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.

Image by soapylove, on Flickr

This website was launched on Thursday December 4th, 2008, with my initial post, Snapshots.

As a Birthday celebration I asked Jon (my website guy) to pull some facts and figures out of the analytics for the website. Here’s what he came up with.

Aside from the homepage, the most popular page on the site is the gallery. I will definitely try to add more photos to this in 2012!

The three most popular stories (in terms of pageviews) on the site are:

1. June 2010 – where I wrote about how London Ambulance Service decided they would no longer use ECPs as part of their workforce. ECPs were officially redeployed to other roles as of April 2011.
2. August 2009 – where I wrote about the subject of Paramedic Prescribing – which continues to be a hot topic.
3. January 2010 – where Charlotte kindly wrote the first in a short series of articles on Life as a Student Paramedic.

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.

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!

Once again I got roped in to taking part in a local Junior Citizens Scheme. Well if I’m honest I actually offered as it’s a lot easier than a tough day on the road as far as I’m concerned and I really enjoyed last time. There is also an abundance of cake and biscuits available all day for the long suffering workers to pick at, and that definitely helped sway my decision to volunteer.

In case you haven’t see the previous post about the JC Scheme have a look here: Junior Citizens 1.
Colleagues from the police, fire brigade, Transport for London as well as the ambulance service were at the venue. This time however, we set up our ‘stalls’ at Selhurst Park Football Stadium. I had a fine view over the pitch, from one of the Executive Boxes no less, and for most of the week we have had some bright if not very breezy weather.

Each visiting school is split up into groups of 10 pupils aged about 9 and 10 years old. They take turns to move through the various stalls and learn about keeping safe in different situations. They must listen carefully, behave well and participate in each of the situations and we award them points for their efforts to add a bit of healthy competition.

As an introduction, I always ask the children if they recognise my uniform and I ask them what they think I am – I give them a clue of course – I say it begins with a ‘P’ (the answer is Paramedic just in case you weren’t sure).
Among the guesses this week were;
‘Policeman’
‘Paediatrician’
‘Parasol’ (? really not sure where that one came from) and my personal favorite…..
‘I know, I know…..are you a Paracetamol?’
‘All good answers’ I say supportively ‘But, No I’m actually a paramedic’
‘Aw, I was just going to say that’ is the usual sighed response!
‘You can’t be’ one little Herbert piped up authoritatively – because they only have paramedics in America’
‘I can assure you that I am a paramedic’ I said, I told him about my certificate stored safely in a drawer somewhere and the epaulettes on my shoulders that proved it to be the case – yet still he looked unconvinced as he shook his head and rolled his eyes. I was sure that I heard him mutter ‘Clearly deluded’ under his breath…….

Coincidentally, and just in time for my birthday (It was my 21st birthday, just in case you were wondering but were too polite to ask) my very own signed copy of ‘Police, Crime and 999’ by John Donoghue arrived in the post this week. This is the sort of thing that happens in my life now that I move in literary circles don’t you know.

The book is a very funny collection of anecdotes written by John, a serving policeman, who in his little car with blue lights on top, patrols a mystery town referred to only as ‘Sandford’. This pseudonym presumably protects the town’s true identity and the sudden and predictable plummet in property prices that would surely ensue should the town’s real name be revealed. Although I am certain that ‘Sandford’ isn’t a particularly crime ridden suburb or any different from most other little English towns in that respect, it just happens to be the one in John’s charge.

I could certainly relate to a fair number of the comical situations described and it may come as a surprise to some, but the police and ambulance service not only share the same phone number and  the care of many of the same clientele but also, we share the same deviant sense of humour.

However, that said, I don’t think you need to be a member of the emergency services to appreciate the wit. My sister Shona was privy to the draft, she loved it, and she’s never even been in the front or back of an ambulance or police car (well not willingly anyway) and we don’t talk about the incident with the fire brigade since she threatened us with a super injunction, I’ll say no more on the matter.

Even though I have been privileged enough to read the book in draft form already (hence the heartfelt ‘Thank you’ in the acknowledgements) I’m looking forward to giving it a second bash, just as soon as I can prise it from my husband’s grip that is. And I’m not even bitter that he stole one of my best soundbites (see page 205). Really, I’m not…

If you enjoy reading about the exploits of your wonderful British emergency services and fancy a good giggle I implore you to  go to www.policecrime999.com and get 10% off your signed copy while the offer lasts. It’s not released on Amazon until August so right now it’s the only place you can get a copy of the book.

Image courtesy ukhomeoffice, on Flickr

We’ve had some gorgeous spring weather lately and one particularly sunny late afternoon I was called to someone reported as being ‘unconscious’ by passers-by. When I arrived there was a small crowd gathered around a man who was lying flat out on the pavement of a very busy road.

Well as you know I’m not a detective, but the carrier bag full of cigarettes and extra strong lager cans gave me my first subtle hint of what the problem may be. The crowd dispersed and I did some observations on my patient. At about this time a public-spirited and kind young man stopped and offered to help me.

“I’m a doctor, is there anything I can do?” he asked. I thought about his generous gesture briefly and replied;

“Well yes actually, if you want, you could ‘baby-sit’ this drunken man until the ambulance arrives while I go off and attend to a real emergency….” Unsurprisingly he declined and left me to it (in a kind and public-spirited sort of way). Just then my patient, who it transpired called himself Mr Lucky, started to wake up, and once he was awake oh boy, he hardly stopped talking for one moment!

He and I sat next to each other chatting amiably like old friends whilst leaning up against the front wall of someone’s house as we waited for the ambulance to turn-up. Well actually he chatted and I just listened, because he barely paused for breath. There were moments of respite for me however, as occasionally, mid-sentence he would list sideways with his head coming to rest on my shoulder as he momentarily nodded off. When the ambulance pulled up he suddenly sprang to life and said to me;

“Here take this and don’t tell anyone, you can throw it away if you don’t want it?” I felt as he pushed something, which I thought was a piece of paper, in to my trouser pocket. I was just getting to my feet and didn’t pay much attention at the time, but from then on he kept tapping his nose, winking at me and shushing his finger to his lips to remind me to keep ‘mum’.

“Don’t worry, it’s our secret” I reassured him, for at least the umpteenth time.

I handed my charge over to the crew and we exchanged details then said our goodbyes. I jumped back in to my car as they set off for hospital with Mr Lucky on board. Remembering the gifted item, I pushed my hand in to my trouser pocket to retrieve it. I was more than a little surprised to find that it wasn’t the winning lottery ticket I had hoped for, but two small wraps of cannabis! I rapidly pictured a scenario:

The police with sniffer dogs in tow, descend on my car out of the blue – I’m dragged out and  slammed up alongside it – the dogs immediately point their noses at me accusingly and sit by my feet -  after a quick search I’m caught red handed in possession of the drugs -  I weakly try but  fail to defend my position – before I know it I’m in a prison cell in bad clothes, unwashed hair, singing ‘Like a Virgin’ with Bridget Jones and the girls – no Colin Firth to save me, no mobile phone or even worse no Facebook access – sheer hell!!!

One step ahead, I phoned our control room to quickly get in my side of the story. I advised them I would be stopping by the local police station to hand in the stash post haste, which I did – and I have the receipt to prove it, just in case you were wondering.

On a stunning early spring day recently, I was called by the police to a quiet street where a young man had been injured. The details were given as ’19 year old male, hurt himself on a fence.’

I was only a couple of minutes away in my car so I got there quickly and found the group waiting at the side of the road. My patient was sitting on the kerb, hand-cuffed. Apparently he had been in his car when he was stopped by the police for a minor traffic offence.

Few sensible people would try to out-run police dogs; however after he was stopped he unwisely decided to make a bolt for it. He ran towards nearby houses, clambered over some low walls then launched himself on to the fence of some neighbouring allotments. Unfortunately he became impaled by one of the metal posts which entered through the left side of his upper chest. His predicament deteriorated further when the police dogs caught up with him and began nibbling at his legs (in that way only an Alsatian can!). He waited helplessly until the police caught up and rescued him from the clutches of their jaws. Unfortunately they pulled him back from the fence before realising that he had been impaled.

When I arrived, although he was conscious and breathing, he was starting to look quite pale. His pulse and respiratory rate had sped up (not just from the adrenaline!) and he was also quite predictably in a lot of pain from the deep wound on his chest.

Thankfully, I saw the ambulance heading towards us from the end of the road shortly after I had arrived. Time is of the essence in these types of calls as things can change very quickly so I was pleased to see them! Our priorities were to almost simultaneously perform all of his physical observations, listen to his chest sounds, give him oxygen, put a three sided dressing over the wound and put in a cannula (a needle into a vein in his arm) as a route for painkillers and any fluids he may need. The crew promptly took him off to the nearest ‘Trauma Centre’ after making them aware of the approximate time of arrival so they would have some time to prepare, leaving me at the road side to finish off my paperwork.

I have heard since that he is doing well and will recover from his injuries.

Deciding to challenge my Italian language skills beyond their limits and seeing the opportunity for a little jaunt to my favourite country in with the deal, I signed up to attend a presentation on safety on the road in Italy.

Those who have passed a holiday in a city in Italy will recall the chaos of the busy cobbled roads. The cacophony of car horns, the hot-headed drivers appearing to flaunt the common courtesy of road manners and the plucky teenagers whipping around the traffic on their mopeds without fear or foresight. And anyone who has lived to tell the tale will recall with a pounding heart, the ‘run for your life’ dashes to cross roads even while on the relative safety of a zebra crossing. “Keep moving, they expect to drive around you, if you stop they’re more likely to hit you” I was warned by one wise friend! Bill Bryson tells us that when traversing a road in Italy, we should attempt to take the hand of a passing nun, as no Italian would ever hit a nun, therefore your safe passage would be guaranteed!

Italy has one of the highest densities of car ownership in the world and unfortunately road accident statistics bear out its image as a country of spirited drivers with little regard for the law or the rights of pedestrians. The number of road fatalities per capita is double that of the UK and nearly four times that of the Netherlands, according to figures from the World Health Organisation. In 2009 there were 4,050 road deaths in Italy (DfT). This equates to 6.7 road deaths per 100,000 of population compared to the UK average of 3.8 road deaths per 100,000 of population.

The ‘Educazione Stradale’ type events have been taking shape for the last couple of decades but since 2001 they have taken a more collaborative approach with the traffic police, fire-brigade and ambulance service delivering the lectures together predominantly to young people in schools. The evening event that I attended was hosted by two road traffic police officers Andrea Scamperle & Antonio Benedetti, and my good friend Massimiliano Maculan, an ambulance nurse who works for the S.U.E.M 118 Croce Verde in Verona (see previous post).

There was a good turn out from the people of the small lakeside town of Lazise on Lago di Garda; at a guess I would have said that there were approximately 100 or so who came along. The presentations consist of a series of videos, depicting both real and reconstructed collisions as well as testimonies from the police and ambulance staff. By far the most powerful of the testimonies came from the families of those who have lost loved ones in a Road Traffic Collision (RTC). Although I struggled at times to understand the detail of what was being said, it didn’t stop me feeling the raw emotions of the mother who spoke about her pain at the tragic loss of her teenage child in a RTC. Various videos were used to demonstrate the dangers of poor driving. During one of the videos in particular, a fatal crash caused by texting on a mobile phone while driving was played out, I could see that some of the family members became emotional. It was very graphic and must have taken considerable courage for them to watch it.

Having attended a similar presentation here in London, Safe Drive Stay Alive, it came as no surprise to note that the key messages delivered are the universal ones – all occupants should use a seatbelt, use no drugs or drink alcohol before driving, never use mobile phones to call or text while driving and of course, always drive at a sensible speed.

With each new generation of young drivers bringing up the rear, the need to repeat these events ad infinitum will remain. Sadly it seems that we human beings never have been very good at learning from other peoples mistakes.

Here is a UK video warning of the dangers of texting while driving.  A little warning here if you have any children in the room with you – it’s a graphic reconstruction.

Image courtesy hsingy, on Flickr

I had a young student paramedic out observing with me this week. With her ‘gateway’ exam coming up soon Jane wanted to spend the day with an ECP to observe physical assessment techniques.

Our first patient was a young man who had fallen almost 3 metres while working on a construction site. It was raining lightly and he was laying in the middle of the muddy building site; it was simply impossible to keep our boots and uniforms clean as we worked on him. He was complaining of back pain so we needed to completely immobilse him. This involves putting a rigid collar around his neck, placing him on an orthopaedic stretcher and using a series of straps to hold him surely. To make all of this fit well we had to cut off his bulky clothing first. As I mentioned, it was raining, and no sooner had we cut in to his padded jacket than the feathers inside were released and flying all around! We were breathing them in, they attached themselves to our eye-lashes and hair, and because we were damp from the rain they were sticking to our uniforms and faces too. By the time we carried him from the building site we were a complete mess, covered in mud and feathers!

Then there was also the very last call of the day. An older man had been found, collapsed at home by the police. Having been alerted by a relative, they gained access to the house where they found him laying in the living room and immediately called for the ambulance service.

His was unconscious, his temperature only 27 degrees, and he had a facial and head injury with heavy bleeding from his nose. He had been incontinent of urine and faeces and had developed deep pressure sores on his face, torso and limbs where he had lain face-down for so long (we guessed at least 2 days). We worked with another crew to stabilize him and undertake the delicate process of packaging him up for the journey to hospital without making his condition any worse. The police were brilliant too. They helped us by holding the drip and cutting his soiled clothes off. As we navigated him out through to the hallway on the orthopedic stretcher, they were on hand again to help us lift him high enough to pass over the bannister.

He was given a scan at hospital and unfortunately his condition was very poor and he was not expected to recover. Afterwards, Jane and I reflected on what happened. We hoped that whatever caused him to fall, he had been unconscious from that moment. We didn’t like to think of him being aware of his gradual deterioration while he waited for help to arrive, help that sadly came too late.