While you may think ambulance workers are mature professionals who have seen and heard everything, every now and then a call pops up on our screen that makes our eyes water. One such call appeared the other day. A four year old boy had somehow managed to get a Triple A battery wedged irretrievably in his foreskin. (Point of note: the FRED system automatically dispatched a fast response car, thinking the “Triple A” bit referred to an Abdominal Aortic Aneurysm. Not so clever, FRED…) This, of course, led to much confusion and speculation as to how the battery found itself in the offending region in the first place and the position it must be in for it to be so irrevocably wedged. No firm conclusions were reached.
The conversation progressed to other foreign objects in genitalia we’d taken calls about in the past. Vibrators, household objects, chillies, razor blades… they’ve all been misappropriated at some point, but the trump story came from a paramedic who now works at HQ. Back when he was on the road, he received a call to a psychiatric patient, who, according to the call taker, was hallucinating and believed she had roots protruding from her vagina. Well, when he arrived, the patient showed him the offending areas, and there, clear as day, were the roots. It transpired that his patient had put no less than FOUR potatoes up “there” several days ago (new potatoes, I hope, not King Edwards) and, as any gardener will know, potatoes thrive in a warm, damp environment. The potatoes had sprouted. I do not envy the poor member of A+E staff who had to dig them out.
This week, a bulletin came round from the control room from the Complaints Department. It said that when ringing back lower priority calls, people have been saying things like “We don’t have an ambulance to send at the moment. All our vehicles are out on higher priority calls, like heart attacks, babies not breathing - that’s what we’re here for”. The bulletin said we should not say things like that, because it gives the caller the impression that their call isn’t important.
I just don’t agree with this. It seems to be saying that it is wrong for Control staff to try to educate people about the proper use of the service. How are we ever going to cut down on inappropriate calls if nothing is done to teach people? By not saying things like that, we are effectively encouraging people to hang on and wait for an ambulance they don’t even need when a subtle prod would have them seeking more appropriate help which they could obtain more quickly. (We do have a telephone advice service, CTA, who ring back lower priority calls and try to point callers in a more appropriate direction, but they’re very busy, so callers have to wait about half an hour for a call back, and if the caller refuses to speak to CTA or insists on an ambulance, there is nothing they can do - we have to send, except in a very small number of cases which are covered by the almost defunct No Send Policy).
Of course, we are not *only* here for heart attacks and babies not breathing. Not every valid call is an immediately life threatening emergency - but if the call *isn’t* immediately life threatening, there should be a concrete reason for needing the ambulance (”Can’t afford a taxi” does NOT count!) - in most cases, it’s because the physical condition of the patient prevents them getting to hospital any other way. An elderly person who has fallen and has minor injuries is an example of a valid but low priority call (actually, if I had my way, it would not be a low priority call at all, but that’s a topic for another post) and it would just make the poor patient feel bad for “bothering us” if we were to point out the more serious calls we have to deal with. But for calls of the variety of sprained ankles, kids with temperatures, stomach aches, etc, I really think “We’re here for heart attacks…” is a totally appropriate and useful thing to say. Thoughts? Do you agree with me?
I must have upset management this week, because I found myself taking calls for the first time in ages. When you’re not used to taking calls it can be a bit of a culture shock to find yourself confronted with the entire spectrum of 999 callers - the rude, the polite, the stupid, the helpful, the suspicious, the infuriating and the plain bizarre. You start the day with your best “polite voice” on keep reciting things to yourself like “there are no inappropriate calls, only inappropriate responses” and “don’t take it personally, they are only shouting because they are upset” but after 12 hours the smile starts to slip. You realise that “I’ve picked my spot and it is bleeding” IS an inappropriate call, whichever way you look at it, and that the only appropriate response is unprintable and will have you on Advice and Guidance - and in fact, Spot Man is going to get an ambulance on blue lights within 14 minutes because he insists that the blood is spurting up in the air, as if from an artery. (It wasn’t. I checked the log afterward to make sure - the crew were on scene for ten minutes, “treated but not conveyed”. Just long enough to put a plaster on.) And the reason he’s shouting at me isn’t because he’s upset about his bleeding spot, it’s because he is rude and selfish and doesn’t care how many people die when he ties up the only available ambulance bringing him a plaster and AAARGH!
The job of the call taker is the most frustrating job ever. I know crews are always calling up and saying “Why have YOU made this a Cat A?” but it’s not us and it annoys us just as much as it does them.
Recently, I went on a call taking refresher course and there was a lot of discussion about how some call takers (not me, of course!) are less polite than they ought to be. The thing is that people (the training department, allocators, management, crews) forget the sheer frustration of being confronted with these awful calls and being effectively gagged and bound by the rules and script of AMPDS. I think if you were able to say, politely, “no, that’s not what we’re here for, so you can’t have an ambulance - but here’s what you should do instead” there would be far less instances of call takers losing their rag and speaking inappropriately to callers. Of course, I’m not saying that it is EVER okay for a call taker, who is being paid to be professional, to be rude, just that it is understandable. Unless you are taking calls 12 hours a day, 4 days a week, you cannot understand the pressure and frustration the call takers are under. And I think it’s good that us “upstairs” staff get stuck back on the 9s from time to time, because as much as I did not enjoy that shift, it was a reminder of what the call takers do for the ambulance service every day. Short of being out on the road, it’s the most stressful and demanding job you can do here. It might even be worse than being out on the road, actually - on the one hand, crews have physical danger and being out in the elements to contend with, but on the other, whilst crews work under their own steam and are fairly oblivious to how busy the service is (because they can only do one job at a time), call takers are under constant pressure to answer one call after another. Also, whilst patients/callers generally want crews to do their job (treating the patient) and are grateful to them, they see call takers as an obstacle to them getting an ambulance. Call takers are rarely thanked - in fact, I have never received so much as a thank you note even though there are several people wandering around today who wouldn’t be alive if I hadn’t been doing my job.
It’s not all rudeness and timewasters though - if it was, I’d have given up this job and gone and worked somewhere where I don’t have to wear green or sacrifice my weekends. The polite, helpful, kind people who call in make it all worth it. The mother of a severely disabled sixteen year old who’d developed serious breathing difficulties (”again”, she sighed), the passerby who stopped at a road traffic accident and took control of the first aid and the bystanders, the kind drug abuse support nurse who’d come round to check on a client on his day off and found him collapsed on the floor, the little old lady who didn’t want to bother us with that silly pain in her chest and down her arm, and even the man who rang because he’d seen a dog been hit by a car and didn’t know what else to do. (I gave him the RSPCA emergency number. There are no inappropriate calls, only inappropriate responses…) Those decent people are the ones who make it all worthwhile.
I expect I’ll be back upstairs tonight!
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It’s become a bit of a running joke that whenever I work on a particular desk on the other side of the room (usually when I am in on overtime), everything kicks off and there is calamity and disaster. Well, the other week, I worked on that particular desk as an allocator, and it was the day from hell. There were three open leg fractures, an old lady crushed by a milk float, a stabbing, a bottling, a fight between forty people and an extremely suspicious death… but one call overshadowed the rest.
The Desk of Disaster, unlike my usual home, the North East, contains large patches of countryside, the no man’s land between London’s suburbs and the territory of the neighbouring ambulance service. Even on blue lights, running from the nearest ambulance station, it takes at least fifteen minutes to reach these areas. (Okay, I am anticipating a derisive snort for those of you who work for Scottish Highlands Ambulance Service and the like, but for us, that’s a long way. Most Londoners live within five minutes of an ambulance station. It’s rare for me to run one more than three miles on the North East). Of course, not a lot tends to happen in these areas, so they don’t generally cause much concern, and now we have every crew’s favourite Active Area Cover (explanation from Tom Reynolds) we have an ambulance hovering around the one village in this area anyway. Which meant when had a call to an 80 year old man who had fallen and banged his head, we were on scene within 5 minutes. Super!
Unfortunately, fifteen minutes later, another call came in Ruralsville, and now the nearest available ambulance was 8 miles away. It was at one of those big posh country houses up a track, miles from the main road. Response time hell. I gritted my teeth and silently prayed it was going to be something trivial, because we had nothing for it.
“TODDLER FELL IN SWIMMING POOL” typed the call taker. “NOT BREATHING.”
Now, I don’t panic. This job requires one to have a clear head and unflappable nature at all times. But if I was going to panic, that would have been a good moment for it. You may just have seen a bead of sweat on my forehead if you looked closely. There I was, doing a job two grades above what I am paid to do, on an unfamiliar desk, working with people I’d never worked with before, and I had a suspended toddler in Outer Mongolia that I couldn’t cover! This was not good.
The first thing I did was to dispatch that ambulance 8 miles away in suburbia. I can imagine their faces as they saw the address and diagnosis, but they didn’t question it and started running on the call straight away. The second thing was to stop the radio op, who was in the middle of dealing with something else, in her tracks and demand that she broadcast the call straight away. (First rule of dispatch manners: don’t interrupt the radio op, it is v rude and irritating. Second rule of dispatch manners: when you have a suspended child, drop everything, including manners). A crew at the nearest hospital heard the broadcast and offered up straight away. They were still five miles away, but a three mile improvement. I sent them and cancelled the first crew. We were getting there. Checking the log, I saw an FRU had been dispatched from 3 miles away and HEMS had also been sent (these are handled separately by other desks in the same room).
Then, our prayers were answered. The crew who’d been on Active Area Cover in Ruralsville, and were just leaving for hospital with the elderly gentleman on board, called up to tell us they would attend the call to render aid to the child until the others arrived. (They later explained that they’d had a third person, a student paramedic, on board, who sat with the elderly man whilst they dealt with the child). They were less than two miles away.
Meanwhile, whilst my colleagues on the Disaster Desk and I performed the less urgent tasks like notifying the police, the DSO (ambulance crews’ manager) and our managers, two call takers were on the phone to people at the scene. Both these call takers did fantastically and afterwards the crews rang up to ask us to pass on their thanks. One call taker was speaking to an adult male at the scene and got us the full address and directions very quickly. The other was speaking to the biggest hero of the story - a teenage girl who was at the poolside. It was this girl who’d spotted the toddler in the pool and dived in to drag her out, and now, with the call taker’s instructions, she was performing perfect CPR, which she continued right up until the moment the first professionals arrived.
It’s a bit strange in the control room when you get a complicated call like this, because there is so much to do until the crew arrives on scene, but once they get there, it all goes quiet and there’s nothing you can do but wait. Oh yes, and deal with the constant stream of heart attacks, road traffic accidents and teenagers with flu that have come in in the meantime.
About an hour or two later, we had a call from the DSO, who let us know the latest. It was very tentative good news - the toddler had been taken to the Royal London by HEMS and was alive, but in a very serious condition. All the crews involved were going off the road for a stiff cup of tea (except the crew with the old man on board, who had to stop off at the hospital to drop him off!) HEMS told us that the toddler was on a ventilator and was undergoing tests on her brain. They’d let me know the outcome next time I was in.
I thought this was a pretty good example of teamwork and how well people can pull together when we’ve a genuine emergency on our hands. If one piece of the jigsaw - the professionalism of the call takers, the quick thinking of the crew with the old man on board, the prompt action of the crew at the hospital, the heroism of the teenage girl on the scene, the way we on the Disaster Desk pulled together - had been missing, the child would have been dead before anyone arrived on scene. It just goes to show that whilst we might all bicker about each other (lazy crews that spend too long at hospital, unsympathetic control staff who bully crews who have done nothing wrong, call takers who can’t spell, unhelpful members of the public, etc…) when it really counts, none of that matters.
I’d like to say there was a happy ending to the story, but this isn’t Casualty, and there wasn’t. Two days later, when I came in for my next shift, HEMS told me that the tests on the toddler’s brain had come back with bad news, and she’d subsequently died. The consolation was that her organs had been suitable for donation - which they wouldn’t have been if she’d died before she got to hospital - and so even though everyone’s efforts didn’t save her life, they indirectly saved others. So all in all, a good day’s work.
Nee Naw has been given a revamp by my friend Eddie of I Want Your T-Shirt Web Design. Please take a minute to have a look at the new design and give me your thoughts. I’m loving the new look but if there’s anything you lot think could be improved, leave a comment here and I’ll pass it on.
I am pleased to report that finally, after a year of torment, Banana Man has been caught and stopped. I worked for twelve hours on the East Central desk today and there was NOT ONE single call to that particular Woolworths, no one collapsed on the runway at Gatwick Airport, no itchy penises and definitely no offers of a banana. He was caught by an ingenious police officer, who called him back pretending to be someone running a competition, asking him to give his name and address so his prize could be sent. Banana Man took the bait and revealed all.
It transpired that Banana Man is only a teenager and is seriously disabled, so at the moment he isn’t being prosecuted. Social Services are getting involved and trying to put a stop to the calls, and so far so good. I must admit that after months of tearing my hair out after being terrorised and frustrated by this individual, my sympathy-o-meter is rating about a zero and I am not terribly impressed by this lenient attitude. Disabled or not, he had the presence of mind to go out and acquire SIM card after SIM card after having them cut off; he was with it enough to answer call taker’s questions and laugh when they reprimanded him for hoaxing. I just don’t believe that he was totally unaware of the consequences of his actions and I think he should receive some kind of punishment for it. It also begs the question, if he is young and/or disabled, where were his parents or carers when the calls were being made?
Still, I suppose this is not for me to worry about and I should just be grateful that I will never be driven to distraction by him again. I expect to see a sharp decrease in the number of calls recorded in the East Central from now on.
For some reason, it seemed the depressives of London all decided to pick the same weekend to attempt to end it all. Even the nurses answering the blue call phones at the hospital commented on the number of overdoses and slit wrists that were coming in. There was one call that stood out, though. A woman in her thirties. Her husband had just walked out, leaving her with a selection of children between four and twenty-one. Beside herself, she couldn’t go on. Then and there, in the presence of her kids, she’d decided to commit suicide. You may ask yourself what sort of person would kill themselves in front of her children, but if you want proof that the balance of her mind was disturbed, look no further than the method she used to die.
She drank hydrochloric acid.
If you’re not familiar with hydrochloric acid, it’s a pungent, fuming corrosive that will burn through almost anything it comes into contact with. It is highly reactive and dangerous. Just inhaling it can be fatal because of the damage it will cause to your lungs. It is used for removing rust from metals, unblocking drains and in oil production for dissolving rock. The acid burned through one of the paramedics’ gloves and ruined the ambulance’s blanket. It took nearly an hour for the crew to clean up the vehicle afterwards.
The patient’s children tried to help her and in doing so, got the chemical on their bodies, causing some nasty burns, so the crew took them in too. A blue call was placed, and the patient was semiconscious and breathing at the time, but as the crew told me later, they didn’t think she could possibly survive. That acid would eat her up from the inside out.
On the way to the hospital, the patient’s ten year old son told the paramedic that as soon as he was back from the hospital, he was going to kill himself too.
On the whole, not the most cheerful of calls.
Meanwhile, on the extreme other side of my patch, a Hornchurch crew were on the way back to their ambulance station, which is located in a semi-rural area on the very edge of London. They were flagged down by a rather frantic looking FRU, who’d come across a loose horse wandering across a dual carriageway.
Horses aren’t entirely my speciality, and this is the LAS, not the RSPCA, but they couldn’t exactly just leave it, so I typed the incident as a running call and called the police, hoping they’d have the faintest idea what to do, because none of us did. An hour later (and fortunately with no life threatening calls in the crew’s area that couldn’t be covered, because that would have presented me with a dilemma) the horse was rounded up and returned to its rightful field.
When a crew attend a call and don’t take the patient to hospital, they have to record a “non-convey reason” on the computer, from a picklist with options such as “deceased, not removed”, “referred to GP”, “assist only” etc. I was amused to see that the crew opted for “declined aid against advice” in this instance. This conjured up images of the crew chasing the horse around and trying to take its blood pressure whilst the horse galloped away, whinnying “Please don’t take me to Newham General!” It had been a long night.
Two police officers on the beat around 2AM, five minutes walk from where I live, saw a gang of youths running away from a bus station. Running to the bus station, they found a eighteen year old boy lying on the ground with serious stab wounds. The ticket the police sent us requested an ambulance “on the extreme hurry up”. Fortunately, one of my vehicle had just finished up at the hospital, about a mile away, as the call came in. It only took them a couple of minutes to reach the bus station, but it was too late. The boy’s injuries were too severe, and although they blued him into hospital, he died.
Six hours later, at the end of my shift, I passed the bus station on my way home. I could see the blue and white police tape, a couple of patrol cars, and that people had already started to lay flowers at the scene. Though this was exactly what I expected to see, it was still a disquieting sight. Sometimes, working in the control room, where you can see nothing and only hear of events second hand, it almost feels like the incidents we deal with aren’t real - like an elaborate training exercise set up to challenge us. Seeing the aftermath, something as simple as an empty crime scene, brings home that every single patient is a real person with a real life to lose.