Another day that played out to a theme. It was CVA day with a few exceptions.

A CVA is a stroke. It stands for Cerebral Vascular Accident. Basically it can be caused by a burst blood vessel or a blood clot in the brain. The seriousness varies from person to person and which place in the brain that the incident takes place.

The first job was to a middle aged lady who had got up rather early and had collapsed. When we arrived she had lost all feeling and movement down the left side of her body. Her observations showed that her blood pressure was very high which was a likely cause of the stroke. We put her on oxygen which we've been using as a miracle drug today. She was rather large so it was a struggle getting her to the ambulance but we managed. Inspired by the prospect of a cup of coffee at the other end I think.

Then to a 24 year old. Now this brings up a problem with the system they use for priotising calls. We got it as an "A" category cardiac chest pain which meant we had to be there in 8 minutes or less. Now it is not impossible for a 24 year old to have heart problems but it is EXTREMELY unlikely. It turns out that she had a bug and had been vomiting for a few hours. She didn't feel too good and I can understand why. Unfortuenatley there wasn't a great deal we could do for her except give her a drug which would stop the vomiting. We left her at home because that was the best place for her.

Then to a 93 year old. She had had a mini stroke. A TIA or Transient ischeamic attack. This is like a stoke but is temporary. She had a lot of these and when we arrived she was leaning to the left which is a good sign. The oxygen went on, which she didn't like very much. She wasn't really with it so she wasn't keen on coming with us to hospital but by the time we got half way there she had more or less come out of it and was as nice as anything.

Then to a few falls. Including one very nice lady who I used to take into Hospital when I worked on patient transport.

Then lastly to a man who had had a fit. Now sometimes you can get all the information you need from the patient and sometimes you can use detective work and sometimes its a struggle. This was all three. He was collapsed in the corner of the kitchen and certainly looked like he had had a fit. Cans of Guiness littered the flat (empty cans).

Aha.

The oxygen went on.

To his partner, "Is X an alchoholic?"

"He does like a drink every now and then"

"Yes. But is he an alchoholic?"

"Yes"

"When did he last have a drink?"

"Two days ago"

Lightbulb goes on. Ping.

When people drink a lot the body and the brain becomes used to having a high background level of alchohol. When these people decide that they want to give up they tend to just stop dead and go cold turkey. The brain rebels at this and sometimes they have a fit. Alchoholics should never just stop drinking, they need to cut down gradually.

He came round nicely with the oxygen and we took him into hospital. If he does give up then that would be fantastic but I honestly doubt he will.

Then back to base and home

So, there I was doing 95 mph down the motorway with the blue lights flashing. In the back was my crewmate and a chap who was in "Status Epilepticus". Thats latin for fitting for a long time. It was dark and raining.

And I was overtaken by a Mercedes.

I'll come back to that.

Another good mixture today.

We seemed to be following the police around for part of the morning which was very odd.

We were called to a young girl who was to put it bluntly, a bit "Screwed up" she was also very drunk. She had a lot of long standing mental health issues and had been in A & E the night before having taken an overdose. Apparently she had taken a few pills again, not enough to cause any damage but enough to register as a cry for help. The message came that she had assaulted her boyfriend hense the presence of the police. It turned out that she hadn't but they hung around anyway. (The WPC was very nice ). We didn't take the girl to hospital but managed to get her GP to mobilise her mental health workers. I hope that she gets the help that she needs because she seemed quite nice but had a lot of problems.

Anyway, we cleared down from that job and were sent to another job just around the corner. And there were the police again. We weren't sure why they were there, they weren't sure why they were there. But they were there. This time it was to an old lady who had just flown back from america and had a bit of a funny turn. She was very VERY deaf. She was fully with it and was quite adament she didn't want to go to hospital which was fine. We had to make her a cup of tea though.

We sat in carparks for a while and then got a job to the chap who was fitting. He had fitted before apparently but never for this long. It was at least 10 minutes before we got there and he was fitting for a while before his carer called us. Thinking about it afterwards I realized its quite rare for someone to still be fitting when we get there. They've normally finished. But not this time. We gave him some drugs that would stop the fitting. They worked but they have quite a strong tranquilising effect so he was out for the count.

The fitting was out of the ordinary so he needed to be in Hospital. The quickest way from where he lived to the Hospital was on the motorway.

Which is where we came in

 Well, I'm back. To misquote the last line from a very famous book

 I was off for christmas and managed to catch Bronchitus from some where, so I was off for longer than I expected. It must be all the ill people I mix with.

 Back with a vengeance. Every single person needed to be carried today and I'm quite tired. Time was when we used to carry everybody that we went out to but we are trying to get away from that these days. The trust is quite keen that we don't carry so many people so we don't go off sick with back injuries, we're quite keen because they are the only backs we've got and we would quite like to keep them thank you.

 Now if someone is having a heartattack or there is something hugely wrong with them then they will get carried but otherwise no.

 All the people we went to today were ill.

 An old man who had been on the floor for a significant amount of time. He couldn't remember falling but he was wrapped around his walking frame and by the time somebody found him he had developed pressure sores on his back

 A woman with abdominal pain with which she had been up most of the night.

 A very large chap who was ill with something. It had developed quite quickley over the last two days and by the time the GP had been to see him he was really not well at all. He was not really with it and became quite argumentative with us. It wasn't his fault but getting off the carry chair halfway down the stairs is a recipe for problems. Never mind we got him to hospital so hopefully he will make a recovery.

 About a year ago we went to a chap who died on us twice and later made a full recovery. I did write about it at the time. It shook me up in a major way. Anyway I got a Christmas card off him this year. Obviously that means he is still alive and well and that counts as a succesfull resuss in the NHS figures. People have to survive a year after a Cradiac arrest to figure. Personally I'm just glad hes's alive. As, I'm sure, is he.    

Another busy day. Very little of importance. People with broken legs who didn't have broken legs, faints, lift off the floors.

2 jobs however were a bit more than that. An elderly gentleman who hadn't been seen today by his neighbours. They kicked the door in and he was dead. We weren't far away so it only took us 4 minutes to get there.

Unfortunately he had been dead a while so there was nothing we could do. He was very cold and just starting to stiffen up (Rigor Mortis). But from the look on his face he had not felt any pain at all. I told the family this, they had just arrived, they took some consolation from it.

We called the police because it was an unexpected death and put the chap to bed. The police arrived and we left them to it.

Then in the afternoon we were on base and the radio opened up. Sometimes you can tell from the mobilisers tone of voice that something a bit nasty has happened. We were sent to the job with a paramedic responder (I've been working with another technician today.)

We exited the garage and the words nobody wants to see came up on our VDU.

"Paed arrest"

SH*T

It was a few miles away but we did it in two minutes, all arriving together.

Fortunately the baby was breathing again. His aunt, who luckily has done first aid, gave it a couple of breaths. It did look very pale however. It turned out it was premature and had been under the weather today. That possibly accounted for why it had stopped breathing. We took them both to hospital and on arrival it was a nice pink colour again.

We all breathed a sigh of relief.

The day did not start well.

7am we started and at about 10 past we were sent out to a male fitting. It was raining and about half a mile into the journey 3 things happened:

1. The windscreen wipers stopped

2. The suspension collapsed

3. A sudden smell of something electrical burning

We called control and said that we couldn't carry on because basically we couldnt see where we were going and we were banging our heads on the roof of the cab everytime we hit a pothole. They weren't very happy but what could we do.

Somebody else was sent to the fitting man and we bounced back to base.

We got on to another vehicle and were immediately sent out to a maternity job.

I hate maternity jobs.

Apparently the contractions were 2 minutes apart and this was the second child.

We arrived and mum was on her hands and knees on the kitchen floor. We both went into professional reassurance mode.

Then she screamed very loudly "Its coming". And it was.

Two thoughts went through my mind at this point: "Oh bugger" and "Wheres the midwife" She was on her way but traffic was VERY heavy.

Another thought "This is down to us then" as I moved round behind mum.

A head was looking at me. Mum pushed and the baby came out very easily. We dried her, she cried immediately which is a very good sign and we got dad to cut the cord. Then the 3 of them got to know each other for a while while we did some tests to make sure they were both ok.

The widwife arrived at this point so we let the expert take control. Unfortunatley mum was having difficulty delivering the placenta so we ended up taking them both into hospital which wasn't a problem for us although they didn't really want to go in.

Everything went well. A Happy event all round but I can say after that I was intellectually, emotionally and physically knackered.

Gravity has been a bit of a problem again today. I don't know why but we've been to nothing but falls.

All ages and all sexes but they had that in common.

But it brings me neatly to one of my favorite weapons in our arsenal.

Entonox. Entonox is also known as gas and air or laughing gas. If you inhale it in sufficient quantity it will help you deal with pain. Now it doesn't work with everybody but for those it does work with its really good. It doesn't take the pain away it just puts you in a frame of mind where you don't care. And yes you do laugh.

We went to a lady who had slipped on her front step and landed hard on her shoulder, dislocating it. She was in a great deal of pain. We checked her over and acertained that she had slipped, not passed out or anything like that. Now the job was to get her up off the floor and into the ambulance. 7 or 8 really deep lungfulls and she began to smile. My crewmate told a joke from the ambulance persons big book of bad jokes. That was it, she was laughing her head off. Using the window of oportunity we got her to her feet and into the ambulance. Her laughing all the way

Now i'm not saying it wasn't a serious injury. For the elderly any fall can be serious. But Entonox helped us to help her and it has no side effects. Brilliant stuff.

We'd just been to see a woman who was having periods of Tachycardia (Fast heart rate). She'd called us because it had woken her up. When we arrived her heart was beating at about 150 beats a minute. Which, to put it mildley, was a bit quick. We put her on the oxygen and by the time we got her to the ambulance she had gone back to a more normal 68 beats a minute.

Anyway we had dropped her off at Hospital and were heading back to base. A message came through on our display terminal. 30 miles away there was a lady giving birth.

We were the second closest vehicle. This happens sometimes. Its all down to timing. If all the vehicles in an area are out on jobs and that one extra job comes in the next nearest is sent.

That was us

As we made our way more information trickled through to us.

Twins

I hate maternity jobs.

As I said we were the second nearest vehicle. The first one was a lot closer than us and arrived quite quickley. Thankfully the helicopter was available and was sent as well. They arrived soon after.

This is where the helicopter comes into its own. For getting to and from remote locations quickley it is invaluable.

We were still on the motorway. Making good time but still a few minutes away.
There is a lot that goes through your mind going to things like this. Is everything ok? Hope we don't get lost (it was well out of our patch) What do I do if X happens? What do I do if Y happens?. I certainly run through senarios in my mind if I have time.

We arrived and the babies were leaving on the Helicopter and mum seemed to be well and was going to go on the other ambulance. In the end we weren't needed but we might well have been. It was about covering all eventualities I suppose.

I hope everything works out all right for all concerned

Friday. I'm working in daylight (sort of). I know its psychological but whenever I'm at work it seems to be dark. Today only dark at the begining and the end of the shift

Nothing spectacular today, no massive traumas, nobody died. We went out to falls, collapses and slight illnesses. It was busy but not very busy.

The first job of the day was a bit of a struggle though. Luckily the day didn't continue in the same vein.

"Man collapsed, fitting" was what we got. We arrived on scene and were met at the front door by the mans son. We went upstairs to the mans bedroom and found him on the floor. He had obviously fitted and he was now post-ictal. This is the state that people who have just fitted arrive at. They don't know where they are and indeed who they are. They are quite scared and become on occasions violent. Its not their fault, the brain is still rebooting after the fit and it needs time to sort itself out.

We did the usual things, or tried to. I have never met such a strong 80 year old before. He pulled the oxygen off his face. We tried to carry him down stairs but he refused to stay in the carry chair. In instances like this you have to wait untill they become calmer and hope they will let them help you which he did.

By the time he arrived at hospital he was as nice as anything. We got him into a & e and collapsed in a corner. He'd worn us out and it wasn't even 9 am