As violence erupted across town, stabbings, beatings and even a hammering, we were zooming off in the other direction.

We were going to what is quite a common occurence. An elderly woman had pulled her emergency cord and now the emergency alarm company couldn't get her to talk to them.

It could be that she had fallen and now couldn't make herself heard, it could be that she was unconcious or worse or it could be she was asleep.

So we were going to have a look.

We got there and let ourselves in. Going from room to room we shouted so we didn't surprise her. There was no sign that she had fallen. We got to the bedroom and opened the door.

There she was, fast asleep.

Now what? Now bear in mind that this is 2.30 in the morning. Do we leave her be and leave the flat and she would never know we were there? What if she's not asleep? What if she's unconcious?

Reluctantly we decided that we had to wake her up. My crewmate shook her gently. No responce. He shouted in her ear. No responce. He pinched her fingernail. No responce.

Ah. My crewmate took some observations (Blood pressure, blood sugar, etc) Now these are all fairly uncomfortable if you aren't expecting them. No responce. This was becoming odd.
 
I had a look at her medical records. She had dementia and diabetes and that was about all. I got onto her relatives to find out if she took any sleeping pills.

The answer to that was no and it was begining to look as if we were going to have to take her to hospital. But then her grandaughter told us that she play sleeps. She pretends to be asleep if she doesn't want to talk to anyone.

And then, as if by magic, she woke up and told us that she wanted to stay in bed and would we make her some dinner as she hadn't eaten for three days. Pushing last nights dinner plate out of the way we explained that it was 2 in the morning and we were going.

Made her some bread and butter though.

Just once I want to tell someone to shut the f**k up.

We've had two today. The first one was a young girl in the local high class shopping centre. Now she was having a panic attack pure and simple. The first aiders in the shop had done a good job and had managed to calm her down to a large degree, when we arrived she was fairly lucid and was answering my questions. As the discussion got to what had happened in the shop she began to hyperventilate and grabbed my collar and shouted that she couldn't breathe and was dying. If someone is shouting that usually means that breathing isn't a big issue for them. Anyway, I was nice which didn't work. I was firm, which didn't work. I was very firm, which did. 

 She then started praying. She asked me if she was going to die. I explained that she wasn't. This went on for a while.

Eventually we got her calm enough to go home. I don't know what was causing her problem because a. She wouldn't tell me and b. Its not really my business.

But when you are trying to help someone and they are shouting in your face those forbidden words start forcing there way to the surface

Then this afternoon we went out to an old lady who could be called a "Game old Bird". She lived on her own in a huge country house and had slipped over in the toilet. She was riddled with arthritis and was in a lot of pain. Her right ankle was swollen and was getting bigger. Probably broken.

The thing with this lady was that she was stone deaf. And she wouldn't wear her hearing aid. And she wouldn't stop talking (shouting) at us. She was very nice but we couldn't get a word in edgeways. So we couldn't tell her that she needed to go to hospital. She'd actually decided that for herself but still.

But still, she could have been nasty. They both could have been nasty. We treated them and they were in a better state when we left them than when we arrived.

Which is the desired result afterall

God its been cold!
 
What happened to the summer that we were having last week? 

Its been a neurological day today. Everything has been to do with brains or spines.

First off to a man who had been walking into the office with his arms full of books after having a bad back all week. He twisted and managed to trap his sciatic nerve. That is INCREDIBLY painful. If you've ever done it you will know exactly what I'm talking about. We arrived and he was crying with pain. We gave him some Entonox which relaxed him a fair amount. Tramadol relaxed him enough to go home. It was while I was filling in the paperwork that he happened to mention he was a lawyer. I filled in the paperwork very carefully.

Then we broke down and had to go to the workshop for some essential fixing, well not essential but it needed to be done and as we were in the area....

Then to a man with MS who had just finished his physio therapy and head butted a table. Small bruise on his nose.

Then off to a lady with cancer who had got a trapped nerve in her back. The result of this was that any pressure on her feet was excruciating. Her GP had booked her in to hospital. While we were at the hospital we were treated to the sight of  a consultant verbally kicking the c**p out of the hospital manager. She was explaining that there were too many patients coming into the hospital. She further went on to say that a lady of 100 years old really wouldn't improve lyeing on a trolley and needed to have a bed. It was great fun and made me smile a lot.

Lunch time

Then off to Oxford to take a patient up to the new, improved John Radcliffe hospital. Very nice it was although we got told off because we went in the wrong door.

A nice day all told although it did snow everytime we got out of the vehicle and was sunny evertime we turned the heating on. English weather, I wouldn't change it for anything 

Well, thats a week of 8-4 shifts over with. Very civilsed they were, going to work and coming home in daylight. We did get two late finishes and one early finish because we didn't get a mealbreak.

Nothing exciting to write about although we did seem to visit a lot of schools for some reason. We had one of the call takers from control out with us for a day and the "curse of the 3rd manner" struck with a vengeance. No death and destruction to show her.

Weekend off now and its back to working for 12 hrs at a time.

Sometimes you can summerise jobs with a word. "Crap", "Fun", "Scary", etc.

Sometimes you can summerise with a sound.

The first job this morning could be summerised with the sound, "Eeeewww"

The job was a woman who had had a C-section about a month ago and now it sounded like she had an infection.

So we made our way to one of the less salubrious parts of the less salubrious parts of town. Blocks of flats built in the '60's and showing their age, now surrounded with 6 feet high iron fences. I think the look the council was after was "New York Prison". I think they got it spot on.

We rang the buzzer and a voice mumbled something and the door unlocked. In we went, up the grubby communal stairs to the flat.

We went in to the sound of an unseen, barking dog. We avoided the puddle of dog urine on the floor, skirted round the disused fridge freezer on the (internal) stairs.
 
Stepping over the half a pizza in the doorway we met the woman concerned. She was laying on a mattress of indeterminate colour in the living room and she explained that she had been recently treated  for an infection following a C-section. Now the pain had come back and she wondered if she had an infection again. Testing her temperature showed that it was quite high. The other observations where fairly normal.

Next came examining the wound. She said that the district nurse came every few days to dress it. She straigtened out and showed me the wound:

And emerald green goo came flowing out of the hole.

With my years of medical experience I was able to confirm that she did, indeed, have an infection.

We took her back to the hospital and while I was handing over to a nurse my crewmate disapeared. I came out to find him frantically wiping down all the surfaces in the back of the ambulance.

Nothing to write about. The weather has been glorious. We've done two jobs all day. Fan-bloody-tastic.

The two jobs weren't particularly interesting either. One was a two year old that had fallen down stairs and done what kids do. Bounce. A slightly bloody nose was the extent of her injuries.

The other was a dotty old lady who had a chest infection.

And thats that.

I'm not complaining however.

I'll tell you about a job one of my colleagues did at the weekend. Somebody had driven past a car crash and reported it to us as a single car RTC with a body lyeing in a ditch. As you can imagine my colleague was trying to get there fairly smartish.

When they arrived they found nobody injured apart from the dead dear in the ditch. Sigh!!

Well, thats another set of nights over and done with

They've been notable for the fact that they've been theme nights and the fact that nothing has been straightforward.

The theme for the last few nights has been Chest Pains. Chest pains are "A" category calls which means we must get there in 8 minutes or less. But as I've mentioned before the information that the patient gives control and control gives us gets a bit scrambled.

But nothing has been straight forward. The classic signs of cardiac chest pain is a feeling in the left side of your chest like an elephant is sitting on it, sometimes you get pain in the left arm and sometimese it goes into the neck and jaw. Another sign is cold sweats and a feeling like you need a poo. A combination of any of these will make ambulance people move quite fast.

But I'll give you a for instance of what we've had:

A lady who presented with left sided chest pain which sounded cardiac but while we were there she had a sudden attack of diarhoea which made the pain go away.

A man who had a history of heart attacks and angina and had had pain since 9pm the previous night. However the pain got easier when he got up and walked about.

There were others in a similer vein but you get the picture. We couldn't say that these people were having heart problems but we couldn't say they weren't. The problem is people like to know whats wrong with them and in instances like these you can't tell them with any certainty.

There's been the fillers as well. The time wasters I suppose you could call them.
 
A lady called us at 3am because she had piles. 

A young man called us because he said he had tripped down a curb and broken his leg. There was no sign of a break but he was maintaining he was in a lot of pain. We got him to hospital and he then discharged himself and went home. We were his taxi across town.

A 15 year old from the next town over appeared saying she had lost all feeling down one side of her body apart from her knee which hurt. Yeah right. It turns out she was a missing person as well.

So all in all a confusing, frustrating set of nights. Never mind you take the rough with the smooth.

God it was windy. I saw rain going upwards.

Nights again. The first half of the shift went very slowly, we spent probably half of the shift waiting at casualty for beds. It was GP Monday afterall. People still don't seem to realize that their doctors work at the weekends so they struggle through til monday. The doctors see them on Monday and because they have got worse over the weekend book them into hospital. Also while a lot of them could make their own way in the doctors arrange for an ambulance to convey them. Hence they all arrive at once. The result of all this is lots of ambulances parked outside casualty for 2 hours at a time.

The nurses were struggling to clear the ward and we were standing around with patients on our stretchers. This again comes down to targets. The casualty department has to have a patient seen by a doctor and moved to another ward or discharged within four hours. If the patient is still on our stretcher then they are technically still in our care and not technically in casualty. So their clock hasn't started. So thats another reason why we were stood around.
 
Its not the hospitals fault, its not our fault. If its anyones fault its the fault of the government for being obsessed with targets.

A storm raged outside.

We then got sent to sit in a carpark for a while. The ambulance rocked gently in the wind. Then we got a job. To a 91 year old chap who was very very very VERY Deaf. He refused to wear his hearing aid so we had real problems trying to find out why we were there. Eventually he produced a letter from his doctor which was in doctor writing. That meant we couldn't read it. Eventually we got to the  bottom of it with a combination of shouting, gestures and penmanship.

Took him in and then got sent to sit in a carpark again. Then we got a call to a house which was just over the road from the first one.

We opened the door and straight away we knew he wasn't well. He was sat in a chair and was really struggling to breath. His breathing was very wet and bubbly and he couldn't talk to us. He was struggling so hard it was making him sweat. We nebulised him but it didn't really make a difference. We found a discharge letter from the hospital that said he was a dialysis patient. Basically what was happening was that his kidneys weren't getting fluid out of his body and he was filling up so much that fluid was entering his lungs. He was drowning.

One of my phrases that I sometimes say to patients is, "You can tell how serious it is by how fast you see us moving"

We were moving quite fast.

He should be being dialysed hopefully by now

What will tommorow bring I wonder   

Sunday. A wet sunday in early March.

For us a completely average day. Not too busy, not too quiet. Nobodies life saved. Nothing interesting to write about.

So I wont.  

 I don't know what was going on today. Maybe its because its a full moon or something.

We haven't done anything spectacular today. Nothing bloody and nobody saved.

The thing is I think everybody driving around today seems to have had a braincell removed.
 
Driving on emergency is dangerous. Its a big adrenaline rush when you first do it but that soon wears off. You spend a lot of time in the middle of the road, overtaking people and sometimes on the other side of the road.

All you really want is for other motorists to find a safe place to pull over and stop. Then we can find a way round. A lot of people, and worriengly a lot of driving instructors, seem to think its ok just to put your indicators on and keep driving at the same speed.

Now, think about what we are driving. They are approximately 4 tons of van conversion with a lot of extra kit on them. They're not souped up or anything like that, they're just ordinary vans. Consequently they don't accelerate very fast. So they can't overtake something thats moving at a fair speed with any safety.

Also when any emergency vehicle is coming along a road, the driver has to assess what the other vehicles on his side of the road are doing; assess what the vehicles on the other side of the road are doing; checking pedestrians, side roads, road signs etc. Its a lot of information to process. It is so much safer to all concerned if the other motorists are stationary.

So can I make a plea. Please check the rear view mirror from time to time. If you see an emergency vehicle coming up behind find a safe place to pull over and stop.

Its safer for you, safer for us, and we will be able to get to where  we want to be so much quicker