Phonetic

Part of our job involves using a radio to talk to Control, so part of our training is in the use of the radio. The training is about three hours long, and you spend it pretending to talk on a radio passing jobs back and forth (this is before the computer terminals were introduced).
One of the things we are taught is the Phonetic alphabet, which I am sure you have all seen in film and TV. Normally it sounds something like “Foxtrot Alpha Sierra Tango Charlie Alpha Romeo”, and is designed to make the spelling out of words over an unreliable radio transmission clearer, and less likely to have errors.

One other thing that you should be aware of, is that our radio has an open broadcast – this means that everyone in the sector can hear you talking on it. You can recognise your friend's voices, and this radio chatter gives you a general idea at what they are doing. Of course, this means that should you make a mistake – everyone knows about it.

Why was it, when spelling out a name I suddenly forgot the phonetic for 'M' (Mike), and instead, in a moment of panic, decided that the new phonetic for 'M' would be…

…Mango?

It's not as if I have mangoes on the mind – I can't remember the last time I ate one, but for some reason it was the first thing that came into my mind.

I bless the radio operator for not bursting into laughter and calling me a twit.

Work was fairly light today, I had one blue call, which was an eight year old who was having an asthma attack. When we got on scene, the child was having real trouble breathing, his lips had a worryingly purple tinge and he was using the whole of his chest to suck air into his lungs. I don't think the mother realised quite how serious her child's condition was.

We gave him a dose of a Salbutamol nebulizer (a medicine for opening the airways of the lungs, making it easier for the child to breath), and 'blued' him into hospital. I carried him into the resuscitation room to be met by a couple of doctors and nurses. By now the child was looking a lot better, and the consultant didn't look too impressed with my bluing the child in. The consultant didn't say anything, but I sensed a definite 'vibe', that he thought we were overreacting. However, once I explained how the child looked when we first saw him, the consultant was more understanding of my decision. The child stayed in the resuscitation room for some time, so they can't have been that unconcerned.

I have a rule at work – if I'm considering bluing in a patient, then I should just blue them in and have done with it. It's more embarrassing to turn up with a dead patient after driving slowly, than to have a live patient turn up quickly. No-one ever lost their job for bluing in a patient.

Sometimes you just know that a patient is seriously ill, even if everything else says otherwise. It's good to listen to your intuition.

I suppose that it can be hard to understand why the ambulance crew has blued a patient in if they look quite healthy when we roll them in through the door. Sometimes it's because the patient has improved, sometimes it's because the patient has a medical history that explains symptoms that would be otherwise frightening and that the patient hasn't told us about them.

And of course, sometimes, just sometimes, patients fake serious illness.

18 thoughts on “Phonetic”

  1. I agree. A seemingly mild attack of asthma can sometimes without warning escalate very quickly into a serious threat to a patient's life and for some reason seems quite under-estimated in this country.

  2. The operator understood you though?Mango was perhaps one of the worst choices, as the phonetic alphabet was designed so that no letter even sounds like another. – and 'mango' is rather similar to 'tango'!

  3. Hey Reynolds, there's been a rumour going around Newham that has spread very quickly. Apparently there's someone going round biting chunks out of people. He's moved down from Birmingham and has attacked people in Poplar and Ilford. It's getting ridiculous because apparently he can change forms into an animal and can make himself appear in different places. It's obviously totally stupid but huge numbers of people are discussing this as though it's fact and I'm totally confused.I know about the guy six months or so ago who ate his friend while on day release from Newham- maybe it's based on that. It's really strange how big this rumour has got.

    Anyway I was wondering if maybe you'd heard it or could possibly shed some light on it?

    -PP

    (Papa Papa)

  4. I was told for asthma to call an ambulance if there is no improvement 10 minutes after use of inhaler, or sufferer does not seem able to use the inhaler properly or if the sufferer looks frightened by the attack (if they are scared it's because it's worse than usual sort of reasoning). Does it seem reasonable rule of thumb to you?Phonetic alphabet is very useful for spelling out words you don't want young children to understand after they have started to learn to read and write.

  5. There was a rumour of a 'vampire' here in Birmingham last week. A friend working in the A & E concerned told me that the rumour considerably embellished the truth, but there had been an incident.Interesting the rumour made it to Newham, even if the shapeshifting vampire didn't.

    Brummie Nurse

  6. We sometimes “blue” patients in without having the hospital on standby. Although its quite different where I work as we often have 20 mins plus running on blues from scene to hosp as opposed to 5 and in peak traffic this can easily run to 40 mins. I've often found there is an invisable force field around hospitals which will often make a poorly patient miraculously better or a stable patient suddenly plumet thus making you look a bit of a Tango Whisky Alfa Tango on arrival!! Fortunately most staff understand!!

  7. We sometimes “blue” patients in without having the hospital on standby. Although its quite different where I work as we often have 20 mins plus running on blues from scene to hosp as opposed to 5 and in peak traffic this can easily run to 40 mins. I've often found there is an invisable force field around hospitals which will often make a poorly patient miraculously better or a stable patient suddenly plumet thus making you look a bit of a Tango Whisky Alfa Tango on arrival!! Fortunately most staff understand!!

  8. Being interested in vampires, I'd heard about this when it was rife in Brum. A nice complete summation of the story can be found here.Strange how these things get around…

    I remember the cannibal from Newham, that was a bit worrying…

  9. I know, I know, I felt like a complete prat. What makes it worse is that the training I got in the LAS was the second time I'd been trained in radio procedure.

  10. Yep, we sometimes do the same thing, especially if traffic is bad – it could be for whatever reason we think warrents the risk of running on blue.And having rolled up to the hospital with a drunk patient who decided to drop his GCS to 3 and lose his gag reflex outside the A&E, I can well understand the invisible forcefield.

    And yes, the staff in the hospitals have never given me trouble over my choice to blue/not blue in a patient.

  11. We generally dont even think about why your approaching us at 90 with the wind behind screaming towards our doors. from personal experence many many Asthmatics arrive under blues, Especially Peads! – A Good decision I would have probably made the same.A&E Nursey

  12. I am an EMT on the other side of the pond ( the US side ) I am actually in paramedic school now, but I digress. we are taught to ALWAYS triage up. meaning, always treat something a step more seriously then it appears. you never know. better safe…B in the US.

  13. How many consultants does it take to change a light bulb?Two. One to change it and the other to wait for the world to revolve around him.

    Unless a consultant makes the decision himself it is automatically wrong. And if he makes a wrong decision then it was usually because you didn't tell him everything.

  14. Had a call centre nightmare this week when quoting a reference number wich included the letter “s”. She said “do you mean f as in fine” which sounded like sign I said no and she interupted with “oh you mean s as in sign” which sounded like sign or fine or god knows what.I said “NO “S” as in Sierra” – “sorry, as in what?”

    Phone down – log on and do it online.

  15. Regarding Asthma.I was studying Nursing at uni before starting Health Science (Paramedic). One of my fellow students died from an asthma attack at age 27. Asthma is very serious IMHO. When I encounter a person who say's they have asthma I always ask if they have their Med's. Not one person has said yes!!! Well they are adults and can die how they want.

  16. Hmm, that's interesting. So it does have a vague basis in fact. What was the incident then, if you're allowed to say? If not, you know patient confidentiality etc- don't worry.Thanks for the Guardian article. I don't think I'm going to tell anyone it isn't true though. I want to see how far it goes and how long it lasts. Every day there's a new 'attack' and someone somewhere must be fictionalising it, I dunno I just find it quite interesting.

    Thanks! 🙂

    -PP

  17. hello from down under.an ambulance colleague once forgot 'tango' when spelling phonetically over the air, and said 't … for thomas the tank engine'. much transmitted laughter.

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