Not Breathing

The car remained broken throughout the night, and the RAC man who came basically confirmed what my clever commenters suggested. I spent the whole night trying (and failing) to sleep on the station sofa, as there wasn’t a spare car for me to use.
The call was to someone who wasn't breathing.

I threw myself into the car, a quick look at the address, then I knew where I was going. I knew the best route, I knew how to avoid the worst of the traffic, and I knew I could make good time.

If she wasn't breathing, then my speed could save her life.

Blue lights were turned on, car was put into 'sport' mode (for better acceleration), trip counter zeroed and seatbelt on, I was ready to go.

I pulled out of the station, a quick look left and right, then left again showed no traffic. A couple of kids were standing outside the chicken shop on the corner – none of them were standing in the road (for once) so I made the sharp turn onto the road.

The first junction. Traffic here is forced into a single line – and drivers often don't see the blue lights as they concentrate on not hitting the parked cars. Thankfully there was no-one else on the road, so I turned right, and accelerated away.

The first hazard was the humpback bridge – visibility is poor, and while there is a crossing on top, kids sometimes cross just under the brow of the hill. The car hugs the road, which means that I can't see over the bridge until I'm already on top of it.

I ease off the accelerator, all clear – I gun the engine.

20, 30, 40 mph. I can see the next hazard, some shops leading up to the traffic lights at the junction. I slow down, right foot covering the brake pedal. A quick check, no-one is looking to cross the road, the car heading towards me has pulled over, and I have a free run to the junction.

And the red lights.

The siren goes on – it's loud, but the closed windows take away some of the sound. Light braking as I approach the junction, there is a queue of cars waiting for the lights (there always is) so I decide to take the wrong side of the road. I'm braking some more, it's a wide junction, so I can see what the other cars are doing. They are all waiting at the lights, the way is clear.

I swing the wheel round into a tight left turn, my folder and my bag shift in the passenger seat. The equipment in the back slides slightly, but are held in place by safety straps.

A good clear road, long and wide, just how I like them. I keep the siren going – it's sunny, and people might not see the lights. I pass the police station, a copper waves as he gets into his car. I wave back.

My eyes defocus, I don't know what I'm looking at, I try to take in the whole of the road and the pavement at once. Two kids on the right side of the road, but they are walking along, unlikely to interfere with me, one looks around at the sound of the siren.

A car ahead pulls out in front of me – can he not see me? He pulls over and lets me past as soon as he clears his turning. No matter, I had to bleed off some speed because I didn't know if he would pull out completely in front of me.

A slight hill. Visibility is less of a problem here, but I still can't go as fast as I'd like. I clear the hill – nothing, the road is clear and I power down towards the next junction.

More shops, more cars, the lights are with me, but I know this junction well – cars will often 'jump' the lights, so again, I'm forced to slow down.

I change the sound of the siren, it becomes more insistent, shriller. My eyes are still unfocused, I note the hazards – the woman with the pram looking to cross the road, the bus in front of me looking to pull away from the bus stop, the car waiting to turn right at the junction, the bike rider (is he weaving around a bit?).

Once more, my foot covers the brake, nothing changes, the woman waits on the kerb (good girl), the bus sits there (thanks mate), the car moves over slightly, clearing my way (good boy), the bike rider straightens up (excellent).

I'm through the junction, but the traffic gets heavier, I need people to pull over and let me pass. I have a choice – I can go down the bus lane, it's clear, but people can get confused and can pull in front of me. My other option, and the one I choose in a heartbeat is the middle of the road, forcing those on my side to pull into the bus lane, and those who can see me oncoming to pull over a little to let me pass.

I hear Obi-Wan Kenobi tell me to “Use the Force”.

I go wide – trying to make myself as big and noticeable as possible. Lights and sirens, yellow and green livery I should be easy to see. Some people don't pull over, I make them pull over. Oncoming traffic gets out of my way, they can see me from all the way down the road. One man however thinks it clever to flash his headlights at me and try to play 'chicken'. Obviously I don't realise I'm driving down his side of the road.

I swear. I swear at him loudly, he can't hear me, but it makes me feel better.

He is making me slow down. He gets out of the way, he has no choice – I give him no choice.

I continue down the road, gradually I pick up speed as the traffic gets lighter. I'm constantly looking to see if any silly pedestrian wants to run out in front of me. If people weren't so daft I could drive faster.

Now for the problem road. I swing into the High street, traffic is extremely heavy, shoppers are crossing the road, there is barely room for two lines of traffic, let alone that magical third lane I need.

I change the siren, then change it again, then again. It's a strange sound, and it gets everyone's attention. Cars slowly try to get out of the way, a bus holds its distance. Someone decides that they can run across the road before I reach them. They are wrong, I have to jump on the brake, luckily I'm not going too fast. I swear some more, then start off again. My speed is slow, my driving has gone from speed to squeezing through gaps.

Don't look at the cars, or you'll hit them I think to myself. I concentrate on the gaps between cars, some are very small. On an instinctual level I know which gaps I can make, and which ones I need to sit behind the cars, lights flashing, sirens blaring, until they make the gap wider.

How did I get here? I'm turning into the street I need – it's one way and the way ahead is clear. I'm glad, once more the parked cars make it barely wide enough for a single car.

I'm counting the door numbers – I'm looking for number 112. Odds numbers on the left, evens on the right. 288, I speed up then slam on the brakes for a speed hump.

Again, again, again. I curse the people who think speed humps are a good idea.

186, more humps – I pray no children are hiding between the cars. 172, 162, 128.

I slow down. I'm trying to see the numbers, but some are small, and some are missing, while I'm doing this I'm trying not to drive into a parked car.

112.

The door is open.

I stop – there is nowhere to park, so I'm blocking the road, it can't be helped.

I grab my bags and run into the house.

“Where is she”, I ask. My eyes are taking in the house, is there anyone laying

on the floor?

“It's me”, comes the reply.

I breathe a sign of relief.

“I've had a cough for the past week and it hasn't gone yet”, she tells me.

Another normal job for me then.

Not reflective of any one job, more a reflection on all my jobs

63 thoughts on “Not Breathing”

  1. OMG, GRRRR… Death (or at least sharp pointy sticks )to all people like her who think that a slight cough warrants an ambulance.Fantastic writing

  2. This is arguably one of the best entries you've written in a while.Curiously, the woman lived at number 112, which happens to be the alarm-number here in The Netherlands.

    I saw one of your Dutch colleagues yesterday, on my way to work. I travel by bus to a busstop in an out-of-the-way area of this industrial area where I happen to work. Someone had found a corpse just a hundreds yards from the stop — just an hour before I got there…

    And I was an hour later at work than I planned.

    It could have been me who found the body, which turned out to be a German truckdriver. Why he was dead there I don't know, but it sounds like a robbery.

    Do you get called to carry off murder victims sometimes?

    Bram Janssen

  3. Wellity wellity wellity. Number 112, eh? And it's the emergency number in the Netherlands? What an amazing co-incidence! We should call the paranormal investigators.Wait, wait, maybe we shouldn't.

    No, I was excited for a second there but it turns out that the author was NOT as dumb as you probably give him credit for. 112 is internationally known as an emergency number. Even in 3rd world countries like England. Oy Vey.

  4. Surely NOT? How did a cough translate to not breathing? Didn't you just want to zap her with your heart-shock machine thing just to teach her a lesson !!! (Aside: God I hope I get my commission shortlisted!)

  5. There are smoke detectors on the market now, I believe, that can tell the difference between “oops I've burnt the dinner” smoke and “oh s*** the house is on fire” smoke. I don't know how they do it and I don't reckon that most of the people who cause false alarms would be bothered buying one anyway!

  6. Has anyone ever done a study on stress-related diseases among ambulance staff? This got my pulse going just reading it.You've had lots of fascinating entries recently. I was about to add a comment on your story about the pregnant woman punched in the stomach, saying what an indictment of society it was. A lot of your stories seem to suggest the same: the one about the homeless kid and even this stupid woman calling you out for such a feeble reason. But in fact the essence of these stories is in the care and concern of people like yourself who do difficult jobs in difficult circumstances and who go largely unrewarded in financial terms. I worked for a few years in the housing department of one of Britain's major cities. People who work in such places are often villified, but I can think of some individuals who I worked with who will never be rich or recognised by society but who had a positive impact on lots of people's lives.

    Snoop

  7. Nice writing – more stuff like this in the mainstream, and maybe people will realise how hard it is for the emergency services just to *get* to where there needed, let alone the risks when they get there (stab vest, anyone …?)Reynolds, I would be seriously tempted to send a copy of the blog to the lady in question. Might make her think twice next time …

  8. You honestly think so? We live in an “I want it now” society and it doesn't look like it will change any time soon.

  9. You have a good tactic: being so vague when you insult someone that the insulted can impossibly retort intelligibly.Except by calling you a troll and order you to get lost, of course.

    You're a troll, get lost.

  10. I've never read such a good car chase. I felt as if I was right in there with you. Tremendous post.

  11. I was having a bad day and you made that job so real – like that film BULLIT or something, thanks!I will get a house number fixed to my new house when I move house tomorrow – never thought of you EMT/ ambulancy peeps looking for the numbers before!

  12. How much do you try and anticipate what you'll find when you arrive at a scene? Clearly here you were concentrating completely on getting there as fast as possible, but was there a part of your mind that was thinking about the possible scenarios you'd arrive to?Laura

  13. 112 is the emergency number in most parts of Europe. (Once more it's only England that has to be “different” *lol*) It also works here (instead of 999) but PLEASE don't run to your phone now and try it *ggg*Nice post by the way (although it drove me a little mad while reading *argh* QUITE STRESSFUL)

    You said a couple of days ago that you were going to write about your (computer) system and the way the calls are categorised etc.

    How many percent of the calls you go to (which should be all Cat A calls right?) are “real” Cat A calls who need treatment and how do you actually deal with the fact that you see a quite fit person when you arrive? Does it change the way you treat the patient?

    Does it make a difference whether there's an old stinky drunk (who actually doesn't need medical help) or a nice lady (who doesn't really need an ambulance either) apart from the fact that (from your point of view) most of them just lie to control when they call for an ambulance.

    What about the people who just can not calculate the position and the seriousness of their or other people's illness? Sorry, but when I see a guy lying on the street or hyperventilating at the cinema I can not tell “it's just a beer too much” or “it's just a panic attack” can I??

  14. The police in some counties prefer you to dial 112 in the UK because I belive its quicker for them to trace you on a mobile that way…Some people seem to be missing the point slightly, driving like a bat out of hell is dangerous, scary, and not nice. (especially for the young observer!) and people like the (fictitious) caller above need a damm good slapping, I belive the adding of blue lights to a vehicle increases the likelyhood of accedent by over 200% putting the crew on board and the general public at much greater risk.

    Reynolds, have you had (many/any) accedents whilst under lights and music? Do you first call control and say sheepishly “send another motor” you seem to be 200% more likely to break it on station before getting to a job!

  15. I don't know how you feel about being publicised too much, Tom. Perhaps you can comment? Because if it won't result in your being out of pocket due to bandwidth or anything there is somewhere you might want people to submit your blog (I won't mention where in case you don't want people doing it) and you'll get a LOT of visitors, hopefully they will read posts like this one and it will make them think.

  16. Excellent – I was biting my nails as I read – and when she spoke …. I'd have killed her myself for frightening me!!Jo

  17. I guess while being primary contact for lots of people is pain in the arse sometimes but meeting that 16 year old and pulling bouncing babies out every now and again must balance things somewhat.

  18. If we assume that there were no mistakes made by the Control Room (and everything I've read here so far suggests that they are pretty reliable), then the only thing that will help this 'client' to think twice (or even once) is a brain transplant from a higher life form. If any surgeons would care to volunteer, I'll supply the goldfish…..;-)I have to admire your restraint – please keep on blogging!

    Best wishes from a Welsh lurker.

  19. If we assume that there were no mistakes made by the Control Room (and everything I've read here so far suggests that they are pretty reliable), then the only thing that will help this 'client' to think twice (or even once) is a brain transplant from a higher life form. If any surgeons would care to volunteer, I'll supply the goldfish…..;-)I have to admire your restraint – please keep on blogging!

    Best wishes from a Welsh lurker.

  20. Very reminiscent of Driving a Triumph 900 through Italian rush hour traffic two up. Great writing, you can smell the adrenalin.Bill Sticker

  21. what's it really like driving like that? is it all adrenaline & you just 'doing' your job or do you get a buzz out of it? – & do you get disappointed when it turns out to be nothing (i mean personally not, erm, morally(?), for the waste of time/money/resources etc) – is it more of a relief that it was an 'easy' job?… anyway, yeah, great post!

  22. I love it when I have an O2 sat. probe on someone reading 99% and they are -telling me- “I can't breathe.” I reassure them that if they can talk, they can breathe, and I am watching their oxygen levels and they are fine, and they just need to calm down, and they insist “But I Can't breathe!”I would have just hoped a dispatcher would understand this process a bit better. “You have a cough dear? How long have you had it? Well, you need to call your doctor in the morning….”

    For those not medically minded, If You Can Talk, You can Breathe. You may be having trouble breathing, it may be hard to take a breath, if you have asthma you can report you are having an asthma attack. But if you can say “I can't breathe” you can.

    Rant over. Lovely writing, Reynolds.

  23. I love it when I have an O2 sat. probe on someone reading 99% and they are -telling me- “I can't breathe.” If you are a medical professional as you pretend to be you should actually know that while having a panic attack (hyperventilation) the patients really get the feeling that they can't breathe and are out of air because they usually take quick, deep breaths which reduce the level of carbon dioxide (CO2) in the blood. This reduced level of carbon dioxide causes the arteries to constrict, reducing the flow of blood throughout the body. When this occurs, our brain and body will actually experience a shortage of oxygen. The brain tells you “breath faster” to balance and make good the imaginary lack of oxygen.

    You think you are out of air (oxygen) you breathe faster, it's a vicious cirle as you should know.

  24. I was talking to someone in the throes of a 'panic attack' just a couple of weeks ago. The quotes are because it was the calmest PA I'd ever seen. She gets them a lot, recognises the onset and tells those about her what's about to happen. And not to worry when she falls over and stops breathing for a bit. Especially not to bother calling an ambulance.Thankfully she didn't get to the passing out stage so I didn't have to make that decision. Not sure if I'd have had the nerve to sit still while someone made like a corpse, waiting to see if they came round or not.

  25. The post isn't any specific job, it's just an amalgam of the normal sort of things I go to. Control are pretty good at realising what calls are genuine, and which aren't (Much like they are pretty good at recognising when things seem 'strange'), but their hands are tied by what the computer says (shades of 'Little Britain' there).So they get a call from someone saying that there is a dead man in the street, but that the caller can't stay on the scene, then we get the call sent to us as “? suspended in street”, we turn up and find out that it is a drunk.

    *shrug*

  26. If there is a death in a public place, then yes, we can sometimes be asked to move the body. If the police think it is a suspiscious death, then they handle it.There are *lots* of people who 'just' drop dead…

  27. “Help I need an ambulance””What is the nature of the emergency?”

    “She's not breathing *mumble*”, or “Not breathing”, or “I don't think her breathing is right”.

    Computer says “Category A response”

    I get the job and race round there.

    It's a cough, or they are crying, or they are holding their breath, or they have hiccups.

  28. Yep, the “Cat A” post is coming.I tend to treat everyone the same, although I would be deluding myself if I said I treated cynical drunks and nice little old ladies *exactly* the same – but I do tend to treat people as if I had loads of witnesses and they are tape recording everything…

    As I think I've said elsewhere, I tend not to be too upset by people who are either a bit dim, or think that something serious is happening, when it actually isn't – an example is people who think that they are bleeding to death, when they have actually a rather minor wound (but a little blood, especially your own, looks like a lot).

    Bystanders who call us, then stay with the patient are fine – those who call us and run tend to annoy me.

  29. I do tend to think about what the job is while getting there – although to be honest most of the time it's something along the lines of…”He'll be drunk then”, or “Bet that's not really what is happening”.But I try to get everywhere as quickly as possible, just in case it is something serious.

  30. Tom,Turns out I have been too much of a romanticist. The German truck-driver had had a heart-attack and had indeed “just dropped dead.” The truck was gone because the police had taken it away to see if anything weird was going on inside of it.

    Here's the juicy part: the driver was delivering paper to an envelope factory. When the truck was being taken away, the manager of the factory had complained to the reporters that he objected to this, because it was carrying two pallets worth of envelope paper and this was not good for his production.

    *sigh*

    My father is a retired trucker, and the manager's comment pissed him off plenty. Pissed me off plenty too.

  31. Well…I've clipped a wing mirror once, got stuck in a width restriction and popped a tyre mounting a kerb. But while I am driving fast (in places) my first concern is always safety.

    Most of our accidents happen when people are reversing, I know I've 'tapped' a pole or two myself when on an ambulance.

    The trick is, that you drive safe first, and instead of driving 'fast', you just 'make progress'.

  32. Bandwidth is pretty cheap, and my hosting company are pretty good about that sort of stuff.Also I love having my ego polished – so if you want to refer/recommend me anywhere, then feel free.

    (My ego is asking me if there is such a thing as being publicised too much).

  33. There are plenty of good things about this job, and they do tend to get you through the tough days.

  34. I tend not to get adrenaline rushes when driving, or to be fair when dealing with a job – just because it is just that – a job.I also like “easy jobs” because (a) Someone isn't really ill – a good thing, and (b) I don't have to do much work – I am lazy after all…

    I try not to think too much about the cost of every job, otherwise it'll get me depressed.

  35. I think Joan's point was that someone who can talk is *physically* able to shift air into and out of their lungs.I agree about the 'feeling' of not being able to breathe though, and that is why I sit there with my probe on their finger trying to explain exactly what is going on so that they can make a conscious effort to slow their breathing down.

  36. Ok then!http://news.bbc.co.uk/1/hi/magazine/4613799.stm

    There's a box for submitting blogs for consideration in the BBC online's weekly “Weblog Watch” – the above link is to the most recent one. It's always linked to from the Magazine Monitor bit of the site.

    Perhaps post this with a subtle hint to people to go and suggest you!

  37. That sounds more like it has a physical cause, because in my experience of panic attacks I have been too terrified to tell anyone and the urge to run has overwhelmed everything. I also feel quite detached and like I'm in a dream, and communicating is very hard.But then I guess we all experience these things differently. I would recommend that person to get tests though as I'm sure there are disorders/allergies etc that can cause people to release an innapropriate amount of adrenaline (one of the causes/effects of panic attacks, I believe).

  38. PS when I say “Physical Cause” I am not implying that panic attacks are solely mental. As evidenced by my reference to adrenaline etc later in the post. 🙂

  39. I *think* I've already been mentioned on it (possibly in relation to the Bloggies).And yes – traffic did spike quite nicely.

  40. I'm the person in posts below mentioning having panic attacks: An effective method I learned to stop myself hyperventilating is to breathe in through my nose and then purse my lips and blow through them on the out-breath.Of course I'm sure you know all this, but I thought it might be of interest.

  41. Obviously it would be best if people wouldn't abuse the ambulance service, but that isn't going to happen. Seems like there should be an actual, hospital taxi service people could call for rides which is separate than EMS. Additionally, fine people who continue to call in false emergencies.

  42. As far as I know, you don't die of a panic attack. You can die of asthma- so you would tell the emt -Asthma attack! You get the right treatment. Having trouble with breathing?- and I know you are getting enough O2- I assess, calm, treat anxiety ( in surgical recovery- probably with an anti-anxiety agent that can impede breathing- so given carefully.) So I try to educate folks with anxiety attacks to be precise in order to get appropriate treatment. Feeling like being stabbed, is not the same as telling someone you have been stabbed. Feeling like you can't breathe and saying that you can't breathe are also very different, with different treatments.You do the kind of guerilla nursing that I find awesome, R.

  43. >The police in some counties prefer you to dial 112 in the UK because I belive its quicker for them to trace you on a mobile that way…That's bollocks… when you dial 999 or 112 (or even 911 works on some mobiles), it doesn't actually send the digits “999” or “112” or whatever to the network, the handset recognises it is a special pattern meaning “emergency call” and the network routes the call accordingly. In some countries you can make emergency calls from a phone without a SIM card, or using a network other than your own, although in the UK the phone companies won't connect the call if a SIM for their network isn't present.

  44. Hey there, this is the first time i have read your blog, even though it has been recomended to me on many occasion.I work in a busy A & E in West Yorkshire and I know the kind of crap you guy's have to put up with as i hear stories from our EMT's like this every day. I't amazing that people can get away with this? There must be a system put in place to assess the patient's need for an ambulance on arrival at the hospital, and if it is determined that there was no medical or social need for an ambulance, then they must be made to pay!!

    They would not do it again in a hurry, i'm sure!!!

    It's just a shame you have to bring them to us – can you not dump them in the river on the way and then go get your selves a nice coffee?? That would be nice.

    gembem81@hotmail.com

  45. I guess one problem regarding panic attacks/ hyperventilating is that you are sometimes not aware of what's going on at all. You feel dizzy, you feel sick, you feel as if you're gonna faint any second and additional to that (if it's a bad attack) you get the feeling that you are actually dying(!) and last but not least the feeling of “unreality” or being detached from yourself (which makes it so difficult to listen to someone who is actually trying to help you and calm you down), it must be horrible and without having experienced it yourself you shouldn't judge.You can read about it in books, you can learn it at med school.. but you will never know how it feels like and everyone is different. (Some attacks are light some are really strong and in the end you pass out for a few seconds) My mother has suffered of those attacks for a long time and sometimes when she was in public there were people who (understandably) called for an amb as they didn't know what was happening and they didn't know my mother. It seldom happened when she was with us, in a familiar situation pp.

    There are a couple of things which can cause such an attack. They usually occur for no apparent reason. The cause is not clear. Stressful life events such as a bereavement may sometimes trigger a panic attack. Sometimes it's a special situation, a special “memory” etc.

  46. As a human being generally I'd rather there being a free service available you can call when you do feel that something isn't right, even if you're not sure…. than have lots of people who *aren't* right think “oh it's just a bit of chest pain, it will be OK, I don't want to bother the ambulance service” (especially if they could be charged if it turns out to be nothing) and then go on to die of a heart attack or whatever…Sure, some people can be far too cautious (or just hypocondriacs) but in trying to weed these out you would have to be very careful not to put off the people who could very well need medical attention.

    I'm sure the fire brigade that keep getting called to where I live because some idiot burns the toast (every time they send 2 engines because of the size of the building) get pissed off too. (Although I have a feeling they can charge for false call-outs?) Sadly the smoke detectors can't tell the difference between a bit of burned toast and a life-threatening fire.

  47. I don't want to see people being charged for ambulances. It would only deter the 'nice-little-old-ladies' having an MI, but are worried about the expense.The little ******s that call an ambulance for nothing, and say they can't breathe, or have chest pain becuase they know they'll get a quick response and a free ride to hospital probably can't afford to pay a fine anyway.

  48. I have to echo the comments above and say how nail-biting this entry was!Thank you paramedics, for never making me feel even worse than I did already.

    Cat

    x

    purplepiranha.blogspot.com

  49. Superbly written – I was on the edge of my seat as I read it.Thank goodness for poeple like you – even if we also have to put up with morons like the woman who called you out.

  50. According to the blog “The call was to someone who wasn't breathing” and lots of people have berated the stupid person for calling an ambulance, but has anyone actually confirmed this claim? i.e. in the 999 call, is that what was actually said, as it might be that chinese whispers or other third parties made this escalate from 'congestion' and there are lessons that can be learnt….. For example clearly the patient would talk of themselves in the first person ” I cannot breathe ” would be a nonsense, so the operator wouldn't have heard that….

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