Fast Car Also Sent

We'd just been kicked off our ambulance station for 'Active Area Cover' – the psychic computer that tells us where the next call is coming from obviously had a headache as this call was next door to our ambulance station.

Category 'A' response blue lights and sirens. Fast car also sent.

She's in her twenties, she has a cold.

Category 'A' response blue lights and sirens. Fast car also sent.

The call has been given as a 'severe difficulty in breathing' It's one of our highest priority calls.

Category 'A' response blue lights and sirens. Fast car also sent.

We've been doing calls like this for the last few days, this is just like the others.

Category 'A' response blue lights and sirens. Fast car also sent.

When we reach her, she's standing at the top of the stairs smiling at us.

Category 'A' response blue lights and sirens. Fast car also sent.

Her husband follows the ambulance to the hospital in his car.

Category 'A' response blue lights and sirens. Fast car also sent.

The hospital is less than half a mile away.

Category 'A' response blue lights and sirens. Fast car also sent.

When I *politely* remind him that the 999 number is for life-threatening emergencies and that he could have taken her in the car he gets defensive and tells me that he is not a doctor.

Category 'A' response blue lights and sirens. Fast car also sent.

They went to hospital two days earlier for the same problem. The hospital gave her Paracetamol for the temperature and told her to take it regularly.

Category 'A' response blue lights and sirens. Fast car also sent.

She last took it fourteen hours ago

Category 'A' response blue lights and sirens. Fast car also sent.

We tried to give her advice, but she ignored it.

Category 'A' response blue lights and sirens. Fast car also sent.

We take her to hospital, I grind my teeth, the husband follows behind in his car, Control call out on the radio – looking for an ambulance to attend to an elderly chest pain.

Category 'A' response blue lights and sirens. Fast car also sent.

It's not news anymore, it's not unusual, it doesn't seem to matter. Our 'No Send' policy is foiled by a patient reporting a blocked nose.

Category 'A' response blue lights and sirens. Fast car also sent.

Elsewhere in our area a man was dying from a heart attack.

47 thoughts on “Fast Car Also Sent”

  1. Nice to know I wasn't wasting anyone's time then πŸ˜‰ It was hard to gauge how much blood there was – perhaps 100ml in total (including in the A&E waiting room) and it took 10-15 minutes. As I mentioned, I had had previous instances of blood in my sputum, but this was the first frank blood. Not frothy (what would that have indicated?), but the ambulance crew did note that there were clots. One factor in my triage once we arrived was that I had been on a plane earlier that day – they were concerned about a possible PE.

  2. some people are sheer idiots..i went on a similar call the other day (i am but an EMT-B) but a cold vs. heart attack…i hate our similar stupid policy where we have to take almost EVERY call to the hospital >.

  3. Just spent three days trying to post a comment,oh dear,old age and technology. Well i'm new to all this mularky,but here's my twopenneth.All this chaos used to be called winter pressures,seems now it,s just getting worse. If we can put aside the eternal struggle between road staff and management for a while and look at a common “enemy”. I quote ” Home Secretary Alan Johnson told the BBC that thanks to better planning,winter was no longer a time of crisis for the NHS.” 18th Dec 2008.

    Really ! So why have all the receiving units nationwide gone black alert,or whatever the code is in your area.

    Sadly the reality is that whilst we have succesive governments that deny a problem exists then there will never be progress.

    Incidently are we still an essential service or a fully fledged emergency service.

    Keep your chin up mate, soon be spring and we will laugh again.

  4. Solongo, in the pre-hospital presentation of your case, you would have definately got a ride on my truck & yes they were right to call 999. Haemoptysis can be life threatening. Amongst my normal questions for gaining history, I would have asked you how much blood have you coughed up? how long have you been coughing it up? what did it look like? was it frothy? That would help me gauge how serious your blood loss was & an idea from where the blood was coming.

    Don't forget, pre-hospital we don't have the luxuries of x-rays, blood gases etc so your presentation was worthy of 999

  5. Great to see you back posting have missed you.When is the flippin LAS and other regions going to get this sorted A + E for a cold is ludicrous – she should have been fined, not taken there or something. I wonder if she would think twice if she knew her call has caused a death elsewhere?GGGGRRRRRR!!!!!!!

  6. “I wonder if she would think twice if she knew her call has caused a death elsewhere?”Probably not, because that wouldn't be her fault, would it? It'd be the system's fault, the service's fault, the government's fault…

  7. Things like that just make me want to beat someone….It's so selfish it's criminal.Good to have you back Tom, I trust you had a nice winter break?

  8. Makes me want to scream. Why can't you just tell them to bloody drive themselves there? It's wrong that you still had to take her when it was obviously trivial.And yet something went horribly wrong in this case. And everyone currently thinking 'should I call the doctor/ go to pharmacy/go to A&E or call an ambulance?' will currently end up thinking 'be on the safe side and call an ambulance'.

    I wouldn't dream of calling an ambulance if I could get to hospital any other way on my own. I had pains in my chest once and called NHS Direct. They sent me an ambulance in the end but if I'd realised they were just going to take me to hospital I would've just called a taxi.

  9. Cant you just refuse to take them? Say if they really want to go to hospital, they can drive themselves? Maybe they *do* think twice next time then…

  10. Newflash: Sill No Cure For The Stupid

    What astounds me is that anyone with a home would want to sit in an A&E department for hours – at the back of the queue because they have a runny fecking nose.

  11. Tom,What follows here is something I was going to say to your previous post, but it seems more appropriate to comment on this one.

    Firstly, good to have you back. But what I would urge you to do in your new “take” on things is to be more explicit as to what exactly you would do to correct any situation/example where something is blatantly wrong. We all have a whinge from time-to-time about things that are wrong, but few people actually put forwards a resolution. Sometimes it turns out that although something has gone wrong, the possible solutions, alternatives, etc. are equally bad or problematic – or worse. Maybe there's a good reason that things are done a certain way, maybe there's a really quick & cheap alternative, maybe the alternative is too costly. Whatever.

    So, in this case, what is YOUR suggestion? We can all agree that this particular case is ludicrous and I'm sure there's a better way of how this should be handled. I can't say what that way is, and I'd be genuinely interested in hearing what you would do to fix it.

    Then, hopefully, a meaningful debate and dialogue can take place, questions asked of your readers, of management, politicians, whoever, and – just possibly – things can move forwards.

    I've just re-read the above and I hope it doesn't sound like I'm having a dig at you as I'm honestly not! And to be fair, as a long time reader of your blog, I know there are times you have expanded on what the problems are (and what the possible solutions are). So all I'm suggesting is that your new outlook should encompass proposing the solution as well as describing the problem. I'm in no way suggesting that you have the answers to all the problems, or that you'll always be right πŸ™‚ But let's start by having a something concrete that can be discussed in our own small little part of the interweb and see where that takes us all collectively.



  12. IMHO, the recent radio and billboard “infomercials” about what's appropriate for A'n'E and what is better treated elsewhere are a good start. This campaign needs to be continued and expanded to include other mee-ja, like telly and tabloid newspapers (apologies if it's already in the papers – I stopped reading them when I realised how inaccurately they reported stuff about which I had personal knowledge).Maybe a follow-up telephone call post-discharge? Instead of “How well did we do?” we could be trying to edumacate the service abusers?

  13. Glad you mentioned the tragic incident with the mother – full article: just hope the conduct more of an AAIB style investigation into this (rather then a typical media one) – namely one where the priority is to stop it happening again rather then pointing a finger of blame.

    How can this be stopped from happening again? Well, better education of the public so they don't phone up surgeries/a&e/999 with simple colds would help (so the system isn't horribly overloaded). Then home visits at least become plausible.

    Speaking of which, how much public education does take place in the UK?

    Are kids taught at school how to get help and which service to use? Are leaflets distributed around households advertising the different services available and stating what is most suitable for what?

  14. I think the answer to this problem is to attend the patient, assess them, and then refer them to the appropriate health care provider (including Boots the Chemist if that's all that's needed). This then sadly brings about another problem, namely how do you give ambulance staff the confidence to do this?I'd love to hear Tom's opinion on that.


  15. While very sad, the only solution to this sort of thing is to admit everyone to hospital, all the time. Then run every test known to mankind.This is unworkable.

    Unfortunately sometimes people die, and as long as the best has been done within reason (and given the limited information it would seem that she received the correct advice for someone suffering flu-like symptoms in the middle of flu epidemic) then that is all one can ask.

  16. Oh, I'll be throwing up solutions as well when it fits the post (this was supposed to be an arty-farty type of post).The simple solution would be to do away with AMPDS (the computerised triage system) in anything other than an advisory fashion, then train the call-takers to a higher standard (for those in the LAS, something like the CTA staff) so that they can use medical knowledge and common sense in the dispatching of calls.

    The problem with that however is that it is a long-term plan that would cost a huge chunk of money.

    The long-term nature of it is what makes such a thing unlikely.

  17. I don't understand what is it that drives people like this to contact the emergency services… OK, I'm a former SJAB member, so I perhaps have more sympathy with regular crews than most, but why can't they see that the ambulance service (and the other services) is a limited resource, and that those who do have genuine need, NEED it…

  18. The 'Front End Model', which I've heard has been quietly shelved.You are right though – this would be one solution, the problem being that there is a perception (if not a reality) that should anything bad happen to the patient the road staff attending would be 'hung out to dry'.

    I don't think that it's just confidence, I think that we realise that we aren't doctors, in training school I was told that we weren't supposed to diagnose, let alone leave people at home.

    Then you need to pay for the training as well as take people off the road for the training courses – essentially you would be training (and then employing) a large number of ECP-types.

    You'd also need to set up the right care pathways for referral.

    Essentially you'd need to have a fleet of GPs in cars whizzing around everywhere in eight minutes.

    It would be nice to have such a system in effect, but given the amount of time to properly assess and treat/refer a patient it'd be quicker for the service to run them to hospital…

  19. one of the problems is this “Nanny State” that insist on making laws DONT DO THAT DO THIS WE WILL HELP YOU ALL THE WAY FROM BIRTH TO THE GRAVE. the trouble is there are a lot of people who miss out who will not call for an ambulance when they should because they feel they will rob someone who is worse off than them. Its that publisity that that stops those people and all the others think well the goverment have put thos provisions in place so i will use them I PAY FOR IT IN MY TAXES SO SOD IT.And its not going to get any better

  20. The day will come soon when at the start of a shift all front line crews will go out to their respective sectors/areas and just 'cold call' on people at home and insist on taking them to A/E as a prevention measure just in case they should become ill in the future. This will be done on a random selection initially before concentrating on the lower wealth areas which have a historical incidence of heart problems etc.The next stage after that will be a quota to acheive, for all paras/techs who are on their way to work, by 'collecting' random people off the street and taking them to their station prior to starting the shift and then taking them onto A/E.

    In fact why not have 'Ambulnace Stops' like Bus Stops where people can wait for an ambulance to take them to A/E.

    A/E or Accident & Emergency is becoming a contradiction in terms.

    We are creating too much of a demand that was not there previously…just sort out the GPs who wont turn out, educate the general public as to what is an emergency by using structured information not scaring the crap out of everyone by intimating that every twinge is a heart attack!

    And get rid of AMPDS and Call Connect!!!!!

  21. Not necessarily, I remember hearing something which is done up here on bonfire night which could easily be adapted. A crew gets given a doctor for the night and sent around all the minor things so the doctor can declare that they have no need for an ambulance, hence freeing up the others. Surely just a few ECP types sent around the people who are obviously trying to play the system would bring up the average response time? After all you've said before that the folks in control know when the system is being played but have to follow the rules.

  22. God, I hope they were made to wait for the full 4 hours allowed nowadays. With the heating off. And the drunks.

  23. At the moment I have a shocking cold. I am coughing and sneezing, and have almost got my voice back after spending New Year tucked up in bed with a hot drink.Have I been taking painkillers? Yes.

    Have I been having the occassional Lemsip (obviously not at the same time as the painkillers)? Yes.

    Have I phoned an ambulance? No. It's a f*ucking COLD!!!!!

    Jeez, some people need a swift reality check.

  24. If I turn out to an obvious waste of time shout, I ask the “customer” – “So what part of this is an accident or an emergency then?” More often than not, they have a little think to themselves & decline transport. I always give them the option of being taken in by ambulance but explain that it would probably be better for a GP to visit or for them to make their own way.I have been doing this for the past 4 years or so without any complaints.

    When there is any doubt in my mind at all, or they absolutely insist that they must go, they travel with me, no questions asked & I explain the situation during handover

  25. Agreed. Also the repetitive “Category 'A' response blue lights and sirens. Fast car also sent.” just got annoying for me, so I ended up reading every other word. Which means the point wasn't made or at least not very well and not beyond having made it in the first line. Two or three reminders at appropriate points would have been more impactful IMO.But it's good to see you back and blogging, hope you find a style you are comfortable with. Sorry to read that you aren't likely to progress within the ambulance service, but I hope things work out.

  26. It all boils down to laziness. Why make the effort to take care of yourself when the NHS will do it for you, and for free? People expect an ambulance to turn up for a runny nose purely because they pay their taxes and it's their “right” – it's time to either educate the public on what an actual medical emergency is, or else charge them for wasting time and resources.

  27. Ambulance phoned for 'a plaster' as the patient didn't have one for a cut finger, ambulance phoned as patient needed a pregnancy test and needed to attend A&E, asmbulance phoned with a case of 2 week old headaches – no GP contact and no analgesia taken. We will never hear the end of calls like this, the 'crap' that people come into A&E is terrible, the general public need educating as to when to call an ambulance.The government should spend some hard earned cash on a few adverts regarding an 'emergency', OOh Gp's should also stop advising admissions without seeing the patient, Nursing Home's should also be more competent in assessing their patients, and people should stop thinking that they will get seen quicker if they phone 999 – its simply not true.

    I had 3 patients walk out last night in a huff cos they waited 3 hours to see a doctor, one of them even had the gall to complain that they weren't being seen – we had a major trauma in – when this was explained to them, they simply didn't care stating that they should also be a priority. Oh for the love of god – i would have loved for that patient, who was alert, well, breathing and with no bones sticking out of them to have seen the state of the trauma – obviously i know this is completely wrong – but it maybe would have made them think twice about moaning.

    Some patients are great though and never complain – these are the ones who get that little bit extra – a pillow if you're lucky, that extra smile – they are the ones who can see that you are busy. I always love it when a relative or patient asks for something when you are rushing about like the preverbial fly, and then mutter when i have to say i have to do it later, i know they may want to go to the toilet, but when someone is going 'off' and i'm trying to stop that, toilteting people really is my last priority, me and my one set of hands have not yet evolved into several!

    I got told off by a relative yesterday for sittiing down for 5 minutes and having a drink – it was 3am, i hadn't had the chance to eat, was dehydrated and ratty – they're loved one was okay and comfortable – am i not human, do i not need some care and attention, and do i not have the right to refreshment. People forget that nurses and allied medical staff are human and need all of this from time to time.

    I urge people to think before coming into A&E – its often the worst place to be!

  28. the public education campaign is a nice start, however, what would really get people to pay attention is to hit them in the wallet. in arizona, land of flash floods, the rescue authorities got tired of people ignoring blocked off flooded roads & then having to risk their lives getting people out of their floating cars. so they fixed the problem: anytime a person ignores posted signage of any sort & need to be rescured, they will be billed for the full amount. taxpayer $ go to legitimate rescues, not to fools. guess what, once people realized this woul stand in court, they started to pay attention to signage:) the nhs is there to cover legitimate calls for help. you want to dail 999 for a cold? then pay for it. would take less than 2 weeks for foolish calls to stop.

  29. Agree with changing the computerised triage system, and it would be helpful if the call-takers were allowed to exercise a bit of common sense rather than being bollocked for not sticking to protocol (just as I was recently, when I asked a patient with a bad cold if they'd been to see their GP at all in the week that they had been unwell.)Also, make the number for NHS Direct and other advisory/GP services free so that people don't call 999 simply because they want to save on phone credit.

  30. When I was young I went on a Junior Citizens course through my school. That was 20 odd years ago, but a quick Google search indicates they're still running today.We learned, through role play and mocked up scenarios, how to cope with fire, accident and calling the emergency services. I vividly remember being shut in a portacabin filled with fake smoke and trying to remember everything I'd been taught – we even got to use a mock telephone box for calling the Fire Brigade. I also seem to remember a fake bicycle accident, complete with casualty. It was an incredibly useful day.

    I would hope that as many children as possible still go through that training and remember it as well as I did. Teaching feckless, ambivalent, selfish adults however… That's a whole 'nother challenge I suspect!

    Cheers Tom, as ever, all power to your keyboard,


  31. ooh these posts really make me fume (not the writing but the idiots mentioned in them!)In the past 18 months I have twice been stricken with abdominal pains that made me double up in the foetal position on the floor and cry. I know what should I do?

    First time I called my GP went to the surgery, a quick examination (jumping the queue) and its was a hospital referal, straight to A+E in a taxi, hand letter in, then through process of investigation, treatmetn given, 14 hours later on my way home ( I went home after GP clinic, was hungry and ate a sandwich, thus delaying any surgey that may have been needed (i know I am an idiot hehe)

    The second time I explained to the receptionist and she quickly spoke to my GP, advised straight to A+E, had a think, jumped in taxi and went A+E, quick chat to ladies on the desk, sat down, 15 mins alter in the cubicles Cannula in my arm, 3 syringes of clear liquid, slight nausea and I was away with the fairies, back up to surgical assesment, another 10 hours alter, on my way home with more treatment.

    Honestly why is it so difficult to pick up the phone and speak to your GP? I have to say the only time I have ever been in an ambulance was when i got attacked on a night out and was knocked unconcious and the police radioed for one, other than that its always possible to make you way to hospital or seek medical advice, blimey, even my dad when he cut his fingers on a hedge trimmer jumped in teh car and drove himself

    why? My mum and a lot of my friends are all nurses in the NHS, Brought up on a strict no nonsense apporoach to illness

  32. they don't even have to have been in the health service – my mum's attitude to injury when we were children was mostly the same and that has been passed on to me. Moans of “but it hurts mum” were met with – “is anything broken? no? well, then you'll live, have a drink of juice and go back out to play” πŸ™‚

  33. Hear, hear!I had to take a couple of sick days recently (flu) and when I returned, my boss asked why I hadn't gone to see my GP. Why would I make an appointment, get dressed, go out in this weather to his/her office, sit in the waiting room infecting others, only for him/her to tell me what I already know, when I'd be much better off staying in bed? Or why waste his/her time by having him/her visit me?

    Actually, I've lived in this country for three years and I never even registered with a GP, so it was a moot point anyway :oP

    But to call an ambulance for a common cold??? There's only one cure for that: a smack upside the head.

  34. That reminds me of my Mum. First thing she always asked: 'did you rip your clothes? No? Your knee will heal, don't worry about it.' If I turned to my Dad, he'd get the iodine spray out, so I wasn't too keen on doing that either ;oPIt's miracle I'm still alive…

  35. The trouble with this is that some of the most genuinely seriously ill people I have been out to (and it's happens with alarming frequency) are the little old ladies/men who worked all their lives and paid their NIC, but who “didn't like to bother me” and have waited far too long to call.These people are often living on state pensions, and the threat of a charge may stop them calling altogether.

    I think I've suggested this before, but one system that may work it this: there is never a charge for dialling 999 and having an ambulance attend. If the crew deem your call genuine, and you need to go to hospital, there is no charge. If the crew judge that you were able to get to hospital yourself, they will still take you, but there will be a charge (deducted from benefits if necessary), of something considerably more than the cost of a taxi to hospital. You have the option of making your own way after assessment and not being charged.

    We are still left with the problem of a perceived lack of managerial support for roadstaff, most of whom still feel that management will “hang us out to dry” at the slightest opportunity.

  36. I also lived next door to a paramedic as a teenager so that probably helped lolI think it just needs more education on 'when' to call an ambulance, and I think paramedics should be able to assess on site if its justified or not.

    But as Tom said it wont happen while the nanny state rules and the 'Its my right' brigade run loose

    Man I feel my age today lol

  37. I was working on the (somewhat ignorant) assumption that the disease could have been easily diagnosed by a GP in a few minutes. However, even for GPs to be able to do a home visit for every case of 'bad flu' would require a rather large quantity of GPs (it would also spread the disease like wild fire….).It was good to see the doctor sticking up for the advice given – and pointing out that little else could have been done. Unlike the local trust which seemed more worried about finding something to blame.

    In response to the junior citizens at school – personally I think something like this should be on the national curriculum. Then (eventually) everyone will know (perhaps even sooner if kids tell parents what happened at school (assuming kids still tell parents that stuff…).

    In Germany it is also a requirement that you have a valid 2 day course first aid certificate to get a driving license. Along with a good Samaritan law tends to make bystanders more useful. Not sure how much this would reduce the time wasters (would certainly increase the number of FAs around though).

    In response to various comments below about reducing ambulance misuse, one problem is that AMPDS uses suggestive questions (well, i think it does – and i'm not dialling 999 to find out :P) – this makes patients think they have symptoms they never had in the first place (like shortness of breath). The other problem is of different peoples' opinions (what is a lot of pain, or a lot of blood?).

    Should we charge for misuse of ambulances? No, I think we should adopt a method I heard once used on a regular drunk.

    After the crew had picked up the regular who didn't need treatment they checked with dispatch to see if they could take him to another hospital – one a little less local. Dispatch confirmed they weren't busy and the drunk went on a little trip through the countryside. Needless to say, the drunk never misused the service again.

    “So you want to go to hospital for a runny nose? – unfortunately East London is on divert, so we'll be taking you to Edinburgh General”

  38. I would be interested to know your view(s) on my recent ambulance ride. I had a cough for well over a month, went to the doctor one morning after seeing fresh blood mixed in with the sputum and was given antibiotics for a supposed throat infection. Doctor advised me to go to A&E if I there was more.Same evening, I start to cough up frank blood and tell someone else in the house I think I need to go to A&E. Being a faithful reader of your blog, I did NOT tell them I needed an ambulance, but they called one, understandably enough. I was a bit too busy transferring blood from my lungs to the bathroom sink to have any input on the call. Ambulance came, very nice men took me to A&E and gave me strict instructions to make sure that I got blood tests and an x-ray and not to let them dismiss me as a healthy young woman. Triage nurse classed me as amber based on obs and history, I had my x-ray and turned out to have TB.

    Yes, the ambulance crew and hospital took me seriously, and yes, I did turn out to be ill enough for a stay in hospital. However, my haemophysis was not life-threatening, even if it was scary, and there was a car available, which someone else in the house followed the ambulance with to the hospital. So… should they have called 999?

  39. most people take the easy path, the NHS does such a great job, better than going to see the doctor, [such a grumpy bunch!! ]Here in La La land, it cost me to go the EMS by Ambulance [1.2miles], 100 smackers, by taxi, 20 smackers and that gives the cabby 5 dollar tip, both my wife used the cab service, she when she had her Heart attack , the medicos kept her in CCU for 7 days, at another time, me for a mouth full of tongue , by the time they could evaluate me my overloaded tongue be back to near normal, so I was allowed to go and annoy 'me' trouble and strife.

    Here also my perception is the 'ambos' have plenty of time to catch up on the latest techniques on saving patients.

    So to keep the service for real problems there has to be some incentive.

    1: I liked, was the one for the over indulge, is to take them to some cottage 'ospital down in Essex marshes not near a bus service .

    2: charge time wasters, one day's remuneration, be tax payers hand out [dole] or wage deduction at the company that pays said wage.

    people seek pleasure not pain, or less pain if they be a pain.

  40. Maybe the management should start being liable for people who's condition is worsened due to a long wait. Then you'd get a better system. Perhaps you should take her, but if it's a LoB, and another cat A/B comes in, you should just drop them out of the back and leave them to find their own way there… (or phone another ambo)

  41. I think that the triage system when calling 999 does need to be sorted out; I recently had to call 999 at work for a colleague who had suddenly got tunnel vision and was feeling giddy. She had hyperventialted in panic, but calmed down with the help of other colleagues who were around.When I dialled 999, the dispatcher asked whether she had difficulty in breathing; I answered “She was hyperventilating, but her breathing is now normal.” I then got a whole load of questions “Is she breathing?” “Is she still having difficulty breathing?” “How long has she had the difficulty breathing for?” “Can she speak?” I kept on trying to explain that the breathing was now normal! Fortunately, before the end of the call, and before the ambulance arrived, my colleague decided that, as her vision was coming back, and it didn't seem like she was going to collapse, she'd rather make her own way to hospital with her partner, so we only wasted the time of the dispatcher, and however far the ambulance had got down the road… I was very worried that it was being sent as a DIB call!

    But, from my experience, it is very easy to see how the system could flag something as DIB, particularly if you don't understand why the call taker is asking the questions.

    It doesn't excuse the abuse of the system in calling out an ambulance for a cold, nor the refusal to self-transport once it was pointed of that the sniffles are not an emergency!

  42. Frothy blood is an indication that it is from within the lungs & not from ruptured blood vessels in the upper airway or oesophagus which is usually just bright red with clots. Not always the case but as I said earlier, pre hospital it is an indication anyway

  43. From one paramedic to another: Had that been my ambulance, Ms. Stuffynose would have had to share the ride with the cardiac patient.

  44. I loved the arty farty rhythm to the post, did you get the meter by banging your head against a wall?We are a nation of wusses, what we need is something to really worry about.

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