Image by JackBetty on Flickr

I saw a lovely patient this week, he was a very shy young man who didn’t speak much English but sadly he had just been mugged. There were three of them and only one of him – so violence really wasn’t necessary, but still they punched him in the face a number of times as they ripped his mobile phone from his hand.

Some women were standing at a bus stop nearby and witnessed everything. Immediately one called the police. Additionally, the other woman had the incredible presence of mind to capture the attack on her mobile phones. It was a brave thing to do, had the men seen this they most certainly would have wanted to get the phone containing the evidence from them and I doubt they would have had any qualms about using force to achieve this.

The police arrived very quickly, but the men had already fled the scene. However, the women handed over the footage on the mobile phone and very shortly afterwards the group were spotted and arrested for the crime.

Even though the victim would soon have his mobile phone back, he was in a lot of pain because he had sustained a broken jaw bone and needed to go to a hospital with Facial Maxillary facilities for surgery. But I would like to say well done to those Good Samaritans who can feel very proud of themselves. Without their selfless quick thinking the cowards may have very well got away with it.

I don’t know if I believe in karma but it certainly seemed to come in to play with my patient last week. Although he was seen fairly promptly and spoken to politely, he was an impatient and somewhat objectionable man from the moment we made contact.

As he told me the story of how he obtained his injury, I could just picture the scene! He barely concealed his anger as he recounted the story in great detail, of being ‘cut up’ by a young driver of a tatty Fiesta as he was driving along a local road. He told me that he eventually managed to manoeuvre his car in front of the lad who was forced to come to a halt (and who from his description, sounded terrified).

Our chap then pulled the lad from his car and started telling him what he thought of his driving ability as he jabbed him in the chest repeatedly. And that’s when it happened…

As he jabbed away with his finger at the poor young lad’s chest – the force of the impact caused it to dislocate! This obviously brought a swift end to the situation, it probably also brought a tear to the eye and a few choice expletives. No doubt it also caused a sign of relief from the young driver too – who took the opportunity to make a dash for it!

With no one remaining to take his frustrations out on, Mr Angry then drove himself to the emergency department, still rather cross, to get the finger sorted out.

Even after I had got his finger pointing in the right direction he remained rather grumpy, and left the department muttering under his breath; he didn’t even say ‘Thank you’!  – There’s just no pleasing some people!

Image by fazen on Flickr

It can be a bit hit and miss when you take an observer out for a shift on the ambulance. No self respecting observer arranges an observation shift with the London Ambulance Service hoping for a quite night on station drinking tea and watching Strictly Come X Factor on Ice; and of course we want get a chance to drive fast, show off our skills a bit and generally give them a night to remember.

Clearly there is something of the Munchausen by Proxy personality in the vast majority of us ambulance personnel. On one hand, while not wishing for anyone to befall a dreadful accident, on the other hand we kind of hope that if they do, that it will be our ambulance that gets sent to them – particularly if we have an observer to show off in front of.

Our definition of a ‘good job’ of course, is probably your idea of a ‘nightmare’, one that will undoubtedly become the blood curdling subject of your dinner party conversations for years to come – long after we have forgotten how much we enjoyed bravely wading knee-deep in your body parts while heroically rescuing you from whatever horror you had succumbed (you can be certain that’s how we will retell the story anyway).

Most shifts we are damn busy and we barely pause for breath for the whole 12 hours. We tend to just lurch from one call to the next. Often we are then rewarded for our considerable efforts with a ‘late job’ to ensure we get home absolutely knackered and even later than anticipated.

In fact the chances of getting off on-time are inversely proportionate to how important it is to be heading away from work as the second hand moves into overtime. For example if, as has happened to  me in the past, your child has their first lead role in the school play you know with absolute certainty that you can kiss goodbye to any hopes of seeing their debut; some selfish bugger with an acute case of ‘No Discernible Symptom Syndrome’ (NDSS) will chose precisely those closing moments of your shift to call 999 for a check-up and you can bet your life that your ambulance will be the only available one within a 20 miles radius. You will arrive at the performance, exhausted just as the fat lady sings and your child starts sobbing because you missed her bit.

The moment one puts an observer into the equation things turn on its head. Rather than being run ragged, we instead run the risk of developing pressure sores from complete immobility, only offset by getting up occasionally to source the next round of tea. The deflated observer hears our pitiful plea that ‘it’s not normally like this – honestly – we’re usually really, really busy’ but it sounds hollow and you know they don’t believe you.

I worked a shift on an ambulance recently with an observer Alfonso who had travelled all the way from Italy for the shift – no pressure there then! Thankfully, fate was kind to us, if not to our poor patients. We had a full-on night. As well as the predictable run of unwell folk, including a couple of kids and a couple of ‘blue calls’, we went to a nursing home for the elderly victim of a cardiac arrest. This happened in a room that was not much bigger in dimensions than the bed it contained and it must have appeared like a surreal, uniformed version of Twister (TM) as we clambered and climbed over each other to undertake various aspects of the resuscitation – and why are those places always so uncomfortably hot?

Of course no observational shift would be complete without the obligatory comedy moment. We got a call to a lady who had had rather too much alcohol to drink and had vomited – prompting a a party goer to reach for the phone and call 999.

As soon as we arrived at the private house party where our patient had taken unwell, it was clear that things were going to get interesting. Firstly, our patient had got drunk on mead – who drinks mead these days? I noticed the flower garland in one lady’s hair ….and then her black cape. One man in the group was dressed like a glamorous undertaker, complete with heavy black eyeliner, top hat and tails. It transpired that this was a party for witches and our patient was a real live witch no less! During our assessment of her, she regaled us with a fascinating story; apparently her husband’s nickname for her was ‘Old Trunkard’

‘Do you mean drunkard?’ I asked in a non judgemental sort of way.

‘No, no it’s Trunkard’ She then went on to explain in detail how she earned the moniker after she fell on to an ornamental elephant and the trunk of the ornament ‘accidentally’ entered her body, necessitating a hospital admission to have the offending item removed from the orifice. She had us in hysterics and thanks to the considerate inclusion of many commonly recognised international hand gestures, no detail was lost in translation for Alfonso.

You know what it’s like when you have a new born baby to look after. You would do anything in your power to keep them safe from harm. One new mum took things a little bit far recently when she found a wasp’s nest in the family home.

A scaremongering friend panicked our new mum by saying that if the wasp went near her baby boy it could kill him. The same friend also helpfully offered a strategy for dealing with the creatures – unfortunately this strategy didn’t involve anything as sensible as contacting the local pest control company. No, this plan involved a lighter and can of hairspray!!! This was never going to go well, but thankfully it wasn’t as bad as it could have been – all things considered.

Fearing for her little one’s life when a lazy wasp took flight in the bedroom, our new mum rushed for the hairspray and lighter. Then with her home-made flame thrower directed at the wasp, things quickly took a turn for the worse. The curtains caught alight and smoke rapidly filled the room.

Luckily the baby was in the next room and mum was able to get them both out to safety. When I arrived the pair were seated safely in the fire-engine – mum was sobbing her heart out. Now, with the benefit of hind-sight, she couldn’t believe that she’d followed her friend’s stupid advice.

We took the pair of them to hospital for a check-up and thankfully the only harm done was to the fixtures and fittings so both were discharged home later that day. As for the wasp, well I have no idea how he did in all this!

Image courtesy megadem on Flickr

I was telling my friends and family about a call I went to recently. It involved a toddler hit by a car with possible life changing or life threatening injuries. My colleagues and I were busy – we had a child screaming with a head injury and the pain of numerous broken bones needing our urgent medical attention, not to mention a traumatised mother and older brother to consider. In the middle of all of this organised chaos I went to retrieve some equipment from my car and as I looked up I noticed that a number of bystanders were holding their phones out in front of them, focussed on the child, filming the incident.

I have to say that I feel considerable disgust at this new social propensity for members of the public to reach for their mobile phone to capture every detail of the suffering of another human being.

When it comes to the media, this is their bread and butter; even the police have no absolute right to stop them from filming. In their guidance it states they have ‘no legal power or moral responsibility to prevent or restrict what they record’. Some matters, arguably, are in the public interest; after all the media are responsible for capturing everyday situations and dramas to inform and record both for contemporaneous and future consumption and that is, perhaps, how it should be. For example, the amateur footage of the tsunami gave an almighty boost to the relief effort; court cases of police brutality have been won and lost on the basis of recorded material – often provided by the public.

However, it surprised me to discover that even if the mother of the child had asked the police to stop people filming him that guidance states ‘If someone distressed or bereaved asks the police to stop the media recording them, the request can be passed on to the media, but not enforced’ – Really? Should that be so?

Am I being a hypocrite? Undeniably.  I too have been ‘guilty’ of watching this stuff on numerous occasions, as has anyone who watches the News at Ten. Perhaps though, there are degrees of hypocrisy. This however, is about the lack of ability in each of us to regulate the setting of our own moral barometer. Have we really become so desensitized to the suffering of others because of the graphic images we are regularly bombarded with in the media that we actually delight in the pain and suffering of a small child to the point where we welcome its presence because it gives us something to share and talk with the family when there’s nothing good on the telly?

What will these non-media people do with their booty?

A) Share it with their children over dinner

B) Commit it to DVD format

C) Send it in to Harry Hill’s TV Burp because one of the paramedics rather hysterically tripped up on some equipment?

A big red helicopter landing on an urban lawn the size of a postage stamp is interesting material, and you can film me doing my job should you wish – I’m doing nothing wrong. Film the blue lights on the brightly coloured ambulance if that’s what you like; but please draw the line at filming a little child lying in the road clearly terrified and suffering during what could be his last moments of life – because next time it could be your child.

Image Courtesy D. Sharon Pruitt on Flickr

One of the toughest tasks that I’ve ever had to do at work didn’t involve any blood or trauma, but it left me choking back the tears just the same.

We had been called to a young mother found by her husband when he arrived home after work, as he entered the living room he was confronted by the sad scene of his little daughter sitting beside her “Mummy’s asleep” she whispered to him.

It appears that she had unexpectedly collapsed while at home looking after her little girl. He called 999 immediately and we were there within minutes, but unfortunately it was already too late.

Initially the details were unclear due to the confusion that can naturally occur in these situations. However, once we realised that it had been more than an hour since her heart had ceased beating and she no longer breathed for herself we stopped our attempts at resuscitating her.

I broke the dreadful news to her husband that his wife had died. Breaking the news to him it was hard enough, but then he asked me to help tell their four year old daughter.

There was no hurry now; she had been taken upstairs by relatives by the time we had arrived, which gave us a bit of time to organise ourselves. I realised at this point that I had never had to break bad news, in particular the news of the death of a loved one, to a young child before. I felt ill prepared and emotional just thinking about it. I remembered some stuff from way back during my nurse training which I called in to play. It suggested not telling children bad news in their own bedroom, as that should be a sanctuary that they can retreat to in the future. It was also about the importance of using age appropriate language rather than medical jargon and using the term ‘has died’ or ‘is dead’ rather than ‘gone away or ‘gone to sleep’ so there is no room for confusion.

Dad and I talked and we decided that it was best if the news came from him with me there for support. We agreed that if he should feel unable to say it, he would give me a look and I would step in and say what needed to be said on his behalf; and when it came to it, that’s exactly what happened. He was too upset and unable to articulate the words when faced with his daughter’s open expression.

As I said the words ‘Sweetie, I have some very, very sad news for you…I am so sorry but Mummy has died…’ I thought my heart was going to bang out of my chest, and my throat squeezed and burned with raw emotion as she turned her head in to her father’s neck and began sobbing pitifully.

I’m not just a paramedic; I am first and foremost a mother. The pain of their loss touched me deeply, but children are amazingly resilient. She has a loving father and wonderful extended family to care for her so I’m sure that she’ll be fine, but of course the nature of my job means that I will never know for sure.

If you are experiencing a similar tragedy and are looking for support, please visit the Child Bereavement Charity.

Levitation, by theyoungthousands, on Flickr

Things aren’t always what they seem at first. When people are describing what has happened to them when they call 999 for help, it can be open to interpretation and even a small breakdown in communication can mean we find something completely different to what we were expecting when we arrive. Language barriers, third party callers and bad connections among other things may all contribute to the problem.

Let me give you an example ‘Male cut leg on food blender’ doesn’t sound too ominous does it? In fact maybe this patient should just take a painkiller, pop on a plaster and man up!

Well, when we arrived and found that actually this was rather more ‘Male cut leg on a great big, heavy, spinning, circular saw’ type of injury we realised quickly that a plaster and a couple of painkillers may not suffice. As we peeled off the two blood soaked sweat shirts to see what we were dealing with we discovered a deep wound that had reached the bone, it would certainly need some skilled surgical intervention. So, after we applied a pressure dressing and administered some serious painkillers through a cannula in to his arm we popped him to hospital ‘quick-as-you-like’.

Another patient was described with injuries thus ‘Female hurt foot when she dropped her drawers’ Oh come on, be honest, it instantly conjures up various possible scenarios in your mind, well it did for me! I was eager to see this woman, she sounded interesting…. Sadly, it would appear that this was nothing more than a common or garden injury sustained while putting together some IKEA furniture. This furniture was accidentally dropped on the aforementioned foot and caused some nasty bruising and swelling. I was quick to point out to her that although she had given me ample fodder for jokes at her expense with her unintentional double entendre, I had admirably refrained from doing so -  I am nothing if not professional and I think that she appreciated that.
Moving on in my assessment of her injury, I asked her if a she had taking any action to help herself deal with the pain and she replied;
“Well I’ve ‘levitated”
“‘Levitated’ you say?”I smiled encouragingly.
“Yes, since it happened, I’ve been levitating, you know?”
“Really? ‘Levitating’ excellent! Now I’d pay good money to see that, can you show me how you’ve been doing this ‘levitating’ please?” Promptly, she stuck her foot out in front of her.
“Ah – ‘elevating’ Well I’m sorry, but I’m not giving you any money for that!” I said, very disappointed.

I’d put my name down to work at the Notting Hill Carnival a few weeks ago, well before the London riots hit the news. I usually enjoy working at these big events (you may know that I have also worked at the London Triathlon, the London Marathon and in the centre of town on New Year Eve). These are fabulous opportunities to meet up with ambulance staff from all over London, who I wouldn’t normally bump in to, as well as work closely with the other emergency services. We also end up taking the patients to hospitals outside of our usual patch, which makes a bit of a break from the routine. Following the press coverage of the chaos and disruption on the London streets during the recent riots, I briefly thought about pulling out, but am so pleased that I didn’t.

I was glad that Boris Johnson decided to go ahead with the carnival; I felt that it sent out a positive message to the world and supported the fact that the majority of revellers were simply decent people intending to have a good ole party!

Unlike last time, this year I was crewed with a student paramedic to work on an ambulance; last time I was based at a Treatment Centre. We collected all our kit and checked the ambulance over, then after being fed and watered along with thousands of police officers in the dinner hall of a local school, we took up our position on a side street  close to the procession while we waited for the first patient of the day – as you might imagine with approximately 1 million visitors, we didn’t have to wait long – and once it started it was non-stop!

With a constant throng of carnival music as the backdrop we treated good natured folks with cuts, bruises and head injuries, most, but not all, had alcohol on board but remained in good spirits none the less. We took them to hospitals near to the event, some of which I had never visited before! For a south Londoner like me, being flung so far north made me feel a little disorientated at times – thank heavens for sat nav! It had been an exhausting shift, sleep was calling me and not a minute too soon, 16 hours after signing on, I was finally back home on south London soil where I think I was asleep before my head hit the pillow!

Anton's broken leg, by Frankenstoen, on Flickr

I had to feel sorry for one of my patients last week. She’d been sent in to the Urgent Care Centre (UCC) for an x-ray to her right leg by her GP. Sadly at the beginning of the year, she had lost a close relative under tragic circumstances and was still feeling very low in mood, so having read that exercise can help beat depression she decided to take up running six weeks earlier. Aged 50 she hadn’t done any exercise for years and although she was normally on no medication and in very good health, she wisely decided to take it gently to start with. However, by the 2^nd run her right leg was starting to be painful and after her 8^th the pain was so unbearable it kept her awake at night. She went to the GP the next day and even though there was nothing in the history to suggest a bony injury, he sent her for an x-ray and told her to return a week later for the results. However, during the x-ray, the radiographer detected an abnormality and asked the patient to come directly to us in the UCC.

The x-ray showed a fracture clean across the fibula of her right leg. It appeared that the fracture was possibly 4-6 weeks old and already starting to heal. She told me that because of the way she had been limping to protect her painful right leg – the left one was now also becoming painful. I made a decision to get that one x-rayed too. Unbelievably it showed that the fibula of her left leg was also fractured! The most likely cause for these types of fractures is osteoporosis (which her aunt and mother also suffered from). I then had to tell her that both of her legs were broken; it was the last thing that she was expecting to hear and she became very distressed. I needed to call her daughter to come in and collect her. In the long term, she will be followed-up by her GP and the orthopaedic doctors.

I amazed that this woman had been running on TWO broken legs – incredible! Once again we see the irrefutable proof that a woman’s pain threshold is higher than that of a man’s – discuss!!

I was back in Italy last week with my friends Carol & Jaqui, and on our first night there we were enchanted as we watched a spectacular performance of Verdi’s ‘La Traviata’ in Verona’s majestic 2,000 year old Roman amphitheatre. Under the inky blue night sky, only the occasional breeze gently reminded us that we were sitting outside.  At the beginning of each interval, as well as the obligatory glass of prosecco, we also rapidly sought out our friends Davide and Alfonso. They are volunteers for the ‘Croce Verde Ambulance Service’ and anyone who has had the pleasure of seeing the opera in Verona will have noticed the ambulance vehicles permanently parked outside the arena during the opera season to provide a medical presence to assist with emergencies during the performance. Luckily as well as being practical, their bright orange attire also made them pretty easy to spot among the rest of the audience (who in general were wearing rather more sober colours). The boys had both kindly reorganised their shifts to ensure that they would be on-duty with their colleagues on the night we were coming. Here are a couple of photographs we took to capture a fabulous evening.

What a spectacular place to work for an ambulance service and I do quite like orange, I wonder if I could get a secondment….