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