Solo Safety

I've written before on how the future of the ambulance service is to have solo responders in cars go to calls, rather than ambulances, firstly to assess and then, if possible, to transport the patient themselves.

It's partly the reason why we have the Zafiras as our FRU's now rather than the Vauxhall Astras. The Zafiras have started to sprout removable seat covers, the implication is that we shouldn't be scared of transporting patients.

I've spoken before of some of the safety implications for this, solo responders get attacked and patients can get suddenly more unwell and need a proper ambulance.

I was working on the FRU the other day and I came across another concern for my safety.

I was sent to a woman in her thirties who had collapsed in the street. She was laying in the middle of the road, shivering from the cold. A couple of bystanders had started to look after her as best as they could, so I suspect that they were glad to see me turn up.

There wasn't an obvious cause for her collapse, although the woman was extremely thin everything checked out.* To leave her lying in the street as the sun disappeared below the horizon would only add hypothermia to her problems.

So I made the decision to sit her in the FRU with the heater turned up full.

Here is my safety issue – all witnesses had disappeared, all it needed was for the patient to make a complaint of sexual misconduct against me and I'd be out of a job. It's dangerous in this world to be sitting in a darkened street alone with a female patient.

I was very grateful when the ambulance turned up.

As someone who had to deal with a frivolous complaint, and as someone who trained as a primary school teacher, I'm always aware of the potential for someone to make a complaint of sexual misconduct against me. It's one of the reasons why I like working as a mixed crew – my female crewmate can deal with anything intimate with women, I can deal with the men.

Imagine if I needed to do a twelve-lead ECG on a young woman – as a solo responder how safe would I feel in exposing the woman's chest? Not very, I can tell you.

It's a dangerous world out there – especially if you value your career.

*It turned out that she had collapsed due to drinking too much – once more I curse my inability to smell alcohol.

I have a day off – so I'll be doing my 'clear my email inbox' today. If you have sent an email and don't get a response by the end of the day, I'd send it again.

21 thoughts on “Solo Safety”

  1. It's clear those who make the decisions don't think of the possible side effects.Do you know how policy is decided in any organisation?All the brass hats sit in a pub for the morning – totally quiet until some minor character shouts he's had an idea. The top dog (without bothering to stop making faces in the froth of his Guinness) just says 'Go ahead – Do it.' Then in the afternoon it's implemented.

  2. Sounds pretty much normal these days. To hell with the potential problems, because if it saves “them upstairs” some trouble, then it's ok… until a complaint does come in!If it seems they will be sticking with this idea, then you should push them for cameras to be installed in each car. I can envisage possible implications to this idea too, but that may just be my cynicism kicking in. Even so, it's not acceptable in any way for them to put you at risk like that.

  3. Hell, we can have three cameras on a bus to protect the driver, why not one or two in an ambulance or FRU…It's just another kind of protection surely?

  4. You should do a FAW course. I did one a few years back and we spent a lot of time on protecting ourselves against accusations of sexual misconduct, sexual assault and racism.We were told that if a male first aider needed to treat a woman, he should have a female chaperone present at all times. He should carefully and clearly explain to to the female patient all that he proposed doing and why, and should only proceed with her informed consent. If she was unconscious or otherwise unable to communicate, the male first aider should explain everything to the chaperone and only proceed if she was comfortable. We should keep everything in plain sight at all times and minimise body contact.When I asked what a male first aider should do in the circumstances specific to my office – where we had one woman and 25-plus men – I was told it would be best to either find a female passer by or await the arrival of the ambulance!We were then told that in the case of Muslim women, our employers should be looking to have a Muslim woman as a first aider to treat them. The trainer told to me not to be difficult when I asked what we should do if we only had one Muslim woman first aider and she was the person needing first aid. He particularly didn't like it when I pointed out the Koran specifically makes exceptions to most of its strictures if it is a matter of life or death.The trainer just about had a fit when another bloke on the course said he worked in the fashion industry and had twice needed to undo corsets when models fainted. Undoing or loosening underwear is a definite no-no!I passed the course, but was left feeling it was totally useless in a first aid sense. These strictures, on top of many others, made rendering first aid difficult or even impossible in many circumstances. On top of that, so much time was spent on legalese that people doing the course had very little time doing hands-on practice of actual first aid skills.

  5. A partial technical fix to the harassment issue might be to have vidcams in the vehicles — or on the responder? — so there's a record of what was done (at least within view of the camera). Then if there's no complaint within some time frame, the record could be overwritten with newer ones. Not being in the business myself, I have no idea whether that would be practical or useful.

  6. Why? It can be kept secure – the tapes are taken back to base and handed over along with the paperwork. It's probably more secure than the paperwork itself, as no one can just glance at it.Another possible advantage of having these cameras around – if there's something visual the first responder needs a 2nd opinion on, they could send a photo to a doctor somewhere. Whether there are actually cases where that's likely to come up, I don't know; someone more medically minded might be able to say.

  7. Confidentiality is the big thing – there may even be specific laws about filming medical procedures and needing consent. And this wouldn't be the implied consent that we deal with on a day to day basis.There is no easy solution.

    It's just down to the person who is there on the ground floor as things happen – that;s part of the 'art' of ambulancing.

  8. Told not to be difficult, I love it. That'll teach you to challenge a teacher.I wonder, when NeeNaw and his co-workers at Control get a call saying “someone's on the floor! Unconscious! I'm not sure if they're breathing!” whether they are supposed to start with “okay, help is on its way, now I'm going to need you to do some things. First, can you check and try to find someone of the same religion, gender, and sexual preference as the patient… no? Okay, I need you to go outside and ask some passersby….”

  9. There is an easy solution – having all vehicles double crewed and having sufficient vehickes and crews to handle all but the most extreme demand.But that would be too sensible and deemed not cost-effective.

  10. Nee Naw and co. do already do this – mainly though it's just for sexual assault/rape where they try to send a crew that has a female on-board.(Haven't come across a male rape, so I don't know if it works the other way around).

    A question to ask Nee Naw – if someone asks for a specific gender crew – do they get it?

  11. I'm sure I've read something wrong there.When you say “Nee Naw and co. already do this”, do you actually mean that in the context of First Aid in the Workplace, when a person calls 999 with an emergency, then before any practical help or advice is given, the call-taker's first step is to ask the caller to go and find someone of the correct diversity combination to perform first aid until the ambulance arrives?

    And that if no one of the correct ethnicity is available, then Stonehead's FAW trainer was correct, and no one should touch the patient until the arrival of the ambulance?!?

    Please for the love of whatever, tell me that all you mean is that *if* there's some choice of crews/first-aiders available, then an effort is made to respect certain preferences.

  12. Of course there is also the other side of the coin – that a female patient who knows nothing about you may feel as uncomfortable as you do in the “alone in car in darkened alley” type situation. A third party is needed for both your sakes.

  13. Good idea, but if that was my with my bazookas out having the leads attached I'd want MEGA assurances that the videos were archived securely unless/until needed – and not likely to end up on a video-sharing service, for example….Given recent data security lapses, it's a tricky one.

  14. “We were then told that in the case of Muslim women, our employers should be looking to have a Muslim woman as a first aider to treat them.” Useful if she's one of the many Muslim women who DON'T wear a scarf…. could be any woman in trousers/long skirt/other modest dress, really, esp. given that plenty of people of all backgrounds convert each year.

  15. Don't be daft, why do the obvious when we can have:all responders living in constant dread of a false accusation;

    potential for the odd case where someone does get out-of-bounds with a patient (dear old Shipman proved that practicing medicine doesn't = saint, as did Beverly Allitt).

    We can then deal in the classic manner of this govt by making surveillance the answer, lose loads of videos which end up online, thus causing some people to avoid calling for help even when it's badly needed…. and on we all go, doing anything but fixing the problem.

    God, if cynicism was a disease I'd need an ambulance right now, but this is just SO predictable….

  16. I remember many years back having to call my (male) GP out on an emergency call (serious UTI, I was feverish for days) where he had to palpate my lower abdomen.I was really ill, and his obvious (and totally reasonable) discomfort about having to examine me with no-one else present just added to an utterly depressing experience.

    So it goes all ways with that, and yes I wouldn't be thrilled under some circs having a male medic prodding some bits of me in a car!

    Plus what's to stop someone with a camera phone (read: everyone under the age of 65) filming it all? What's the provision for privacy in the cars?

  17. Better safe than sorry but I think:It's also about empathy: If I have an 18-year-old girl with a panic attack I'd rather make my horse shit in front of the pharmacy (a saying in our language *lol*) than putting her on a 12-lead.

    If it's a middle aged woman with palpatations (how do you spell that word?) but a clear, healthy mind it doesn't really matter coz it's unlikely she'd even think about pressing charges agains me (if you can see where I'm comin from).

    Just the other day my (male) crewmate and I were dealing with a 25-year-old (unusually pretty) girl, a tourist from Denmark, who had been found unconscious in the local church(!) toilet.

    When we closed the doors of the truck she looked at us as if we were going to rape her any second. Initially she wouldn't even take off her scarf but she was very pale and had a bit of heart history. So what do you do? Obviously we tried to calm her down and to appear as harmless and professional as possible (I succeeded, my crewmate didn't ) yet after she had taken off her coat for BP check she kept holding on to her cloths as if we were gonna steal it or something, it made ME pretty uncomfortable to be honest and I already saw the paper headline infront of me. Not nice.

  18. I think I've stuck that reply in the wrong thread, or just written in wrong (My excuse – more man-flu).What I mean to say is that Control only really do this if there is a specific reason to – say in the case of sexual assault. Although I do think they try if the patient/caller specifically asks for it – but that they don't guarantee anything.

    Again – I think Nee Naw is better placed to answer this.

    (But yeah – that reply came out a bit wrong)

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