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"I have described nothing but what I saw myself, or learned from others" - Thucydides, Peloponnesian War "I have just jazzed mine up a little" - Spike Milligan, World War II This is general gathering, en-masse, of journal entries, thoughts, anecdotes and ideas - during my time in the Ambulance Service. Clearly it is not intended to insult, offend, horrify, antagonise, bully or bring down in any way, the very fragments of society as we know. It is meant to be fun - nothing more...please take it as that that. As Spike Milligan says....I've just jazzed mine up a little.

Not on my shift . . .

I collapse to the ground and lean back against the trig-point atop the small hill of Brunt Knott.  My body is awash with sweat from the short walk up.  Working in London has certainly taken its toll on my fitness.

Sitting back, I take in the majestic views of the Kentmere valley and the surrounding Lake District.  The sun beats brightly above me.  A gentle breeze blows across my face, and Skylarks singing above mark the only break in the mountain silence.

I breath in deeply.  The air is fresh and clean.

Sitting in this joyous solitude I can feel tears falling freely down my cheeks.  Another memory has broken the peace and invaded my mind.  I close my eyes, but the black canvas of my eyelids only acts as a projector screen and enhances the images I see . . .

. . .

“Am I going to die?!”

My patient’s eyes pleaded with me, their pupils wide with fear. 

“Not on my shift!”

I quipped back, striking my standard mockingly heroic pose.  The security guards standing over my patient chuckled out loud.  Success! This seemed to break tension and I smiled down at my patient expecting the same back. 

I’ve used this phrase so many times now, together with the ridiculous pose, it’s become my trademark.  It would instantly bring calm to a situation and allow my patient to see that everything was under control and not as serious as they first perceived.  After all, a large part of being a paramedic is bringing an image of calmness that convinces the patient, and those around, that everything is going to be fine.

My patient had been out shopping when they’d collapsed outside a busy shopping centre.  I was working as a solo paramedic at the time, and as such, was first on scene. 

My patient stared back at me, pupils growing wider, their colour draining. The Lifepak15 started blinking different colours at me and making funny sounds

Within seconds of uttering my life saving mantra, my patient had become unresponsive.  Then they stopped breathing.  Then they went into cardiac arrest. 

Then they died.

And nothing I, nor anyone else did, changed that outcome.

This, however, was not a particularly “bad job” in the grand scheme of being a Paramedic.  This sort of thing happens all the time – of sorts.  But it was affecting me.

I was having increasing flash backs of every job where I was questioning my decisions, and it was changing my life.  I would constantly go over and over a job trying to change the images of what had happened, to change it to something that should have happened.  Over and over it would go, round and round in my mind. And I couldn’t shake it. Ever. And I would always lose. I would always end up back at the conclusion that I’d fucked up. And it was getting worse.

I was also having nightmares more and more, going over the same decisions again and again.  But in my dreams the images and scenarios were accentuated and often exaggerated. And this would always happen as I was just drifting off.

I was becoming short tempered.  I was drinking more.  I would even randomly burst into tears in public places!  I was losing interest in all the activities I loved – like climbing and walking. My concentration on simple matters was waning and as such, perpetuating the mistakes I would make at work.  And as such, the whole thing repeated again and again.

I didn’t realise at the time, but something was clearly wrong.  Apparently, we never do.  We just get on with it and convince ourselves it’s all just “part of the job”. 

However, I’m not as strong as my fellow colleagues, who have seen and done a lot more than me, and I couldn’t stop this cascading process collapsing on and around me. So, two years ago, I made the difficult decision to leave London and move Up North.  And, ironically, it was only once I left that I started realising and accepting that something was wrong. 

I eventually left full time Ambulance work and am currently Bank staff. I maintained my LAS Bank contract for a while but only worked the minimum required. And even then, every time I was due to work it would feel ten times worse than the feeling I’d get when going back to school. So, eventually, I dropped the LAS Bank contract and am just Bank up here now – doing Paramedic “Practitioner” type work in Walk In Centres and Urgent Care Centres to keep the money up.

However, as time has slowly crept by, the longer I have lived here, the more I have felt the dark heavy shackles, the dirt and the grime, and the anger and the guilt, gradually fall away . . .

. . .

I open my eyes.  The tears have stopped. 

The sun still beats down and the Skylarks continue to sing.  The air is still fresh.

The images and memory are now gone, and I smile.  The mountains have rescued my mind again.

I slowly and stiffly stand up and begin the long late afternoon walk back down.

I have lived here for two years now and the bad memories are coming back less often now.  And I no longer seem to have nightmares.  My mind is more and more focussed, and I can feel my strength and happiness of yesteryear returning.

More importantly, I feel the increasing desire to return to work as a front-line Paramedic. 

I suspect my story is not uncommon. However, I have been fortunate to end up living where we do. The Lakes has provided a magical mountain therapy for me.   And the more I spend in the mountains the stronger I become.  

It’s taken over a year to be able to write this and I apologise for that. I really haven’t been sure on how to approach this subject. I have been nothing but a mediocre Paramedic in London and never thought I would have any of these issues. I was always cautious of the problems that can arise. But clearly somewhere along the way I missed the signs. No matter what I admit to, I still feel some shame and embarrassment and can’t help that. My colleagues in the service have done and seen far more than I could ever.

I will continue to write this blog – but as usual, I will wait on timings and inspiration. Thank you.

Stopping a thief

I like my coffee.  I mean, I REALLY like my coffee!

“QUICK!  Someone’s being beaten up! By five men . . . over THERE!”  The old man looked frantic and genuinely concerned.

I was about to take the first sip out of an extra hot, posh, independent artisan cappuccino that I’d just purchased.  As such, I wasn’t overly impressed by this rude interruption.  So, just like the fishing pilot at the beginning of Raiders of the Lost Ark, who had the dilemma of finishing catching his fish or starting the plane to escape, I toyed with my coffee for a few seconds before exiting the FRU in a grump to see what was up.

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Top 10 Do’s and Don’ts of Obtaining an ECG

If you’ve ever wondered what all those leads and sticky dots were doing when placed over a patient in a hospital or in a film then they were probably having their heart monitored.  And by monitored, they were probably having some form of ECG (Electrocardiogram . . . with a C, for Cardio.  Not EKG, like how the septics spell.  ECG!).

ECG’s are a fantastic system used in lots of hospital and pre-hospital environments to help determine cardiological issues and help us determine the correct course of treatment and outcome for the patient.

They measure the electrical output of the heart and we do this by strategically placing several (10 in the UK) sticky dots attached to leads, over the patient’s chest and limbs.  And, after the patient remains still, we gain a readout from the Lifepak machine that gives us 12 different views of the heart.  This is when we, the clinicians, pretend to know what we’re looking at.

So below, to help anyone who might be in the remote bit interested, I’ve put together a quick Top 10 Do’s and Don’ts of how to ECG . . .

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A visit to Control

I did an observer shift in Control a while back.  I wanted to watch and listen to how calls come in, got triaged, allocated and then managed.

So, sitting with Laffieres*, a Clinical Team Leader, I was able to listen in to a patient call back.  They had rung 999 feeling faint and had won themself an Amber response that could see her waiting a long while for an ambulance.   London were holding a ridiculous amount of calls and, as usual, only had a finite amount of ambulances to send.  So, it was Laffieres’ job to ring the patient back and re-check their clinical status to see if anything had changed and to see if there were any ‘alternatives’ that could be used to help the patient.  This was all done using the Manchester Triage System, a quick, more concise generalised system to help clinicians triage a patient’s needs over the phone.

After a short conversation Laffieres concluded the patient did not need an ambulance at all.  And, upon receiving the news that they were no longer going to be getting one, the patient’s demeanour changed.  One second their voice had been woeful and demure, the next it was harsh, cruel and direct.

“If you don’t send me an ambulance I’ll ring 999 again!  And I’ll keep ringing, over and over!”

My jaw had genuinely dropped.  I could not believe what I’d just heard.  Laffieres laughed.

“We get it all the time mate.  Every day, over and over.  She’ll call back in a minute, I guarantee”

And she did . . .

London Control Room

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Red 1 – Pseudo fit

“He apologised?”
“Yep.  Admitted he had been a dick and had put the whole thing on, and was genuinely apologetic”

The officer was referring to a patient that, a couple of nights previous, had almost caused a mini riot and forced me to call for ambulance back up over an open mic, as Red 1 . . . for a pseudo fit!

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A neighbour let us in to the patient’s flat and led us to where she was lying on the kitchen floor.  The poor old girl had simply fallen and not been able to get up, and had subsequently been lying for over six hours.

Now, I don’t have much of a sense of smell.  I put this down to constant exposure to horrible smells over time.  And thus, when we stepped into the kitchen, the smell of faeces that hit me was like a ton of bricks to my senses.

My god!  I thought.  That really MUST smell bad if I can smell it.

And to make matters worse – that sneaking, creeping, terrible feeling of awareness started prickling at the back of my neck . . . .

We were going to have to clean her up!!!!

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