough to text my body piercer friend for advice. His reply was: “Sounds impossible, unless she had it pierced right at the tip and then pulled it really hard. Also her mouth would be filling up with blood so she would not be able to call you in first place.”
It turned out that there had been a certain amount of exaggeration and melodrama within the diagnosis. The girl didn’t have two independently wagging tongues or anything like that, it was just that the hole had opened up further and become very sore. CTA referred her to NHS Direct.
It didn’t stop me grimacing for the rest of the shift though. I am a bit squeamish when it comes to tongues.
Last night was one of those crazy busy Saturday nights. It was a nice warm night, Arsenal and Chelsea were playing in the FA cup and the people of London wanted a night out. It didn’t help that the computer system decided to go down not once, not twice, but three times. When this happens, the calls get taken on pieces of paper and read out to the crews by phone or radio. It’s not so bad once you get going - the problem is the transition from computer to paper which results in a hairy ten minutes or so where you have to work out where all your ambulances are and what they are doing. It’s almost as bad changing from paper back to computer, so therefore it’s better if the system goes down and just stays down rather than going off and on like it did last night.
By 3am, the computer system was up and running again and I was holding about 25 calls. The most frustrating thing about this was that not only were most of the calls rubbish, most of the “patients” were not even there any more. Drunk people on Saturday nights tend to call in with things like “I’ve just seen this drunk man fall over”, then get on a bus and leave. When we fall back ten minutes later to warn them that there are going to be delays, they are long gone and can’t confirm if the patient is still there or not. When you finally get an ambulance to the scene, of course, there is no sign - but the crew will have wasted at least fifteen minutes getting to the call, searching and doing their paperwork. And that’s a fifteen minute delay on reaching the NEXT call. And so it goes on.
Even more frustrating are the people who call in with something like “My drunk friend has fallen and twisted her ankle”. They then wait ten minutes for an ambulance, and when nothing arrives, take the patient to A+E in a taxi - without cancelling the ambulance. If this happens at a home address, we can’t simply take “no answer at the door” as an answer. We have to ring round the local A+Es to see if the patient is there - and if we can’t find them, we have to call the police who will then make the decision as to whether to kick the door in. Needless to say, I am always silently hoping they will. If you ever manage to track these people down, they are totally unapologetic about failing to cancel the ambulance and instead moan that it was our fault because “we took too long”. The irony is that it is people like them who are causing the very delays that they are complaining about.
As an allocator, you are presented with a dilemma: do you send on the calls where you know the patients are still there first? Do you assume that if the ones you can’t contact really needed us, they’d call again or answer their phones in the first place? Or do you consider that the reason they aren’t answering is because they are lying, dying in a pool of blood, too weak to pick up? Do you just allocate the calls “by the book” (in order of priority, then order received, making sure ambulances only travel a reasonable distance to a call). But if you’re going to do it that way - why not just allocate by computer? The point of having a human being allocating is so you can use your own judgment. Last night I went with “send to the people you know are still there first” and fortunately, when we finally got a crew to drive round looking for all the non phone answerers, they didn’t find a single corpse lying in the road.
Last night we had a call to a woman who’d fallen over and sprained her ankle. The location of the call was “sitting in a black cab”. Sitting in a black cab a mile or two away from the hospital on a busy Friday night. Why on earth did they call an ambulance? Surely the obvious solution here is to get the cab driver to drive to the hospital? They could have driven there and back twice in the forty minutes it took for an ambulance to arrive. I can only suspect the patient didn’t want to pay the fare, or thought she would be seen quicker arriving in a big white taxi as opposed to a black one.
It gets worse, though. The ambulance crew were on scene for about fifteen minutes and didn’t even take the patient to hospital. As soon as they had left, the taxi driver called 999 - potentially blocking life threatening calls from getting through - to moan about the attitude of the crew who attended.
I can only guess what the crew in question said - I think they probably echoed the sentiments of everyone in Control.
If the taxi driver ever does find the correct procedure to make a complaint, I cannot imagine the complaints department having a lot of sympathy. I wish we could make a counter complaint against him for making rubbish calls!
Lots of people keep asking so I thought I’d just give you a quick update about how things are going with the book!
I’ve got to submit it to Penguin at the end of May and I’m pleased to say I’m well on target. I’ve probably already got the requisite amount of words down although it still needs a lot of tidying up. So far, it consists of:
* A “how ambulance control works” section (stuff I’ve probably written about before in my blog, but not all at once)
* My favourite posts from the blog.
* All new material - some completely new stories and a bit more detail on some of our regular callers. Plus the inside scoop on my visit to 10 Downing Street and the story of How I Found My Flat.
I’ve tried to balance old stuff and new stuff - I want all the best stuff from the blog in (especially for people who haven’t read the blog) but I don’t just want it to be the blog regurgitated as I want to give something extra to those of you nice enough to shell out your hard earned pennies on it!
I’m going to be donating a percentage of whatever I make from the book to HEMS (London’s Air Ambulance) as they do a really brilliant job with minimal NHS funding and I think they’re a really good cause.
If there’s anything you’d really like to see me talk about in the book, now is the time to suggest it! I can’t promise it will get included but all suggestions will be considered! Oh, and it hasn’t got a title yet either - I was just going with Nee Naw but apparently there is already a book called Nee Naw. It’s a children’s cartoon book about emergency vehicles!
The book won’t be out for AGES yet - probably next January but do not fear because both Tom Reynolds and Stuart Gray have new books coming out very soon, which should provide you with your Ambulance Literature Fix!
A week ago, you may well have noticed some rather small scale rioting going on London’s financial districts. Had you been anywhere near the London Ambulance Control room, you might have also noticed some small scale panicking coming from the East Central Allocator (me) too. The area of the protests was slap bang in the middle of the area I cover, and if it all kicked off, it was going to be a very busy day.
When a major incident occurs, we open up another, smaller, control room (known as ICR - Incident Control Room) next to the main control room. It has its own allocators, radio operators, etc. Any call related to the incident is transferred out there. Because we had prior knowledge that the G20 protests were happening, the room was already set up and ready to go, with the computer system automatically transferring any calls within the relevant areas to ICR. Control staff and ambulance crews were in on overtime to cover it. The ambulances had special callsigns starting with a V to distinguish them from the “ordinary” ambulances. ICR set up several rendezvous points, ie, safe areas to which casualties could be taken for the ambulances to pick them up. If anyone was injured, they had to be taken there as it was impossible to reach most areas.
Although I wasn’t dealing with the protests directly, I knew that if anything serious happened it would have a huge impact on my sector. Road closures, full hospitals, extra ambulances needed for large numbers of casualties - any of these things could have catastrophic implications for those ordinary people who inconsiderately decided to have heart attacks and strokes on such a busy day! I kept my fingers crossed and kept checking my two sources of information. The first was the log being kept in ICR of all noteworthy events related to the protests. Fortunately, the majority of the entries were something like “Sandwiches failed to be delivered to base this morning. St John Ambulance sent on service run to Tesco’s to replenish supplies” and “Hippies seen dancing to sound system near Trafalgar Square. (Ten minutes later). Hippies disbanded to pub.” The second was the plasma screen showing Sky News above my head. I must admit that every time I saw a surge in the crowd, my heart beat a little faster. Was this going to turn into a huge riot?
Fortunately, as you know, the majority of the protests were peaceful and ICR were well equipped to deal with the small number of casualties they received. The only problem for me was the road closures, which meant that I had to think carefully about which crews I dispatched to my calls - sending the nearest ambulance is not a lot of good when it has to take a five mile detour! Another minor problem was that of Rubbernecking Crews. Having heard something exciting was possibly occurring, several crews mysteriously drifted towards the city presumably in hope of being called upon to deal with serious calls (and get a good look at the riots). I took to sending “urgent messages”, which send a loud, unpleasant bleeping noise into the cab of the ambulance, saying “Please leave the city area immediately!” to which the crews would invariably call up apologetically, saying they had taken a wrong turn. I felt rather like I was chiding naughty schoolchildren!
The day passed, and I was relieved to find that the protests never escalated beyond the odd skirmish. Looking at the rows of ambulances parked outside Control, ready to deal with a much larger incident, it was clear it could have been a lot worse. Of course, the day will inevitably come when I have a great big humungous major incident kick off in the middle of my sector. But I can wait a bit longer for that.
I need a favour. I need a nice ambulance crew (or FRU) who are willing to let me come out with them for an observation shift between now and the end of May. The shift, or parts of it, will get a mention in my book (which I have permission from the LAS to write and will be observing all confidentiality stuff so don’t worry about getting in trouble!) A crew from the NE or EC sectors would be best as that’s where I live but I will travel if necessary! Steve has very kindly let me come out with him a few times but has a training crew at the moment so can’t. He can vouch for the fact that I am great at carrying oxygen bags and won’t insist on going back for a rest break, though.
Thanks!
EDIT. Shift arranged! Thanks for all the offers!
