On Yer Bike

It has been announced today by the Association of British Insurers that cyclists should have insurance to protect themselves should they be injured in a crash or indeed to compensate others if they are at fault. The full story is available here...http://www.bbc.co.uk/news/business-15892074.

Now as a cyclist this concerns me slightly!  Firstly, I cant afford to pay for cycle insurance.  I already have life and critical injury insurance, which to my mind is enough.  Secondly, I take steps to avoid becoming a victim of an accident.  Driving about for a living, Day in, Day out I see cyclists NOT following the most rudimentary of measures to protect themselves and herein, as far as I'm concerned lies the problem.  So, in the spirit of the "big society" I will share my pearls of wisdom...

1. Wear a Helmet.  Quite frankly this is a no brainer, pardon the pun.  The tarmac is just as unforgiving whether you're on a pedal bike or a motor bike.  Just because its not legal doesn't mean you should wear one!  I personally have attended cyclists from beginners to competitors who have suffered severe injuries as a direct result from hitting concrete/windscreens.  This leads to point 2...

2. PUT YOUR KIDS HELMETS ON!  Child in a carrier with no helmet on?  Daft.  Fine if you want to end up a gibbering mess but don't sentence your little angel to the same fate!

3. Stand out.  So, it's getting dark.  Or the traffic is heavy.  Or you're on a road with an average speed of a the space shuttle.  Now, if that's me I'd quite like to be spotted by the juggernaut that insists on passing close enough to slap my arse, so a bright florescent jacket I don.  Doesn't have to be pricey, mine was a tenner from lidl...

4.  As with 3, Put some flaming lights on.  Enough said.

5. Where possible use cycle ways.  Sustrans among others have developed hundreds of mile of safe routes to ride.  Even in cities, generally designated routes are safer.

6.  OBEY THE LAW.  I've given up counting the number of cyclists I see jumping red lights, cycling on pavements, going the wrong way up a one way street.  This puts them at tremendous risk and moreover is ILLEGAL!

So pay heed and hopefully you wont need insurance.  Ignore it and maybe you just don't deserve the payouts...

A Dedication

This is a dedication to the unsung heroes of the emergency services.  The wives (and partners!) of us that work there!

You put up with us working long hours.
You cope with us working Christmas, New Years and in fact most public holidays and religious occasions.
You understand when we finish late day after day.
You get used to sleeping alone on nights and staying quiet during the day.
You don't mind when we're ranting about a bad day and listen with a smile.
You know we could get called out any time time night or day and not sure when we could return.
You wait up until stupid o'clock until we're home and safe.
You send make sure there is a packed lunch for us each day.
You understand we do what do because we love what we do.  For that we Love you too.

Dedicated to my very caring and understanding Wife,

48 hrs with a Paramedic pt2

Part 2

The second installment of 48hrs with a Paramedic!

Today we join Dan on a Late Ambulance shift.  Today’s shift starts at 1400.  Dan arrives on station at about half one to change and prepare for the shift.

Unfortunately, today the Ambulance Dan and his crewmate are due to work on is currently VOR – Vehicle Off Road – but a contractors are on their way to repair it!  Dan’s crewmate today is Hannah a newly qualified Paramedic; she arrives not long after Dan.  The time waiting for the Ambulance, a 7-year-old Renault Master, to be repaired is not wasted however.  Dan has the opportunity to catch up with some paperwork and speak with the station officer.  He then is able to fully check the Ambulance, stock it fully and give it a good clean, inside at least!

The crew are able to book on at just gone three and are soon despatched on listening watch, but never arrive as they receive an emergency call, to transfer a patient to Casualty from a smaller Minor Injuries Unit.  Having safely transported their patient the crew clear, making themselves available to control.  The MDT flashes the dispatch message to Return to Base, so dutifully the crew leave the casualty.  The traffic in the town is heavier than normal today, probably due to the weather and the Ambulance does not make much ground before the next Emergency and MDT alarms split the conversation in the cab.

As there are two persons aboard control rarely pass the incident by voice, but instead in a text message for the crew to read.  This incident is a medical call, and the crew are “backing up” an RRV.  Dan switches on the blue lights and starts weave his way through the heavy traffic but its hard work negotiating the queues of cars, red lights and pedestrians who are rushing to get home without getting wet.  Dan cycles through the sirens to make the ambulance as noticeable as possible, but still people fail to see them, causing the ambulance to come to intermittent grinding halts.  They eventually clear the town and although the traffic is still heavy, the roads open up.  They arrive on scene, receive the handover and convey the patient to the Hospital providing treatment as required. 

For the second time they clear the Hospital and are sent back to base.  Again, for the second time they are despatched an emergency call, another Medical call.  This time they are able to treat the patient at home, rather than take them to hospital.  Finally, Dan and Hannah get back to base and have their break.  While on break, the night crew arrive and confer before they themselves are despatched on an emergency call.  As soon as the break is over the ARP’s burst into life, another medical call, a patient has collapsed.  The crew arrive on scene and start assessing the patient, who looks quite poorly.  The casualty is carried out to the ambulance using a carry chair - a relatively lightweight collapsible chair with wheels to carry patients down stairs - and lays them down on the stretcher.  The crew continue to examine the patient and it becomes clear that an urgent conveyance to hospital is required.

At the hospital the crew hand over to the Nurse in Charge and register the handover using a computer terminal connected to the clinical hub (control) as they have done all night and leave the hospital.

Fortunately, the crew see the final hour or so of the shift on station, allowing them to put the vehicle away and on charge - there is so much electrical equipment that without plugging the ambulance into the mains the batteries would go flat! - restock, mop the floor and return the controlled drugs to stores.  Tonight, the crew are able to book off on time, not always a luxury, and go home.

You have experienced two days in the life of modern Paramedic.  The pay is not brilliant, the hours are unsocial and long and the working conditions can be arduous.  Some days are busier, most days are rarely quieter, and some days filled with trauma, some with medical.  Some days you are a counsellor, some days a referee, one day you maybe a teacher to a junior colleague, other days in awe of a crewmates tact, experience and skill.  In the morning, you may see the end of life, in the afternoon the beginning of a new one.  All I know is no two days are the same, no two patient the same, each demanding a different approach, skill set and outcome.

All I know is this is the best job in the world.

48 hrs with a Paramedic pt1

For more information about this weeks’ blog I direct you to last weeks’ one, that will tell you all you need to know, but in the meantime time, here it is, my updated (and NOT cynical) version of “A day with a Ambulance man”, 48 hours with a Paramedic!  It is rather wordy and there are no pictures so as to protect confidentiality and security.

Disclaimer:

This post is fully compliant with confidentiality to patients, my colleagues and corporation as a whole.  The following events although recorded straight from reality, are subject to artistic licence for confidentiality of aforementioned patients.

48 Hours with a Paramedic

Have you ever wondered what it is like to be Paramedic in the Modern NHS?  Well for the next 48 hours, “we” will give you an insight into the life of Dan, a Paramedic in a busy ambulance service.

Introducing Dan

Dan is a Paramedic with nearly a decade of operational ambulance experience.  He started his career in Ambulance Control, answering 999 calls as well as GP bookings and general enquiries.  He soon left control to move “on the road” as an Ambulance Technician.  He finally realised his dream of becoming a Paramedic in 2009.

Dan works at a small semi rural ambulance station with a large catchment area and a mixed population of young and old.  There is a large agricultural community dissected by very busy trunk roads.

We will be joining Dan on two shifts over 48 hours to see a typical day in the life of a Paramedic in the Modern NHS.

Day 1 0600 RRV

Its 0520.  Its still dark outside, but Dan alarm has just gone off.  He groggily slides from bed, kisses his wife goodbye and heads to the bathroom to get dressed.  At 5.40 he leaves the house, the car is cold and is barely warm by the time he reaches station.  Pulling into the yard the night ambulance is not there, an ominous sign he mutters.  It is now ten to six, the station is in darkness and Dan heads to the locker room to change into his uniform. 

Modern service uniform is dark green and across the south of England all ambulance staff wear the same uniform, for continuity.  Grabbing his kit bag, with High Visibility Jacket and trousers, medical books and guidelines and other Personal Protection Equipment, such as facemasks and gloves, he heads out to the Garage to find his RRV.

An RRV is a Rapid Response Vehicle, a car fitted with blue lights, sirens and reflective markings.   It is equipped with a range of life saving equipment including a defibrillator and allocated to the most serious emergencies, ahead of an ambulance to stabilise patients and begin treatment, or to assess more minor calls to prevent an ambulance attendance.  Today Dan is working on a Skoda Octavia Scout 4x4.  He books out his Morphine, a potent painkiller and “books on” using the MDT, the mobile data terminal. 
This small computer links the RRV to the ambulance control and allows emergency calls, information, dispatches, statuses and text messages to be sent to and from the car.  The car is also fitted with Advance Vehicle Location Services or AVLS, which allows control to track the RRV and allocate it to the nearest incidents.  The final piece of communication equipment is the ARP Radio, a digital radio system that acts a two-way radio, pager and phone.

Dan checks the cars equipment, medical supplies and drugs and washes the car.  Whilst doing this control send a dispatch message through to the MDT.  They instruct him to head over to the next town and wait for an emergency call there known as standby or Listening Watch.  Its 6.15am

Dan leaves the station, the night crew not back yet and it is still barely light, he stops at a petrol station to fuel the car and arrives at the dispatch point, a room in the towns’ fire station at 6.35.  It has basic cooking facilities, IT, TV, comfy chairs and toilets, making it a “social” dispatch point, meaning a crew can be left there all day.  He takes this opportunity to check emails and view the current trust call volume.

At 9.15 the ARP handset bursts into life, the screen reads AS1 Emergency.  Dan Heads downstairs to the RRV and sees the emergency call.  It is in a village about 10 minutes drive away.  He books mobile on the MDT and switching on the blue lights leaves the yard.

About 5 minutes into the drive control page on the radio and notify Dan that he is attending a female with chest pains and an ambulance is on route from another station.  Dan arrives on scene and begins an assessment of the patient, including an ECG, an electro-interpretive recording of the hearts activity.  Although it didn’t show this patient was having a heart attack, she still had chest pain, so when the crew arrived the decision was made to admit the patient to casualty at the nearest district general hospital.  Dan completes his handover, the process where the care of the patient passes from himself to the crew and then completes his element of the PCR, the patient clinical record.  This legal document records the care pathway and any treatment given to the patient by an ambulance clinician.

No sooner had Dan booked clear he was allocated another emergency call, this time about 20 miles away.  Control quickly paged through the details, Its another medical call, a female with a severe headache.

It takes about 15 minutes to drive down a network of windy country lanes to get to the patients house.  The patients’ carer, who explains what is wrong with the patient, meets us.  Dan then begins his assessment a full range of medical and neurological observations.  The patient is still in severe pain despite medication from the GP.  After a discussion with the patient, she agrees to attend casualty in an attempt to manage her pain.  Dan uses the Radio to contact control and ask for an ambulance.  They advice its ten minutes away, so Dan take the opportunity to give the patient some Morphine, through an IV catheter for her pain.  The ambulance arrives and Dan hands the patient over fully explaining to the crew what has happened before he clears scene.

Control dispatches Dan back to the ambulance station for his meal break.  This is a 30-minute period where crews remain protected from emergency calls.  In this time crews are able to eat and use the facilities however, the break is unpaid.  He takes the opportunity to eat a sandwich, chat with the station officer and restock the car from the previous job.  Whilst on station, the day RRV Paramedic arrives and Dan has time to have a chat with her before control again dispatch him on listening watch.

Two hours later Dan is despatched to the third incident of the day, an elderly female who was possibly having a stroke.  An ambulance arrives about 20 minutes later and takes the patient to casualty.  Control ask Dan to remain on cover in the town and at 1500 hours he is sent to what turns out to be the last call of the day, however, he is stood down before has left the town, the patient deciding to seek another route to health care.

Dan returns to the ambulance station where he meets the oncoming Paramedic and hands over the car.  He changes and leaves for home.  Its 16.10

Overtime Travels or An Introduction To Next Weeks Blog!

I do a lot of overtime.  Not excessive amounts but a lot.  This is mainly due to the fact that with two children and rising costs my basic salary doesn't stretch.as far as to have fun.  When I do overtime I like to sometimes venture out of the comfort of my own station and head into to the county, maybe catch up with some old  friends from my trainee year.
It was on one of these excursions I traveled deep into the middle of the county, where accents are thick and most jobs involve the need to negotiate livestock of some degree!  On my meal break, sat down in the deserted crew room (I guess they knew I was coming) I spied an old looking childrens hard back book on the table.  This book had become the basis for next weeks post.  The reason for it being next week shall become clearer.
The book was called "A day with an Ambulance Man" written by Jane Elizabeth Bowler and Christine Day, publshed in 1982 by Hodder Wayland and is one in a series of books for children about important people in society.  An interesting point to note is who they have featured.  Publicans, MPs, Fire Fighters, Hairdressers to name a few.
This book features an Ambulance Man from the former Sussex Ambulance Service.  I think his name was Colin, though I am most likely wrong.  The book starts by introducing us to "Colin" and about shift work.  We then follow him to work, meeting his crew mate.  The authors haven't brushed over a thing.  We watch the men do their VDI, even checking the oil.  We then accompany "Colin" and his Crewie "Roger" - again see previous disclaimer - on a routine transfer and a couple of emergencies including a fatal road accident and the ensuing paper work.  Then at the end of the shift we follow "Colin" home and meet the family.
The book is amazingly illustrated with photos depicting a wonderful insight into the 80's ambulance service now lost such as the old CF Ambulances.  Some old hats may feel I'm looking back through rose tinted glasses, but I don't care!  It's nostalgia from when the Ambulance Man was respected, wore smart uniform and had time to keep the chrome hubcaps clean!
The book had me intrigued and enraptured for my entire break, my tea even went cold.  There were so many similarities to now, the VDI,  the handover to sister, even the little hand gestures I have found myself using to indicate a red call (even that name hasn't changed in nearly 30 years!).  But it also high lighted the stark differences in todays' modern ambulance service.  The job titles, Paramedics after were devised in the 90's and only in the last decade have become a protected professional title.  The Uniforms, the vehicles, the staffing.  There wasn't a single female ambulance person in the book and the station officer only made a brief appearance to deliver a new great coat!  This book also inspired me.  Inspired me to write a modern equivalent, but in the form of the novice authors medium, the blog.  I thought about what constituted the modern ambulance service and how best to highlight key differences.  So I have chosen two shifts next week that I think will do that. Monday 0600 RRV and Tuesday 1400 Ambulance This time next week I shall publish it, with photos (where legally allowed).
In doing so I hope to give this wonderful little book a modern lift that can be enjoyed and maybe give younger people some information into a relatively mysterious service.