Reprieve

Four miles away 'Bob' was about to stop breathing.
Bob's friends had seen him come out off rehab earlier that day, they had then invited him around to their flat where they then saw him inject some heroin.

Bob's friends had then watched him pass out for half an hour, and then his breathing had slowed and he had gone a funny shade of blue.

His friends decided that now might be a good time to call for an ambulance.

I arrived at the same time as the police who were there to make sure that I was safe.

One of the residents held open the main door to the tower block.

“Another fucking junkie?”, she asked, “It's a fucking crack house up there”.

We got in the lift, carefully avoiding the nasty smelling puddle in the middle of it, and I hit the button with my gloved finger.

Sure enough, if you worked in film making, and were asked to create a set based on a crack house – this is what you would come up with. Actually, as crack houses go, it wasn't too bad – there were no human faeces spread around for a start. No carpets either, which is a good thing because it's easier to spot the wet patches on lino.

To give Bob's friends some credit, they had managed to put him into the recovery position in the middle of the kitchen. Bob had either vomited, or his friends had poured some water on him. Either way there was something sticky on the floor around him.

For the second time on this job I was really glad I was wearing gloves.

His friends were both clutching cans of cheap, but strong lager. One of them was so skinny he would have made Iggy Pop look like Pavarotti. I left the police talking to them.

So Bob had decided that breathing four times a minute was quite enough for him but the blue pallor of his skin, and my training would tend to disagree with him. Bob was very nearly dead, I suspect he would soon break the first habit of his life – the habit of breathing. So I put an airway down his throat, pulled out my ambu-bag and started breathing for him.

He soon pinked up and perked up and his breathing got better, so I could stop 'bagging' him. Now I could relax a bit, and watch him while I waited for the ambulance to arrive – which wasn't long.

We moved him into the carry chair, being careful not to stab ourselves with any needles that might be lying around him (or in his clothing, his pockets, or lying underneath him). It was about now that he started to wake up.

Another life saved, although no doubt his habit will kill him one day.

It strikes me as ever so annoying that for some reason I can manage to save heroin addicts, but not 12 year old girls.

20 thoughts on “Reprieve”

  1. Maybe your shoulders hurt from the coughing you did? Assuming you coughed a lot when you were choking.You must CHEW your meat before swallowing it!

    (sorry couldn't resist that!)

  2. I understand your annoyance. However, as a potential 'customer' of the ambulance service, I can't help but be glad that you clearly do everything you can for everyone you are called to, regardless of their age, sex, race, habits etc. Even though I'm not a heroin (or anything else) addict myself, it's very reassuring!

  3. 'Bob' sounds like the kind of name that you would give to a dying friend if you didn't want to reveal their name… am I right?

  4. I want to send out a thank you to EMTs everywhere. I am alive this morning because of quick thinking friends and trained people at a birthday party. A slug of meat went down wrong, and I am told I turned blue. I woke to a cop putting O2 on me and the beautiful sight of dirt as I breathed. Followed quickly by two lovely uniforms and a strange trip in an ambulance.I love oxygen, I love breathing, I am more grateful than you can imagine that I didn't ruin a party or leave my spouse bereft.

    Oh, and my shoulders hurt. I'm guessing referred pain from the diaphragmatic beating. A wonderful misery, as it beats the alternative. I'd never heard it described as a side effect from the Heimlich maneuver, but it has to be that, right?

  5. Nope, we all knew his real name, but (patient confidentiallity and all that), I wanted to call him something other than my usual “The patient”.Just playing around with how I write stuff.

  6. Oxygen and breathing is the one habit I'm happy for all my patients to have.Congratulations on being alive.

    The pain between the shoulderblades is probably from people bashing you on the back to try and get the food out. Our 'protocol' is…

    1) Encourage patient to cough.

    2) 5 Back slaps (between the shoulderblades with the heel of your hand)

    3) 5 abdominal thrusts (the Heimlich that you can do laying down)

    With children you do chest compressions instead of abdominal thrusts because they have squishier internal organs.

    You probably don't remember this because of the whole passing out through lack of oxygen thing.

  7. It's not about “managing to save” them, it's about doing your job to the best of your ability no matter what, which you do.

  8. I thought I had, but it was one of those gummy pieces of meat, the small bit was going down, and the larger one just followed without an invitation. Wasn't talking or anything when it happened. Very scary.The shoulder pain is right at the top of my shoulders and into my neck, not down where they may (sure, who am I to say?) have pummeled my back. And as a CPR instructor here, we are not taught back blows, only standing up or lying down abdominal thrusts on adults. As for anything else, a blur, then darkness.

    But I really did not want to qualify for a Darwin Award. Felt so stupid and helpless. And now so grateful. Sending out waves of gratitude to the universe at large.

  9. Don't be so hard on yourself, Tom (in reference to the last sentence). Heroin addicts are easy to save because you know what is wrong with them and there are meds out there that can help them.

  10. Sharbeans right, mate. It's a piece of piss to secure an airway and bag someone up til the stupid tit starts breathing again…having a child in fine VF (which is pretty unusual as you know) is a bastard and not even something I've ever seen in PICU.Nice style, BTW.

    Cheers

  11. Sorry – I don't know how to contact you.Could you comment on 2 things – 1) the recent pay rise announcement for paramedics

    2) what it would be like to enter your profession for a middle aged guy seeking a chnage of career

    Love and Peace etc

  12. The pay rise announcement for paramedics, whilst being a significant rise, is not the great deal that it's been made out to be, with very little option for improving your pay based on skills and knowledge.The rise for Technicians which is what you would be to start with if you joined the ambulance service, is still to be decided. The offer from management has been thrown out by the unions as it was utter rubbish, and it's now been referred to a national committee. If the rumours are true, and it seems that's the way it will be, techs will be placed in Band 4 of Agenda for Change, so while our gross annual salary will rise to just over 25k, our basic salary will effectively drop from 21,900 to around 19k, with the rest being made up from enhancements – unsocial hours payments, London allowance etc. We'll get time and a half for overtime, but that'll be based on the 19k basic. Plus band 4 doesn't recognise us doing ECGs, giving drugs and supervising trainees.

    To put it into perspective – there are hospital cleaners that are going to be placed in band 4. Enough said?

    Sorry to rant on but this A4C stuff, but it really annoys the Hell out of me!

    As for a middle aged guy joining the job – I personally can't see a problem – on my technician course there was a 50 year old bloke, who completed the course successfully. If you want to do it – go for it! Despite the crap going on over pay and conditions at the moment, it's still the best and easiest job in the world.

  13. No problems (actually, can I nick that for a post?) – you've have pretty much said all that I would have said to Chump.Or much in a much shorter paragraph.

    Agenda for change is one huge screw-up, but the job itself is one of the best jobs in the world, no matter the age/experience.

    I'd recommend this job to most people.

  14. Well, the thing about the last sentence was I was going to say somethng about about there being no God – but thought better of it at the last moment.That's why the comparison is there.

    Reynolds – Providing DVD like extras

  15. Why do you guys waiste youir time with these types of low lifes?Surely your time and effort can be spent on some one more needy

  16. Chump – You have to realise that it's not just about the pay rise – it's about recognition for the skills and knowledge that we have. As technicians, we currently do 12 lead ECGs and interpret them, we give life-saving drugs, and we work with and supervise trainee technicians. The job profile for Band 4 of Agenda for Change doesn't recognise ECGs, the giving of drugs or supervising trainees.The 33,652 quoted in the standard is for Emergency Care Practitioners – advanced paramedics, who will be in pay band 6.

    Paramedics in band 5 will get about 31k, providing they qualify for the maximum 25% unsocial hours payments. Remember I said the deal isn't all it's being made out to be? Paramedic's basic pay will be around the 23k mark.

    Next you'll be hearing that paramedics have received X thousand pounds in a lump sum – that's what they're owed in back pay to October 2004 when A4C was supposed to come in.

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