Nee Naw

We had a week of horrible, nasty, gory and scary deaths last week. It’s all my fault, I think, for complaining that people call us about rubbish all the time. These calls were the antithesis of rubbish; in fact, it was like being caught up in a cross between a Ruth Rendell murder mystery and the Casualty Christmas special.

As well as the “normal” spate of cold weather related deaths of elderly people and several people dying or being seriously injured in horrible ice-induced road traffic accidents, we took the following:

1) Brother breaks into his sister’s (age 30) house not having heard from her for a few days and finds her dead, surrounded by empty pill bottles.

2) Man watches his partner (age 40) die of a heroin overdose. Crew are unable to save her.

3) Woman (age 40) found dead in bath by her parents. Circumstances somewhat suspicious. Police to scene.

4) Man finds his son (21) dead in his bed. He has no health conditions other than asthma. Caller is so calm that I have to get him to repeat “dead” twice because I can’t believe I have heard him right. Police again.

5) Woman enters flat and finds partner (34) dead on the floor for no apparent reason. Her screams can be heard across the control room.

Runner up for horrid call of the week also wins prize for most bizarre call. A man had just been discharged from hospital, and had made his way home to his flat on the 10th floor of a council box. Opening the door, he quickly realises something is wrong — the house is completely bare. Burglars have broken in and taken all of his personal belongings, including furniture. Inspecting the devastation, he goes into the bedroom, and there he finds what appears to be a dead body. Needless to say, he does not stick around to check the body for signs of life before running away as fast as his feet could carry him and calling us and the police from a safe distance.

The body was confirmed to be dead soon after. No one could shed any light on who he was, or how he’d got there.

After dealing with this incident, you’d have thought things couldn’t get any worse, but early on Friday morning we got a message from the police saying they had been called by a hysterical woman saying her three-year-old daughter was dead. We sent an ambulance straight away, and one of the dispatchers called back the origin number. Sure enough, the phone was answered by a hysterical woman who was screaming that her three-old-daughter was dead. Our dispatcher tried to start resuscitation, but the woman was far too upset to listen. She was telling him that she’d found the little girl face down on her bed, and there were boxes of some kind on top of her, preventing her from moving her, and to add to the pandemonium there was a small baby crying, and the woman herself was eight months pregnant. In short, we had no idea what was going on, and as the scene was only two minutes away from the nearest ambulance station we did not get to find out before the crew and police burst in.

We sat and speculated as to what was going on for the next ten minutes. Perhaps the girl wasn’t dead? The woman was too hysterical to know for sure, and perhaps she’d just had a fit. A lot of people think their children are dying when they have fits. Three years is a bit old for it to be cot death. Perhaps it’s nothing. The child probably has the flu, and the woman is just a little anxious. Yes, I’m sure it won’t be as bad as it sounds. We all like false alarms…

The ambulance crew came up on the radio.

“This is K603 blue to Oldchurch, with a three-year-old female suspended, CPR in progress, no further details, eta 2 mins”.

So it wasn’t a false alarm.

Normally when ambulance crews come up on the radio with their blue calls, they sound quite impassive, and describe the horrible things they are bringing in a clinical manner. Because they see a lot of horrible things and dying people, they get quite “gallows humour” about it all and most calls are water off a duck’s back to them. They’re usually chatty and unfazed after bringing in a suspended patient, and I often wonder how they do it, although I suppose in some ways it’s only the same as me taking a suspended on the phone one minute going on to take another call seconds later. This time, though, it was different - the crew member that I spoke to sounded really stressed and upset, and as soon as they had finished at the hospital, their DSO (manager) rang us to say that they were being taken off the road for the rest of the shift.

I wouldn’t have liked to have seen what they saw.

In the control room, we have a mapping system which shows exactly where every ambulance the service owns is. If the vehicle is in use, we can see their callsign (something like “T601″ - the first letter and number denote the ambulance station it comes from), if it is not being used, we just seen their fleet number. As well as seeing them zooming around the map, we can also see how fast they are going, which direction they are travelling in, or, if they are still, when they last moved.

A few weeks ago, I was on the FRU desk when one of the cars was involved in an accident and went up in flames (blog entry). That vehicle has long since been towed away, of course, but on the mapping it still remains at the place where it “died”, now telling us that it has been stationary for nearly a month. Funnily enough, the crash happened only a couple of streets away from where I live, so now whenever I walk past that corner, I feel the ghost of that FRU haunting me.

There are various other long-term stationary vehicles dotted around the map too, which presumably are also “ghosts”, and sometimes I sit and wonder what happened to them all. I know there was a vehicle in Putney once that mysteriously went up in smoke for no apparent reason. It was just after July 7th and at first we all thought it was an Ambulance Bomb! Also, for a long time there was a “vehicle” which seemed to be floating in a reservoir in Tottenham. Whether this vehicle really met a sticky end in murky water I have no idea!

Some of our callers really do have some cheek. The other day, we had one of those more-calls-than-ambulances situations building up on our dispatch desk, so I set about calling back all the rubbish calls to see if I could coax them into deciding to take a more appropriate course of action. We are not allowed to say “what a load of rubbish, make your own way/call a doctor/go back to bed”, of course, but sometimes hearing that all the ambulances are out dealing with life threatening emergencies spurs people in action.

The first call I rang back was a Maternataxi, some woman who just started to go into labour and whose boyfriend had made the phone call.

“I’m afraid all the ambulances are out dealing with life threatening emergencies,” I said. “Has there been any changes? Oh, you’ve had two contractions now? Is your boyfriend able to drive you to the hospital?”

“Er, yes…” said the woman.

“Great!” I said. “We’ll cancel the ambulance, just call us back if there are any problems and you decide you do need us after all.”

So what do you think they did next. Get in the car and drive to the hospital? No, they called the police complaining vociferously that we weren’t rushing round to them and demanding that the police tell us to send straight away! Needless to say, the police just sent the message back to us, the call went straight back to the bottom of the queue (since the original had been cancelled and the time of origin was now the time the police called us). I rang back the boyfriend and gave him a lecture about wasting police time.

Their cheek, however, was dwarfed by a caller I had the next night whilst call taking.

“What’s the problem?” I asked.

“I called you earlier!” said an angry sounding man. “It’s Mr Bloggs! From 14 Gravida House, Bile Street, E20!” He sounded very angry that I didn’t know who he was. I looked up the original call. It was to a 20-year-old lady — the caller’s girlfriend — 6 weeks pregnant, vomiting. It had been through TAS, who had decreed this was a bit of garden-variety morning sickness and that we were not to send. TAS had given homecare advice, and told the caller that if they really wanted to go to hospital, they should make their own way. I repeated this back to the caller, to make sure he’d understood TAS man properly and see why he was calling back.

“Yes!” he said. “We are at the hospital!”

“Erm,” I said, confused. “So why are you calling 999?”

“Because they say we have to wait to be seen! And she is womiting! You must tell them to see us straight away!”

“I’m afraid I can’t do that,” I said (not adding that even if I could, I wouldn’t be doing anything of the sort). “There are always long waits in hospital, you will just have to wait with everyone else. If you have any problems, speak to the hospital staff!”

The man continued ranting and saying that TAS man had assured him that he would be seen immediately (which I am sure is a lie!) and that it was disgusting and didn’t I know that his girlfriend was WOMITING? We are not usually allowed to hang up on callers, but if they are ringing from an A+E department we can make an exception, so I took great pleasure in telling him: “Sir, I have four calls waiting to be answered, and these people could be dying, so I am going to have to terminate this call. Goodbye!”

I didn’t think it was long before those TEA BREAKS KILL headlines hit the papers, and I was right. Here’s one from the BBC and another from the Evening Standard. Neither article explicitly states that the delay in sending an ambulance caused the death (in fact, I suspect both patients may well have died anyway) but the implication is there, and I suppose the point is that no one will ever know if a quicker response would have made any difference.

I’ve done many a shift on dispatch since my last post on the matter and am now in a better position to comment. I am not a fan of the new tea breaks system. Neither, it seems, is anyone else in Control. In fact, the screensaver on the North East Desk computer now reads “I H8 TEA BREAKS!!” in big letters. Our niggles are as follows:

1) The whole break business is ridiculously complicated. Crews get a break “window” (the earliest and latest times they can take a break) which varies according to how long their shift is and when it starts. The length of their break also varies. When the staff on one ambulance are working different shifts (as sometimes happens when people work overtime) all hell breaks loose. The upshot is that us control staff have no time to actually get on with that saving lives stuff, as we are too busy being glorified break monitors.

2) Giving crews breaks is the sole responsibility of Control. Crews do not have a say in the matter. This means we have to weigh up whether we should give the breaks to all crews during quiet periods, thus having more than one crew having a break at a time, or stagger them throughout the day, meaning we will have crews off the road whilst holding calls, and risk several crews missing their break and going home half an hour early as compensation, meaning that come half six, you will be left with one single ambulance to cover your whole sector.

3) Some crews do not seem to want breaks at all. They would rather go home half an hour early, or get the £10 payment for no break. They grumble when you tell them to have a break, and take action to avoid having breaks, such as suddenly having to go off the road to clean their vehicle or taking the scenic route back to station in the hope of copping another call and missing their break window.

4) On the other hand, some crews really do want their breaks and then get very miffed with you when they miss them. They end up missing breaks when we are holding high priority calls in their area when their break is due. The crews who are most likely to miss their breaks are the busiest crews, and thus the crews that need a break most.

5) Even when we give crews a break and they want a break, they often do not want it at the time we have given it. This is perfectly understandable, if you are working 7am to 3pm would you want a break at 9am? Thought not.

6) Generalised trouble and sniping occurs when Control inevitably get in a muddle and ring crews up in the middle of their breaks by accident, or we try to put crews on break at the wrong time or wrong place, or we disagree with a crew about times (”our break finishes at 45! It’s 44 now, so we get a tenner for interrupted break! No, MY watch says 44!”), or someone accuses a crew of taking the scenic route back to station (I keep having to pipe up on the radio and say “T601, please return directly to station, over” which as you can imagine goes down a treat). I have lost count of the number of pointless rows that have broken out over tea breaks.

I think it should be up to the crews themselves to decide when, where and if they want to take a break. After all, if they feel they are tired/hungry/etc enough to need one, they should know. They should be able to ring us up and say “T601, taking a break at 1pm” and that should be that. If they don’t want a break, then that is their prerogative. I’ve never come across any other workers who have management or the EU breathing down their necks saying “right, you must take a break NOW!” - why should ambulance crews be any different?

And one final point, on a different note — I presume we’re going to get these headlines every time a person dies whilst a crew is on a tea break. Why don’t we get headlines saying “Man dies whilst ambulance crew attend 20-year-old with flu”? Because I can tell you, this happens a whole lot more often, and has been happening for years.

Thanks to Simon Gray for pointing out this petition for more public education about the proper use of the 999 service. Please spare a moment to sign it.

So much for the season of goodwill! I have never seen so many fights, brawls, domestics, stabbings, assaults and general nastiness in my entire life. It didn’t even stop for Christmas Day. All I can say is that I am glad that I was not rostered to work on New Year’s Eve, as I hear things went absolutely crazy.

Two examples of Seasonal Skirmish stood out.

The first came from a household in an undesirable area of London. The caller was a medium sized child, who reported that their parents had been having a fight, and that Mum had thrown a plate at Dad. Our first priority in calls like this is to get the police down there; ambulance crews don’t relish the prospect of dodging low-flying crockery. As there was a bit of a shortage of ambulances we told the police to let us know when they got there, and then we would send an ambulance in. There’s no point in having an ambulance parked up for an unspecified period of time when we don’t know how quickly the police will be able to get there. Our sector controller rang back the patient, as is procedure when there is going to be any kind of delay.

“His eyeball’s cut open!” wailed an older child. “And there’s a piece of plate still wedged in it!”

As you can imagine, this call suddenly jumped to the top of our list and we sent a message back to the police saying that this call was perhaps a little bit more urgent that we initially thought.

“Don’t pull the plate…” began the sector controller.

“My brother’s just pulled it out!” exclaimed the child. “And now there’s blood EVERYWHERE! HEEEEEEELP!”

Poor kid - he was only trying to help, I suppose. No child should ever have to witness something like that, let alone be expected to do the right thing.

The second happened late on Boxing Day. A man and his girlfriend were making their way home from the pub and got into an argument, as I imagine a lot of couples do this time of year. “You bought me socks AGAIN!” “You made me cook the turkey all by myself!” “You invited your horrible Aunt Betty!” (I’m hearing this in my head, of course I don’t really know what they were arguing about.) Exasperatedly, the woman pushed the man. Drunkenly, the man fell into the road. Along came a big, red, double decker bus. The driver didn’t see the man lying prostate on the tarmac. He only stopped when he heard the woman’s screams. By then, the man was trapped under the bus, tangled in the mechanism.

He was dead by the time we got to him. His girlfriend never got to say she was sorry. That’s one Christmas row that won’t be forgotten by New Year.