The Common Hospital Pillow ( hospitium diripio )

The Hospital Pillow is an extremely long lived organism. It roughly oblong in form and is approximately 2 feet long by 1 foot wide. With no obvious external sensory organs it does have an external carapace which it sheds at regular intervals.

The common Hospital Pillow

It is a species with two genders and an extremely strong migratory instinct. Therefore when spawning time comes around (approximately once a month) the entire species migrates, en-masse, to the spawning ground. There they lay their eggs and return to the feeding grounds

It is not known what they eat, they could use photosynthesis due to the total absence of mouthparts and the fact that they are almost always found in brightly  lit areas.

The Hospital Pillow in its natural habitat

 They are closely related to the House Pillow although this organism does not share the migratory instincts of its cousin. 

They are almost always pale in colour, a natural camoflage it allows then to blend in with their environment

As a species they appear to be thriving due in no small part to their mobility and their lack of natural predators

So there we were, zooming through the (rather sunny) countryside. We were off to an old chap who was having chest pains. As you probably know more times than not the call is a false alarm.

So, we were the third resourse to be sent. There were two responder cars ahead of us and when we arrived they had the situation well in hand. The patient was on Oxygen and an ECG was being done.

One look was enough

"I'll go and get a chair", I said. He was having a Heart Attack

His pain was bad but he was coping well. We got him downstairs and on to the Ambulance.

As the responder was a paramedic (I wasn't with my usual crewmate today) we were able to help him with the pain. First off we gave him some morphine and then we gave hims ome drugs that would help get rid of the clot that was killing his heart muscle.

We did this. The pain was easing, probably because of the morphine. I loaded his wife into the front with me and we hotfooted it to the cardiac care unit.

On our arrival, I opened the back doors of the ambulance to find a man with no pain and a normal ECG.
 
Marvellous stuff. Just a shame its 600 quid a dose. Its worth it though. We went back to CCU some hours later and he was sitting up tucking into a Ham salad.

The very next job did not have such  a happy ending. We got sent to another old chap who had died sometime in the afternoon. Unfortunately his family did not discover him immediately. By the time we arrived he had been dead for some hours. Nothing for us to do.

Last job of the day was a bit of an oddity. One of the suburbs of my town is up on a hill. A lot of roads come off the hill and a man was driving his white van down one of them. Problem was he didn't stop at the bottome of the hill and continued on, into someones front room. They were having dinner and were quite put out as you can imagine.

It turns out he had had some sort of convulsion, reason unknown. He wasn't badly hurt but the scene was absolute carnage and chaos

A definate "Oh F**k" moment

And the award for quick thinking in a non comedy situation goes to........(fumbles with envelope).....

Me and my crewmate.

Last job of the night to a house full of partying teenagers. Usually a queue for swearing under the breath.

Anyway, we got the job as "Male..fitting"'. We fort our way through the throng to the kitchen where the lad was. The lyrics of an old Jona Lewie song echoing through my mind.

"You'll always find me in the kitchen at parties"

So he was lieing on the floor in the recovery position. I asked the assembled what had happened and they all answered me together. We shooed them all out bar one and started again.

It turned out that he had had a fit and after talking to him he was showing all the signs of it. A bit confused and repetitive.

At that point a drunken girl wondered into the kitchen and said, "There's an ambulance outside"
 
We turned and in unison said,"We know"

The patient then said in surprise,"Why is there an ambulance outside?"

"Well, normally we fly but seeing as its the end of the shift and we're both tired..."

Then his mum came in.

I had a dream last night:

Darkness, orange lights in the distance. Grass under my feet but crunchy. I look down and there, sparkling, shards of glass

A smell of oil, petrol and hot water.

A car on its roof, smashed, people standing around not talking. A girl sitting on the grass, shaking.

We went to an RTA or RTC or TC or whatever they're called this week. It was on the main dual carriageway up from the motorway. One car was all that was involved. Basically they had steered slightly wrong, hit the central barrior and flipped the car.

Nobody was badly hurt, more shaken up than anything.

But as we walked over to them my dream came back to me. It was virtually identical. Now, we go to a lot of car accidents but the similarity was marked.

Make of it what you will

Well, the weekend gets better.

It started quite nicely too. First to a 5 week old who had had a fit. Very tiny she was. We managed to reassure her mum and make her a bit happier and got them all to hospital.

Then to a publican in one of the rougher pubs in town. He had varicose veins from being on his feet for sixteen hours a day for twenty odd years. He was climbing out of the shower and caught a vein somehow and then proceeded to decorate his flat in an interesting shade of blood.

We arrived and he had managed to sort it out himself, although his flat looked like the texas chainsaw massacre. As is so often the case we couldnt find the actual wound. He was a nice guy but I'm really glad we didn't have to carry him down stairs

Then to another pub and a girl that was acting a bit odd. Without going into too much detail at the moment it all got very nasty. She told us to "F**k Off". Her boyfriend got violent, we called the police and they both got arrested

We were both quite shaken by the whole thing. Especially as a woman came up to us and said that she had spotted him urineating up the side of the ambulance

I am heartily sick of this to be honest. I am trying to do my job and get abused for it. Why do we have  to put up with it? Is it worth it I wonder?

Oh well.

The rest of the night was taken up with the usual elderly people with breathing problems and chest pains. But I don't think either of us were giving a hundred percent.

iwho,r

You might gather from the above that I'm a bit p**d off.

We didn't get a break today. At all. Although we did have a cup of tea. Another reason I'm P**ed off.

Fitting seemed to be the order of the day for a lot of people that we saw. Ranging from a three year old, who had just been diagnosed epileptic. This was quite distressing for mum as you can imagine. We gave him some drugs to stop him fitting and by the time we got him to hospital he was starting to come round a bit. 

 Then to a man at the other end of the spectrum. He was a very heavy drinker who was trying to come off the booze. Like a lot of them do he had stopped drinking completely. And as so often happens, his body had thrown up its (metaphorical) hands and he had had a fit. Basically his body had become so used to the amount of alchohol that it had in it that when this was removed his brain couldn't cope.

While I admire peoples intentions when they are trying to kick the booze they go about it the wrong way. Slowly decreasing the amount is the only way to do it. This is probably harder but in the end its best.

And that was it. Actual ill people and very busy. Again because of the lack of staff.

I do wonder when the crisis point will come 
 

We were three today. Which is bloody handy sometimes. Three people is the optimum number for most jobs; it seems to make life so much easier.

Lots and lots of chest pains today. Although as per normal, non of them were your standard chest pains with pain going down the left arm and shortness of breath. The classic symptoms. Although we got them all as "A" category chest pains, they all seemed to be something else. Chest infection, gastric troubles, you name it.

Thats the problem with diagnosing over the phone I suppose. 

I can't think of anything more to say so I'll stop there.

I'm off to bed.

'Night! 

It always seems to be a struggle at work. We started at 6.30pm and the garage was empty of ambulances apart from the real dregs that people dont work on unless they have no choice because they don't actually work properly . We had no choice because the people we were taking over from were very late finishing. The problem is that because we always seem to be short of equipment it took us ages to actually create an ambulance that could do things. Of course we didn't get the chance.

We got a sent to a lady who possibly had meningitiss. The GP was still there and had given the patient a big dose of penicillin. Sometimes the cure feels worse than the disease and she felt pretty rough.

The streets seemed to be pretty empty and on our arrival at casualty we found out why. Everybody was in hospital.
 
Sounds of: babies crying, old people with dementia shouting for help, low buzz of conversation, phones ringing, pagers going off.

Smells of: excrement, bleach, coffee,  curry from the nurses lounge when they try and snatch a bite to eat

We assumed our custamory position under the clock and waited for a bed.
 
Night fell and we went back out into the madness. The staff level was a bit better tonight and it showed.

Back to the university. A student who was having breathing difficulties. The fact that he had drunk three and a half litres of Grolsh in one go might have had something to do with it. Sorting him out we ended up back at his room and as he was doing a computer course he had quite an impressive computer setup. Me and my crewmate are both geeks and we were drooling a bit over his system.. 

Sorted his problem out

Then to an old peoples home, one I'd never been to before. An old lady had fallen over and cut her head. Now, apparently she had dementia but she seemed to be making more sensce than the staff. The cut wasn't bad but she had cut a minor blood vessel so needed to go in. Getting her out was a bit of a struggle but we managed. I discovered that I seemed to have a pair of old lady pants stuck to my leg for some reason. I got them off hurridly.

We were due to finish at 0530am and listening to the radio we heard both the other crews who were working get jobs so it was inevertable that at twenty past we got a job.

A car was coming down a residential street, the driver drunk. The car ended up on its side, the passenger quite cross. Nobody was badly hurt but when we asked the driver if he was hurt he insisted that he hadn't been in the car. Twenty witnesses said he was. We left him to the police who he had a fight with.

Silly boy. How to make a bad situation worse. 

I'm typing through that familier feeling of muzzyheadedness, bone weariness and the fact that my eyes seem to be acting just that little bit slower than I want them to. This is what I feel like after a night shift.

A busy night. I know I say that a lot but tonight was a bit different. The town where I live and work has a population of about a quarter of a million and last night there was one ambulance and one car on duty. Three people. It was very, very lucky nothing major happened.

The night shift was bookended by drunk east europeans. The first one had a fight with a car, and lost. He had a lovely semi-circular hole in the back of his hand. After we had cleaned it up a bit and had a look we could see all the tendons working when he moved his fingers. Sort of like in the film Terminator (but without the guns)

Then off to a dont-care home. A lady who had been ill for a couple of days but had got steadily worse and was now not responding at all. We were greeted by a member of staff for who English was a second language, or maybe a third. She led us to see the lady. We walked in a could see that she was twitching. She had parkinsons, but this wasn't a parkinson twitch.

She was having a fit.

"How long has she been doing this?" I asked

Smile, "What?"
 
"Twitching like this"

Smile "Twitching?"

"This", I gestured

"Two hours"

Two Hours

This lady wasn't well and we both knew it. I don't think the care assistant did though.

I got a bit short with her and sent her off to get her notes so we could find out any medical history. My crewmate went to get a carrychair so we could get her to the ambulance. She was on Oxygen so I made a phonecall.

I rang control to find out where the nearest paramedic was. This was a judgement call, a paramedic can give her drugs to stop her fitting but will it be quicker to get her to hospital?
 
The nearest paramedic was thirteen miles away and we were five minutes from the hospital

Peddle to the metal.

It turns out she had a very bad infection somewhere as her temperature was quite high as well. She was admitted to hospital but whether she'll come out again I don't know.

The University students are back so we spent the next three or four hours picking up girls who had had their drink spiked, people who had collapsed for no apparent reason and people who had had decided to have a fight.
 
Then to a guy who had been in hospital earlier because he was absolutely bladdered. He had discharged himself with a canula in his hand. He was on his way back to get it taken out but was standing on a wall and then fell off.

He landed flat on his face and broke his nose. Lots of blood.

And finally to Tesco's carpark to see a drunken pole who kept telling us he couldnt walk as he walked round. He wanted to go to hospital. I couldnt be bothered to argue

I think he wanted somewhere to sleep

Well, I was quite cross earlier but my mood has mellowed. What I was going to write about I may still but not right now.

I spent the second half of the shift with one of the new Emergency Care Assistants (ECA). I must say, right off, that he was a nice guy, very switched on and eager to learn.

But, in discussion with him, the flaws of his role have become more apparent to me.

The ECA's are our version of the PCSOs that the police use. People who look the part but can't do a good chunk of the role. Cheap bums on seats if you like.

The ECAs cannot actually care for a patient in the back of the ambulance. They can drive, they can do basic CPR and that appears to be about it.

Now, the management will say that's ok. They won't actually be going to patients as a first responce; what they will be doing is following a paramedic in a car around

The management will also say that the ECA will always be working with a qualified member of staff (Paramedic or EMT) so there is no danger at all

But. With the state of the level of staffing we have at the present how long will it be before ECAs end up working together. So instead of having two trained people in the ambulance that comes to you, you will have two people who have first aid certificates

Secondley, if the ECA manned vehicle is the closest to an emergency the mobiliser will be under a lot of pressure to send it so he can meet the responce time targets.

Thirdly, the chap I was working with was quite happy to deal with patients but theis was technically against the rules. I was happy that he did because they were simple cases. But is this how its going to be? Are the trust going to turn a blind eye until something goes wrong and then jump on the person responsible? Probably!

I stick with my original thoughts on the matter. I think the ECA idea is potentially very dangerous. I think that someone will die because of it