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Tonight I have been driving around going to Maternataxis, and a man who's legs have been twitching…

…since June.

I'd also be grateful if someone could please explain to me how you can get to 56 years old and think that gastric reflux is the same thing as choking to death.

Twice she asked me, “So you are sure it won't kill me?”.

Then there was the person who regularly fakes an angina attack so he won't have to walk home after going to the pub with his girlfriend…

Don't ask about the hate-filled drive to a Maternataxi while my tasty-looking dinner was getting cold on station.

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While I have been going to these non-emergency cases, someone was stabbed to death about 400 yards from my ambulance station.

It's not that I missed out on an 'interesting' job (and trust me, I'm trying my best not to sound ghoulish about it). Instead it's that we have to send ambulances to so many calls that don't actually need an ambulance, and that my “for utter, utter emergencies only” unit is going to such complete and total **Expletive Deleted**

Twitching legs since June, or serious stabbing, which would you rather be sent on?

It's a good job this is my second, and not fourth night, otherwise I would be wanting to make with the stabby

32 thoughts on “Expletive Deleted”

  1. But this is London. There's a fair chunk of people with more cash than they know what to do with, and who'd happily drop 50+ for the extra peace of mind they'd get from a Big White Taxi. Especially for labour, when it's the health of their new kid.

  2. I am guessing twitchy legs man answered “No” to the question “Are you breathing normally?” This is a bit of a stupid question (in my opinion “Are you having difficulty breathing?” would be much better) but it is part of the protocol so we (call takers) have to ask it. People, unfortunately, cotton on that giving the “right” answers to these questions get you a quicker response. It's not at all uncommon for something stupid like toothache to come out as a category A “breathing problems” call and for me, as a call taker, it is EXTREMELY frustrating. I feel like writing “sorry, ambulance crew” on the ticket before sending it up.If the patient said yes, he was breathing normally, then it would probably get a category C and Telephone Advice could ring it back and tell them that they should call a GP/taxi/whatever instead.

  3. I don't know — a lot of the timewasters give “But I can't afford a taxi! I'm on benefits you know!” as good reason why they should be sent a nee naw. I some people would do what you're saying, but the embarrassment of being issued an “inappropriate use charge” might put some of them off, and the 50 fines could be used to raise call takers' wages buy more ambulances.

  4. Exactly as you say – I got the call as a “Severe Difficulty In Breathing”.I've given up asking, “So where is the difficulty in breathing then?”

  5. and breathe. Find the happy place. As for the expletives, say 'em loud and say 'em proud, although there probably aren't enough appropriate ones for a night like that.

  6. Try looking at jursey (yes the uk one) amb service idea. They charge 80 for ambulance to turn up. Strangly, they only get real cases there, ort at least fewer idiots.The real cases stil call as its “Sod the cost in need one NOW” time, but the others tend to find its cheeper by car or taxi. Perhaps this total free at point of delivery is not as good as its cracked up to be, just imagine all those that call for a free asprin how shocked would they be.Wopit

  7. Trouble is, then the old dears who can't breathe or are having severe chest pains but 'don't want to bother anyone' would have even more reason for not calling when they really need to.

  8. the trouble is, the public should have been educated years ago about what the Ambulance Service is for and isn't for.Look what happened on the 7th July, blanket messages saying only call us in life threateneing emergency situations…. i don't know what happened that day, but i bet the the number of “oh my god, i've chipped a nail, i need immediate transportation to the nearest intensive nail care unit” calls was zero

  9. grr. i had to leave teaching because of a lack of ability to deal with idiots. i think (as i said about a similar collection of idiots on neenaw) that these people should be stamped permanently with “idiot” across the forehead so that we can spot them in the future…

  10. I think in Australia (any Australians reading can tell me if I'm right) they charge you for an ambulance if you call one for a stupid reason but it's free for genuine emergencies. That is certainly the system I'd like to see in place here — plus a way of educating people about what does and doesn't need an ambulance. A lot of these timewasters genuinely believe that calling 999 for an ambulance is an appropriate thing to do when someone has flu/goes into labour/etc and I think you'd get rid of about half of them if they knew it wasn't. It would also help greatly if us call takers were allowed to explain that to them.

  11. Correct — I was call taking that day and from about 11am onwards the call rate just stopped dead. It was eerie.Thing is, people should only call is in life threatening emergency situations anyway, irrespective of bombs.

  12. Ah, “different country same story” is spot on! In Melbourne Aus in recent months i've been sent code 1 (lights and sirens) to an old bloke with a cut lip (“potentially dangerous bleed”!!), 39 year old guy severly pissed and who collapsed- “potential CVA” (“pfo” or pissed and fell over we would say) etc etc something seems to get lost between the call taker and the patient! Our major problem is those who see the ambulance as a free “big white taxi'. If you subscribe in Victoria for $100p.a you are covered for all trips and if you're a pensioner/health care card holder its all free so why not call!Still its a great job and we treasure taking care of the real sickies

  13. Nee Naw thats my point exactly, the public are not really stupid (ok ok ok, i might have lied about the last bit) but if they're educated, they would know what to do…… that day they received continuous information about what to do, and if they did it that day, what can't they do it for every other day.But then some number cruncher would go…..oh, why have you got XX number of ambulance for only XXX jobs……… its a no win situation

  14. Right now we have too few ambulances for the number of jobs, which is even worse. The calls that really suffer are the “doctors' urgents” which are ambulances booked for 1-3 hours' time by doctors, usually for elderly patients with pneumonia, broken hips, DVTs etc etc being admitted to hospital. We have to deal with the “emergencies” or broken nails, stomach ache etc before we can deal with these calls, and they often end up waiting much longer than they ought, even though the patients are much sicker than the so-called emergency patients.

  15. Actually, I have gastric reflux. On occasions, it can be extremely frightening as it takes a while before I can breathe again. More than once I've been afraid of not making it. The last time, even my partner was starting to panic.

  16. But why would the despatchers even send you to the guy with the twitchy legs?? Surely that's not entirely the caller's fault?

  17. I suffer from the same frustrations as you, at times I just cannot comprehend how someone can genuinely believe that they are a life threatening emergency and justify the resources they are using up. The best way I have come up to with dealing with it, and I'm pretty easy going, not much winds me up which helps, but you still get paid the same rate if you are doing a job where you don't even need to crack open an O2 mask or a proper working job which every single piece of kit you've got (including the ceiling of the ambo) gets covered in some sort of bodily fluid.

  18. My WBT sometimes asked “are you having trouble breathing normally because of the pain or because you are having difficulty breathing” That kind of questioning tends to weed out some of the rubbish but I'd probably get a slap on the wrist from QA!!There's a huge difference between “it hurts to breathe” and “difficulty breathing” Stupid American protocols!! (I love america really!) Just wish we had a completely UK system that was catered directly to our needs as opposed to those of an overly litigious society!

  19. I blame NHSdirect and over-cautious procedures for my last ambulance – I'd been having chest pains for about an hour and my painkillers weren't helping, so I called NHSdirect hoping they could suggest, oh I don't know, breathing techniques or stretches or something. Instead…”Do you have trouble breathing?”

    “Not really, it's just a bit tight.”

    “Do you have pain in your arm?”

    “No.”

    “Are you pale or grey, particularly your lips?”

    “No – look, there's nothing wrong with my heart you know…”

    “I'm sending you an ambulance.”

    “But I don't need one!”

    “Sorry, I have to send you an ambulance.”

    Cue two paramedics dashing to my flat and finding an extremely embarrassed little me going “I'm really, really sorry…”

  20. Perhaps the protocol should include the question, Do you understand that if you demand an ambulance for a condition that isn't life-threatening, someone else might die?After all, we get nannied in everything else we do.

  21. According to The Training Department you are not supposed to do that, although I must admit I do it sometimes too.I sprained my ankle a while back and all I could think as I was bundled into the (standard, not Big White) taxi was “puff, pant, oh, I see what they mean about 'not breathing normally now', puff, pant, ouch”…

  22. That'd be good. Except it should be worded 'You realise when we send you an ambulance for a bloody papercut some poor bastard gets left lying on the freeway in a pool of their own blood getting run over by more cars, plus we come round after and tell all your neighbours what a scumbag you are.'

  23. Misuse of ResourcesThis blog could just as well be called, random acts of stupidity. I am not just talking about the patients. How long did it take to establish a presence and for the first ambulance unit to arrive on scene at the fatal stabbing?

    I agree with batsgirl, sometimes you just got to let it, fucking, rip! In these sort of circumstances a good long rip. Very good for maintaining optimum mental health! And I should know!

    You are going to make my dissertation on, The Real Response of the London Ambulance Service to Accidents and Emergencies; With Particular Emphasis on The London Borough of Newham very hard work. I do hope the local Members of Parliament and councillors start logging in for your current birds eye view of the underbelly of emergency care.

    Who do you blame for all these Fuck-ups and foo-bars? It is not really controls fault; the majority of controllers do good work. Of course even they can have a bad mental health day and mistakes are made. Mistakes that cost lives and limbs!

    It is the system that is at fault, a historical truism reinforced by the previous failures of the mark 99 model of the system of allocation and the 98th, 97th etc. The trouble is that the bread and butter work creates a kind of fog of war, and that coupled with the stress and strain of dealing with the dichotomy of who gets priority that leads to break-downs of logic.

    The London Ambulance Service along with all the other emergency services, right down to the Automobile Association, is usually at its best, when the shit really hits the fan. Within minutes of a major crisis all the services become fully-focussed on their primary function, the protection of property, maintenance of good order and the care and control of the victims of crisis, in all its forms. In these situations the Services response is always appropriate to the event. The LAS like all ambulance services is part of the strategic reserve. The Service always has to be on the lookout for situations which could be the spark of crisis, the first flicker of a major disaster and on a London wide basis. With this in mind there must always be a strategic reserve vehicle available, at virtually a moments notice to be dispatched to the scene of potential disaster.

    When the solo responder or Rapid Response Vehicle role was first instituted by the then Chief Executive of the LAS, Mr John Willby back in the early nineties, this was the main selling point presented by senior management to operational staff, as justification for introduction of the role. Additional funding was provided by government in order that this vital function would be initiated. There was some staff resistance to its introduction, but every occasion when the only available ambulance had to travel a considerable distance to the scene of potential disaster reinforced the usefulness of the rapid response unit. I have been in this situation all too often and on arriving on scene and witnessing that a solo was already there has gladdened my heart. Many of these incidents could have been described as turning out to be minor emergencies, an every day convey to hospital kind of job, but all to often they had the potential for disaster. This is the primary role of the solo ambulance unit, to investigate and through establishing an on-scene presence to relay information and orders back to Ambulance Control. The person performing this function becomes the focal point and embodiment of the Emergency and Accident arm of the London Ambulance Service. Once the potential of any situation has been established, the appropriate action (operational order) can be initiated and followed. What ever the end product of such action, whether one or many patients have been treated then dispatched to hospital, the ideal solution would always leave the Rapid responder still on scene and in a position to provide a near instant response to the next, potentially disastrous situation.

    During my seventeen years service, I was regularly dispatched to distant and real emergencies and when I requested if the Rapid Response Unit had been dispatched, all too often the answer was in the negative. Later enquiries as to what the RRU had been responding to at the time of my real emergency and usually it was some piece of drivel.

    Childbirth is one of the most natural events and most babies deliver by the mother themselves. They do that by pushing and most are well equipped for the task. Although each and every one of them has a potential for disaster, once the level of potential has been established, a function which in most cases should be resolved on the telephone, the prospective mother or her carers should be directed to make their own way to the local maternity unit, either by use of their own transport or by licensed taxicab. If the patient has no money at the time of the incident the Service should provide a contract taxi at public expense and reclaim the money at a later and more appropriate date.

    That you were dealing with a bog standard maternity case at the time of the Stabbing event is culpable and a perfect example of inappropriate allocation of a precious recourse.

    To any family in the land, serious illness or accident to a member of their family automatically become a major incident and a potential disaster. If the Service does not respond properly to such an incident, whether as the person on the ground or the person in Control, then there is justifiable cause for complaint and such failure brings the reputation of the Service into disrepute. This is an offence under the Services code of conduct and its general moral and ethical responsibilities to the people of London.

  24. Nee Naw is quite correct, its the urgents that pay the priceWhenever I ever met people for the first time and they became aware what I did for a living, the inevitable question was not long in being presented. How dose one cope with the blood and guts? Vomit and the shite? Simple, I would tell them! Its their blood and their guts. Their vomit and their shite! I dont find these things particularly traumatic, because its happening to them! I have attended numerous urgent calls all over East London and too often came across serious illness which was well past its sell by date, and we had been dealing with rubbish for the last three hours. These calls can be traumatising! One is left with ghosts in the machine. Too many visual and emotional memories of what it can be like and eventually will be like to be old, fragile and unwell.

  25. The system varies from state to state. In Victoria all pension card and health care concession card holders recieve free treatment and transport. There is also a subscription scheme which provides 100% coverage for emergency treatment / transport (including air wing) and authorised non emerg transport.For everyone else it is around $300 for ambulance attendance, and a minimum of $700 for transport. As you can imagine AME and rotary transport isa bit more exspensive.

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