More Blood, More Sweat and Another Cup of Tea

‘As you know I was working in London for the ambulance service, it was a pretty good job, but back then the health service was run and funded by the government. So a lot of things went wrong.’

The young man interrupted, ‘That was when Blair the Deceiver was in power? Just before the Party started to dissolve parliament?’

The old man looked sullen. ‘That’s right, bad days, very bad days.’

Sensing that the old man was about to enter a fit of depression, the young man decided to prompt him, ‘But about the blankets…?’

‘Yes,’ replied the old man, eyes suddenly snapping into focus, ‘we used to say back then that the only equipment we really needed was a chair and a blanket, but on that day there were no blankets to be found. We searched the stores, we even tried ransacking disused ambulances in case they had some—but there were none to be found.’

‘What did you do?’ asked the young man.

‘Well, we got onto our Control—they tried to contact someone in management, but no one seemed to be around. So Control spoke to their overseers—the people who had the job to look after these emergencies. They were no help.’

‘Was the management ever any good?’ the young man asked.

The old man was quiet for a moment before continuing, ‘In this case it turned out that there were no blankets at our central stores. Normally the blankets would be stored there before being delivered to individual stations by a tender driver. But the warehouse that washed and packed the blankets hadn’t delivered any to the stores.’

‘With no blankets, how could you help patients?’

‘Well, after talking with Control they suggested that we “liberate” some blankets from the hospitals in the area—so some of us went on stealth missions. We’d take in a drunk and while the nurses’ backs were turned your crewmate would sneak out with an armful of blankets.’

The old man threw another chunk of bread to the anxiously waiting ducks. ‘We didn’t call it stealing. Besides, the hospitals had more than enough.

‘Of course,’ the old man continued, ‘back then we’d share a blanket among a couple of patients—there wasn’t enough for one blanket each. This was before the H5N1-MRSA cross-breed became epidemic. You’d never get away with it these days. But back then if there wasn’t filth on the blanket, you would use it again. We had to or there would have been blanket shortages every day of the year.

‘In this case the shortage lasted for a couple of days. It turned out that nearly everyone in the blanket warehouse had applied for annual leave at once, so there was hardly any staff working. In those days you had to use up most of your annual leave before April. That year they prevented the ambulances from collapsing by letting us carry over more leave to the next financial year than normal, but they forgot about some of the support workers.

‘We were lucky that year…we didn’t know it was about to get worse—’

The youngster clicked off his recorder before the old man could continue. ‘Yes, but we all know what happened in twenty-o-nine. I’m just researching the precursors to the health collapse and I was thinking that this might be of some use.’

‘Well, I hope I was of some help,’ the old man said standing up from the bench with a groan. ‘I’m off to stretch these worn bones. If I can be of any more help, just let me know.’

‘Will do Mr Reynolds,’ said the young man, ‘will do.’

Yes, we did have a shortage absence of blankets a couple of days ago. So far there is no official reason, but the tender driver told me the theory that I used in this story. It’s also true that we have to reuse blankets for different patients. There was a manager around, but he was in a meeting. I don’t know what the ‘overseers’ suggested.

There is no H5N1-MRSA cross-breed. I’m keeping my fingers crossed that I’m still alive in 2046.

Yes, I wrote this because I have too much time on my hands.

Sorry.

On the Power of Blankets (#ulink_60f9df7d-4313-55de-ba98-2ba3a6da0ee8)

I have mentioned that the blanket is one of the more important and versatile bits of kit that the modern ambulance can have. In the good old days of horse-drawn ambulances the proto-EMT would refer to his equipment as ‘one and one’, meaning one carry chair and one blanket.

Even today, with our increasingly technologically based healthcare system, the humble blanket has a multitude of uses. For those of a ‘hitchhiker’ mindset think of a blanket as a towel writ large.

Primarily it is used to stop little old ladies (LOLs) from getting cold when you drag them out of their nice warm house into the often freezing conditions of the ambulance.

Said little old ladies don’t like being wheeled around in our carry chair—it has no handrests and feels very unsafe. LOLs will often try to grab out at things to steady themselves—this is dangerous, especially if we are carrying them down stairs. So we wrap the patient in a blanket, and make sure that their hands are gently restrained.

You can use the blanket as a sliding/carry sheet when transferring a patient from a bed to a stretcher, or from the ambulance stretcher to the hospital trolley. The ambulance blanket is thick and strong with a close weave. While I wouldn’t like to try using it to lift someone off the floor, I would imagine that it is strong enough to do so.

When in the ambulance we can use the blanket to protect modesty. Some of the things we do to people require them to bare their chest, for females this can be troubling. We can use the blanket to cover the patient as much as possible.

If the patient has been incontinent while wrapped in the blanket, we can ‘gift’ the blanket to the hospital—it’s what nurses are for (and we don’t carry warm soapy water and wipes in the back of our ambulances). Nurses soon learn to unwrap carefully the patient who has been left in the ambulance blanket.

Because of the thickness of the blanket, and the difficulty of carrying vomit bowls into houses, the blanket can catch any vomitus the patient may produce while leaving the house. Reassuring the patient that it is fine to vomit on the blanket is important in case they become embarrassed.

When moving a dead body from a location, two blankets in the ‘T-wrap’ will disguise the lack of life from bystanders. It’s also good for wrapping up very frail LOLs when it is freezing outside.

With the addition of two triangular bandages the ambulance blanket can be converted into a pelvic splint. This helps stabilise pelvic fractures which can become life threatening if allowed to wobble. As an aside, the next time I see a trauma surgeon flex the pelvis in a suspected fracture, I’m going to find their car and let down their tyres.

If you don’t have the head blocks that go either side of the head to protect a possibly broken neck, then by the correct folding of the blanket you can form a snug-fitting c-spine restraint. I prefer the use of blankets to the specialist kit here because the blanket is better able to form itself to the patient’s head and neck.

Our blankets are red—this makes them ideal for hiding blood.

If you have a nasty trauma in a public place the blankets are large enough to be used as screens. This requires the use of two firefighters to hold each end. Don’t worry, they were probably standing around doing nothing anyway.

The blanket also works well as an ‘NHS special’ pillow. We don’t carry pillows on our ambulances and many hospitals are short of them. So roll up your blanket and place under the patient’s head. LOLs with a curvature of the spine will be especially grateful, as in a moving ambulance without a pillow their heads tend to roll around like a nodding dog.

If folded correctly, you can put it on your trolley bed and have ‘AMBULANCE’ written down each side. This not only looks good but also makes it really easy to wrap patients up in it.

If you have a patient who might become aggressive then the blanket—if tucked in tightly—can provide a mild restraint.

Doing CPR on the floor for an extended period of time can be wearing on your knees—a folded blanket makes a nice cushion to rest on while pounding away on some dead person’s chest.

If someone decides to have an epileptic fit in the back of your ambulance, the blanket can be used to protect the head (or other part of the body) from hitting the ambulance wall or other hard surface.

Have you had a huge spillage of some noxious fluid? Are you worried that as you return to your station to mop out the back of the ambulance the fluid will run through the door into the driver’s cab and thus contaminate your packed lunch? Simply mop it up with a blanket.

If someone tries to attack you, throw it at them like a net—it may distract them long enough for you to run away.

There are probably a hundred more uses for the ambulance blanket—and no doubt as soon as I publish this I’ll think of another 20. Still, I think that you will see that the humble blanket has many more uses than our defibrillators and ECG machines.

Friday Night’s All Right for Fighting (#ulink_45ff1d45-c3be-5877-be5d-2945ab9873d2)

The first job of our Friday night was to a little old lady (actually, she wasn’t that little). She had been standing on her bed with her daughter to fix the curtains when she’d felt dizzy and fell down. She then bounced off the bed and landed on the floor. Unfortunately for her, she had landed on her neck and head.

One of the first things that I do in a case like this is to make sure that there isn’t an injury to the neck. I’ll do this by gently feeling the neck while the patient tells me if it is sore. If there is soreness to one side of the neck then this will normally be a muscular injury while if the pain is in the middle of the neck then there is a chance that the injury is more serious. Like a broken neck.

This woman nearly leapt from her bed when I gently touched her neck—she had a potentially serious neck injury.

So we needed to be extremely careful in order to make sure that if the patient had broken her neck, we wouldn’t make her injury worse by bouncing her down the stairs from her flat to the ambulance. Unfortunately, everything we had to tell the patient had to be translated by the daughter. I need to learn Bengali; it’s a real shame I have no head for languages.

The patient had to be moved down the bed so that our scoop stretcher could go under her then she needed to be securely strapped onto it ready to be carried downstairs. In this case I used a blanket roll to secure her head rather than the more expensive and less effective head blocks. We called for another crew to give us a hand because in a case like this it is better to be safe than sorry, and you need to be careful carrying a potentially unstable neck fracture down two flights of stairs.