The Road to Paramedic

I am still alive...

2010-05-09T10:54:00.000-07:00

... but hard at work at the moment. I've nearly finished my ambulance technician course, but it's taking up nearly all my life at the moment, and the rest of it is taken up by spending time with my girlfriend, looking for somewhere to live, eating, and sleeping! No time, therefore, for blogging, although I hope to get back to it as soon as I can once I've finished my course.

In the meantime, I want to link to a Daily Mail article, and, for once, I'm impressed.

http://www.dailymail.co.uk/health/article-1275309/Natalie-Pinkham-pedalling-Paramedic-TV-presenter-joins-rapid-response-team.html

The way the job makes you think

2010-02-18T11:13:00.000-08:00

She sits there, weak, and starting along the way to confusion. She's asleep when we arrive, and her husband answers when we arrive. Before we walk in the door, I've already spotted the removable wheelchair ramp, and the wheelchair itself by the door. As we walk into the living room, I see her gradually waking up in the corner. Immediately, I spot the specialist cushion she is sitting on to avoid pressure sores. This tells me that she is spending long periods of time sitting in the same place. Further evidence is added by the hospital-style table that sits by her, everything strategically placed within reaching distance. I talk to the husband briefly, and I can see the exhaustion in his eyes, the sag of his shoulders, and the relief on his face that tells me he is exhausted, and needs some time off.

We sit down and talk for a while, and I learn that she can't get upstairs any more, and that this means she can't get into the shower. I learn that she has a frame, and sticks, but that she generally can't use them. I discover that her husband is having to lift her in and out of the wheelchair/car/seat/bed if she wants to move between them.

Without noticing, my mind starts ticking over what they need. First off, they need some respite care sorting. She needs a stairlift fitting. She needs modifications in the bathroom in order to allow her to get in and out despite the increasing weakness. They need a hoist installing so that he's not putting his back out moving her from place to place.

These are the things I'm thinking, as I would with any other patient. Difference is, this isn't my patient.

It's my auntie.

Exciting times

2010-02-12T14:33:00.000-08:00

Occupational Health passed, and I finally got confirmation of my place on the course today. I'll be starting fairly soon, but forgive me if I don't tell you exactly when.

It's a great day to get this confirmation - not only is the next step in my EMS career now in place, but today is also the launch of the Chronicles of EMS - not to be missed. I'm sitting at my computer as I type (there's a surprise!) waiting for the premiere to start. Whilst I've yet to get involved in any way, I have been following with interest. With this, and the discussions I'm seeing around the blogosphere about EMS2.0, I feel like we're standing on the verge of something incredible, and I'm going to be there. Admittedly, the whole EMS2.0 thing is a bit more of an American thing than British, but I believe that it's effects will be seen this side of the Atlantic too. Already, UK pre-hospital care is being significantly influenced by studies from across the pond, and we're seeing more and more pre-hospital research being done. I want to be a part of this.

So here's my vision of EMS2.0:

I want to see paramedic-led pre-hospital research. I want pre-hospital research to be about more than "doctors have found that this helps, now let's see whether paramedics can apply it with sufficient skill - despite less exposure - to use it pre-hospitally".

I like the concept of paramedics as a means to ensure that people get the right sort of care - members of the public don't have the same knowledge as people who work in healthcare, let's use the ambulance service to get people into the right type of care, or even keep people from needing to go into the healthcare system at all.

I want to see clinician-led telephone triage systems, or at least a system which increases specificity in terms of calls which warrant a blue-light response. If we can increase sensitivity too, that would be a bonus.

I want to see paramedics being given more power to define their own scope of practice. I like the minimum skill set that currently exists, but I want to see courses and assessments available which pass on the knowledge required to increase the skill set, and to ensure that competence is maintained.

And that's just for starters. UK pre-hospital providers, what do you want to see in EMS2.0?

What can you do?

2010-02-03T04:49:00.000-08:00

I was at work the other day, doing A&E support work.

One of the patients we went to was an elderly gentleman with alzheimers. I can't remember what was his presenting compliant was, except that it meant he needed to go into hospital. Problem was, he really didn't want to.

In this situation, we have to determine whether this person has capacity to refuse.

Are they capable of understanding information?
Are they capable of retaining information?
Are they capable of weighing up the information available to them, and making an informed decision?

Unfortunately, the answer to all of these questions was "no", however he was adamant that he was not coming with us, and wanted to stay in his chair.

Taking over 2 hours on scene, we eventually bullied this little old man into coming with us, but this was only due to being lucky enough to be able to seize the one moment out of the entire two hours where he relented for a moment.

So I have some questions for you, dear reader (if there's anyone out there still reading)

1. How long are you willing to stay on scene in a situation like this?
2. What options are available to you if the patient continues to refuse?
3. There is someone there with Power of Attorney over the patient. How does this affect your thinking?

Now I know that there are powers available to various people under the Mental Health Act - the patient can be sectioned, but I'm fairly sure that the patient wasn't eligible for any of these.

Oh, and (surprise, surprise) it was after opening hours for her GP surgery

The One Show as a sign of our times

2010-01-27T11:38:00.000-08:00

When there's an article about the fact that hairdressers aren't required to be registered, but no mention of the complete lack of regulation in private ambulance/first aid cover, and when there's an article on how obesity is killing pets, without a mention of the effect it's having on humans:

It tells us something about our society

An apology

2010-01-25T19:25:00.000-08:00

Seems to me that this blog is currently a lack of posts, interspersed with the occasional apology for a lack of posts!

It has been like this, because I have had very little news - joining the NHS Ambulance Service entails a lot of waiting around, and that is what I've been doing for the past several months. Anyhow, I've finally been offered a place on a course (provisionally, of course), and need to go for my occupational health assessment a week on Thursday. All being well, I'll be starting a course come mid March, so fingers crossed - the wait might well be over soon.

Useless things

2010-01-11T05:32:00.000-08:00

TOTWTYTR asks "what are the 5 most useless things on your ambulance?"

I thought I'd share mine.

1) Nebuliser masks: I'm not trained to administer nebulisation. Neither of my partners are either. We don't carry nebuliser medications. Seems, therefore, a bit pointless to give us the masks!

2) Venturi masks: Potentially useful in a hospital setting where blood gases can be measured, and required O2 concentrations can be accurately calculated. Prehospitally, a mixed concentration mask is far better - it makes titrating against patient presentation / SpO2 much easier.

3) Tempa-dots - those disposable temperature probes that get held under the armpit or stuck on the forehead and change colour depending on the temperature. They just don't work!

4) Spare canvas to number 5, below (if something is useless, a spare is even more unnecessary!)

5) Canvas and poles to make a pole stretcher. We have a trolley bed, a long board, a scoop, and a carry sheet. I think we have enough stretchers!

When on a train...

2009-12-18T04:29:00.000-08:00

... and there are no seats available, and a little old man gets on the train, barely able to walk.

When on a train with no seats available, and a little old man gets on the train barely able to walk, with his little old wife, who walks so badly that he is having to help her.

When on a train with no seats available, and a little old man gets on the train barely able to walk, with his little old wife, who walks so badly that he is having to help her, and the journey is going to take at least 2 hours.

When on a train with no seats available, and a little old man gets on the train barely able to walk, with his little old wife, who walks so badly that he is having to help her, and the journey is going to take at least 2 hours, and you are perfectly young, fit, and able

When on a train with no seats available, and a little old man gets on the train barely able to walk, with his little old wife, who walks so badly that he is having to help her, and the journey is going to take at least 2 hours, and you are perfectly young, fit, and able, Great British public, have some respect and offer them a seat.

For Christ's sake, don't make them walk the length of 3 carriages before giving up and standing in the gap between carriages.

Grrrr it makes me mad.

Setback

2009-12-14T16:12:00.000-08:00

I'm not going to reveal too much at the moment, but suffice it to say that there has been a bit of an issue at the ambulance service side of things that means that there is a good chance I won't be starting my training any time soon. Unfortunately no solid facts, or figures, so I'm not sure whether to try to get another job in the meantime (on top of the ambulance shifts I'm currently doing), or just to stick with what I've got.

In the meantime, I'm keeping my fingers crossed that I'm getting worried over nothing.

Lights and Sirens

2009-12-07T06:54:00.000-08:00

I accept that calls to the ambulance service can only be triaged according to the information given to call taking staff. I accept that certain calls need to be attended to quickly, and that, in order to maximise efficiency, calls occassionally get dispatched before they have undergone the triaging process.

I do not like, however, the fact that we are asked to run on lights and sirens to a call before it's level of urgency is set. Especially when said call is a headache. Technically, as I understand things, by running on lights and sirens to a call that you do not believe warrants it you are breaking the law. Personally, if I were the driver, I would be proceeding under normal road conditions to this until/unless it is upgraded with a category. If it were an untriaged difficulty breathing, or other potentially serious incident, then lights unless proven otherwise, but my safety, and adherence to the law are not to be risked just because there are not enough ambulances. That is not my fault!

My first proper post in a while

2009-11-19T06:58:00.000-08:00

I got sent a link to this earlier today by my girlfriend. She asked my opinion on it, and I thought it would make an interesting blog post - something I haven't really done enough of recently. I read the main article, and the comments, and will comment on both.

Unfortunately, everything in this life costs money. Other than in a perfectly communist system, this is always going to be the case. This includes healthcare. We all have a limited amount of money in our bank accounts. This means that we can't afford everything we want. I have to prioritise the things that I want for the things I can afford.

Governments have the same problem, only they have a much larger budget, and a much larger number of expenses to prioritise. The obvious arguement is that if one life can be saved by a drug that costs £3000, or 100 lives can be saved by a drug that costs £30, then given a limited amount of cash, the decision is obvious. This is a simplification, but it demonstrates the point that there is a limited amount of money available, and that it is important to do the greatest good with the limited resources available.

Someone on the forum, it was suggested that this problem could be solved by taking the money from other budgets. Now, whilst I agree that there are a lot of inefficiencies in nationalised systems, such as the NHS, I'm not sure that cutting their budget is the best way to solve these. I feel for a start that efficiency might be increased by paying significantly more to the top level managers - by paying the top wages, we might entice the best managers into these positions, and therefore counterintuitively increase efficiency.We could fund these increased wages by streamlining the management system, and eliminating the excess managers. This would mean that the same budget is paying for a better system. What it doesn't do is free up any money to transfer to any other budget, perhaps the budget for medications.

So, if we can't redistribute NHS money, where else can we get the money from?

How about the education system? I don't think anyone thinks that that is worthy of a reduced budget? Sanitation? Transport? Reducing funding to either of those is going to stretch the NHS even more as people catch diseases, ambulances break down on dodgy roads, more people crash......etc.

We all wish that treatment could be provided to all people regardless of cost, but this just isn't possible.

Highlights of last night's shift

2009-11-18T05:52:00.000-08:00

Emergency call

Sat Nav can't find address
Stand down
Emergency call to pub
Arrive on scene
Walk into pub
Stand down
Emergency call - CPR in progress
Roadworks block our route
Find a different route
Arrive scene, RRV already there
I get out, crewmate parks
I go in
Paramedic shakes her head - ROLEd
I go out
Get back in vehicle
Go to standby
Emergency call
Stand down
Emergency call to nursing home
Small cut to arm, stopped bleeding.
No transport required
Back to station
Kip
Home time

Letter to the Arts Council

2009-10-22T11:18:00.000-07:00

Tip of the hat to Tom Reynolds for pointing this out.

It angers me - it is such a waste of money! To the extent that I've sent an email to the Arts Council, complaining.

See below. I'll keep you updated!

"Regarding this project reported on by the BBC: (http://news.bbc.co.uk/1/hi/entertainment/8320287.stm)
From what I've read of this project, the budget you and your colleagues have for this is £5.4 million.
Frankly, I'm appaulled that we as a nation are willing to waste this much money on such a pointless project. Not only this, but that (whilst espousing the benefits of being environmentally friendly, and insisting that home-owners and businesses decrease their carbon footprint) it is allowing such un-environmentally friendly projects as destroying Scottish woodland to create temporary football pitches, and transporting a giant statue of Lady Godiva from Coventry to London.
There are several essential services within this country which could do so much good with £5.4 million, we could decrease the issues within the ambulance service (chronically overstretched, with several trusts currently operating at REAP 4 as standard). We could ensure that the military have the equipment and personell required to do the job we are asking them to do properly, in both Iraq and Afghanistan. We could provide funding to schools and universities to help further education. Perhaps we could provide more support for children in sport. We could fund more prisons so that we don't have to release prisoners early to create space for new criminals.
How can we justify this waste of governmental money, especially in the face of international recession. Further to this, how can the government decide to do this without first consulting with the general public?
I'm looking forward to your response on this issue, and as part of this, would be interested in knowing what the annual budget of the Arts Council is."

What do you think? Justifiable?

Bad timing

2009-10-20T01:33:00.000-07:00

Beeeeeep, beep beep beep beep beep

The Airwaves radio goes off
I leave it, knowing that my crewmate will answer.
Quickly, I stand up, pulling my trousers up and doing them up.
Flush the chain.
Hear crewmate walk into toilets
Clip belt together.
Hand on cubicle lock
"OTR, we're going on standby"
Swear
"Two minutes"
Unbuckle belt
Trousers down
Finish off!

Making progress

2009-10-12T03:37:00.000-07:00

Passed my C1 Driving Theory test today, and have my practical lessons and test booked. Slowly getting towards my aim of actually starting the course!

For the record, I'm never getting in a car with the driver of the Hazard Perception camera vans!

In other news, I've got myself a job, working on ambulances, just doing PTS work and GP urgents mostly, through St John's commercial wing. Hopefully starting either Friday this week, or Friday next week, currently TBC.

Things are looking up at last

Free Media

2009-10-08T05:12:00.000-07:00

Every now and then, I'll come across videos such as this on the net. I've seen several others (although I can't be bothered to find the links) of people exercising their "right to free media". I've had to deal with them when I used to work in security. These people regularly get into confrontational situations with members of staff, Law Enforcement, and other people in positions of public authority. Here's the inside scoop these amateur journalists of the free media are looking for: by getting in the faces of LEOs or ambulance personnel, they are preventing that person from doing their job, and as such are comitting an offence. This is not why they get into confrontations, however. The reason that confrontations happen is that these members of the free media...

... are almost all unsufferable pricks!

Yes, that's my opinion, and not an objective fact. Look at the evidence, however. Take the video linked above. The EMS Captain asks the videographer to stop filming him. Yes, he is perhaps a tad impolite when doing this, but he is trying to do a job, and this guy is getting in his way. Add to that the fact that the videographer chooses at what point to start the video, and we have no idea what happened before that.

To any members of the free media, I suggest (whilst I am all for free speech etc.) that you start thinking about what you are filming and what you have filmed. There are some things that are not appropriate to film, eg. treatment of a casualty who has not, or is unable to, give consent. There are some things which look dodgy, but in fact aren't (reference the G20 riots in London, and the many videos of the use of supposedly "excessive" force by police officers). Think about what you are recording, and if you deem it acceptable to film, take the effort to contact the people you believe to be doing something wrong (after the event), and get their comments/explanations. Talk to their peers, see whether they agree. Just because something looks wrong to you, please remember that you are not an expert, and that painting these people in a bad light for your own self gratification is not a good idea. If you are doing it for a noble cause, then rather than publishing these things on the internet, take your evidence to the courts, and get the individuals dealt with properly.

Link

2009-10-03T12:49:00.000-07:00

I was contacted today by Richard Hemby from http://blog.onlinecollegeguru.com/.

He asked me to pass on the link to his post 26 iPhone/iTouch Apps for EMS Personnel.

I don't really have anything to say on this matter, or any apps to add (other than to ask him to perhaps compile a list of BlackBerry apps as well!), but I think it's a useful enough link that I'm happy to provide the link.

Driving

2009-09-28T06:06:00.000-07:00

I've just spent an hour or so making various phone calls to various people, and am now booked onto my C1 driving theory test, have several books on the way for this, and have a plan for how I'm going to do the practical training/test.

All in all, when you add in the cost of the medical I had to do before I could even get my provisional license, this is going to work out as about £1200

My poor bank account is in pain - 10/10 on the scale!

I'm in!!

2009-09-26T10:12:00.001-07:00

Hell Yeah!

Got the job I was after. Need to train to drive C1 class vehicles, but once I've done that, I'm in!

In the unlikely event that anyone is reading this...

2009-09-25T05:01:00.000-07:00

... and the even more unlikely event that anyone is reading this, and not any of the other blogs which have contributed to The Handover, head over to Life Under the lights, and read the latest edition - guaranteed to make you laugh*

* guarantee may not be true, but I'd be surprised if you didn't!

The waiting game

2009-09-22T06:27:00.000-07:00

I'm supposed to hear by today.

Waiting to hear whether I've managed to get the job of my dreams.

Yesterday I got an email from NHS Jobs - telling me I hadn't got through the shortlisting process for a different job I'd applied for - my heart was in my mouth as I waited for the page to load and tell me whether I'd got the job, until I discovered it wasn't even from the right trust.

Now I'm waiting. It's finally hit me today that I'm waiting for someone else to make a decision, to decide what direction my life is going to take.

I feel like I have to stay by my computer, just in case they contact me.

I don't actually know how they are going to get in touch, but in the meantime, I'm here

Waiting

Acceptable?

2009-09-22T02:41:00.000-07:00

On the same A&E Support shift as my previous post, asked to take a patient to Small-Town Hospital from their home in Nearby Small Town.

His GP has seen him, and determined that there is nothing seriously wrong with him, however he does need to go into hospital for further assessment/treatment.

The patient is living alone, with no surviving family, and has no car. He is currently out of work, and living on the Jobseeker's allowance, and the cost of a taxi to hospital would take a significant chunk of your weekly income, as would the return journey. Talking to him, it is very obvious that he isn't abusing the benefit system, but that he genuinely wants to get back into work, but is having problems doing so.

My question, therefore, is this: Is this appropriate use of an ambulance? There's no accident, no emergency, and the patient does not require a stretcher or a wheelchair. At the same time, how else is the poor bloke going to get there?

Not My Job

2009-09-21T10:53:00.000-07:00

I was doing an A&E Support shift the other day. In theory here, we (St. John) can be used to respond to anything, but in practice, we generally do Patient transport work and attend Dr's Urgents.

We were driving past Home City Hospital, when the radio call went out:

"All units, General Broadcast. Are any units clear near Home City Hospital to back up the ECP to an outstanding cardiac arrest?"

Silence

I look at my partner "We're going to have to shout up for this one, aren't we"

Just at that moment, another crew offers to take it, and we breath a joint sigh of relief.

Then we hear it

"Be advised, CPR is being refused by the parents"

"Shit, glad that's not us!"

I didn't go, but it bothered me somewhat. What kind of parents can refuse CPR on their own child? Now, fair enough, their may have been an extenuating reason - perhaps the child was terminally ill, with an awful quality of life - but surely in these circumstances, there should have been a DNR or a Living Will present. Perhaps there was, but I imagine that, if there had, control would have said this rather than that the parents were refusing CPR.

Is this grossly unfair of me - yes, I know of the existence of DNRs and Living Wills, but is their existence common knowledge?

One week into the waiting...

2009-09-16T17:01:00.000-07:00

... and up to another whole week to go. I'm really not enjoying not knowing whether I've got the job!

Longer post when I've got something to write about, at the moment, I'm doing nothing but hanging around at home, which leads to very little interesting to talk about!

Blog-date

2009-09-11T23:26:00.000-07:00

Nickopotamus and I met up for a pint last night. We (for the next week or two) live near each other, both volunteer for St John Ambulance, both want to go on to train in healthcare etc. and we've said several times that we ought to meet up. Well, yesterday we finally did.

It was weird - I got to the pub first, and waited for Nick (he was driving) in the car park. I felt like someone who was on a blind date - I wasn't completely sure I'd recognise him, or that he would recognise me, and was somewhat concerned about being stood up!

When he arrived, however, we recognised one another immediately (benefits of Facebook!), and pretty much immediately set about putting the world, specifically the world of St John, to rights, as if we'd known each other for some time (which I guess we had in a way, just never before in person!)

It was good to finally meet you Nick

Interview 2

2009-09-10T12:15:00.000-07:00

I had another interview the other day. Seemed to go OK - better than the last one, although I've yet to hear whether I've got the job, I've got my fingers crossed.

Wish me luck. I really need to start something soon - I'm getting really fed up of living at my parents' house, with no income, and nothing to do. I need to start working!

Fire responding for EMS

2009-09-04T12:13:00.000-07:00

I've been reading a lot recently about the use of the Fire Department in the US to first respond to EMS calls. Link, link, link, link, link, link

For the sake of this arguement, even where Fire provide the ambulances, I'll differentiate between Fire and EMS.

In rural areas, which rely on volunteer fireys/EMTs, I can understand them being combined (understand it, not think it's the best way forward). But in cities, and densely populated areas, the main arguement that is being used is that fire appliances can get there quicker. This, in turn, implies that EMS vehicles can't get there quick enough.

Seems to me (and to be fair, TOTWTYTR got in there first), that the unrecognised solution to this is not send FD to EMS calls, but should be get more EMS.

I don't see an issue from the perspective of EMS with using FD/PD as first responders if they do happen to be closest, or as extra pairs of hands, however, is this a good idea from the idea of general emergency services?

FD/EMS aren't expected to respond to PD calls. PD/EMS aren't expected to respond to fires. Why are FD/PD expected to respond to EMS calls?

:-)

2009-09-01T11:39:00.001-07:00

Found out with 15 minutes of the working day left - I'm through to the next round.

Wish me luck!

:-(

2009-09-01T08:41:00.001-07:00

Still haven't heard. Doubt I'll hear before tomorrow now.

More and more concerned it'll be bad news

Waiting

2009-09-01T07:37:00.000-07:00

So I'm supposed to hear today if I've got through to stage 2 of assessment with one of the Ambulance Trusts I've applied to. I know that some people have heard that they have passed, and I've yet to hear anything. Not happy. Worried. I really want this job, and don't want to have to go through the process of applying for another if I can help it.

Wish me luck!

Blogging

2009-09-01T02:20:00.000-07:00

My old blog, which I have mentioned before, was not particularly well known, or highly regarded amongst the blogosphere. Having said that, I had a good number of readers, and got fairly regular comments from them. I regularly commented on a number of blogs, and I had made friends through the blog. I was happ with my blogging career.

Now though, having had a hiatus of several months, and changing blog, I'm, unsurprisingly, not getting the same interaction. I'm sure that one day I will begin to get it again, but in the meantime it irritates me!

No real point to this post, but thought I'd share anyway!

Rejected

2009-08-27T02:50:00.000-07:00

Letter in the post today. Failed to get in to the first job I applied for. Don't know why, other than that I failed to successfully pass the interview.
I'd originally applied as a "Student Paramedic", but the job changed at interview to "Assistant Ambulance Practitioner". I'd thought the interview had gone OK, but obviously not. Phoned up for feedback, which I will get eventually, but I have to wait for one of the interviewers to phone back.

Oh well, there's always next time. I'm willing to move anywhere in the country for the job, which gives me more of a chance than a lot of people who are too settled to move.

Losing my virginity

2009-08-25T11:17:00.000-07:00

As part of my work with St John Ambulance, I am a cycle responder. I was at an event the other day, working solo on the bike. This is brilliant in summer, as it is the only role in SJA where uniform can include shorts.

This particular day was very sunny, and I had been cycling round all morning, exceptionally bored, with nothing to do. I'd just been in for my (free) lunch, and got back on the bike. Next think I know, I get called.

"Control to Charlie Romeo 3"
"Charlie Romeo 3?"
"Charlie Romeo 3, please attend campsite 3 for a female feeling unwell. Security to meet you at the gate and direct you from there"

I make a quick U-turn, flip on the blues, and hover my finger over the siren, blipping it occasionally at the odd pedestrian who hasn't noticed me, and make my way quickly to the gate. Security see me coming, clear the entranceway, and let me know that the casualty is up the hill (typical)

"It's by the big blue tent, you can't miss it."

Making my way up the hill, I understand exactly what he meant. There's a crowd of people standing in a circle around a woman lying on the floor.

Pushing my way through, I hear someone say "There's a doctor with her".

I break into the middle of the crowd, and see two people crouching over the casualty, and a man standing over them, directly in front of me, back to me.

"Excuse me" I say
He turns around, taking in the uniform, then turns away again, directly in my way.
"Excuse me" I say again, pushing past him and squatting by the woman's head.

I look over to the woman kneeling at the other side of my casualty, and ask what's wrong, simultaneously starting my own primary survey.

D: Loads of people around me, but no danger. Difficult access to my bike, but doable.
R: No
A: Seems OK, but I'll just make...

"Query MI", she says. "I'm a nurse, he's a doctor" she says, indicating the third person by the casualty's side (although the person I pushed past has now disappeared), with clear undercurrents of and we don't need the help of some jumped up first aider thankyouverymuch.

"I've got oxygen, and a defib if we need it", I say, standing up to get it, figuring I'll leave patient care to the professionals.

Grab the kit, and return, radioing in report to control at the same time.

"Control, Charlie Romeo 3, female casualty, query MI, off-duty Doctor and Nurse on scene"

Pull out a trauma mask, hook it up to the oxygen, and hand it to the nurse.

She puts it on the casualty, and starts looking for a pulse. I, meanwhile, am looking at the mask, amd noticing no misting on the plastic. I pull it off again, and contort myself into a position to check for breathing.

B: No.

Shit!

"He's not breathing"

Look up, expect a response

"Has he got a pulse?" - the doctor

"Nothing at the radial" - the nurse

I push my finger into her neck

"No"

I look up again, reaching around behind me to grab the defib, and switch the oxygen mask over to a bag-valve-mask (BVM - a device which allows us to breathe for the patient)

Look back

No movement

"Perhaps we should start compressions"

Doctor grabs the AED, and starts setting it up.

I open up the airway, and apply the mask of the BVM. I've never used one before, so it takes both hands to get the seal right. Doctor's still faffing. Nurse gives a couple of breaths. Doctor starts CPR. He's not pushing hard enough, looks like a token effort.

"Control, Charlie Romeo 3, CPR in progress"

"Analyzing heart rhythm, stand clear of patient" Get doctor and nurse to let go. Yes, it's 'only analyzing', but automated defibs can't cope with someone touching the patient

"You got an airway?" - Nurse

"No shock advised"

"OP" I reply, mentally thinking normal-sized adult female, green is what I presume I'll need. Grab the airway (OP = oropharyngeal airway - the only airway adjunct currently available to me), pop it in. BVM seal again.

Breaths Must do something about those compressions. How to correct a doctor?

SJA Ambulance arrives. Crew includes a paramedic, who pushes his way in to take over compressions. Driver appears, turns around and leaves again.

Breaths. I've finally got enough of a seal to do these for myself.

Driver comes back, stretcher and carry sheet.

Roll casualty onto carry sheet, lift onto ambualnce stretcher.

Onto ambulance.

No room for Doctor or Nurse. Paramedic takes airway seat, and bags. Looks like I've got compressions then

1 and 2 and 3 and 4 and 5 and 6 and 7 and 8 and 9 and 10 and 11 and 12 and 13 and 14 and 15 and 16 and 17 and 18 and 19 and 20 and 21 and 22 and 23 and 24 and 25 and 26 and 27 and 28 and 29 and 30.

Blue lights.

NHS RRV arriving, paramedic bags

More compressions. Paramedic cuts off t-shirt

RRV pilot on board.

Finally enough people for the paramedic kit to be broken out.

12- lead on

"Analyzing heart rhythm, stand clear of patient" - the AED pipes in again.

Paramedic turns it off - "Everyone stand clear and we'll do a 12-lead"

Take the opportunity to remove my CRU equipment vest - too warm

"Start compressions"

Compressions

RRV para is behind me, cannula goes in

Breaths

I scrabble about in the paramedic's bag, looking for a saline flush

The nurse is on board. Spots it first. I get back to compressions.

Compressions, flush goes in.

Breaths. Paramedic wants an ET tube. Pass over the laryngoscope and a tube.

Patient starts making respiratory effort.

Look at monitor.

Normal Sinus Rhythm. Return of Spontaneous Circulation. Assisted ventilations only.

Attach blood pressure cuff, attach pulse-ox

Kicked off ambulance, blue lights on, they leave.

"Control, Charlie Romeo 3"

"Go ahead"

"Charlie Romeo 3 back in service"

Welcome

2009-08-23T16:58:00.000-07:00

This isn't my first foray into the world of blogging, however it is the first time I've done so anonymously. I was an ordinary bloke, with an ordinary life, blogging about what I wanted to, without any need to worry about what I wrote.

Except, I wanted to be a paramedic.

I had made this decision before I had ever started blogging, but at the time, it was so far away from being a reality, it wasn't an issue.

As it became closer to reality, however, I started to realise that blogging publically was a bad idea. I shut down my blog, and stopped. I stopped for several months, and got used to living without it again.

I miss it though, so I have decided to come back to blogging in a safer manner. No longer will I publish my name for all to see - it is not safe.

So, what will I tell you? Not a lot for now. I'm male. I've just graduated from uni, having studied a science subject. I volunteer for St. John Ambulance, and am an "Emergency Transport Attendant". I cover events for them, and occassionally go out "on the road" doing A&E or Patient Transport shifts.

That will do for now. Welcome to my journey