4 Responses to “Now you see us: soon you won’t”

1. Adam Says:
   October 10th, 2006 at 6:53 am

   It sounds like there’ll be staff manning cars and less manning ambulances. So less ambulances, meaning longer waits for transport to hospital?

2. Carmelo Says:
   October 10th, 2006 at 6:56 pm

   And when they change the ORCON game in 2009….
   ..which means at the moment ORCON is measured from when the resource is dispatched. In 2009 it changes to when EOC pick up the phone, essentially taking 2 or 3 minutes off ORCON times. No doubt times will go down.

3. Millietant Says:
   October 10th, 2006 at 11:16 pm

   League tables? What with like a premiership and a third division etc? Will those in the premier league be paid more money and have wives that like to shop. Will the wives develop eating disorders and appear ‘airbrushed’ in the latest edition of ambulance times. Who will sponser the PremierPara’s, will it be Carlsberg, or more likely White Lightening ? I don’t think there’s an official supplier of heroin with the exception of Afghanistan.
   My original reason for posting was your ‘uk forces killed in action’ image at the top, having spoken to the father of a medic in Afghanistan the death toll is apparantly the tip of the iceberg which doesnt reflect the number of horrific physical and mental injuries, which are not being reported.

4. Al Says:
   October 27th, 2006 at 10:24 pm

   Bloody great, I work for a different service and part of my responsibility is to put ‘league tables’ together. I always come out last.

   I remember traipsing for 55 minutes a few years back into another services area that had lots of cars and very few ambulances, the poor patient we had been called to had no less than four cars on scene attending to him from no less than two ambulance services, we came from a third service and landed just behind another ambulance from the original service. So for one patient - four cars, two ambulances, three ambulance services, confused? I was.

   Fortunately nowadays it would all be the same service anyhow so it wouldn’t be quite as astonishing. Good thing really, I think we shall see more of it. Desperately ill patients waiting for well in excess of the ‘golden hour’

   http://diagnosisnfi.wordpress.com/2006/10/09/now-you-see-us-soon-you-wont/

   • 

   A blog from Magwitch, an ECP on the frontline in the South East

   Ambulance service struggles due to lack of staff

   Evening Standard (London),  Dec 16, 2005  by REBECCA SMITH

    

   STAFF shortages are leaving London Ambulance Service struggling.

   There are almost 200 vacancies and a recent salary shake-up has cut the amount of overtime paramedics want to do.

   It means fewer 999 calls are being reached within the eight- minute target.

   Staff were commended for their response to the 7 July bombings but the disruption was felt for months afterwards.

   With the busiest time of the year approaching, more disruption is feared.

   Russell Smith, deputy director of operations, said: "We have been struggling."

   Union representative Phil Thompson said: "We don't know if the shortfall will be coverable."

   (c)2005. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

    

   Bike-riding paramedics set to patrol the City

   Evening Standard (London),  Aug 15, 2006  by REBECCA SMITH

    

   PARAMEDICS will travel on mountain bikes in an effort to improve response times to 999 calls in the City.

   In a two-month trial, a team of four will be sent to all emergency calls in the Square Mile and a regular ambulance will be dispatched at the same time.

   The bright yellow bikes are fitted with blue lights and sirens and carry equipment including a heart-starting defibrillator, oxygen, pain-relieving gas and a maternity pack for delivering babies.

   For more minor calls a bike paramedic will be sent alone and can request assistance if required. It is hoped the move will free ambulance crews to attend more serious calls where patients need to be taken to hospital.

   Bicycle teams have already been judged a success in saving lives at Heathrow.

   City Cycle Response unit manager Paul Davies said: "More than 300,000 people work in the City of London and their numbers are swelled by the several million tourists who visit the area each year.

   "Using the bicycle gives us an opportunity to save potentially vital seconds in starting treatment, especially in the narrow streets which ambulances have difficulty negotiating quickly."

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

    

   999 ambulance computer failure putting lives at risk

   Evening Standard (London),  Aug 23, 2006  by REBECCA SMITH

    

   LIVES are being put at risk because of a crisis with London Ambulance Service's computer-controlled 999 system.

   The system, which sends ambulances on emergency calls, has failed repeatedly over the last three weeks.

   To track ambulances, staff have had to go back to using pen and paper - a system last used 10 years ago - sparking fears that people could die in the confusion.

   A shortage of staff in the call centre has compounded the problem.

   At peak times calls are diverted to the Met Police control room, to staff who have no medical training and cannot give emergency advice such as how to start CPR in a patient whose heart has stopped.

   It is reminiscent of a computer crash in 1992 which resulted in the deaths of up to 20 people because ambulances were delayed in reaching patients.

   An insider at London Ambulance Service said: "It has taken us back to the old days of call-takers having to use a London A-Z to find addresses and the allocaters having to try and guess where ambulances were - and who was available and who was not.

   "It has been a nightmare. Patients are being put at risk because when they dial 999 and it's busy, they get through to a voice message and are then diverted to a police call-taker who is not trained to give medical advice.

   "This does not happen every day, only when call volumes are high, but it is now a regular occurrence.

   "When the computer systems crash, the operations centre does not know which ambulances are on emergency calls, or returning to their stations and available."

   When working properly, London Ambulance Service call-takers input details of emergencies into the computer system.

   Then it automatically alerts the nearest ambulance via a screen in the cab, allowing the most efficient response.

   Managers at London Ambulance Service say there is no evidence that patients are being put at risk, that the system only goes down for a short time, and that the pen and paper system works well.

   A spokesman said the main problems have now been fixed and were related to a software upgrade at the end of July.

   "When the system has not functioned normally, we have reverted to the tried and tested process of recording details of emergency calls on paper and then passing information to ambulance crews over the radio system.

   "We are of course very sorry for any distress that may have been caused to patients or those who have called on their behalf. Staffing in the control room has been an issue and covering some shifts during this month have proved problematic," he said.

   This put "additional pressure on our ability to manage periods of particularly high demand", he said.

   "As a result, there have been a limited number of occasions when incoming calls have been diverted to the police for a very short period.

   "This is part of our normal contingency planning and is always in place to deal with surges in 999 calls.

   "Despite these issues, the service is meeting its key performance target of getting to 75 per cent of all life-threatened patients within eight minutes."

   In 1992 health unions said up to 20 people died because of a " catastrophic failure" with a new computer system.

   It led to the resignation of the head of London's ambulances, John Wilby.

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

    

    

   Home-start paramedics to speed up 999 response

   Evening Standard (London),  Oct 3, 2006  by REBECCA SMITH

   PARAMEDICS will be scrambled from home to answer 999 calls in a bid to speed up response times in London.

   Specially equipped ambulance cars will sit outside the homes of on-call medics to deal with emergencies in their neighbourhoods.

   The scheme is to be piloted in outer areas of London where emergency response times are worst. In a raft of new measures, league tables of each paramedic's performance will be drawn up and those who perform badly will be asked for an explanation.

   The London Ambulance Service is investigating ways to speed up 999 response times before new targets are introduced. Paramedics and technicians-must be on the scene at 75 per cent of all life- threatening - or Category A - calls within eight minutes.

   Currently, the clock starts when the call-taker establishes the address and predicament of the patient.

   But in 18 months it will start when the call is put through the switchboard-meaning the whole process must be made quicker. Among other measures are: . Checking calls are categorised correctly so only the most serious trigger a response within eight minutes. Less- serious cases are not subject to the target.

   . Increasing the number of control room staff dispatching ambulances from seven to 14. Now it takes an average of 23 seconds to dispatch an ambulance.

   Part of this process will be automated.

   . Sending single paramedics in cars to the most serious calls more often.

   They can then request an ambulance to take a patient to hospital if needed.

   Eventually, most Category A calls and all Category B calls will be sent a paramedic in a car in the first instance.

   . Staggering shift start times to prevent a dip in performance when vehicles are being handed over to staff starting work.

   . Identifying individual staff who take longer to reach emergencies or hand over patients at hospital, and finding out why it happens.

   Some frontline workers say the changes are a "Big Brother" approach and morale will be hit.

   Others claim single paramedics in cars will endanger patients.

   But Ian Todd, assistant director of operations of the service, said the changes would mean significant improvements for patients such as heart attack victims, whose chances of survival drop by 10 per cent for every minute's delay in getting treatment.

   Mr Todd said: "By moving the clock start time back two minutes it gives every cardiac arrest patient a 20 per cent increase in their chances of survival."

   He said the move would also reflect a patient's experience of dialling 999 more closely but added: "It is a major change and effectively means we need to find a 25 per cent time saving."

   The service wanted to shave off vital seconds throughout the emergency call process.

   Mr Todd said: "As we move closer to the new clock start we are contemplating becoming much more reliant on cars and solo responders in the first instance.

   "There are many cases where patients can be assessed and treated on scene and then referred to other services without going to AE. We are moving away from the traditional blue light two-crew ambulances responding to all calls, which is very expensive."

   In addition, the service is now at almost full strength and so will be less reliant on staff overtime.

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

   Ambulance crisis

   Evening Standard (London),  Oct 5, 2006  

   THE LONDON Ambulance Service is having to cope with swingeing cuts to its budgets, and all because other parts of the health service are struggling financially. The NHS in London ended last year almost 168 million Pounds  in debt; this year the figure is expected to be lower, at Pounds 90 million.

   Health trusts and hospitals are being asked to contribute towards cancelling the debt and building up a contingency fund for the future. The problem is that those parts of the health service that have managed their finances adequately, like the ambulance services, have to bale out those that have not.

   The ambulance service - although in credit - has to contribute Pounds 3 million towards the shortfall.

   As a result, it will have to reduce staff overtime, which will be restricted to busy periods, such as weekends, and to limit severely the number of ambulances staffed by a crew of two. Instead, there is to be an increase in the number of ambulance cars, driven by a single paramedic.

   It is right that the NHS should have to balance its books, but the idea of doing so at the expense of emergency services is unacceptable. The service is at the very front line of the NHS, dealing with critical situations very quickly. Cuts in staff overtime may save money but this may turn out to be at the expense of patients during unexpected emergencies outside weekends - the London bombing, which took place during the week, is a dramatic case in point.

   And sending out ambulance cars with a single attendant, rather than proper ambulances, may actually compromise the safety of crew and the soundness of the decisions that are made in emergencies. The service's management is trying hard not to compromise patient care - but this is a cut too far.

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

   The Paramedic's Diary
   A record of the working life of a London Ambulance Paramedic. All in-confidence. All real.	Previous Entries   Alert Me as Entries are Posted   Get the Feed

   All About Me I am a Registered Paramedic. I work for the London Ambulance Service in Central London. I have a degree in Paramedic Science and have been involved in pre-hospital care at every level (including the army)since 1992. This diary reflects my daily routine in my own words, as accurately and honestly as possible. It does not purport to reflect the views of the London Ambulance Service NHS Trust. I cannot identify patients or locations and may change certain facts in order to protect patient confidentiality and I hope you understand why that needs to be done. At this stage, I am reluctant to fully identify myself but those of you who know me will know me...if you know what I mean! :-)   Recent Entries 06/11/06 COLD  04/11/06 Running Call  01/11/06 Air Conditioning  30/10/06 TIA  30/10/06 A good night's work  28/10/06 ETOH  26/10/06 Not Happy  08/10/06 Threatened  08/10/06 Religious experiences  02/10/06 Predators    Other Blogs Street Watch: Notes of a Paramedic A Day in the Life of a Paramedic Carmelo Alongi Nee Naw Random Acts of Reality   This Blog has been read times since its creation on 12 April 2006

   06 November 2006 18:26:06 o'clock GMT COLD   I have a few days rest coming now. I'm looking forward to being lazy. My last couple of nights were contrasting; a very busy Saturday followed by a slow, quiet Sunday. Obviously people were too tired after their energetic weekend out to stay up late on Sunday. The cold has a lot to do with it too. A frosty start to Winter has reminded many that going home time is around 1am these days. There are two kinds of socialite out there in my experience; mainstream and hardcore. The mainstream drinkers start after work and generally go home on the last buses and tubes running. The hardcore (clubbers and 24-hour party people) start their evenings at around ten and stay out 'til the late early hours, even if that means sitting around for a couple of hours until the tube network gears up again for the day! The latter run a much higher risk of exposure to cold and hypothermia. Among the many calls I received over the past couple of nights I have attended and treated at least three cases of hypothermia. Let me clarify. The normal temperature for the human body to function correctly is anywhere between 35 and 38 degrees centigrade. If your core temperature (measurable in the ear usually) falls below 35c you are hypothermic. You won't be dead or dying but you WILL be cold. Your body functions will begin to slow down and your brain will take longer to process information, like the answer to the question "What is your name?" Alcohol and drugs exacerbate heat loss from the body and so does wearing nothing but a t-shirt or flimsy dress in atmospheric temperatures approaching zero! Understandably, its not cool to show up for your big night out wearing two jumpers and a huge puffa jacket (unless its a gang thing). One of the first calls I received was to a 'male lying on the ground unresponsive'. When I got to the scene I could not see anyone. However the area is a popular sleeping spot for street people and there were six or seven lying around in sleeping bags and blankets. I figured the caller may have jumped the gun and dialled 999 when he/she spotted one of them lying there. I checked the area and called it in as a false alarm / no trace. When I drove off I saw a young man lying on the pavement further up the road. He was on his back with his arms folded across his chest. I guess I jumped the gun myself! I called control and told them I had found our patient. The guy was around 20 years old and was wearing jeans and a light t-shirt. He was completely oblivious to the world and had a grin on his face as he slept the night away in the freezing cold. I used my air horn to rouse him (that works very well) and he awoke with a start. Then he went back to sleep - didn't even look around. I got out of the car and tried to wake him up. I prodded, shook, shouted and pinched him. Nothing. Nothing but a big grin. He was somewhere else. I got on the radio to request an ambulance because I knew he would be cold; his exposed arms were like rods of ice, but there was nothing available. I thought I might get some police help to put him in the car and warm him up but I struck out there too. I went back to him, put a blanket on him and tried to get some obs but my finger probe wouldn't work (he was too cold) and a BP wasn't going to be possible with his arms folded like that. A BM measurement would have been difficult because his peripheral blood vessels would be shut to preserve heat and any other time-wasting analysis would have been nonsense, so I covered him in more blankets. As soon as I did that he woke up and looked around. He saw the car, saw me and wondered what was happening to him. I explained that he was sleeping in the street and that he was very cold. He was very apologetic and confirmed that he had been drinking all night and had been making his way home. He lived in completely the other direction, however, so my best guess is that he became disorientated as he got colder. I bundled him into the back seat of the car and took his temperature, or at least I tried but my in-ear thermometer would not read. Sometimes the machines let you down all at the same moment! I thought it was best to get him to hospital quickly so I left the non-essential stuff alone and got moving, gleaning details as I went. He was very confused and still very apologetic. When I got him to hospital his temperature was checked and read 33.3c. That's cold. Survival below temperatures of this level becomes increasing unlikely as time goes on. He may have developed serious and life-threatening heart problems if he had been left for a few more hours. The person who called it in may well have saved his life but let's not be too dramatic, low body temperatures are perfectly survivable, given the right treatment and so he soon found himself wrapped up like a sausage in specially heated foil. He was still smiling. Obviously a good night out then. My advice for those of you planning a night out in the cold is to carry something warm and insulating. Put it in a bag if that is practical. Do NOT go home alone if you are exposed to the cold and have been drinking a lot. You will become disorientated and confused - getting lost and becoming unconscious in a quiet alley where nobody will find you for hours is extremely dangerous. I had two similar calls during my stint of nights. Roll on Summer. Be safe. Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 1 comments: Show Recent | Add your own     04 November 2006 16:57:32 o'clock GMT Running Call   A running call is a job that you either come across whilst on duty or you are flagged down to attend, usually either by the general public or the police. It is a call that has not yet been processed by ambulance control and has not been designated a CAD, or job number and to which an ambulance has not yet been assigned. It was freezing o'clock when I finished my shift this morning. I am wearing more layers to work now. I had a heated night though: drunken falls, head injuries, fights and assaults. I got hit three times by a drunken male with a head injury, he managed to elbow me in the face as I was talking to him (I should learn to talk from a distance but I feel like I am shouting at the patient when I do that). He also kicked me and grabbed my wrist and had a go at the police and the crew who were in attendance. The main events of the night, however, were my two running calls. I seem to get a lot of these and I think I am getting a reputation on the FRU desk! The first call occurred as I was parked up on stand-by in the West End. There was a sudden uproar of screaming from around the corner - all girls, and people started to run in the direction of the commotion. A LOT of people were running in that direction. I drove around the corner and had a look. There was one young girl sitting down, surrounded by people. She had a head injury of some kind and there was blood trickling down her face. She was quite hysterical. People began to run up to me and some tried to pull me out of the car to help but I stood my ground and tried to call it in. I could now see that there were at least two girls injured; the other had facial injuries but I still wasn't clear about what had taken place here. As I neared the crowd (the police were now arriving) I got a call from the FRU desk to ask if I was okay. I had attempted to make a priority call on the radio twice but had not received a reply so now they were calling me on my service mobile. I confirmed that I was alright but that I needed two, possibly three ambulances to the scene. I had not yet determined the cause or extent of the girls' injuries - they could have been stabbed for all I knew, so I had to ensure I asked for the minimum level of support that I thought I may need here. I could always stand down resources if the scene changed. I had checked the first girl's injuries quickly and moved on to the second when a young man came rushing through the crowd towards me and the girl. The screams started again and I thought this might be the assailant. The police were quick to restrain him but not before he got his hands on the girl. Later I was told that he was the girl's boyfriend and that he was 'concerned' about her. He had a pretty aggressive was of showing his concern. He got himself arrested for his trouble. A third girl was brought to my attention. She had a neck injury but it was not serious. In fact, when my mini-triage was completed and with resources now on scene (two ambulances and another FRU manned by a friend of mine who had come to help), it was clear that all of the injuries were relatively minor. They all had to go to hospital however to be treated. The girl and her boyfriend had been arguing when she stormed off, pushing her way through a gang of other lads. They made some kind of derogatory remark and the boyfriend launched into them. He got beaten up by the gang and bottles were thrown and used as weapons, resulting in one girl sustaining deep scalp wounds and a swollen head, another with a hole in her lip and a deep leceration to her chin and another who got thumped on the back of the head. The fight was over in 30 seconds but when it started, and from my vantage point, it sounded like someone was being murdered. That's certainly what I expected to see when I drove round that corner. My second running call came immediately after my first. A very drunk diabetic girl was lying on the freezing ground, surrounded by her male friends. It was her birthday and had made herself dangerously ill to celebrate. Her BM (measure of blood glucose) was 22.2 (the normal range is anything from 4 to 10) and she could not move herself. I called for an ambulance but was told that there would be a delay so I waited and waited. She was getting colder by the minute and I couldn't move her to my car. I put blankets on her and did all my usual checks...and waited. I called in again and was told that there were no vehicles available. This meant that the ambulances were all busy on more important (CAT A) calls. I made a decision and cleared it with control; I would take her to hospital myself. I don't like the idea of conveying a drunken, semi-conscious individual in the car but it was that or she freezes and her condition worsens. She was stable and rousable so I would take the risk. With the help of THREE police officers I managed to get her into the back seat of the Zafira (it's back on the road). One of her friends travelled with her to keep an eye on her and we set off. It took me 5 minutes to get her to hospital and her BM had risen to 38 when she was next tested. I like to think my instinct was sound in this instance. Off I go again. Be safe.   ** Xf Replies ** 6th November 2006 socialdespatch I have had to wait for a while on a few occasions but not as long as you have (not yet anyway). We are busy with the run up to Christmas and have fewer resources available, so delays are inevitable. Hopefully, like me, you find a conversation topic to keep you going!   Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 4 comments: Show Recent | Add your own     01 November 2006 09:32:49 o'clock GMT Air Conditioning   A routine day quickly escalated into a cascade of skills for me today. After the usual run of collapsed ?cause, stomach pains and back pains I was called to a train station to attend a man who had suddenly become ill at work. I drove onto the platform and was greeted, as usual, by the efficient staff who led me to the patient in the main control room. The place looked like the deck of the Starship Enterprise (no, I'm not a trekkie). The man had taken ill but had no specific medical history to suspect, so I persuaded him to have a colleague take him to hospital (he wasn't an emergency and all his vital signs were normal). We are still very busy out there and under-manned at the moment so each call I went to meant waiting for an ambulance. Part of my job is to cancel ambulances if they are not required or to find another means of conveyance. I am not driving the Zafira at the moment (it's OTR - off the road), so I am in the Astra and I do not convey patients in that vehicle. As I was getting my paperwork for the man in the control room, I was called by the Central desk and asked if I could attend another call that had originated at the same station. I couldn't really say no and so I asked the first patient to wait until I had dealt with the second call. This one was to a diabetic amn who had collapsed inside a train. When I got there he was being cared for by a doctor who just happened to be in the same carriage. It looked like a simple hyperglycaemic collapse; his blood sugar level was a little high, so I called for an ambulance to convey him to hospital. He was recovering well when I got there and I had little to do but minotor him for ten minutes or so until the crew arrived and took over. When I got back to my original patient he had already gone to hospital with his colleague! In the middle of my day I received a call to investigate a girl who had a 'cut to the head' caused by a falling air conditioning unit. It had come down as an amber and she was described as a minor injury. Nevertheless my control desk asked me to investigate and so I did. When I arrived, she was sitting on the stairs of her office with a dressing wrapped around her head. There was a decent amount of blood around but scalp wounds tend to bleed quite a bit before they stop, so I wasn't too concerned. I took the dressing off (carefully) and had a look at her wound. She had three wounds in fact; two lacerations and a large bump to her head, near thefront. She was fully conscious, had no neck pain whatsoever and was alert and orientated, so far so good. The police arrived a few minutes later and that threw me a little. I had been told that a piece of metal from an air conditioning unit had hit her on the head - a glancing blow I was told and she had not been knocked out. She was Spanish and I couldn't communicate 100% with her. I was relying on an interpreter who seemed confused about what had taken place. It was only when I asked the police officers why they had been called that I was filled in. The girl had been outside the premises in an alleyway when a van had reversed and hit the air conditioning unit, forcing it off the wall. It had just missed her as it landed but a piece of the structure had hit her on the head. I went outside to have a look and instantly realised I had to change my management of this patient. The air conditioning unit was the size of a large fridge and it had dropped from at least 15 feet! She was lucky to be alive. Only a section of the bracket mount had hit her but when I picked it up and felt the weight of it I knew, on mechanisms alone, that I had to be cautious. I had originally called my control desk for an ambulance and confirmed the injury as minor but I called back and advised them to let the crew know that this was now a collar and board job. I went back in, told her to lie on the floor and took control of her C-spine. I explained to her friend (who interpreted) that, although she had already been walking about I had to suspect a possible neck injury and even a skull injury based on the weight of the metal bar and the height from which it had struck her. The girl understood and did not panic as I reminded her that this was a precaution. When the crew arrived we placed a collar and strapped her down to immobilise her completely. I should say at this point that she had never complained of any deficit (no tingling or numbness) and she still had no neck pain. I always feel like I am going over the top when I decide to do these things but I was not prepared to walk her into A&E after what I had seen. Sure enough when she got to hospital she had x-rays and c-scans carried out. Her neck was cleared but she was kept in overnight for further scans on her head. I wasn't the only one being cautious. My last job of the day was a chaotic one. I was asked to attend a young man who was having a seizure in a wine bar. When I arrived I was taken to the first aid room where two men were having to physically hold the patient down on an examination bed because his seizure was so violent. When I got to him and asked him if he could hear me he was able to nod his head. His eyes were fixed in a stare but it was clear he knew what was going on to and around him. I asked him if he had control of his tongue and he nodded. Always good to start with a safe airway. I put him on oxygen and asked about his medical history. He was not epileptic or diabetic and had no other specific illnesses. He denied taking any drugs, stimulants or steroids, illicit or otherwise and had not been binge-drinking recently. His colleagues told me that he had experienced left-sided abdominal pain and had been taken to the first aid room to lie down when he suddenly began to convulse. Bear in mind that he was still thrashing about on the bed while I established these facts. I knew this was going to be a tricky task and I had little room to move about as the room was small and cramped, as many first aid rooms tend to be. I inserted a cannula into his arm and gave him 5mg of diazepam (diazemuls) immediately to control his seizure and make him easier to manage. The drug took effect within a few minutes and he began to relax. I then checked his blood sugar levels and found them to be a little low; not critical but lower than normal. I made the assumption that there may be a connection so I gave him 1mg of Glucagon by injection. This would help to increase his blood sugar level by mobilising stored glucose in the liver. I waited longer than usual for an ambulance on this job. I was with the patient for almost 30 minutes and by the time the crew arrived my patient was stable and much more alert. His blood sugar level had risen to 8.4 (normal) and he was much easier to manage. I escorted the ambulance to hospital on blue lights and when we got him into Resus, just as the doctor was taking blood from him, he had another seizure. His blood sugar level had dropped to 5.2, which is still normal but indicated a rapid drop in level over time so I wondered if he had a pancreas or liver related illness. His earlier abdominal pain, coupled with a drop in blood sugar possibly leading to seizures made me consider pancreatitis, although seizures aren't commonly associated with it and the pain tends to be more central in this disease. The doctors were still trying to establish what was wrong with him when I left and prepared to be stood down for the day. I will update you if and I find out. Be safe. Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 6 comments: Show Recent | Add your own     30 October 2006 21:15:10 o'clock GMT TIA   Sometimes you have days (or nights) when the calls are similar. You know, you get called to one heart attack and then another and then.... Today was about TIAs; Transient Ischaemic Attacks. They are also called "mini strokes" by those in the know. They are common and there is a lot of debate about the possibility that LOTS more people have them than is believed and that they simply get over them without any long term problems. Its all about the brain of course. Strokes are caused by either bleeding which puts pressure on the brain or a blockage in an artery in the brain. Either way, the effects can range from headache to total paralysis or, if you are very unlucky, instant death. I completed 13 calls today. Its mad out there. Three of the calls were of a very similar nature. One was an obvious TIA/Stroke - the man was as pale as a sheet (a white sheet) and had lost some function without warning. I'm sure he will recover fully but he definitely needed to go to hospital by ambulance. The other two were a little more subtle but still bore the hallmarks of a possible (I have to stress) TIA: sudden onset of minor dysfunction, tingling and numbness down one side of the face and a gradual decrease in awareness. I also dealt with a man with back pain that looked and sounded like it was Renal in nature. Kidney pain, as some of you will know, is pretty bad. Whether its an infection or you are trying to pass a stone, pain relief will be needed. I gave him morphine and it had an immediate effect. I have treated lots of dislocations over the years and a dislocated knee seems to produce more pain than most. I went to a football field in Central London to deal with a young man who had slipped his patella after a hard tackle. Entonox, or gas and air, is good for this and so I duly obliged until he was carted away for treatment. I even got a laugh out of him but that might have been the entonox. Two head injuries today. One involving a female who, with her male friend, fell backwards onto the floor of the wine bar they were in and cracked her skull. She adamantly refused to go to hospital but she was extremely drunk so I had a hard time persuading her that she ought to. Eventually, after a lot of trouble and the involvement of the police, she complied. Another lady who fell under the influence was sitting in a cafe with two police officers when I got there. She had a very deep cut above her eye and it needed closing. She too refused to go to hospital but eventually agreed with a lot of gentle persuation, a free cup of tea and the promise of an early release from A&E! Only one call wasted my time today and it was a "Gone before arrival". I drove all the way to SW1 from NW8 for an emergency call just to be told at the other end that the patient had gone his own way. This happens to every crew and its a frustrating part of the job. The most disgusting job of the day was to an elderly ex-drug abuser who is now an alcoholic (two bottles of wine per day). He has had cancer of the bowel and a colostomy bag was fitted. I was called because he had been bleeding PR (par rectum - you figure it out). His home was absolutely filthy; nobody helps him keep it clean. When I got used to the smell and the sticky floor I examined him more closely and found that his bag was full...I mean FULL. The crew who arrived to take him away included an EMT2; a trainee. This was a baptism for her! A young woman who accidentally punctured her thumb with scissors (ever so slightly) was given as a CAT A (so blue lights and hurry up) because she 'felt faint' but didn't actually faint at all so I left her with a plaster and some advice about pain threshold. Meanwhile another woman (72 year old) who got her shin trapped between a train and the platform, resulting in a bone-deep laceration was given as a GREEN1 (blue lights, but only because it was a public place so no real hurry) because she didn't feel faint! You figure. None of us can. And things I've seen today that made me smile? A big guy in a bright yellow jacket with his Sony discman plugged into his ears as he danced and sang Michael Jackson's 'Beat it' quite badly in front of the tourists and confused Londoners in Trafalgar Square and a guy wearing shorts, pulled right up his waist 'Cowell' style, with a flowery shirt and a white wide-brim hat strolling across Leicester Square in October! Priceless. Be safe. Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 4 comments: Show Recent | Add your own     20:50:34 o'clock GMT A good night's work   Not a single drunk tonight (Saturday)! Every call was a genuine ambulance case. The booze bus was on again so that probably explains it...I could hear the sirens going all night as I dealt with my own workload. They're a pleasant, happy bunch of guys manning that ambulance - hats off. The call of the night was my first. An epileptic 8 year-old was having his sixth seizure when I arrived. He was curled up in bed in spasm and having some difficulty breathing. He was producing thick phlegm and it was interfering with his airway so I set about clearing it manually (with my gloved fingers) as it was the most immediate way of remedying his problem. I then used the suctioning machine to keep it clear as he trembled and jolted through his experience. I have a lot of sympathy for epileptics and many people completely misunderstand the nature of the condition so there is still a taboo about it. When the crew arrived we quickly got him into the ambulance. He knew what was going on and he could roll his eyes to look at you if you said his name. He had the look of a drowning person. He went on to have another seizure in the ambulance and I stayed with him whilst the second EMT followed in my car. That way I could remain in charge of his airway and gain IV access for drugs. He had already been given 5mg of Diazepam by his mother and so another 5mg was required but we got to the hospital quicker than I could prepare it and his airway was a continuous problem and therefore my primary concern. He will be fine. He has lived with this all his life and will probably survive many, many more episodes like this. I heard on the radio that a crew had pulled over when someone had waved at them because they took that to mean that they had reached the call origin. It turned out to be a person who was just waving to them! This has happened to me so can you please NOT wave at an ambulance when it is running on blue lights and sirens - we are very easily distracted :-) Oh and don't make childish whooping noises along with the sirens as this tends to degenerate others to copy you and then we have a whole bunch of people on the pavement making a perfectly decent siren sound stupid. Many thanks. Someone tried to throw a burger into the car as I was driving along slowly in traffic with my window down. I gave him a glare and he gave me the finger. Respect. Be safe. Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 2 comments: Show Recent | Add your own     28 October 2006 16:54:40 o'clock BST ETOH   Fourteen calls last night. I feel ragged and worn this morning with another night shift to come. Most of the calls were of the alcohol-related kind; ETOH we call them. The acronym refers to Ethyl Alcohol (chemical formula CH3CH2OH), which is grain alcohol and so generally used to describe any relative alcoholic condition. That's the science done! Excuses for being so drunk that you cannot control your bladder or gag reflex include "I think my drink was spiked" and "I only had three pints of lager and I've had much more than that in the past". This misunderstanding of the nature of alcohol and its collision processes within our bodies leads to a very heavy HNS workload on a Friday and Saturday night! Sometimes you just can't hold your drink and that's that. So I was running around dealing with males who had only drunk a few and females who had been spiked (not that it doesn't happen of course but you can see the difference in most cases). There was no "booze bus" on duty - that's the ambulance specifically tasked to collect drunk patients and take them to a designated hospital - so the workload was doubly difficult to handle. I miss my good friend who runs the booze bus. I didn't realise how valuable he was to me until now! Among the myriad booze calls I got a few 'real' jobs. I visited an elderly gentleman who had collapsed outside his home. When I got there I checked his blood glucose (he was behaving very strangely and seemed confused) and found that it was 'HI'. This is what the glucometer reads when a BM measurement is above the device's highest range (usually well into the 30's). I apologise if you are not au fait with the terms and numbers but I'm sure a future entry on diabetes will clarify this for you (I'm too lazy right now and have to get to work soon). The crew turned up soon after my arrival and together we agreed his hyperglycaemia (he was not a known diabetic) was cause for concern - he needed to go to hospital. The gentleman's neighbour then told us that he was carrying a lot of cash and suggested we secure that first. This is tricky territory and we all have to be very careful about handling a patient's cash and belongings so we devised a plan to leave his cash in his flat and get the neighbour to witness this fact by signing a slip of paper on which was written the counted amount. When the money was produced from his wallet and counted however, I was a little shocked. He was carrying over £1500! This man was far too confused and vulnerable to be loaded with cash like that - especially at night in London. I advised him strongly against it in future but I don't think he will remember me or my advice by tomorrow. I also attended a RTC (Road Traffic Collision) - we used to say RTA (Road Traffic Accident) but apparently the word accident intimates that it was nobody's fault and so collision was installed instead...hmmm. Sometimes I scratch my head and I don't have an itch. Anyway, the young pedestrian had been hit by a moped as he stepped off the pavement. He had been drinking and so, even though his head injury was minor, he was treated a little more seriously - mechanisms and all that. For some reason the HEMS team showed up too. I didn't call them, they were passing by apparently. The road was closed off and the lad's clothes were cut from him as the full protocol for injury checks swung into action! I'm a bit wary of shearing off an expensive pair of jeans (HEMS do it almost instantly) but the downside is that if you don't check for significant injury and its missed you will be dropped from a height. Still, I didn't think he had been hit that hard. I'll be saying something completely different if and when I join HEMS, wont I? Got to go. It's been real. :-) Be safe.   ** Xf Replies ** 4th November 2006 jennyandkirk Sorry about the delay in replying to you. Yes, I think there is a tendency to overlook the possibility of a drunken soul possibly being the victim of spiking. I try not to be complacent but, as I said, you can usually tell the difference and if the patient has accepted a drink from a stranger then the chances are higher. In the absence of this fact it is difficult to determine one way or the other and, as you said, hospitals simply won't test for it. It is a serious problem nevertheless. Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 9 comments: Show Recent | Add your own     26 October 2006 08:35:55 o'clock BST Not Happy   I'm back. I had a good long rest and got a tan too. Now I have to deal with the criticism I am getting from a few people who know me. Fair enough, although I have explained time and time again that this is a DIARY...it is written in such a way as to portray what I think and feel, not anyone else. I am having a hard time understanding why you want to make these comments. None of them are actually constructive and none of them invite me to debate anything. They are just thrown in to show how much you obviously hate this blog. They are announcements to the readers of this blog that my view of the job is not correct (in YOUR view) and that, in some way, I am hurting someone by writing it. Who am I hurting? You? Does my blog cast some sort of shadow over your own ego that it taints it to some degree? Do people point at you in the street and say how bad you are because you are somehow associated with my blog? Unlikely. Speaking of egos. The ego is the SELF, so yes, I am writing for my own benefit. Try reading the many other pre-hospital blogs that are out there - Random Acts of Reality for example is written by an LAS technician who has recently identified who he is and has published a book! He does radio interviews and has just had a full page interview in the Metro. Seems to be no problem with either ego or confidentiality there, don't you think? Might be worth pointing out that I take great care not to breach confidentiality and I couldn't agree with you more...I do sail close. You try writing like this without having to carefully balance fact with locations and names. As for the date and time - these are automatically placed on each entry when I write them...just like a real diary. They are not the dates or times of the jobs! If anything has threatened my anonimity and therefore my patients' confidentiality it is the fact that you declared to all of the readers of this blog that there is only one Zafira running out of Waterloo so thanks for that. You are wrong anyway, there is often more than one running on the same day. The LAS hierarchy know about this blog and the Press Office monitor it. I let them know about it before the AOL release. My readers are NOT all lonely women who want to idolise me. I do not encourage or invite particular comments. I am not fishing. They don't know who I am and have never seen me so how could any of their comments serve my ego? Their comments are often meant for ALL of us - they are saying thanks to me and to you. Yes, I feel good about my writing when I get nice comments just as I feel lousy when you make comments but the readers of this blog range from professional journalists to students. There are many nurses and ambulance workers reading this and I do receive comments every now and again which I can answer. You give me nothing to work with, you simply make a statement and vent your spleen. I will only ever block someone if they repeatedly try to offend me or the nature of the blog. What else would you have me do? After all, I have tried to email you and I am blocked. What does that say about you? Why do I live in a fantasy land? I write this in a specific way. I write it with passion and emotion. I do not criticise or demonise anyone if I can avoid it. I don't swear and I use no vulgarities to express myself. I change things around and I omit facts so that I ensure confidentiality and deliver a readable story - 99% of my readers like the way I write. I'm not everyone's cup of tea but that's okay. Just don't read it! You wouldn't attend a reading by an author and start shouting out how much you disliked it, that's just heckling. It only serves a bitter person. There is no way you can win an argument with such a person, they have one view and one view only - they are right and you are wrong. If you don't like the way I write this blog then don't read it. If you do but you object to something else then be constructive about your comments. Allow me the right to reply and defend my patch. I get paid nothing to write this and I write all of it in my own time. I designed it from the outset to be a very personal perspective so everything I say is what I think. So what do you mean about telling the job the way it really is? Do you mean the way YOU see it? I know that this isn't what you want to read but I LIKE MY JOB! This is my career and I have worked extremely hard against the odds to be here and you know that if you know me at all. This IS how I see the job and I describe the good and the bad if you bother to read any of the past entries. My readers only get the highlights and lowlights of my day, I don't want to write about the bitching, back-biting and everyday grind of working for a large organisation - other blogs do that very well. I honestly think people want to see something different and I give them that. If that doesn't square with what you perceive as the REAL job then I'm sorry. Once again, I do not write this for LAS staff. I write it for people who want to read my view of things. If it was a book you probably wouldn't be so offended. You could try commenting in such a way that I can have a proper debate with you or you could walk up to me and talk to me face to face. Alternatively, why don't you tell me what it is about this blog that you find so irritating that you go to the trouble of re-inventing yourself just to get back in and then leave three comments in a row soon after saying you would not be back? Or is it just me you don't like? I extend the same invitation to those from BWT who commented on this blog after the publicity. I realise that some of the entries are disjointed and so my work method looks wrong but I am only telling the story and the order of things isn't always correct. I am also NOT ex-voluntary services and I am fine with my height thanks! I am genuinely asking for input in case I am missing something here so please respect this platform and make a genuine case for or against it. If I believe what you have to say I might re-think the whole thing but I will continue to write it the only way I can. As for my regulars, carry on reading and commenting but remember that I am happy with you just reading it - its my outlet.   ** Xf Replies ** 26th October 2006 lefflump Thanks. You gave me an idea actually. I have never listed other blogs and so I think its time I did. Nee Naw is there - same family, different angle. chezer1969 Again, thanks. You are right but I must face my critics before ignoring them, otherwise they leave a comment that I do not defend and others think they have a point! I don't know how to filter comments but I can, and do, delete and block. I get all sorts of weird and not so wonderful emails and comments so I am screening this carefully. Believe me, if I write about a job that I realise I got wrong then I will either delete it and learn from my mistakes or simply own up and learn nonetheless. hypnohelp121 At last a constructive comment and you are right about me, I am quite sensitive to this sort of criticism - It's in my nature and it may all just be ego so I will have to examine that closely. This was my last stand as far as these comments are concerned and I will simply delete and block future destructive comments. I must, however, entertain the possibility that I may be overlooking something and these people have spotted it, thus my invitation to elaborate. On the other hand, as you suggest, there may be no other explanation but action for the sake of reaction. I can be quite easy to wind up if you catch me in the wrong mood :-) but one thing you will discover about me that these people already know...I never quit when I am doing good. Many thanks. Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 26 comments: Show Recent | Add your own     08 October 2006 21:26:47 o'clock BST Threatened   I wonder what it feels like to have a gun pointed at you by an angry and senseless person? The gun wouldn't even have to be real. It would just have to look real. An early morning call today (Sunday) to a 'man with head injuries - possibly mugged'. I was asked to go and assess the need for an ambulance. It all looked tame enough on the screen. When I arrived there were a couple of police officers outside an office building. They directed me to the basement toilets after showing me the blood spattered outside on the pavement and smeared on walls all the way to the loos. A young man was in there with another police officer and his head and face were covered in blood. He was attempting to wash it all off. The police had already helped to stop the bleeding with their own dressings before I arrived and so there was bloodied litter everywhere. I calmed the man down (he was very upset) and asked him what happened. He told me a story that did not match the one the police had just given me. There was only myself and the patient in the room now but I knew that something was wrong with the details. He had two nasty gashes in his scalp and a bruised lump on his cheek. He had been in a dispute with someone (I won't elaborate) and the guy, with a friend in tow, had attacked him. One of the assailants pointed a replica 'BB' pistol at him and fired off about a dozen little ball bearings. One of them had hit his cheek I think. Then the gunman set about beating him over the head with the butt of the gun. I don't think the police realised that a gun had been aimed and fired at him, even if it was only a BB gun. I told them what I had learned and the scene changed immediately. The area was cordoned off and forensics were gathered. It all sounds over the top but its horrifying to think that someone can just stick a gun in your face and only that person knows it isn't real and won't kill you. The poor guy was beside himself. He broke down and cried at one point. The police take this sort of thing seriously and I'm glad they do. When they catch up with this idiot he will have more than one real gun pointing at him. Before this call I was asked to check a patient who had called an ambulance for 'a cut to the lower leg, cause unknown'. When I arrived at the address in South London there were a few people in the flat and this guy just looked at me and said "can't you just stitch me up and go". He didn't want anything to do with police or ambulance. He didn''t want uniforms in the house. There is usually a good reason for that. Eventually he unwrapped the filthy towels that had been covering his leg and I immediately identified his injury as a large stab wound. He claimed it happened without his knowledge as he walked past some youths at a party. He went home and a few hours later discovered it! He was wearing shorts...how did he miss it?! It wouldn't stop bleeding without pressure so none of what he said made any sense but I was very uncomfortable in that flat and I dressed his wound and left. He didn't want an ambulance anyway so I took the hint. I'm resting for a while now so won't be making any entries until I am back at work. Thanks to those of you who have been positive about this blog. I know my 'regulars' but I wouldn't mind hearing from some of you out there who are reading in silence. My hit counter has never worked properly so I don't know for sure how many readers I have now. Drop in and say hello! Be safe.   ** Xf Replies ** 9th October 2006 pastlife007 True enough I did but my entry isn't about owning them or keeping them. It's about pointing a gun of any kind at another person with the threat of it being used. If you know me you will also know I have handled and fired live weapons in the past. Yet again, someone feels they need to 'watch' me. Why don't you leave me to reflect on what I am doing NOW instead of initiating your opinion of me personally? It's easy to hide in the shadows and undermine me. A lot easier than moving on. Magwitch Forgive my lateness in replying. Thanks for your comment. Unfortunately it is the same old stuff up West. I did work in another sector before going Central and, again you are right, communication becomes a major issue at times! tomcoop121 Congrats on your successful entry into my world! There is no real average age for trainees as many people of all ages and from all walks of life join the Service. However, the increase in University entrants over the past ten years may well have resulted in an average trainee age of 22. Not that I mean you are average :-) madphckngplac LOL. Something I considered but I lead a bunny-free life now! Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 27 comments: Show Recent | Add your own     21:06:25 o'clock BST Religious experiences   GOD works through the evils of others and reveals himself. Well that's what I was told by the nice man handing out leaflets in Trafalgar Square today (Saturday). My first of two shifts in the daylight hours - and they are shrinking fast (the daylight hours that is). Strange day for sermons about God and religion. I tried to explain that I'm not much of a religious person and that this job doesn't really offer much of an opportunity to see God in action. Nevertheless, as usual, the spirit of a Christian can never be broken...so he still tried to convince me. Elsewhere, in Piccadilly Circus, there was a fair haired man with a tan talking through an amplifier about the sins of life to crowds of tourists and Londoners who were just passing by. No interest there. I watched him speak as I idled at the traffic lights and he is either listening to his own speech through earphones as he delivers it or he has a walkman plugged in and is listening to Razorlight because he is bored! I don't know this guy's name but he is well known for speaking here and they have tried to ban him. He's harmless. Typical. Let's ban him anyway. I did do some work today. A suspected overdose with a large mean Doberman at the door. The patient wouldn't answer and the police officers were not interested in talking to the dog so we waited. Eventually, the patient came to the door and all of us (in unison) jumped back and I shouted for him to put the dog away in a closed room before it got hasty and tried to do something heroic for its master! Away it went. As for the patient - he was drunk and a bit fed up. He hadn't overdosed at all. How much does one paramedic and two police officers cost these days? I attended a fractured wrist and conveyed the girl to hospital ( she fell on it because her 'weak' ankle gave way as she walked) which I saw as an unfortunate combination of bad luck. I also dealt with a panic attack, a dizzy spell, a man with very bad alcohol withdrawal symptoms and two little mystery jobs. I like them as you know :-) The first was a call to a woman who had been assaulted. It was barely 8am and she claimed to have been walking home when a man grabbed her from behind and punched her in the face. She wasn't mugged so there was apparently no motive. I noticed that the knuckles of her right hand were bloody and bruised...like she had been punching something herself. Then she revealed that she had gone home to bed after the assault and her husband had seen the bruise to her cheek when she woke up. So the assault actually (allegedly) took place earlier. The story was full of holes. The second call was to a man 'having a fit' in a shopping centre. When I arrived I found him on the floor. He wouldn't speak to me and only stared into space. I thought he might be foreign so I tried a few phrases I've learned in different languages. It didn't work and I felt a bit stupid. This guy didn't smell of alcohol (although he did smell bad) and he didn't show any signs of being post ictal (the last stage of an epileptic fit). I asked for the police to attend so that I could have him checked for ID and I arranged for an ambulance to come and convey him. Something was wrong with him but I didn't know what. After a few minutes he started to get up and become a little aggressive. He still didn't speak but he threw his arms around and tried to force me and the security guys away from him. When the police arrived and searched him he had no ID on him at all. Mystery man. The ambulance crew arrived and, with the help of a pair of handcuffs, we managed to get him to hospital. He remained combative and aggressive and now he was swearing at us (in English) so he was going to be a nightmare to treat for the hospital staff. What could I do? I couldn't leave him and I couldn't treat him. To tell the truth, I couldn't see anything of GOD in the calls I attended today. Maybe tomorrow will be better. Be safe. Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 4 comments: Show Recent | Add your own     02 October 2006 18:55:07 o'clock BST Predators   There are young men out there whose sole objective is to harrass and abuse vulnerable young women. I watch them wander around Leicester Square in the early hours, usually in pairs and they are looking for a single female (but no more than two) to follow and exploit. Usually it ends with a dismissive wave of the hand from the girl or a less polite "F*** off!" but usually it ends right there. I was sitting in the car on stand-by when I was approached by a young girl and asked if I could take her to West London. She explained that she knew I wasn't a taxi and that I wasn't supposed to do that but if I could she would be willing to pay. This isn't unusual. I often get asked by drunken males and females for lifts home. The tube is shut for the night, taxis are rare and the night buses seem to confuse them. In every event I politely refuse and they walk away. If I know what I'm talking about I give them directions to the nearest relevant night bus stop. This girl was pleading and after a few minutes she whispered that she needed to get away from the two guys who were following her around. I had noticed that she had a couple of young men in tow and they were still hanging around near the car but I had assumed she was with them. I saw the fear in her eyes and decided to help. I told her to get into the car and I called Control to let them know I was going to convey a vulnerable person to the nearest taxi I could find. I was given permission to do this and drove away from the West End (where no taxi was available) to a location I knew would be busy with free black cabs. In the few minutes that she was in the car she broke down and cried, explaining what had happened and I won't repeat any of it here. She was quite drunk but she knew what was what. I hailed a cab for her as soon as I could and made sure she got in safely. Off she went into the night. I do not consider what I did to be brave, heroic or any of that stuff. I consider what I did to have been my duty as a carer. There were no police officers around and she was at immediate risk if I just ignored her. I took her to a place of safety and that is my brief whatever way you look at it. It was a little unorthodox and yes, I did create a potentially risky situation for myself but I do that (and so do my colleagues) every time I go to work and have to treat and care for young women. I do not shrink from that responsibility and I am not naive enough to open myself up without thinking first. I can't believe that these two men were hanging around the car waiting for me to tell her to go away so that they could move in on her. Their interest in her evaporated as soon as she got in the vehicle and I took her away. They probably went off in search of another young girl. It's ugly to watch. I know that there are young females that read this blog. I would ask you to be very careful when you go into Central London, especially in the early hours. If you are on your own or with just one friend, you are very vulnerable. Make sure you know how you are going to get home and check out the night bus schedules - know where to get the bus, not just when! End of lecture. That was my last night shift for a while. I start my early turn again this weekend. Until then I am off! (Sleeeeep. :-)) My colleagues have all been feeling the strain this weekend. I know this because every time I met one of them out there I saw a tired, weary face. Hats off to them all I say. For my part, I was kept going by my love of this job and the coffee (and sometimes apple pie) given to me by my friends at the Fiori Corner in Leicester Square. Thanks guys. Be safe.   ** Xf Replies ** 4th October 2006 maxfreeman488 I believe Kingston Uni are offering the foundation degree which can be studied whilst working. The alternative is the BSc.(Hons), which is the degree I completed. This involves 3 years of full time study with a year spent working for your Technician qualification in the middle of it; so 4 years in total. The University of Hertfordshire offers this but you will not get in til next year. Places are limited and they tend to get around 400 applicants for 40 places. Does it make a difference? Well, it does to me and in the future you will need at least a foundation degree to become a paramedic. Whichever way you do this, it will take you at least 3 years of hard work to achieve but if you want it, like everything else, you can do it. Good luck! Written by thexfileman . Link to this entry | Blog about this entry | Notify AOL This entry has 11 comments: Show Recent | Add your own

   Thursday, November 23, 2006     reallife@the-sun.co.uk     Kayleigh ... tragic death  RELATED WEBSITES  • Sign the petition   Did NHS cuts kill Kayleigh?   By CORINNE ABRAMS November 23, 2006   IT is Jean Murphy's daughter Kayleigh's 16th birthday tomorrow but the mum from Holloway, London will not be celebrating - instead she will be delivering a petition to Downing Street in a bid to prevent another death like her daughter's.   Kayleigh Macilwraith-Christie died on July 14 this year after an ambulance sent to help her as she had an epileptic seizure did not have a paramedic on board. The emergency technician manning the vehicle was unqualified to administer a vital drug that could have halted her fit and saved her life. Below mum-of-three Jean, 46, describes the heartache of losing her youngest child and her brave campaign to stop it happening to anyone else.  In the week before Kayleigh died, she came home with a glowing report, had been given the Best Pupil award at school and had some of her artwork displayed on our estate. She was a happy-go-lucky girl with a talent for singing and a gentle nature. When around 300 people turned up at her funeral, I realised just how popular she had been. She was looking forward to going to Spain with me for a week in August and kept talking about how she couldn't wait to get in the sea there. Kayleigh didn't want too many people knowing about her epilepsy, and it wasn't too much of a problem. Seizures were rare for her because the condition was controlled with medication. But she had had fits before, so I knew what to do when she started having a seizure that day. I put her in the recovery position and called an ambulance. I told them she had epilepsy, which I later found out meant she was a Code Red, and they would send a paramedic. When Kayleigh had seizures before, the ambulance had arrived at our flat within eight minutes, she had been tended to by a paramedic and was then taken to the hospital where they had all the treatment she needed. It was so straightforward that once, after a seizure, the doctor even said she could go back to the adventure playground. But this time was different. The first ambulance that was sent, with the paramedic on board, had been diverted to an accident on the way. When the second one arrived, half an hour later, it went to the wrong address and I had to chase it down the street. I was in a complete state. It was then that I found out the person manning it was not a paramedic, but a technician. He and his two trainees were not authorised to give Kayleigh the muscle relaxant Diazepam (known as Valium) she needed to save her life. I called the ambulance at 6.50pm, and the hospital says we got there at 7.40pm. But by this time it was too late, Kayleigh's heart had given up because she was fitting for so long. At 8.30pm, after half an hour of trying to revive her, Kayleigh was pronounced dead. I was devastated. A few weeks after her death, some paramedics contacted me saying I needed to lodge an official complaint, and asking me to contact the media. They said the ambulance service was in a right state through lack of funding and that Government targets are making their jobs impossible. Before that day, I didn't even know emergency technicians existed, but now I understand they man ambulances. They aren't qualified to administer some drugs or carry out some procedures. I have spoken to many people, even doctors, who didn't know about emergency technicians. They wear a similar green uniform to paramedics, and the only way to tell them apart is from the gold writing on their shirts. I decided to start a petition to raise awareness about the fact that when you call an ambulance, a paramedic will not always be on board. I'm calling for every ambulance to fully trained staff who can deal with any situation. Now we have more than 12,000 signatures and will be handing the petition in at 10 Downing Street with our local MP Kelly Thornbury on Friday. The day will be especially poignant, because it would have been Kayleigh's birthday. We have a peaceful protest march planned through the streets of London before we get to Downing Street. It is not the way any parent would like to spend their daughter's 16th birthday, but I just don't want anyone else to go through this. I can't say 100 per cent that Kayleigh would have survived if a paramedic had been on board the ambulance, but I feel like she was not given the best chance. In August I went to Spain, as we had planned, and threw some of her ashes into the sea. I miss her terribly, it is really hard.  CLICK here to sign visit the website and sign Jean's petition. London Ambulance Service investigation into the death of an epileptic patient Following the death of epileptic patient Kayleigh Macilwraith-Christie, the London Ambulance Service has conducted a thorough investigation into the emergency response it provided. Assistant Director of Operations (East London) Richard Webber said: “We are very sorry about the untimely death of Kayleigh Macilwraith-Christie. “We have conducted an investigation into the care we provided to her and have recently met with her family to share the findings of our investigation and to reassure them that we are taking this matter very seriously. “We are committed to learning lessons from this tragic case to improve the treatment we provide to our patients. We are making changes in our control room so that we will be able to easily identify which of our vehicles have paramedics on so we can target them efficiently. We are also in discussions with the Medicines & Healthcare Products Regulatory Agency (MHRA) to change the laws around the use of diazepam so that in the future this could be provided by emergency medical technicians.”   Computer problem hits 999 calls BBC News in video and audio   News services Your news when you want it   Last Updated: Wednesday, 23 August 2006, 17:10 GMT 18:10 UK   London Ambulance Service's (LAS) 999 operators have had to take calls down on paper due to a computer problem. In the past few weeks the computer-controlled call-taking system has crashed. It means staff have had to take calls by hand and then pass information to paramedics by radio, instead of the computer doing it automatically. An LAS spokesman said the problem had now been corrected and patients' lives had not been put at risk. During busy periods, some 999 calls have been diverted to the Metropolitan Police control room. Tried-and-tested The problem, caused by a software upgrade in July, has been compounded by staff shortages in the LAS control room The LAS spokesman said using pen and paper to take call details was a "tried-and-tested" system and one previously used by the service before the computer system was introduced years ago. He said: "Although we are currently nearly at full control room staffing, we have also been experiencing some difficulties in fully covering some shifts during August and this has put additional pressure on our ability to manage periods of particularly high demand. "As a result, there have been a limited number of occasions when incoming calls have been diverted to the police for a very short period. "This arrangement is part of our normal contingency planning and as such is always in place to deal with surges in 999 calls. "It should be noted that despite all these issues, the service is meeting its key performance target of getting to 75% of all life-threatened patients within eight minutes." News The Commissar Won’t Want To Hear There is always room for improvement comrades! “Comrades, from April next year your party expects an increase in potato production per hectare. Co-operatives failing to meet the new quotas will be permanently re-assigned to the mines of Siberia”. ++++++++++ Well, my hunting around the internet, in a serious search for the origins of the 8 minute response time “holy grail” has borne fruit and turned up a hitherto unknown testament (at least to my knowledge). No doubt Commissar Hewitt, in collusion with MI5, has already sought to have the authors permanently gagged under threat of a fatwa. It seems the initial positing of an ‘8 minutes response to life threatening calls’ (read; out-of-hospital cardiac arrests) all came about in 1996 in a government sponsored paper by the ORCON study group, under the direction of R Chapman, entitled: “Review of Ambulance Performance Standards; Final report of steering group. NHS Executive 1996. I wrote to the DoH in an attempt to get hold of a copy. A Mr Davie kindly responded. “Currently we have no publicly-available copies of documents dating back from that time; any publication from that date would now be out of print. In sourcing copies, either print or electronic, I suggest that you contact the British Library.” So, this catechism, that dictates the whole strategy of ambulance services up and down the land, is no longer available but is languishing in an archive somewhere slowly gathering dust. It’s findings; the current ORCON standards that are now ’set in stone’ have gone unchallenged for nearly a decade. Until now that is….. I stumbled across this little gem; The Costs and Benefits of Changing Ambulance Service Response Time Performance Standards, Medical Care Research Unit, School of Health and Related Research at the University of Sheffield. May 2006- Download a PDF copy. This is another tome from the black arts of academia. But first, a little recent history: As mentioned, the ORCON standards are ’set in stone’ and have been since that government report of 1996. It’s main commandment was that 75% of all Category A (life threatening calls) must be reached within 8 minutes. Of course the interpretation of 8 minutes was open to question. What exactly did ‘within’ mean; less than 8 minutes i.e. 7 mins 59 secs? or up to 8 mins 59 secs i.e. 9 minutes? And when did you start the clock running?; when the EMD in control picked up the phone?; when Control dispatched an ambulance?; when the ambulance left the yard? And when did the clock stop?; when the para/emt actually reached the patient?; when they pulled up outside the house?; when they got to the street? All these variables allowed managers to cook the books, manipulate the times sorry, interpret the results in different ways. Of course none of this has anything to do with patient care or clincial outcomes, it’s just become another way for the current oligarchy and their obsession with targets to ‘tick the right boxes’ allowing Comrade Hewitt to declare that the NHS is “having its best year ever.” Last year the Department of Health published (another) document: Taking Healthcare to the Patient; Transforming NHS Ambulance Services. In it, the mantra of the 8 minute response time was reaffirmed only now: “..for the purpose of measuring 999 Category A and Category B response times, the clock should start when the call is connected to the ambulance control room. This will more closely match the patient’s experience and can be consistently understood and applied by services. This change should be introduced from April 2007.” This, ’supposedly’ is great news for patients - the ambulance should reach them more quickly; and great news for ambulance services as we’re all starting the clock at the same time. In reality it means that crews will have less time to actually get to the call, response times for Cat ‘A’ calls will plummet and there’ll be the usual knee-jerk-we’ve-not-given-this-any-thought response from management. As I blogged earlier, LAS are re-stucturing their whole fleet in order to meet these new, and more stringent targets; ‘Now you see us; soon you won’t‘. This was based on an article in the London Evening Standard. In it Mr Ian Todd, LAS assistant director of operations towed the party line and stated, “the changes would mean significant improvements for patients such as heart attack victims, whose chances of survival drop by 10 per cent for every minute’s delay in getting treatment.” Sounds grand doesn’t it? Where’s the evidence to back such a claim? Tom Reynolds has also posted about it in What is an Ambulance? ++++++++++ So now let’s have a look at the conclusions of this new paper from the University of Sheffield; Overall, rapid response in terms of an 8 minute target makes no discernible difference to survival to discharge. Nevertheless, we also know there are benefits – for the survival of a small number of out-of-hospital cardiac arrests, and in the short term in reducing levels of anxiety, pain and distress. For all patients together there was no reliable evidence of an improvement in outcome with faster response, and we estimate that the odds of dying were only 1.4% less with responses ≤ 8 minutes compared to responses over 8 minutes. Further developments in Ambulance service performance should be focused on better targeting and better clinical care rather than further response time improvements. In addition, the ambulance services that the group reviewed were all using AMPDS, except one which used CBD. What did they think of computer assisted prioritisation? The identification of life-threatening incidents was poor with over 40% of patients not needing admission to hospital. So the Party has decreed that the yield per hectare of potatoes must increase, yet it’ll make no overall difference to the production quotas. Just more Labour lunacy in an effort to convince the great-unwashed that “things are improving”. This entry was posted on Tuesday, November 14th, 2006 at 6:01 pm and is filed under NHS. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

    

   Links

   Kayleigh_s_petition_87401.html

   http://www.londonambulance.nhs.uk/aboutus/facts/facts.html

   http://www.disabilitynow.org.uk/search/z06_09_SeDNX/death.shtml

   http://www.disabilitynow.org.uk/search/z06_10_Oc/union.shtml

   http://news.bbc.co.uk/1/hi/programmes/panorama/archive/603789.stm

   http://news.bbc.co.uk/1/hi/health/863399.stm

   http://news.bbc.co.uk/1/hi/health/428391.stm

   http://www.disabilitynow.org.uk/news/news_nov_2006_extra.htm

   http://www.paramedic.org.uk/story.php?title=Mums-paramedic-petition-gathers-pace

   http://nhsblogdoc.blogspot.com/ excellent

   http://nhsblogdoc.blogspot.com/2005/12/read-this-or-die.html

   http://randomreality.blogware.com/

   http://journals.aol.co.uk/thexfileman/TheParamedicsDiary/