12 Hours

It’s a Wednesday night shift, which means that hopefully there won’t be too many drunks roaming the streets.  It doesn’t hurt that the weather is, to put it politely, occasionally raining.  I shall be writing what I have been doing every time I get back to station – so if this post seems a little disjointed, it’s because it’s been written over twelve hours.

The first job of the night was just on the edge of my ‘patch’, a woman in her thirties suffering from chest pain.  In people of this age it’s often related to some form of chest infection.  However, when I reached there, the first words out of the relatives mouth was, “She has a heart condition”.

The patient, and her relatives were pleasant to me, but for a person with a serious long-term illness, she didn’t really know a great deal about it.  I asked her what sort of problem she had with her heart, and she couldn’t name it, I asked her about the operation that she was waiting for, and again she didn’t know what it was, or what it was for.  I had to use my knowledge of hospital treatment (“Did they massage your neck the last time you were in hospital?”) in order to work out her previous medical history.

A shame really, patients should be a bit better clued up on what ails them..

My next call was to a location around 200 yards from my first job, unfortunately I’d managed to get back to the station, so I felt like I was on a rubber band.  I was beaten there by the ambulance, so I had little to do apart from making sure that the crew didn’t need my help.  The patient had a pretty standard bellyache coupled with a panic attack.  I did however manage to practice my reading of Polish drug names, translating them into English.

I got back to station, and while writing the first part of this post started shaking uncontrollably.  My legs were weak, and my head was spinning.  What was going on?

I checked my blood sugar…

3.6 mmols!

This is a low blood sugar, our guidelines say that we should give sugar treatment if the blood sugar drops below 4.0 mmols.

I have no idea why my blood sugar was so low – I’d had a big dinner around my mum’s house just four hours earlier.

So I sucked on some sugar, and then got Control to take me off the road for a bit so that a station mate could drive me to the nearest take away shop so I could ‘fill up’ on some longer term sugars.  Chicken chop suey and curry and chips should see me through the night…

I was soon feeling better, so I made myself available for calls.  A few minutes later I got sent to one of our regulars, an alcoholic who had been locked out of his hostel for the night, so he claimed to have chest pain and called for an ambulance.  As this is my first nightshift, I’m fairly ‘chill’ about this sort of job.  There was nothing for me to do apart from chat to him until the ambulance arrived.  It wasn’t raining, and he has always been pleasant towards me, so it was an easy job.

My next job was…Trauma!  A stabbing to be precise.  A young man who had been mugged and stabbed in the leg. Luckily it was a fairly minor wound, and apart from putting a bandage on him, there was little that I could do.  The HEMS doctors turned up in their car, and they were quite happy to leave him in my *cough* capable *cough* hands.  I only had to wait around 15 minutes for the ambulance.

Then I was sent on a ‘chest pain’ job,  but another RRU was there, so it was what we call a ‘duplicate job’, maybe someone up in Control needed a coffee…

A Maternataxi next, she had contractions every 10 or more minutes (and very weak contractions at that) and her membranes were intact.  I was on scene for 50 minutes waiting for an ambulance to turn up.  I was getting so bored that I actually considered reading my ‘Agenda for Change’ booklet.  Apparently there were eight calls in the area waiting for ambulances.

On the way back to station (for a well deserved emptying of my bladder…) I came across one of our ‘make-ready’ people driving an ambulance to the nearby petrol station.

He didn’t realise that he was driving along with both of the back doors open.

As I write this line it is 2am, and I’m conscious that I have 4 and a half hours left to the rest of this shift.  I also fancy a cup of tea…

Forty-five minutes later and I’m racing through the streets to an ‘elderly man, unconscious’.  He is indeed unconscious when I reach him.  Apparently he was asleep with his wife, when he shouted out and became unrousable.  This is the sixth, or seventh time that he has done this, and the hospital are supposedly baffled.  Observing his recovery (looking scared and confused, ‘plucking’ at his clothes), to me he looks like an epileptic who is in the ‘post-ictal’, after-fit state.  The ambulance are thankfully quick to arrive, and he starts to recover as we lift his heavy body down the narrowest flight of stairs I’ve ever seen.

I’m then granted nearly two hours on station, where I have a little doze before being sent out to another elderly man who has been bleeding from his penis for the last 24 hours.  A classic example of the ‘I didn’t want to bother you’ brigade, his house is spotless and he has been married to his wife for nearly 60 years.  It’s nearly 5am and his wife is dressed as if she were going to a Womens Foundation cake sale.  Both are polite and helpful, and more importantly – they laugh at my jokes.

It’s now an hour to go before the end of my shift, and I’m wonder whether to have a cup of tea or not.  I don’t want the caffeine keeping me awake when I go home to sleep, but I am rather thirsty.

Perhaps a glass of water?

It has now reached that time in my shift where the next (hopefully last) job is either going to be someone waking up to their elderly, yet very dead, husband – or another maternataxi…

And as if by magic – 12 minutes after writing that line…

Another bloody maternataxi!  And this one didn’t want to talk to me, refusing to answer any of my questions.  Well, that’s fine, at this time in the morning I don’t particularly want to talk to her…

This time however, the ambulance is a lot quicker to arrive, and I’m left with half an hour until the end of my shift.

Will I get another call?…

The short answer is….No.  Instead the day relief came in quarter of an hour early, and has sent me home.  By the time this has been posted off, I shall be slumbering peacefully in my bed.

Last night is what I would consider a fairly ‘good’ night, a couple of jobs where people were actually ill, a stabbing (although a rather minor one, needing only assessment and a bandage) and with the exception of waiting fifty minutes on the maternataxi, I wasn’t left high and dry by the lack of ‘proper’ ambulances.

And later tonight, I do it all over again.

And while it will be completely different, it will also be the same.

20 thoughts on “12 Hours”

  1. 3.6 four hours after dinner is a bit worrying, but if it helps at all a couple of diabetics I know have had really all over the place readings the last couple of days (anything between 4 and 18!) for no apparent sensible reason, so maybe it's the weather or something.Hurrah for a productive night!

  2. Hrm. So having a near constant “resting” blood sugar level of 3ish to 4.5ish max (unless 5 mins after eating) isn't really a good thing?

  3. I have one of those long term illness thingies and I have to repeatedly ask my doctor to give me the details about it that someone of your ilk would require should I go splat for some reason. I get the impression the GP thinks only hypchondriacs or malingerers should have such an unhealthy (geddit) interest in the ins and outs of their malady.Plus of course when you walk in the surgery there is the giant invisible clock going tick tick tick which if you are there more than a minute, will obviously apply a painful electrical charge to the physician's genitals.

  4. You know more about this than I do but would it be a good idea to be medically checked over? Goose and gander you know.Pat

  5. Re: the hypoglycaemia, what did you have for dinner? Apparently if you eat only low glycemic index foods at a meal it can cause a hypo a few hours later.Did you have any booze that day?

    I'm sure you know all this but thought I'd add it in case you don't. 😀

  6. That's where this internet thing comes in handy – your doctor gives you the name, the internet gives you more information including local support groups (and of course a million and one “cures” but it's probably best to skip them).

  7. Yeah I have a name for it, but he won't tell me specific levels of things when I have blood tests and won't tell me which variety of the condition I have etc. Basically just wants me to bugger off!

  8. I took a blood sugar test (first time ever – not repeating that experience for a while) an hour ago and got 4.1. I was told that a reading of 3 to 7 mmol is normal, but that value varies from book to book. For your build and the work you do, 3.6mmol is probably low.

  9. What does your mum say about your blood sugar level? I bet something along the lines of “You really should see a doctor, you know”. And what do you reply? In all likelihood: “I'm sure it's nothing really”. So what an excellent opportunity to set her a good example!”Yeah, right. As if I have the time”, I hear you thinking. One mum's enough for anyone, so I'll stop the dialogue here, but you know what to do better than me.

  10. finger-stabbys are horrible – I used to give blood and I have no problem with as much blood as they like being taken fron the crook of my elbow, I'm also not bothered if I cut myself, but finger-stabbys for a drop of blood are yowch yowch yowch and I hate them.

  11. Well at least you should think yourself lucky – I still don't know exactly what's wrong with me after 3 years of various tests and appointments and X-Rays. I just presume I've been given tablets to placate me, and to support the NHS from prescription costs. The best 'diagnosis' i've had was polyarthralgia, which is as much use as a chocolate fireguard. I could tell you that a lot of my joint hurt without a degree in medicine.C'est la vie.

  12. If you wash your hands in warmish water rather than cold before hand and keep your hand down for a bit then you don't need to set the lancet on as high a number to get enough blood and I find it also hurts a lot less if you prick slightly to the side of the fleshy bit of the finger tip rather than bang in the middle of it. For what it's worth.

  13. I came across one of our make-ready people driving an ambulance to the nearby petrol station.He didnt realise that he was driving along with both of the back doors open.

    whoops, you cant make this stuff up could you.

    when will they be fitting back doors open alarm to the ambos ????

  14. bleeding from his penis for the last 24 hours. That's it? You're just gonna leave it like that without further comment…holy crap, what on God's green earth would cause such a condition?

  15. If you do it properly it doesn't hurt at all whereas that big needle they use when you donate blood is more a weapon than anything else I hate that

  16. Sorry but I couldn't bother seeing a doctor about that either.. what's the point?If you have chocolate for breakfast or just sweets when you're really hungry it has the same effect. Your bloodsugar level gets too high too quickly = you'll get loads of insuline from your body = the level gets down again quickly = low blood sugar level = hungry again:-)

    That's why they teach you: eat regularly and choose food not based on too many simple carbohydrates

  17. The new trucks have got back door alarms now – well at least on those that the fitters haven't disconnected the alarm because it keeps going off with the door closed instead of finding the fault.It sounds like it was one of the old LDV ambulances which don't have an alarm fitted.

  18. Don't worry, I count my blessings daily. I know things could be a lot worse, I was just commenting on doctors being crap more than anything, in an attempt to explain why the heart patient Reynolds mentioned might have not had much of a clue about her condition.:)

  19. Hi Tom,This low blood sugar thing, another black mark of my scale of normality! Four hours between meals when working as a paramedic technician, is tantamount to self abuse. You should have learned by now that working out on the street, either your own or with a partner is much more stressful than working in the casualty of an accident and emergency unit.

    Paramedics are a bit like angels in that they have to go where most others would fear to tread. They have to treat with kindness and care, some of those that the average world citizen would rather pass on the other side of the street! Dealing with other peoples trauma, whether it be physical or psychological is often traumatising in its self. Not having to deal with real emergencies, such as the half hour or acute belly- ache which in the vast majority of cases is later resolved after a good fart, whilst relaxing or even better walking around the casualty waiting room. But transport is free in a BWT and of course these plonkers and neurotics (they are the ones who are really and secretly infectious!) are under some stupid illusion that ambulance patients get some sort of priority. A little practice at standing in the entry corridors of majors, some times waiting one or two hours before being able to transfer ones patient to a trolley would soon set them straight. Its the same sort of selfish nutters who cause halvoce on the roads by always having to be at the front of any que that cause deaths by the thousand every year as precious resources are squandered on sociopath the socially incapable and irresponsible. As one dear female friend of mine used to say and most likely still does, CUNTS!! As is her right, silently whilst with the patient, saving her very vocal stress release, for the ambulance park of Newham Hospital or on the odd occasion back at station! Of course if you dont transport these pricks and they get all self righteous about the NHS charter and go complaining to Big Brother or Big Sister then one had better look out! One letter from some creative hack, working for the Independent Complaints Advocacy Services, such as the one at the Mare Street Citizens Advice Bureau and which seems to be run by a bunch of failed Nigerian law students and you are init right up to the nostrils. Like I said in a previous comment, there is no quicker way of getting Sue from the Professional Standards Units, knickers in a twist, than to do something like asking Does the patient speak English? or not transporting a belly-ache that lasts longer than the standard hour, the type that only need a casualty laxative and a good —-! Trouble is and always has been and always will be, there is always the one where it is a bit more than bit of wind or indigestion. With your years of medical experience youre not likely to be caught out by the stoical, because you examine the patient and note and consider history and symptoms! But there is also the Wallys! Those who dont notice the obvious and of course the tired and the worn out after a long and exhausting twelve hour shift. People just like you, slightly hypoglycaemic and in need of a little rest and a good feed! Little wonder some crew staff rushes into their stations whilst passing on the way to a call and grab a forgotten sandwich or packet of sugary biscuits. Better to get there sane and safely, than to end up in an RTA on the way or be mentally befuddled on arrival and miss the obvious! Safety first rules the day! You did the right thing, call control and make it their responsibility! If they send you on a call when youre in the state you describe, they would be acting irresponsibly and would have to take responsibility for anything that went wrong.

    Of course irresponsibility and socio-pathological behaviour are everywhere! Even in the LAS Ambulance Control. (Comment, Community Relations). I remember years ago at Newham, when a QAP crew (brothers and now a senior officer of the service!) responded to Call Red Accident given as severe abdominal pain, as Just another Paki with a belly ache! When they eventually got to the scene, having travelled in their usual style, no lights, no horns, stopping at every set of traffic lights and every other zebra crossing before finally applying lights and horns just around the corner from the house (THIS WAS STANDARD PRACTICE WHEN I AND OTHERS ARRIVED AT NEWHAM AS TRAING QAPs. IT WAS ALSO TRUE OF MOST STATIONS IN THOSE DAYS. What did Mr Flaherty, Mr Sayle and Mr Morris do about it! Fuck all! Gutless bastards! They sneaked off to the Training School leaving the shit on the matt and got under cover leaving real men and women to sort out the mess.)

    The trouble with all this grief and what I would call micro-trauma, is the operational Paramedic (not one of those green bag carriers living near the top of Waterloo Ivory Towers), can become subject to many subconscious stresses, anxieties and ultimately to severe depression. I would suggest that its most likely that what you experienced was a bit of post-crapauma, exacerbated by a reduction of electrolytes due to insufficient carbohydrate in your system. It could always be an early symptom of bad news! Four years ago, I was attending an initial assessment with a very attractive middle aged female LAS councillor when she asked the simplest assessment question, “If you had an invisible glass of water in your hand would it be half full or half empty?.

    I was very naive then, These days every glass of water I pick up very quickly develops a leak and pours all over my trousers!, I told her.

    After two one and a half hour sessions, with a real psychiatrist in the same counselling suite, he told me I was suffering from a moderate clinical depression and had done so for a number of years! When I suggested that I was no different from most of the people I worked with he said, I know. Quite a large proportion of them are depressed as well. Its that kind off job! Why do you think the turnover rate is so high?

    When I got back to station, I told various people what the shrink had said and was astounded by the number of colleagues, who the told me that they were taking anti-depressants and all to avoid having to go sick. Unfortunately I have an atopic physiology and can develop sensitivity to various medications. When I tried this strategy it made the situation worse by inducing quite a severe allergic reaction and I ended up off the road for good, so

    Eat well and prosper!

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