A Changed Role (The Secret Is Out)

So after some time (arranging things with work, battering my computer into submission and have a day of doing nothing except “chilling out”) I think I an finally reveal the 'big secret' that I have been using to keep you coming back to read this blog…
I'm still in the London Ambulance Service, and I've not been promoted – however the vehicle that I drive, and the role that I play will change.

I'm no longer going to be driving one of these… An old style ambulance Or even one of these… New shiny ambulance

But one of these… Rapid Response Unit

For the foreseeable future I am going to be on the Rapid Response Unit.

The role of the RRU is to get to emergency calls within eight minutes, thereby pleasing the government, and by extension, pleasing management.

I am to get to calls as quickly as possible, get a history off a patient and start treatment until an ambulance can arrive – I then leave the patient in the care of the ambulance crew and drive off looking for another emergency call. When I don't have a call to go on, I am to spend at least some time driving around the area in the hopes that I will be closer than an ambulance when a call does come in.

This means I have even more autonomy than working on an ambulance, because I am working on my own – there is no crewmate to bounce ideas off. There is also a better chance of things going horribly wrong – imagine having to deal with a cardiac arrest on your own, with distraught relatives knowing that there isn't going to be an ambulance for 30 minutes…

Still – it should be fun, especially considering that I'm starting this new rota with a Friday, Saturday, Sunday night.

52 thoughts on “A Changed Role (The Secret Is Out)”

  1. I'm a complete outsider as regards ambulance work and I don't even live in Britain any more. As a result, I'm actually quite shocked at the information you give in your posting.I'm amazed that people like yourself should be sent out on your own into what could be potentially violent situations (pub fights are the pits). And what happens if a dispute arises for any reason between you and the patient/family over the course of action you take? For safety's sake (and not just physical safety), I assumed that you would go about in pairs at the very least.

    You and others like you do very valuable work. We should all be doubly grateful that you put yourselves at such risk for our benefit.

  2. Congratulations on your sort of promotion to the RRU. As an asthmatic with two previous sponataneous pneumothorax I have nothing but respect for ambulance staff.The RRU has been to me a few times as I live in rural Lancashire and obviously the RRU gets here faster as its supposed to.Its a shame the same can't be said for first responders.I had one of those last March after my second pneumothorax and I couldn't answer the door to him,he didn't even try the door handle(muppet),it was unlocked and he could have gotten straight in.You should have heard the language from the paramedic in the RRU that arrived 5 minutes later.!!! He gave him a right ear-bashing…and he sure deserved it.I know he couldn't have done much for me had he got in but that isn't really the point is it???

  3. I don't wanna sound smug, but I'd kinda said to myself “I bet he's moving to RRUs” as you told us more and more about your 'secret plan'.Anyway – congratulations! I will be very interested to hear about how you get on with it 🙂

  4. I actually thought you'd be swapping your uniform for a suit and joining 'da management'.And as for not having anyone to bounce ideas off – should we expect some Rob Brydon / Marion and Geoff like confessionals?

  5. I think the Marion an geoff thing should be started. Sit there in a a layby and write your blogs about nothing in particular. Itl be ace.Congrats on the RRU. Dont forget to watch your back while your out there, and wear ur vest!

  6. Congratulations. But…I thought they only put paramedics in these? I know that as a technician you'll be able to use the defibrillator, and give oxygen, but as I understand it the paramedics have a range of drugs they can administer, useful if they're on scene first, but it seems a bit pointless to rush a technician to a scene without the drugs, and then presumably when the crew with a paramedic arrive the paramedic will have to start any drug administration.

  7. You won't catch me joining Management – I enjoy working out on the road too much.I also enjoy work, but that's a joke for another time…

  8. Heh, just wait for the podcast for that one…And I'm not wearing my vest – it'll only slow me down when I'm running away.

  9. You would think so wouldn't you……but the RRU isn't there to provide Paramedic care, per se, but instead to get there within 8 minutes.

    Time is all that matters as it's what our performance as a trust is measured by.

    To be fair though, the only time you are going to be disadvantaged by having a Tech instead of a medic is if you are in Status epillepsy, or if you are having a cardiac arrest.

    And if you are having a cardiac arrest, then chances are that you are dead, and all the drugs in the world aren't going to help you.

    Unless you are in VF, then defib might bring you back…and I can do that.

    The last time I looked there was no evidence that drugs affected the outcome of a cardiac arrest, dead is dead after all.

    There will no doubt be a 'proper' post about this at some point inthe future.

  10. Congratulations TR.I've got to confess when you first started at the LAS, I reckoned you'd go for being a Paramedic. But now you get to play Nicholas Cage – I have Clash adn Kennedys cds if you want to borrow.

    Well the best of luck in hitting that target.

    Drive safely

    Ben H

  11. You are not getting me on one of those deathtraps…Also I think they are limited to central London, as the only time I see one is when it is brought into the garage to be fixed.

  12. Sounds similar to the MICA ambulances in Melbourne, Australia where they drive subaru 4WD s/w's – however as a previous person commented they are ALS Paramedics and usually only attend serious cases

  13. Congratulations Tom, thats great. I think you should go for the Big White one as its cool and looks like less of a moving target than the yellow one.

  14. Congratulations. Thank god you didn't go into management – think of all the cars you would have to wash!!! Good luck 🙂

  15. Congratulations on the new role.We had those rapid response motorbikes here (Sydney Australia). Haven't seen one for yonks. But they looked like fun the time I saw one zooming about the underground bit of Central Station.

  16. here in the North east US we call them “Fly Cars”, and they are staffed by paramedics. with the theory being they get there first ( it's rural here, cant always do 8 minutes ) and then the medic rides in the ambulance to the hospital, and a member of the bls ambulance crew takes the “fly car” to the hospital. you will do zero transport, you lucky dog! congrats.Brett, an envious EMT.

  17. Nice one, hope you enjoy your new role. Is your old line still open for you should you want to go back. Again up here its all paras on the cars, but we don't have the luxury of a para on many (nearly missed the m there!! – think it just feels like that) buses. And a lot of the time we are considerably further than 5 mins from a hospital!

  18. Not being medically trained or a technician or anything I don't really know enough to pursue this further. Obviously the post touches on other issues such as arrival time being the measure of performance, but I don't want to go down that route today. What I am tempted to ask though (and I'm playing a bit of devils advocate here) is: If there is no great benfit from having a paramedic first on scene, is there any great benefit in having paramedics at all?

  19. In germany I'm told many bus's have four+ people riding in them!then the cars come from the hosptals with Dr's ITU/ED nurse's and funkey equipment

  20. Lucky you , working by yourself, but is it a bit dangerous not having a partner as back up?regarding personal safety that is?

  21. Oh don't get me wrong – medics are great, they have better painkillers than Techs, and can intubate during an arrest.They also can infuse fluids – which can be handy.

    And of course they have the always useful 'Narcan' (Used to reverse opiod overdose)

    They also carry drugs to (hopefully) reverse seizures.

    The other good thing that they can do is stop a resuscitation attempt if it is hopeless, by following our protocols

    So yes – Medics are good, but in London, where you are normally close to a hospital (and therefore a doctor) then they tend not to need to use their skills that much.

    But like most things – when you do need a medic, they are bloody handy to have around.

  22. It only means, when running away I don't have to worry about my partner being slower than me – and therefore looking like a cad when I outrun them and leave my partner to the baying crowds tender mercies…

  23. Congrats Tom! Here in Austria the RRUs are usually manned by two people. Usually an ER doctor and a paramedic (what luxury!). Anyway, all the best and not too many bad jobs…..

  24. Congrats to you, hope it all goes well and you enjoy it as much as driving the big ambulances! I spose you can get there quicker cos the car is smaller too, just an observation…

  25. Thats great news Tom. Ive been reading the site for a while now, just joined.Thanks for giving a great insight to service to a wannabe!

  26. I'm almost no longer a wannabe!! Just waiting to hear in the next 72 hours whether my application to be an ambo in melbourne, Aus has been successful (following a 8 mth selection process).

  27. Reynolds- I'm in!!!!!! Just received the call and the next intake is April. I'm over the moon.Anyway, thanks to you and the other paramedic bloggers for helping me to know what I should be doing with my life. Look forward to some tales from Downuder in the not too distant future (the program in Melbourne commences with a 15 week intensive at Monash University).

    Good luck with your new role.

  28. Was at an RTA the other day in dire need of some morphine for my patient. Had to wait for another motor to show that had a paramedic on it, took 20 mins. I was trying to treat a bloke with bi lat # humerus, #patella, #pelvis and #thumbs with enotonox. Think I might go do my paramedic course, won't feel so useless then. Was told there was no one else available to help me and my tech crew mate. Grrrr.

  29. pls forgive my ignorance, but what's the difference between a Tech and a paramedic? and the difference between the white and the yellow ambulance? thanks!

  30. I'll answer about the Tech and a Paramedic in a later post – you aren't the first person to ask so it seems like a point worth clarifiying.As for the white/yellow difference…

    The yellow Mercedes are the new motors, they have tail lifts, are nice to drive, have more room in the back and most importantly of all – they have a radio.

    The white motors, are old, can be slung around without a care in the world, hate cold days and spend most of their time in the fitters being fixed.

  31. Yeah, I know the bloke and although the accident wasn't his fault, it still makes you a bit worried.Needless to say, I was told by someone high up in management that I should drive safely first, and let ORCON deal with itself…

    (Nice to hear someone in management say something of sense – but then I expect it from this bloke)

    I'm always available for a bit of lifting, or helping out crews – when I was on my assessment the Team Leader assessing me told me that all I should worry about was getting the patient's name and DOB, then going green as quick as possible.

    But I'm afraid I'm going to have to ignore him and stick around just that little bit longer. I'm not looking to make any enemies over this.

  32. Congratulations mate….I hope with you having to spend more time in the car, that your output won't be reduced? ie. those odd times when we actually get a couple of hours on station… (where I actually prefer to browse the internet than watch some late night crap TV or go to sleep! It's not the sleeping I don't mind… I'm not very good at waking up fast… anyway I digress). Do you actually write this in those times on station?

    Another thing re: the para/tech question…. esp with regard to cars too…. (we call them RRV's up here)… They're very popular with 'da managment' and soon with AfC to be more so. As you yourself know, the only thing we are judged on is ORCON standards… (patient care quality??… lolol)… anyway with AfC the word on the telegraph up here is that they're gonna expand the cars… fill 'em with paramedics and leave Techs to be the bus drivers/caretakers following up with the ambulance to pick up those patients up that are going to hospital (decided by the more autonomous paramedic). So I for one am applying to do my paramedic as soon as…. (don't believe the 'handle'… just helps not having to explain to the layperson all the time , that no! I don't fix the ambulances) because I want to retain my love and interest in the job… and not just become 'an ambulance driver'.

    So all the best…. and be careful out there… you're very precious to us all!

  33. Now I know what they are. Suspiciously, there's always one parked next to the pool when I go swimming – I think they must know I'm a learner!

  34. nice to see someone using pods an bloggs for something worthwhile. look forward to hearing your adventures and learning a trick or two as i will be appyling to join the LAS next year.keep up the good work and keep scanning…

    nice legs… oops- brake!

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