21 thoughts on “Roll With It”

  1. That's interesting – I didn't know much about how the US medical system worked, so thanks for posting that.When a police, fire or EMS vehicles has lights and sirens on, everyone gets out of the way, and cars that don't have anywhere to go are authorized to run a red light, drive the wrong way or do whatever is necessary to clear the way and then immediately pull over. Is this not the case in the UK?

    Good question. I don't remember anything specific from my driving lessons, beyond the basics of “get out of their way”, which would normally mean “pull over to the side of the road as soon as you can”. I've had a look at the Highway Code, and the section on Emergency Vehicles has two relevant comments:

    29: Emergency vehicles. If an ambulance, fire engine, police or other emergency vehicle approaches using flashing blue lights, headlights and/or sirens, keep off the road.

    194: Emergency vehicles. You should look and listen for ambulances, fire engines, police or other emergency vehicles using flashing blue, red or green lights, headlights or sirens. When one approaches do not panic. Consider the route of the emergency vehicle and take appropriate action to let it pass. If necessary, pull to the side of the road and stop, but do not endanger other road users.

    So, there's nothing specific about actually breaking the normal rules. I also came across a tabloid newspaper report about someone who supposedly got into trouble (fine/points on licence) for going through a red light to let a police car through, but I don't know the specifics of that case, so it wouldn't surprise me if the details were misreported.

    I'm doing a driving theory course with St John Ambulance in a month or so, and hopefully that will tell me a bit more about the rules in this situation. But as it stands I'd say that even if there are rules set up then most people don't know what they are.

  2. The NHS is funded out of general taxation. It's a bit like asking “how much of your salary is taken to pay for the White House gardeners?”This article (http://observer.guardian.co.uk/nhs/story/0,1480,616951,00.html) reckons that it costs about 1000 per person per year for the NHS (or about $1800). The thing is that everyone knows the NHS is free at point of delivery, and so it gets slightly abused. However, I do think that the benefits out way these drawbacks – if you get cancer, you will be covered. Doesn't matter if you have been made redundant, forgot to pay your premium this month, or there is some exception in the T&Cs. There are no deductibles – nothing to pay at all. Cost is not really an issue (except in some very rare cases). There is however a fixed charge for prescriptions everything is about 6, no matter what the doctor has prescribed.

    As for your other points – there are waiting lists for things like hip operations, but good ol' Tony is working away at the problem. It depends on your GPs practise (Primary Care Practitioner or whatever your term is!), but it can vary between having to ring on the day (ie, you can't choose to wait), or a few weeks as you say.

    Once you are qualified as a doctor, you earn a good wage in the UK – its the people like the student doctors, nurses and EMTs 😉 that don't get paid enough.

    As for education – its a normal (but long) degree. The (very) new student top up rules mean that you may have to pay up to 3k a year, but this is not paid up front, and is instead taken out of your pay packet when you get a job. Obviously, for less well off people, this is graded, and there are also grants and bursaries.

    HTH. Say if you have some more questions and everyone else correct me where tiredness overcame me!

    Martin

  3. Strange ad. The text in it looks like it's been grafted from 50 Cent's back. The road's look wide and clear though. Obviously not shot in Newham.Also, the close ups of the eyes look like ben affleck. I did wonder what he'd been up to since Gigli and Daredevil

  4. All those flashing lights. So many colours. The way out sirens. No hassle. Just plug in the electric shocky thingy and BAM. One live patient. No blood. No jammed roads. Clear track through casualty. No having to dodge trolleys loaded with near dead patients in corridors. It's such a great life.More chance of getting shot though.

  5. I'm confused. What is the unusual part? Of course, the music and graphics are a little silly. And yes, that is the normal width of roads in cities and suburbs. As far as clogged roads, it is the law here for people to immediately pull to the outside of the road and leave the inner lanes (even the other direction) open. When a police, fire or EMS vehicles has lights and sirens on, everyone gets out of the way, and cars that don't have anywhere to go are authorized to run a red light, drive the wrong way or do whatever is necessary to clear the way and then immediately pull over. Is this not the case in the UK?As for getting shot more often, that is something I would have to look at the statistics on. I've never worked a shooting that came from a legally owned gun. From what I've heard, while guns are illegal in England, illegal guns are still available if you know where to look. I've never had a paramedic or EMT shot. Any scenes that sound dangerous automatically have a police car sent to secure the scene before ambulance crew are let in. (And police have training in things like CPR and massive bleeding so they can briefly attend to the patient until the ambulance crew can get there.)

    As for dace's credit card comment, I'm not sure if it was tongue in cheek or not, but I've run into quite a lot of misconceptions about our health care system, so I'll respond as if it was a serious comment. At no point during emergency treatment is a patient asked if they can afford to pay. They may be asked if they have insurance, and what kind if it isn't urgent, as the ambulance crew knows that somewhere down the line the patient will have to pay, and insurance companies may pay more of the bill if the patient is at the “right” hospital. That is waived in a true emergency, and they are taken to the nearest facility that will handle them. Every hospital in the country must post signs either in the ER waiting or triage rooms informing patients that they have a right to medical treatment, regardless of their ability to pay. True, we don't have a true national system, but we are able to choose from multiple plans if we have the money, and the poor recieve medical insurance from state and national programs. Because there is a charge (but usually little or no enforcement) for an ambulance, people tend to call more for true emergencies, and maternataxis are rare (unless you count complications). I have never in my life sent or recieved an ambulance that took more than 6 minutes. If we are ever tied up, we can turn to a private company to take additional patients. Many hospitals have their own, and private companies often have contracts with nursing homes and other high-volume areas. Most notably, all of our ambulance crew are also firefighters, so when we recieve confirmation of actual flames sighted, 2 private ambulances are called for (one to check occupants of the building for smoke inhalation, and another to wait at the station for the normal ambulance calls), and whenever one of them recieves a call, a private ambulance starts on its way to the station. For a one-mile square area, I had access to 30 ambulances before having to ask the adjacent city to send ambulances.

    While it would be nice for everyone to have full and complete (including preventative) care, I prefer knowing that I can always have access to an ambulance in an emergency, that it will usually get there within 4 minutes (the magic time they tell us that it takes a major artery cut to bleed to death), even if it takes me a year to pay it off later. I like knowing that we can prosecute people who purposely fake calls. (Claiming their baby isn't breathing when they haven't got a baby, not for someone who might honestly believe something dangerous had happened.) Many community programs exist on a free or sliding scale. Once a year, many local hospitals and other groups sponsor “health fairs”, where for as little as $5-10 US (or less if you qualify for low-income assistance, or have insurance which prefers to pay the lower bulk cost for these tests), you can have a full physical, including a blood draw which scans for 50+ different indicators, and your results are given back to you with directions on who to follow up with. ie, 4 pages of nonsense to the layman, with a summary at the beginning that tells them, “your thyroid levels are abnormal. This could be an indicator of a serious, but easily treatable condition. Please show this packet to your doctor. If you do not have one, here is a list of clinics close to your home which offer free or sliding-scale payments…”

  6. Wow, what an ad. I can only think that recruiting in the Black and Latino communities is a really good idea.But then I think about Bringing out the Dead, and EMTs I have known who report low wages and abysmal working conditions…

    Still, the ER nurses I know think rather highly of the EMTs they work with.

  7. John Kirk:Hmm…that article does seem to suggest that the rules are different. Here, we are taught to pull over as soon as possible (on major highways, slowing to 20 below the limit in the far right lane until the vehicles are past generally suffices). If you are uncertain where the best place for you to move would be, you are advised to stop wherever you are and wait for the emergency vehicle to advise you via loudspeaker. So long as you don't do anything to put people in danger, you're generally exempted from any punishment. If all else fails, the traffic prosecutor can dismiss charges “in the interest of justice.”

    As far as the medical system, there are admittedly gaps. Since all but the poor do have to pay for their medical care (and prices of those who can afford to pay are raised to compensate for those who can't pay), some choose to forego preventative care because it isn't free. I do wish there were more free preventative care available.

    In the States, here is what I have been told of national health care in the UK: Medical care and prescription medications are free of charge, but non-emergency visits can take weeks or more to get an appointment. Also, I have been told that medical staff are very underpaid, but I have also heard that you may be able to go to school for free or very low cost if you intend to work in a medical profession. I'm assuming that parts of this are true, while parts are not. Anyone able to help me out here?

    speravi (and anyone else from a country with a national health care system):

    I wonder, what is the perception in your country of the US's health care system? How much of your salary is taken out to go towards the health care system? (Personally, I pay about $20 US per doctor's visit for things like annual physical, and $5-15 US for a month's worth of prescriptions. If anyone in the US has medical costs that equal more than 7.5% of their pay, there are special tax programs that let you pay less tax-which to me sure seems like a government subsidy, although far less.)

    One clarification: I posted before that all “our” ambulance workers were firefighters. That's not true everywhere in the US, but it was in the city where I dispatched. Each city handles their structure differently, but there is generally a mimnimum level of medical training that all firefighters have to have as part of their certification.

  8. About people tending to call only for more serious conditions – I believe, in all honesty, that's a rural / suburban thing. Get into an urban area, where poor people are less likely to have a car or cab money, and get ready to run your a** off on BS like that.People are pretty good about the roads, though – that brings up something else interesting; do you all “roll with” Optocons? (e.g. in major metro areas and even increasingly out in the suburbs, our approaching ambulance throws any 4- way intersection light to stop-all-ways with an IR beacon. Best. Thing. Ever.)

    And, yes, it is strange culturally to see so many postings about the LFB as a completely distinct entity; you'll notice from the video and elsewhere that it's not at all uncommon (indeed probably slightly more often than not, especially in all-unpaid-volunteer systems,) that Fire/EMS are one department. (Your St. John's seems to be a sort of auxiliary service, not sure what it's like out in the hinterlands, but in the US outside cities of about 50,000+, your EMT is likely to be an unpaid part-time cross-trained firefighter. Even paramedics, actually. Paid and unpaid EMS have , usually, identical training and equipment, dispatch, etc. I've seen anecdotally that your coastal rescue service is somewhat similar? (in that you don't seem to governmentally run it like a Coast Guard, but instead have municipal volunteer corporations? I could be very wrong, here.)

    It does go a long way towards facilitating things like vehicular rescue / landing sites / mass casualty incidents, etc. that I can grab anyone on scene in a turnout coat, put them in the ambo, and there's an EMT who knows where all the stuff is (or alternately drive the truck or land my helo, all on the same frequencies, 911 system, etc.)

    The police are a whole different bag, attempts to integrate that have usually failed badly, but from our perspective, it seems that the Fire / EMS / Rescue roles have so much overlap that there's more to be lost than gained by seperating them…(intra-discipline bitching aside.)

  9. Some nice comments asiji, thanks for taking the time.“If you are uncertain where the best place for you to move would be, you are advised to stop wherever you are and wait for the emergency vehicle to advise you via loudspeaker.”

    Heh – they wouldn't trust us with loudspeakers… Too much swearing for a start off. And I dread to think what tricks some of us would get up to with them.

    We also don't have the 'traffic light changing boxes', although I think some fire services have them. We just take our lives in our hands and treat red lights as 'give way' signs.

    I must admit, when I've visited the American continent, I've been impressed with the big roads, and how quickly people get out the way for you.

    With regards to the advert, it's the whole 'gung-ho' aspect that made me laugh, along with the 'To ride with us, you need to have badass in the blood” (or words to that effect).

    The one for the LAS would have various intercut scenes of us…

    Poking a sleeping drunk in a park with a stick.

    Sweating our bollocks off carrying a heavy patient down 4 flights of stairs.

    Having a drunk throw up in the back of our truck.

    Watching as someone rolls around in their own urine.

    Ticking off a nursing home for doing something incredibly stupid.

    Trying to finish a cup of tea while whizzing around on blue lights.

    Dealing with a cough that someone has had for three weeks.

    And of course…

    Picking up women in labour who's duration between contractions could be measured on a calender.

    Just me being cynical.

  10. Oh yes…and when they 'shock' the fella, the 'base' paddle is on his shoulder…not a good place for it to be.And the only time my 'heart is in my throat' is when I'm gasping for a cup of tea and I manage to get within 100 yards of station.

    Heh-heh…

  11. I think that the drivers didn't contest the tickets – because I would suggest that any magistriate hearing the case would discharge it.I may be wrong, I'm not a lawyer.

    Either way – if you get the ambulance crew involved (and they can be found) then I'm sure they'd stick up for the driver.

    I would also suggest that there are a large number of drivers in Newham who have not only, no driving license, no road tax and no insurance, but who have also never even heard of the Highway code.

    Just personal experience mind you – I have been to more uninsured RTAs than insured ones…

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