Once cast as part of the 'axis of evil', Iranians have shown they are real people, not collateral damage in waiting Published in the Guardian...
Too much to say about the man, the music, the performance & phenomenal contribution to Pop-Culture in general: "Thriller", his 1983 Motown 'Moonwalking', Guinness World Records including one for "Most Successful Entertainer of All Time", 13 Grammy Awards, over 750 million records sold worldwide, even lesser known bonkers stuff like filing an "Anti-gravity" patent to use in the "Smooth Criminal"...
The nation watches and either feels its veins bulge with rage or shrugs with resignation, despairing at society's inability to change Published in the Guardian...
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.
One weekend has seen the Middle Eastern landscape transformed and the US president's critics are already circling Published in the Guardian...
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.
Though it may not last, the prime minister is finally back on the terrain he likes best the issue of spending plans Published on the Guardian's website...
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.)
To win back the voters of the broken heartlands, Labour must remind the public what it's for. But I fear it won't be enough Published in the Guardian...
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.
Published on page 1 of the Guardian's Top stories section...
Published on page 1 of the Guardian's Top stories section...
Published in the Guardian...
If Barack Obama means business, we will now see if our criticism of settlement policy was merely token Published in the Jewish Chronicle...
Opponents of Gordon Brown claim Downing Street smeared the communities secretary after she quit this morning Published on the Guardian website...
A coup d'etat, a Johnson coronation, an early election all the options for saving Labour are now fraught with risk Published in the Guardian...
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.
