The Complete Blood, Sweat and Tea

An example: we got called to a drunk who was being verbally abusive to a bus driver – we were called because the drunk had fallen over, while the police were called because of the abuse. The drunk man was obnoxious, and well known to both of our services, and because of the lack of an injury was left in the care of the police. If he had been injured then the police would have left the matter in our hands.

So, when we co-respond, the ambulance crew pray that the patient is uninjured, so the police have to deal with them, while I suspect that the police hope that the patient is injured so they don’t have to arrest them.

However, there are a lot of specialist teams in the police service that we tend not to come into contact with that often; we mainly get to meet the normal ‘beat’ coppers. Thankfully, we rarely see the murder, child abuse, drugs or dog teams. This isn’t to say we never see them (and our station did get a Christmas card from the local murder squad telling us to ‘keep up the good work’), it’s just that it is fairly rare.

So, it was rather surprising that I met with the dog-handling team twice last week. On the first occasion, we were called to a known schizophrenic who had threatened to kill herself. The patient herself (a regular attender at the local A&E) was a bit of a pain to deal with, she wanted to stay at home and kill herself and couldn’t see why we wouldn’t let her do that. Her dog, on the other hand, was a real pleasure – happy to see us, interested in smelling all our equipment and extremely friendly. As the police were already there, they got the dog squad to look after the animal until the patient was discharged from hospital.

In case you think I am being harsh on the mentally ill, the patient attends A&E every day with the same complaint of wanting to kill themselves … she hasn’t managed it yet.

The second time I saw the dog-handling team was when we had to gain access to a house where the patient was unable to come to the front door and let us in. The interesting part in this story is that there were five dogs of unknown temperament in the house. For half an hour the police unsuccessfully tried to gain access, mainly by climbing up a ladder and trying to open a bathroom window. We were able to talk to the patient, and so we knew that they were not badly hurt, otherwise we would have had to kick the door down. Then the dog team turned up and, using a top secret criminal technique, managed to get the front door open in about 10 seconds, thus putting to shame the half-hour everyone else had spent trying to gain entry.

All five dogs were really lovely, although energetic, and at the end of the job I had to spend 20 minutes brushing the dog hair off my uniform.

There is a joke we have about dogs. When we ask a patient if the dog is friendly, the patient always answers that they won’t bite; the reply to this from the ambulance crew is to add the unspoken ‘They only bite people dressed all in green.’

I’ve only had one dog take a dislike to me. But I managed to pull my hands away from his gnashing teeth before he could catch me.

Perils of Drinking (Number 1 in a Series of 230)

It was the usual type of busy last night – we heard rumours that there is such a thing as an ‘ambulance station’, a mythical building where one might use the toilet or partake of the life-giving ‘cup of tea’. It must be a myth, as we never saw it at all.

As I have mentioned, we get our calls sent down to a computer screen in the ambulance cab; sometimes you wonder how the Control crew have entered it while keeping from laughing down the phone at the patient. A case in point was one of our calls last night which was given as ‘53-year-old male, taken 3 × crack cocaine, cold and lonely, needs to be put back together’.

Avoiding the rather obvious ‘Humpty Dumpty’ jokes, we soon realised that the complaint, and the location he was calling from, fitted one of our semi-regular callers. By the time we got there he had left the phone box and neither us nor the police could find him after a search of the area. Obviously I was distraught …

Our other stand-out job of the night was a 57-year-old male fitting. We quickly made our way to the location, to be met by a block of low-rise flats that often sneak up on you in our area. These are three or four floors high, and have no lifts. Also there was one of our First Responders. We entered the block, and immediately made our way to the stairs (it is a little known law of physics that in flats with no lifts, people on the ground floor are never ill … only those on the top floor).

Entering the flat, the general state of disrepair, mess and the 3-litre bottle of strong cider I tripped over tended to give the impression that it was owned by an alcoholic. We got into the living room to find a large man lying senseless on the floor, while his daughter was sat over him stroking his hand, trying to reassure him. A quick check over, some oxygen and a chat with his daughter revealed a history of alcoholism (surprise!) and the occasional alcoholic fit. He was a big man, so we packaged him up in our carry-chair and carried him down three flights of stairs. All the time his daughter was saying how strong the nice ambulance men were – which only goes to show that she wasn’t paying attention to my reddening face and struggles for breath …

We got the patient into the back of the ambulance where he started to fit again, this time lasting about 2 minutes. He also decided to bite his tongue and vomit, which meant that the back of the ambulance (and myself in some part) was covered in bloody, cider-smelling vomit. I think I’ve mentioned before how I can’t smell alcohol on someone’s breath, yet I can smell cider when it has been vomited all over my ambulance … and it turns my stomach. We packaged him up and ‘blued’ him into Newham, where he had another two fits (despite some rather strong sedation) and by the end of our shift he was still in Resus’ having infusions of phenytoin and Pabrinex.

So, a busy night without the chance to see our station, with at least one mopping out of the ambulance … pretty standard really.

The vomit in the ambulance took place at the end of our shift, so we couldn’t even get back to station to use the mop. Unfortunately, with the increased number of calls we have, getting back to station is becoming rarer than ever.

Security

Yes, I know I’ve written before about kicking down doors. However, in this post I offer people advice in making the beating down of their door as hard as possible. So please excuse the repetition. Like all good health-care professionals I regularly ignore my own advice.

There is a visceral pleasure in kicking down a door. Once or twice I’ve managed to see someone who is really ill trapped behind a locked door, occasionally there has been someone who has just been unable to open the door. And just the once I have kicked down a door that the patient refused to open because they were schizophrenic and didn’t want to open the door – not that I knew that at the time.

I’ve even been surprised at the ease in which I can kick down the doors of the flats that I live in. Actually, it would be more accurate to say that I am scared with the ease in which the doors can be broken. Oh well, it’s not as if I have a lot to steal anyway …

My experience of kicking down doors has taught me which security features are useful when trying to prevent someone from stealing your TV and video.

If you have a deadlock-type lock, then use it – always. The skill of kicking down a door relies on breaking either the lock, or the wood holding the lock; deadbolt-type locks are a lot more secure than the normal Yale type lock.

If you are in the house and have a bolt on the door, then use it. It takes a lot longer to kick down a door when there is a bolt in the way. Another trick behind kicking down a door relies on applying the force of your kick to the (hopefully) single point of resistance. If there is a bolt at the top or the bottom of the door it makes it a lot trickier to break that door.

Windows in the door are a bad idea – they are a weak point that can be easily broken, and then a skinny hand can reach through and unlock the door.

If you really want to be safe then have a bar across the door. I’ve seen it once or twice, and if someone has a bar across the door then there is no way I’d be able to break that door down. Just make sure you don’t collapse behind it.

Major Incident Cover

One of the perks of this job is the need to cover football games. Well … it’s a perk if you enjoy seeing your local team play. Personally, I can’t stand football but overtime is overtime, and it does make a nice change from the usual jobs I go to. So, this Sunday I got to see West Ham play against Derby.

The LAS provide ‘Major Incident’ cover for these games, we don’t look at sprained ankles or minor injuries (that is the job of the St John’s ambulance). We also don’t look after the players who get hacked down and are unable to walk, only to watch them turning somersaults a scant 5 minutes later when their team scores a goal (that is a job for the private medical firms).

So, unless a stand collapses, there is a major fire, a bomb goes off or someone drops dead in front of us, there is very little we have to do. At the West Ham ground (my local football club), there are four ‘road crew’ present, along with at least one major incident support vehicle, one radio operator and an officer. The road crew sit down near the pitch, while the officer and radio operator sit in a VIP box overlooking the whole ground.

Today I was given the role of ‘safety officer’, which doesn’t mean I’ve been promoted, it just means that in the event of a major incident, I’m supposed to watch out for the safety of the ambulance crews present, liaise with the police and fire service about any hazards that might be a problem, and to make sure that any crews that attend the incident are not getting too stressed. I also have to talk to the person in overall control at the incident about any issues within this sphere that may occur.

We were warned that there was an increased chance of violence at this match because some hooligan ‘supporters’ were appearing before the magistrate tomorrow, and that some of their ‘crew’ might want to cause some trouble. Luckily for us, that did not happen, despite a 2–1 loss.

It was really cold down there in the stands, I had my undershirt, shirt, body armour, fleece and hi-visibility all-weather jacket on, but I was still freezing. Anyone listening carefully as I walked around trying to keep warm would have heard a clink-clink-clink-clink sound as my frozen balls knocked together.

As I’ve mentioned before, I’m not a huge fan of football (overpaid idiots, getting more money in a week than I get paid in a year for booting around a plastic ball), so I spent most of the match listening to music (The Magnetic Fields) on my smart-phone, while stamping around trying to get some sensation back in my toes.

As a quick aside, who needs an iPod Shuffle? My smart-phone can do the same thing and more – it can even make phone calls …

Half-time came and went so we joined the St John’s Ambulance for a cup of tea and a sandwich, rather than watch a bunch of scantily clad young women prance about. Then we were back in the cold, where I tried to stay awake while West Ham, perhaps predictably, lost …

With the exception of someone having a crafty cigarette and setting off a fire alarm, it all went rather smoothly. I did find it funny that the people in the stadium knew what the ‘Inspector Sands’ announcement meant, and did nothing but laugh quietly at it.

At the end of the match we have to stay around until we are ‘stood down’ as the last few supporters leave, so we sat in the ambulance, with the heater going, wrapped in our own blankets (remember, we know what those blankets have been wrapped around, yet we still used them – that is how cold it was).

We then started making our way back to station …

… to come across a policeman who had tried to stop a car – only to have them speed up (possibly accidentally) and hit him. He wasn’t especially badly hurt, but we took all precautions as we transported him to hospital. He’ll need a few X-rays, but I suspect that he will be fine.

‘Inspector Sands’ is a codeword for use over a public address system. It is used to let the staff know that a fire alarm has gone off without alerting the public and possibly panicking them.

Phonetic