Ambulancemandan

A second public service announcement....

2015-03-27T11:57:00.001+00:00

I was going to write a long spiel for this post about the 999 triage system, but I have since come to realise that there are several different one in operation, from AMPDS, to NHSPathways and others. These are clever (if not computer orientated) triage systems and have changed "since my day". This is however not a cop out and I feel the need to delve deeper. What I can say for now is this...

The questions the call handler asks are relevant.

The questions do not delay your care, but are aimed at enhancing it.

If a call is identified as life threatening, which happens at the beginning an ambulance is immediately dispatched.

Call prior it can go up as well a down.

Please help the call handler, which in turn helps us, by answering truthfully and politely. Rudeness towards staff is never acceptable.

It's short I know and hardly informative, but hopefully more to follow at a later date!

A public service announcement...

2015-02-23T19:49:00.001+00:00

In recent weeks I have come across some confused and frustrated patient who didn't know which telephone number to call for medical assistance, resulting in apologetic 999 calls.

There are a few numbers to call for help and below should help to clarify that, so first, 999.

The 999 emergency number, launched in 1937 was the worlds first specific emergency only telephone number and reportedly recieved under 1400 calls (Holland 2010). Now ambulance services alone recieve more calls daily. This is the number to call to contact the emergency services, Police, Fire, Ambulance, Coastguard and Mountain/Cave rescue. Examples of appropriate calls include a crime in progress, a fire or road traffic collision, a patient not breathing or someone in trouble in the sea.

From an ambulance point of view 999 should be used for :

Cardiac Arrest (patient unconscious and not breathing properly),

Unconscious Casualty,

Chest Pains,

Supspected Stroke,

Severe Asthma and breathing difficulties,

Anaphylaxis (severe allergic reaction)

Convulsions,

Traumatic injuries and Road Traffic Collisions,

Other medical emergencies requiring immediate assistance.

There is now another number to call for medical advice. That is 111. This system was introduced to replace the variety of different numbers for advice, GP services and other medical needs. If you need medical advice or out of hours wish to reach a GP this is the number to use. You will speak to a call handler who will screen your call to identify any immediatley life threatening problems before being contacted by a clinician who will determine the best course of action for you call, be it advice, a GP appointment or an ambulance attendance. This number should not be confused with 101...

More and more patients are confusing 111 with 101, the national police non-emergency number and 112, the European Standard Emergency Number. Whilst 112 will get you an ambulance, it may not get you the most appropriate care and could result in an ambulance attending unessasarily. 101 will allow you to speak a police call handler, who if identified that you need medical assistance will pass you to the ambulance service, but ultimately will delay your care.

The next post will bust some myths around what happens to your 999 call! Watch this space!

The first hurdle

2013-10-06T02:57:00.001+01:00

So I did it. I actually went for a run. The wife even laughed when I said I was going, but go I did.

I found a park at the top of town that has a nice circuited path, that is about half a mile long. It's also far enough away from my house that the neighbours won't see me!

Anyway, I decided in order to break myself in, so to speak, to do a mix of walking and running (I've heard that's a good way to warm up and get started...) Last thing I need is to collapse with chest pains and have to explain to my colleagues! So off I went, five minutes of walking then five of running etc etc. Forty minutes later, quite frankly I'd had enough. I was hot, thirsty and my legs hurt....I had though, run about 1.5miles in total! Yay me! Feeling rather chuffed I went home in a sickeningly good mood and had a cold shower (I've heard that's good for recovery?!).

In order to track my progress I thought I'd share with you some vital stats. When you read the following, imagine it's being displayed with a rotating photo of myself, NFL Style...

So, I currently weigh, if I'm being kind to myself, 85kg., I'm 5'5 (and a half) and have a 36" waist, which means I have a BMI of 31. So I'm overweight. This I knew. I eat too much. I like food!

My Resting heart rate rate is 78 and my last blood pressure was 131/78. I "ran" a mile in 14 minutes (this isn't wholly accurate 'cos I like totally walked some of it!). I'm hoping that all these figure are going to drop. Obviously not my height. There is nothing I can do about that, I've made my peace there...

So, on Monday morning I'm going out again. This time, I'm going to see how far I can run before I have to stop, just to set a bench mark there! I'm hoping I can manage at least a mile. I have some learning points from this week though.

1. Take water

2. Cycling to and from work the same day, means the next day I will hurt!

3. Cold showers are horrible!

Onwards and upwards!

Big ideas, small begginings

2013-10-02T12:53:00.001+01:00

I have decided to do something daft. Allow me to explain...

Earlier in September I watched my Sister and three our friends, Martha, Sophy and Lucy run the Bristol Half marathon.

This has inspired me to do the same. Now, naturally, in my line of work I'm not unfit. I mean, I'm not at a peak level of fitness by any stretch, but with regular cycling to work and the demands of the job I'm no couch potato. However I detest running. I'm not a runner. At school, I cam last in any event that required running and I have been frequently heard to complain that running should only be used to get away from fire and lions...

So why have I decided to do something that I hate so much?

Well, my sister and our friends managed the half, some with minimal training and really enjoyed themselves. They also raised £1000 for BIBIC, the charity for brain injured children. They also have a memory to look back on and say, 'I did that...'

There's also the charity element. It's a great way to raise money. I have a charity in mind, I've not told them yet, but in my mind it's the perfect one.

So, here's my plan...

I have 50 weeks until Bristol Half Marathon 2014. I am going to blog, weekly about my progress, the pain and the fundraising. All I need you to do is keep reading, supporting and donating money.

Am I crazy? Yes!

Am I motivated to do this? Yes

Is it going to hurt? Absolutely!

Wish me luck

Next blog to follow...

Advice, Tips and Guidance for (new) Student Paramedics

2013-08-22T17:42:00.001+01:00

There are an increasing number of universities now offering Paramedic courses and therefore that means more student paramedics. I thought it may be helpful to pen a 'tongue-in-cheek-with-a-element-of-truth' piece for our newbies. I have has the privilege of mentoring a student through the last 3 years and also can remember what it was like for me starting out as a trainee Technician all those years ago. Setting the record straight, I'm not against the student paramedic route, nor am I solely in favour of the 'old way', both have pros and cons. Anyway, here goes, Ambulancemandans' Advice, Tips and Guidance for student Paramedics:

1. Firstly, congratulations on achieving your place at University, you've already gotten through the first hurdle. You've entered into a highly competitive market now though, so the hard work has just begun...

2. Ask yourself, "Why do I want to be a Paramedic?"

If your answer is "So I can drive around really fast on blue lights and go to lots of car crashes and stuff" Stop now. You have picked the wrong job. Perhaps Firefighting is more your calling?

However if you answered along the lines of "to care for mine and the wider community, day or night, dealing with a variety of people with sometimes complex medical, social and psychological needs as well as being equipped, trained and ready to save the lives of those afflicted with the most serious medical and traumatic injuries often at the expense of my own personal well being, social and family life" then proceed to the next point.

3. This isn't your usual University course. You will have placements all over the area. You will spend time in operating theatres, GP surgeries, psychiatric wards and in ambulances. You will "work" shifts 24hrs a day, on birthdays and bank holidays. Come rain or shine. On top of that you will need to study, write essays, reflective practices and attend lectures. It is going to be hard work.

4. In light of 3, take the chance to rest. You will be tired and stressed. Join a Uni social club, a choir, sports society somewhere you can de-stress and talk about something other than Paramedicine.

5. On placement you may come across people who expect you to know everything from day one. They may be short with you or treat you like a fool. This is not your fault. Do not take it personally.

6. On placement you will come across people who are excellent with students, who will teach you, encourage you and challenge you. Learn from these people.

7. Be nice to your paramedic mentor. They do a lot of work for you for nothing extra from the service or Uni. Sometimes, donuts, cake or Thank you is appreciated.

8. If you do not understand something ask. If you're not sure on a procedure, ask. We have all been in that position.

9. If you're stressed, scared, tired, nervous, or struggling, tell someone. We've all been in that position.

10. Don't try to pass your course by sleeping with people. It is frowned upon.

11. Don't try to pass your course by cheating. It is frowned upon.

12. When on ambulance placements, pee at every available opportunity. It could be a while between stops!

13. Be proactive and engaging. Be prepared to learn from all staff. Each has something valuable to teach you.

14. It takes time to settle into an ambulance station. You won't be able to step straight into the banter, it will take time for people to get to know you and trust you. Don't take it personally.

15. Pee at every opportunity!

So, take these words with a pinch of salt, an element of reality and with the humour intended and may I wish you the best of luck!

Team Work

2013-03-14T23:39:00.001+00:00

Cardiac Arrest.

The words strike fear and excitement into the core of any medic. The adrenaline courses through the veins, the heart quickens, breaths deepen, this is it. This is what you've trained for. The chance to save a life and of all our life saving skills, this one probably gets used the most. You are the only thing standing between a patient and the coroner. The important thing to remember is, to reverse a cardiac arrest, teamwork. Obviously there are the underlying medical causes to address, but none of it makes a difference if the rescuers can't work together.

I'm going to tell a tale of teamwork, hard work and good work.

David is a businessman. An important man? I don't know, perhaps we will never know, all I do know is he is about to experience Team NHS at its best. David has just arrived at work. He walks into the office, a little sweaty, quite breathless, a lot pale. He looks up at his colleague and tries to speak as he collapses to the floor. A hush fills the room and after what feels like a eternity the cries of "Call an Ambulance!!" break the silence.

"Ambulance Emergency..." The call taker answers "What's the problem."
"He's not Breathing!!" stutters the secretary, her voice quivering...
"OK, I'll tell you what to do, the Ambulance is on its way..."

The call handler talks David's colleagues through CPR. It's 2 minutes since he collapsed, already bystanders are forcing blood around David's body, keeping his brain oxygenated, giving him every chance.

Simultaneously a First Responder, seconds from David's office is dispatched, as is my ambulance, a second from the next town and our HEMS team.

4 minutes, the responder is by David's side.
Defibrillator on.
One shock
CPR

12 minutes after his collapse we arrive. Grabbing all the kit we can can my crew mate and I run to David. We arrive at a scene of utter calm and disbelief. The responder has everything under control and a good history ready. He carries on with CPR, whilst with a glance and a nod my crew mate and I assume our roles, one on Airway and Breathing, the other on IV access and drugs.

15 minutes after his collapse David is Intubated, ventilated, has patent IV access and begins to receive life saving drugs. We swap. I take the CPR, the responder squeezes the bag, delivering oxygen to David and my colleague looks at the reversible causes.

20 minutes Post arrest - we pause...."rhythm check"

David's got a pulse, it weak, but its there. The second crew arrive with stretcher and scoop. David is stabilised, fluids to correct low blood pressure, cooling packs to reduce brain injury, he is carefully lifted onto the stretcher and carried out to the ambulance.

35 minutes.

Our HEMS service has landed a short distance away. It's too far to walk, so he is driven to the waiting helicopter. As we pull up next to it, his heart stops again.
More drugs, more CPR. A needle is inserted into David's bone, it's brutal, but stronger, the intravenous access already damaged from all the movements.

45 minutes after his collapse, David is now in the Helicopter. The noise of the engines and smell of aviation fuel fills the air. The downdraft throws up leaves and mud as the small aircraft lifts off and disappears over the houses. The hospital know he is coming, they are waiting.

60 minutes. 1hour later. David is now in the Emergency Department Resuscitation room. He is surrounded by Doctors, Nurses, Anaesthetists, all trying to keep him alive. His heart started to beat again in the helicopter, so now the team had to keep it that way. Bloods were taken, scans done all trying to piece together what had happened...
Meanwhile, my crew mate and I are staring at the devastation that is our ambulance. It was like someone had turned it upside down. We simply close the doors and drive back to the ambulance station and only there do we sit back and reflect.

We managed to find out what happened to David. Sadly, despite everyone's valiant efforts, the damage to his heart was too great and it finally stopped. It's a sad outcome, but I know that the whole NHS team did everything possible to try and save him. I'm proud to work for such a team, in such a team and with such a team.

Regulars...

2013-03-02T22:54:00.001+00:00

We all have regulars. Pubs have regulars, hairdressers have regulars, hell I'm sure even the coffee shop has them and the ambulance service is no different.
Regulars are all varied. Some are just plain annoying, calling because they're bored/lonely/can't find their back door key. Some are just victims of their circumstances, alcoholics, chronic respiratory problems or regular fallers. Some aren't regarded highly due to they're persistent aggressive and generally unpleasant demeanour, whereas some are adorable, kind, grateful and you may find yourself accidentally spending an hour there.
And then there are the special ones, regulars who out live many ambulance crews, who are known not just to the station, but to the sector and beyond.
In the years I've been doing this job I've come across many regulars, some spanning the length of my career, some very nice, unfortunate people and some nasty pieces of work.
I knew a particular one, who ticked all the boxes...At times a nasty person, with a horrendous addiction who was troubled by their past, or so it was to be believed and as, over the years the substance abuse took hold, they became more, contrite, to the point of grateful, no longer using us but relying on us. Maybe just because we were sympathetic, maybe deep down we understand or perhaps we had no choice, we would help where we could and leave when we couldn't. Recently I met this regular again and for the last time. The years of battering had ruined the organs and left them a shell, a shadow of their former selves.
As we delivered this barely conscious, dying patient to the hospice we said our goodbyes, so longs, in the cheery fashion we always do, like nothing is wrong.
The patient, for pretty much the first time since we arrived opened their eyes and looked straight at us.
"Thank you"
It was barely a whisper followed by a slow, tired smile
"Thank you, boys"
The room fell silent again
We turned and closed the door to the room, knowing that the years of trouble, strife, aggression, even violence were repented and admonished in just two little words.
The journey back was silent until my colleague wryly says, without eyes off the road
"The thing with regulars, one goes, another fills their place, just a gamble who it's going to be..."

Absent (Without Leave?)

2012-09-23T23:00:00.001+01:00

Today, I read one of Ella's blogs. This isn't unusual, I frequently do. Her blog reminded me of one I wrote a year ago, about cyclists. This prompted two thoughts. One, that I had promised her a 'guest blog' about three months ago and two, I hadn't blogged since lent.
Being asked to write a blog for someone whose blog you admire is both an honour and humbling. But it induced a crippling writers block! What should I write about? The Chickens? Work? Family? Something else? Could I even write something half as good as others? Would I just look a fool, like a child trying to speak at the grown up table...
I ran away from blogging, thinking I couldn't write again and certainly not of the standard of other bloggists.
"it's ok" I said to myself, "I'll write about Edinburgh". Our theatre company's tour to the fringe, that should provide some inspiration. It did, and I wrote furiously. For about 20 lines. Then I decided no one would read that drivel and deleted it! The tour was excellent by the way, seamless production, military precision on get I and strike and a well rounded three star review to boot!
Then this morning I read Ella's blog. Then I read mine. I like what I read. I realised how much I'd written. I felt compelled to write again, to offer an explanation perhaps?
I may have been AWOL, but am back in the ranks now and I feel rejuvenated!

Distraction Techniques!

2012-02-26T23:19:00.001+00:00

So, we're what 3-4 days into Lent. I've been good and not touched social media. On the first couple days I hardly missed it! I found plenty of things to distract myself anyway! Shopping, eating out, work, cycling, dinner with friends, geocaching....
Then today I found a new and obsessionable toy. Plane Finder, an iPhone app. Those that have it know what it is, but for those that don't, it basically allows you to know loads of info, such as flight numbers, destinations and carriers of the planes above your head!
So this resulted in me and Daughter1 running about the garden plane spotting! Brilliant! Next years lent perhaps?

Unsocial Networking...

2012-02-23T20:02:00.001+00:00

We have just entered the forty days and forty nights (or so) between Ash Wednesday and Holy Saturday, the period better known as Lent. During this time practicing Christians observe rules of abstinence, fasting and generally doing without as a homage to Jesus' forty days in the desert.
Now, I'm not a practicing Christian. I know the stories, I find them interesting and so every year, at Lent, the Wife and I challenge each other to a penitence.
This year, for me Social Media lucked out. It is true to say I have become somewhat addicted over the last year or so to the likes of Twitter, Facebook, and Foursquare, whiling away the quiet hours at work with other peoples thoughts and opinions.
So like a good sport, yesterday I severed myself from the Social Network, like a drone cut from the collective now standing seemingly alone in the universe. I turned all alerts off on my phone, cleared the history from my browser and sent "goodbye" posts on TwitBook...
The rules are simple. I am not allowed to use, access or post to Twitter, Facebook, Foursquare or any other social forum. If people need to contact me or visa versa then it must be via Phone, Text or Mail.
The only exception is this blog, to share the experience of leaving the internet sensation behind!

The trouble with badgers...

2012-02-17T19:05:00.001+00:00

Meles meles or the European badger. A Brock if you like. 40lbs of solid wildlife.
Generally this timid, nocturnal creature causes little interference to humans, give or take the odd bit of TB or a badly placed sett.
The one problem with badgers is their lack of road sense. Now with other creatures such as rabbits this doesn't pose a problem, a light thud, a guilty feeling and it's all over. Not with badgers...
I take you back to Monday night. I'm on the way to work to start my 2nd night shift. Out side my house there are currently some roadworks that have closed the road. I decided, as I had a little time to take the scenic route. It pops me out right by station and breaks the monotony of nipping through the housing estate.
I had had a good day. I was chilled out, having had a bath, a good sleep and nice meal. Driving down the lanes I see ahead a badger, trotting down the road, he disappears in to the hedge. Thinking nothing of it I continue, approaching a corner and the spot whet Mr badger had disappeared. The without warning and like a shot he flew into the road. In a split second I had to make a choice. Hit or try and miss. Having hit one before and needing to replace an entire steering system I went for the miss. I hit the brakes. Hard. The wheels locked on the wet, muddy road. All I could see ahead was a large oak tree...
Somehow, most likely by luck not skill a regained enough control to miss the tree, putting the car into the hedge and bank. Hard.
No for those of you worried about the badgers welfare, wether he got home for Valentines day I can assure you he is fine. Perhaps even laughing at me.
My car on the other hand was resting in the hedge looking sorry for itself. Me standing next to said car, shaking, feeling sorry for myself.
Then came the worry of "I'm in the middle of nowhere, car in the hedge and IM GOING TO BE LATE TO WORK!"
To my relief the car started and unpicked itself from the hedge with minimal fuss. There was, however, a worrying, steaming wet patch on the bank. Turns out I smashed the radiator to bits. Cue frantically ringing round garages, trawling the web for parts. Cue 5 days without my car. Cue a repair bill to the tune of £220. Cue relentless jokes, badger references and risk of badger related gifts for a while from friend, family and colleagues.
Brilliant.

The belle of the ball...

2012-02-11T11:35:00.001+00:00

So tonight is the night! The MAdD theatre companies' Valentines Ball. Months of planning, plying of tickets and stress, hours in the kitchen making mini tarts, meringues and Creme patisserie! At 7.30pm all the hard work will be over.
For those who don't know the company is taking their home grown show to the Edinburgh fringe festival this year and this ball is in part fundraising and in part a damn good party.
There is to be music by Green and Bushell, Sonic Sound Disco and yours truly. Food has be hand made (imagine me, at 12 midnight, high on sugary leftovers rocking in a chair covered in cream and sugar...) and table decorations hand constructed!
So if you want to join us please do, tickets available on the door, just email me for details!

To Edinburgh 2!

2012-01-28T18:57:00.001+00:00

Well, our venue has confirmed. Greenside, studio 2! Everyone is very excited and Kat and Sophy are in the process of signing contracts! We're a go! So now begins the arduous and unenviable task of rehearsal schedules, logistics and publicity! The hardest task of all is going to be getting our 'get in' and 'get out' down to five minutes a piece. That is set, band, props and cast in and out in five minutes. I envisage a military style drilling to develop a precision known only to the SAS!
The other issue of fundraising still continues though. The valentines ball preparations are in full swing, the band is booked, the sound and light is ready, the tickets made. Sales are going well, about half have been sold which means any of you lucky readers who wish to come and enjoy an evening of music, food an MADD hats still can! Visit www.maddrama.org to buy your tickets!!

Targets

2012-01-19T18:16:00.000+00:00

My local news last night included a story on how the private sector is turning its back on unemployed, redundant public sector workers, with 88% of companies interview brandishing us as 'work shy' and 'not target driven'.
I nearly threw my cup of tea at the television. How dare they!
So, here's a little personal reminder to potential private sector bosses on just hard working and target driven I am.

I work an average of 4 shifts a week., 10 or 12 hrs a shift, including lone working, double crew and supervision of students. I see about 4 to 6 patients a shift. That's somewhere between 800 and 1200 a year. I work predominantly nights as well as raising a family, running a volunteer responder group and supporting the long suffering wife's company (private sector I'll add). I work Christmas, New Year, Bank Holidays, and Birthdays.

I'm answerable to the following targets.

Mobilisation within 35 seconds,
Respond to Life Threatening A Catagory calls within 8 minutes,
For certain calls, Such as Heart Attack, be on scene for less than 20 minutes,
Monitored against several points with Clinical Performance Indicators for patients suffering Myocardial Infarction, Stroke, Hypoglycaemia and Asthma Attacks,
Handover at hospital within 15 Minutes,
Handover to clear within 10 minutes
Mobilisation to Dispatch point within 5 minutes (I'm not sure on this one!...)

There are other targets that although not solely my responsibility, I help to acheive

Call to Balloon time of 150 minutes for confirmed STEMI,
75% of all Non-Emergency calls for transport to be at their destination within 15mins of the agreed time,
75% of all A catagory calls reached within 8 minutes and 90% to have a conveying resource within 19 minutes,

There are even more targets that affect us, such as Call Connect, C Catagory responses, GP OOH's call backs etc.

All these targets affect our funding and our jobs. They ultimately affect the patients, the reason we do the job in the first place.

I'm not stating in any way that we work harder than the private sector, we work just as hard as each other, nor am I saying that these targets are more important than the patients. These private sector bosses, these 88% who were interviewed, really need to take a closer look at the facts before slinging mud and wrighting us off.

A bit of healthy competition?

2012-01-16T09:35:00.001+00:00

This is a little impromptu but i have to share!
It finally happened. The long suffering wife decided to have a go at blogging.
"How do I set up one of these blog things?" she asks.
So I showed her where to go and what to then left her own devices.

Credit where credit is due she wrote a very good one and before long was racking up the page views.
This is when it started to get ugly!
First it was casual questions like "how many have you had today?" or "how many did your first one get?". This developed in to a competition, more one sided perhaps as to who could achieve the most views in 24hrs.
Unfortunately I lost.
It's not a bitter defeat, I'm really pleased for her and it really has the potential to be great if the first post is anything to go by! I don't plan on changing the way I blog either as I'm as much about keeping old readers happy as well as getting a wider audience!
So if you want to read a competition winning blog it can found here

An Eggceptable Subsitute?!

2012-01-15T01:45:00.001+00:00

As you may know, I have chickens. Four little ladies that have been munching their way through what is left of my lawn and pooping on my decking (not a nautical term!).
Well, I had my first egg the other day. A momentous occasion really, and quite a lucky find seeing as it was tucked under some straw and mud on the floor of the run, a little cracked but intact.

I ate it. It was very good!

Since then I have been expectantly looking in the coop for more eggs. This morning I found one, smashed and leaking by the coop door. Clearly the girls hadn't sussed where the nest box was!
Mournfully I disposed of the destroyed egg. Normally one would purchase a fake egg or perhaps a golf ball and place it in a nest to encourage them to lay there, but I had another plan.
Now perhaps because I'm a genius, or more likely because I'm a cheapskate I decided to make my own! This resulted in me making scrambled eggs Heston Blumenthal style, carefully preserving the shells, filling them with flour and water, a bit of red poster paint for colour and then baking them.
This evening I lovingly made a couple of nests and placed my fake eggs in. Now to spend the next few days obsessively checking to see if they have fallen for it!!

Kids Games?

2012-01-07T23:51:00.001+00:00

I pick an unusual topic today. Kids toys...

Those of you who follow me on twitter may have seen my little 'rant' earlier today about the lack of toy ambulances in shops. They are full of fire engines, police cars, construction vehicles and sports cars, but very few ambulances. Even those that do are generally lacking effort, or as in today's case, came with a police man wielding a truncheon! (I can believe some would like this to be a reality when dealing with less salubrious of characters!)

It's not envy at my fellow services, not jealousy that someone hasn't made the effort to create us in miniature, it's bigger than that. Well, it's an element of that, but it's mainly, for me, about a lack of awareness. Kids grow up playing with, recognising, understanding the other services. They become interested, they have a drive to become a police officer or firefighter. They develop (generally) a respect for these services.

They know little about ambulances or Paramedics or the service. They fear them at times, and certainly don't respect them! It's as much the fault of the profession for, in it's nature, being secretive but maybe if they sold more ambulances, RRVs or little plastic helicopters tomorrow's new paramedics might say "I've wanted to do this since I was given a toy ambulance!"

I know they do exist, heck I own a couple, it would just be nice though to pop into a shop and see some on the shelf looking proud next to their colleagues!

To Edinburgh?

2011-12-30T00:18:00.001+00:00

Well that's settled then.
MADD Theatre Company is going to the Edinburgh Fringe Festival this summer.
Following a successful tour of Somerset towns we as a company decided to take our home written show on this ambitious project. And I daftly agreed to assist with publicity...

The show is titled Retail Therapy. Written by Kat Wilsher and Sophy Layzell it centres on a department store in the near future. Filled with love, deceit and faulty equipment the long suffering staff low through the sales period! The music for the show was all written by Natalie Wilsher and even now we still hum the tunes!
So, we have our full cast, our very excited technical team and hopefully our venue of choice! The re writes have been done (it had be condensed from 1hr40 over three acts to 1hr over1!) and we are redesigning the set . We are ready!
So, do you want to support a local predominantly youth theatre group who have the ingenuity, drive, creativity and talent to take this quirky little show to one of the greatest arts festival in the world? If so then keep watching for press releases about fundraising, sponsorship and previews!

The Fringe, MADD is coming!

PS I have added some photos of the the tour, one from each venue, a church, a warehouse, a kickboxing centre, a dancehall and a village hall!

A series of unfortunate events.

2011-12-12T02:49:00.000+00:00

It was a journey I've done numerous times before. It's a journey of about 100miles. On Saturday it went wrong.

The plan itself was simple enough, the long suffering wife, daughters one and two and myself go to Swindon by car on Friday, spend the day with family. On Saturday morning I get the £6 train, change once and then after walking across town, catch the slightly more expensive bus to work in time for 1400. Easy. Granted there was little margin for error in catching trains and buses, a little like Phileas Fogg and Passepatout!

I decided as I had no clean uniform, to take some to Swindon and once cleaned and ironed wear it to work, easier than carrying a bag I thought, I'll only be travelling for an couple hours...

I got to Swindon at 0945, ten minutes before my train to collect my prepaid reserved ticket. The station was HEAVING, I barely made it to the platform in time. Fortunately the train was three minutes late. Not a massive delay but enough that I actually caught it. The train was busier than the station and, fortunately no one had stolen my seat. On we went, all was going well until Box Tunnel. The train, on leaving the tunnel ground to a halt, then crawled all the way to Bath. Over the tannoy came the announcement "would the train manager please contact the driver".
Never a good sign in my experience. We were now about ten minutes late.

The train manager shortly announced that, due to a mechanical fault we would be holding at Bath for ten minute whilst it was fixed. I looked anxiously at my watch. ten minutes was cutting it fine, and would leave me about five minute to catch my connecting train.

Twenty minutes later we depart. Unfortunately my connection departed at the same time. Great.

Arriving at Temple Meads nearly 20 minutes late I started the hurried search for another train passing through to Taunton. Scanning the departure boards there was a Paignton bound train in ten minutes. Brilliant! That would give me just about enough time to get the bus. Its a Cross Country train. Damn. Checking my ticket, hoping it says "all routes". Nope. Great Western only.

"Ok, don't stress" I say to myself, "Just find someone in a Jacket and ask when the next one is, or if I can blag a ride on the XC train"

The helpful lady says to me that,trying to use a Great Western ticket on that train would incur a fine and we "wouldn't want that eh?!"
"Um, Nope..." I reply
cue awkward pause
"so when IS the next train I can use this on?"
"an hour, platform 7"

Now at this juncture three things simultaneously occur. One, I remember I'm in full uniform. Two, the Brother in Law and LS appear, like genies, by my side and Three, I realise that I'm going to be late for work.

I explain the saga and dilemma of my travels to TE and LS and joke that "oh well best make myself useful while I'm here".
I'm NEVER doing that again. A man in a HiVis jacket approaches out of the corner of my eye..

"Scuse me.."
"Yes?"
"Are you a Paramedic?"
"Yes."
"Oh Good, Your not working are you?"
"No, I'm trying to get to work.." I was about to lay a rant to him about being late but he cuts me off..
"Only someones collapsed on a train, would you mind coming over?"
"yes...I mean No...oh, wheres he too...?"

His face lit up a little. 3o seconds later I'm standing on yet another hot, full train, tending to a chap who had indeed collapsed and had a funny paleness about him. A rather bemused crew took my handover and my explanation as to why I was there etc well and wished me luck on my travels.

Fortunately this little escapade had used up most of my time to kill, so I had enough time to call control and explain the situation. Again.

I now boarded the next train. I had hatched a new plan, The bus was out. It wasn't going to get me in on time. So I decided to walk to the nearest ambulance station and hope there was something spare there I could borrow to complete my journey! Arriving at the final train stop at the same time as I should have been at work I power marched across town. It's further than it looks on a map!
Any way, there was a staff car unused for a couple days so on controls' authority I procured it like a secret agent. In Out Gone in less than five minutes. I made it to work with 10 minutes to spare, made a cup of tea and....Got sent straight out!

The chicken blog!

2011-12-03T10:38:00.001+00:00

When I was younger my parents were reasonably strict about what TV, if any myself and my siblings could watch. One of the programmes allowed was 'the Good Life'. This started my mind off on a 20 year quest for self sufficiency, not helped in part by mothers good intentions to do the same and my grandparents who, as far as I was concerned were already there with a big veg patch, goats, sheep, chickens, fruit trees and bees!

Last year I floated this notion past my long suffering wife. She was, to my surprise, quite keen! I managed to obtain a disused allotment from the council, which to be honest is a major work in progress. Now the winter is here I can actually start to clear the forest of Ivy, Brambles and the odd sapling!

The best thing however happened about a month or two ago. The wife and I were discussing the risky subject of Christmas presents for each other. The ideas were being bandied about until someone (probably not me) suggested getting chickens as a gift...

Neither of us objected...

The research began...

Within a few weeks we had selected a little house (a coop apparently) a breed, Orpingtons, and a seller, a man that had become affectionately known as "Chicken Man" After making sure we were ready for this commitment, already having 2 daughterts and a cat, we bought the house.

Two days ago we made the trip to Bristol to collect our Urban Hens! We bought four in the end, two Orpingtons called Lady Bantam and Mrs Hughes and two Pekin Orpington crosses called Cybil and Violet. Funnily enough the house has been dubbed Henton Abbey!

So, as I continue me quest for self sufficiency I shall be adding to my blog Chicken and Allotment updates!

PS for those who maybe interested in chicken husbandry The Urban Farmer, based in Bristol, is reachable via his website www.urbanfarmer.org.uk

On Yer Bike

2011-11-27T19:59:00.000+00:00

It has been announced today by the Association of British Insurers that cyclists should have insurance to protect themselves should they be injured in a crash or indeed to compensate others if they are at fault. The full story is available here...http://www.bbc.co.uk/news/business-15892074.

Now as a cyclist this concerns me slightly! Firstly, I cant afford to pay for cycle insurance. I already have life and critical injury insurance, which to my mind is enough. Secondly, I take steps to avoid becoming a victim of an accident. Driving about for a living, Day in, Day out I see cyclists NOT following the most rudimentary of measures to protect themselves and herein, as far as I'm concerned lies the problem. So, in the spirit of the "big society" I will share my pearls of wisdom...

1. Wear a Helmet. Quite frankly this is a no brainer, pardon the pun. The tarmac is just as unforgiving whether you're on a pedal bike or a motor bike. Just because its not legal doesn't mean you should wear one! I personally have attended cyclists from beginners to competitors who have suffered severe injuries as a direct result from hitting concrete/windscreens. This leads to point 2...

2. PUT YOUR KIDS HELMETS ON! Child in a carrier with no helmet on? Daft. Fine if you want to end up a gibbering mess but don't sentence your little angel to the same fate!

3. Stand out. So, it's getting dark. Or the traffic is heavy. Or you're on a road with an average speed of a the space shuttle. Now, if that's me I'd quite like to be spotted by the juggernaut that insists on passing close enough to slap my arse, so a bright florescent jacket I don. Doesn't have to be pricey, mine was a tenner from lidl...

4. As with 3, Put some flaming lights on. Enough said.

5. Where possible use cycle ways. Sustrans among others have developed hundreds of mile of safe routes to ride. Even in cities, generally designated routes are safer.

6. OBEY THE LAW. I've given up counting the number of cyclists I see jumping red lights, cycling on pavements, going the wrong way up a one way street. This puts them at tremendous risk and moreover is ILLEGAL!

So pay heed and hopefully you wont need insurance. Ignore it and maybe you just don't deserve the payouts...

A Dedication

2011-11-14T21:39:00.002+00:00

This is a dedication to the unsung heroes of the emergency services. The wives (and partners!) of us that work there!

You put up with us working long hours.
You cope with us working Christmas, New Years and in fact most public holidays and religious occasions.
You understand when we finish late day after day.
You get used to sleeping alone on nights and staying quiet during the day.
You don't mind when we're ranting about a bad day and listen with a smile.
You know we could get called out any time time night or day and not sure when we could return.
You wait up until stupid o'clock until we're home and safe.
You send make sure there is a packed lunch for us each day.
You understand we do what do because we love what we do. For that we Love you too.

Dedicated to my very caring and understanding Wife,

48 hrs with a Paramedic pt2

2011-11-11T23:23:00.000+00:00

Part 2

The second installment of 48hrs with a Paramedic!

Today we join Dan on a Late Ambulance shift. Today’s shift starts at 1400. Dan arrives on station at about half one to change and prepare for the shift.

Unfortunately, today the Ambulance Dan and his crewmate are due to work on is currently VOR – Vehicle Off Road – but a contractors are on their way to repair it! Dan’s crewmate today is Hannah a newly qualified Paramedic; she arrives not long after Dan. The time waiting for the Ambulance, a 7-year-old Renault Master, to be repaired is not wasted however. Dan has the opportunity to catch up with some paperwork and speak with the station officer. He then is able to fully check the Ambulance, stock it fully and give it a good clean, inside at least!

The crew are able to book on at just gone three and are soon despatched on listening watch, but never arrive as they receive an emergency call, to transfer a patient to Casualty from a smaller Minor Injuries Unit. Having safely transported their patient the crew clear, making themselves available to control. The MDT flashes the dispatch message to Return to Base, so dutifully the crew leave the casualty. The traffic in the town is heavier than normal today, probably due to the weather and the Ambulance does not make much ground before the next Emergency and MDT alarms split the conversation in the cab.

As there are two persons aboard control rarely pass the incident by voice, but instead in a text message for the crew to read. This incident is a medical call, and the crew are “backing up” an RRV. Dan switches on the blue lights and starts weave his way through the heavy traffic but its hard work negotiating the queues of cars, red lights and pedestrians who are rushing to get home without getting wet. Dan cycles through the sirens to make the ambulance as noticeable as possible, but still people fail to see them, causing the ambulance to come to intermittent grinding halts. They eventually clear the town and although the traffic is still heavy, the roads open up. They arrive on scene, receive the handover and convey the patient to the Hospital providing treatment as required.

For the second time they clear the Hospital and are sent back to base. Again, for the second time they are despatched an emergency call, another Medical call. This time they are able to treat the patient at home, rather than take them to hospital. Finally, Dan and Hannah get back to base and have their break. While on break, the night crew arrive and confer before they themselves are despatched on an emergency call. As soon as the break is over the ARP’s burst into life, another medical call, a patient has collapsed. The crew arrive on scene and start assessing the patient, who looks quite poorly. The casualty is carried out to the ambulance using a carry chair - a relatively lightweight collapsible chair with wheels to carry patients down stairs - and lays them down on the stretcher. The crew continue to examine the patient and it becomes clear that an urgent conveyance to hospital is required.

At the hospital the crew hand over to the Nurse in Charge and register the handover using a computer terminal connected to the clinical hub (control) as they have done all night and leave the hospital.

Fortunately, the crew see the final hour or so of the shift on station, allowing them to put the vehicle away and on charge - there is so much electrical equipment that without plugging the ambulance into the mains the batteries would go flat! - restock, mop the floor and return the controlled drugs to stores. Tonight, the crew are able to book off on time, not always a luxury, and go home.

You have experienced two days in the life of modern Paramedic. The pay is not brilliant, the hours are unsocial and long and the working conditions can be arduous. Some days are busier, most days are rarely quieter, and some days filled with trauma, some with medical. Some days you are a counsellor, some days a referee, one day you maybe a teacher to a junior colleague, other days in awe of a crewmates tact, experience and skill. In the morning, you may see the end of life, in the afternoon the beginning of a new one. All I know is no two days are the same, no two patient the same, each demanding a different approach, skill set and outcome.

All I know is this is the best job in the world.

48 hrs with a Paramedic pt1

2011-11-11T21:20:00.000+00:00

For more information about this weeks’ blog I direct you to last weeks’ one, that will tell you all you need to know, but in the meantime time, here it is, my updated (and NOT cynical) version of “A day with a Ambulance man”, 48 hours with a Paramedic! It is rather wordy and there are no pictures so as to protect confidentiality and security.

Disclaimer:

This post is fully compliant with confidentiality to patients, my colleagues and corporation as a whole. The following events although recorded straight from reality, are subject to artistic licence for confidentiality of aforementioned patients.

48 Hours with a Paramedic

Have you ever wondered what it is like to be Paramedic in the Modern NHS? Well for the next 48 hours, “we” will give you an insight into the life of Dan, a Paramedic in a busy ambulance service.

Introducing Dan

Dan is a Paramedic with nearly a decade of operational ambulance experience. He started his career in Ambulance Control, answering 999 calls as well as GP bookings and general enquiries. He soon left control to move “on the road” as an Ambulance Technician. He finally realised his dream of becoming a Paramedic in 2009.

Dan works at a small semi rural ambulance station with a large catchment area and a mixed population of young and old. There is a large agricultural community dissected by very busy trunk roads.

We will be joining Dan on two shifts over 48 hours to see a typical day in the life of a Paramedic in the Modern NHS.

Day 1 0600 RRV

Its 0520. Its still dark outside, but Dan alarm has just gone off. He groggily slides from bed, kisses his wife goodbye and heads to the bathroom to get dressed. At 5.40 he leaves the house, the car is cold and is barely warm by the time he reaches station. Pulling into the yard the night ambulance is not there, an ominous sign he mutters. It is now ten to six, the station is in darkness and Dan heads to the locker room to change into his uniform.

Modern service uniform is dark green and across the south of England all ambulance staff wear the same uniform, for continuity. Grabbing his kit bag, with High Visibility Jacket and trousers, medical books and guidelines and other Personal Protection Equipment, such as facemasks and gloves, he heads out to the Garage to find his RRV.

An RRV is a Rapid Response Vehicle, a car fitted with blue lights, sirens and reflective markings. It is equipped with a range of life saving equipment including a defibrillator and allocated to the most serious emergencies, ahead of an ambulance to stabilise patients and begin treatment, or to assess more minor calls to prevent an ambulance attendance. Today Dan is working on a Skoda Octavia Scout 4x4. He books out his Morphine, a potent painkiller and “books on” using the MDT, the mobile data terminal.
This small computer links the RRV to the ambulance control and allows emergency calls, information, dispatches, statuses and text messages to be sent to and from the car. The car is also fitted with Advance Vehicle Location Services or AVLS, which allows control to track the RRV and allocate it to the nearest incidents. The final piece of communication equipment is the ARP Radio, a digital radio system that acts a two-way radio, pager and phone.

Dan checks the cars equipment, medical supplies and drugs and washes the car. Whilst doing this control send a dispatch message through to the MDT. They instruct him to head over to the next town and wait for an emergency call there known as standby or Listening Watch. Its 6.15am

Dan leaves the station, the night crew not back yet and it is still barely light, he stops at a petrol station to fuel the car and arrives at the dispatch point, a room in the towns’ fire station at 6.35. It has basic cooking facilities, IT, TV, comfy chairs and toilets, making it a “social” dispatch point, meaning a crew can be left there all day. He takes this opportunity to check emails and view the current trust call volume.

At 9.15 the ARP handset bursts into life, the screen reads AS1 Emergency. Dan Heads downstairs to the RRV and sees the emergency call. It is in a village about 10 minutes drive away. He books mobile on the MDT and switching on the blue lights leaves the yard.

About 5 minutes into the drive control page on the radio and notify Dan that he is attending a female with chest pains and an ambulance is on route from another station. Dan arrives on scene and begins an assessment of the patient, including an ECG, an electro-interpretive recording of the hearts activity. Although it didn’t show this patient was having a heart attack, she still had chest pain, so when the crew arrived the decision was made to admit the patient to casualty at the nearest district general hospital. Dan completes his handover, the process where the care of the patient passes from himself to the crew and then completes his element of the PCR, the patient clinical record. This legal document records the care pathway and any treatment given to the patient by an ambulance clinician.

No sooner had Dan booked clear he was allocated another emergency call, this time about 20 miles away. Control quickly paged through the details, Its another medical call, a female with a severe headache.

It takes about 15 minutes to drive down a network of windy country lanes to get to the patients house. The patients’ carer, who explains what is wrong with the patient, meets us. Dan then begins his assessment a full range of medical and neurological observations. The patient is still in severe pain despite medication from the GP. After a discussion with the patient, she agrees to attend casualty in an attempt to manage her pain. Dan uses the Radio to contact control and ask for an ambulance. They advice its ten minutes away, so Dan take the opportunity to give the patient some Morphine, through an IV catheter for her pain. The ambulance arrives and Dan hands the patient over fully explaining to the crew what has happened before he clears scene.

Control dispatches Dan back to the ambulance station for his meal break. This is a 30-minute period where crews remain protected from emergency calls. In this time crews are able to eat and use the facilities however, the break is unpaid. He takes the opportunity to eat a sandwich, chat with the station officer and restock the car from the previous job. Whilst on station, the day RRV Paramedic arrives and Dan has time to have a chat with her before control again dispatch him on listening watch.

Two hours later Dan is despatched to the third incident of the day, an elderly female who was possibly having a stroke. An ambulance arrives about 20 minutes later and takes the patient to casualty. Control ask Dan to remain on cover in the town and at 1500 hours he is sent to what turns out to be the last call of the day, however, he is stood down before has left the town, the patient deciding to seek another route to health care.

Dan returns to the ambulance station where he meets the oncoming Paramedic and hands over the car. He changes and leaves for home. Its 16.10

Overtime Travels or An Introduction To Next Weeks Blog!

2011-11-04T15:45:00.000+00:00

I do a lot of overtime. Not excessive amounts but a lot. This is mainly due to the fact that with two children and rising costs my basic salary doesn't stretch.as far as to have fun. When I do overtime I like to sometimes venture out of the comfort of my own station and head into to the county, maybe catch up with some old friends from my trainee year.
It was on one of these excursions I traveled deep into the middle of the county, where accents are thick and most jobs involve the need to negotiate livestock of some degree! On my meal break, sat down in the deserted crew room (I guess they knew I was coming) I spied an old looking childrens hard back book on the table. This book had become the basis for next weeks post. The reason for it being next week shall become clearer.
The book was called "A day with an Ambulance Man" written by Jane Elizabeth Bowler and Christine Day, publshed in 1982 by Hodder Wayland and is one in a series of books for children about important people in society. An interesting point to note is who they have featured. Publicans, MPs, Fire Fighters, Hairdressers to name a few.
This book features an Ambulance Man from the former Sussex Ambulance Service. I think his name was Colin, though I am most likely wrong. The book starts by introducing us to "Colin" and about shift work. We then follow him to work, meeting his crew mate. The authors haven't brushed over a thing. We watch the men do their VDI, even checking the oil. We then accompany "Colin" and his Crewie "Roger" - again see previous disclaimer - on a routine transfer and a couple of emergencies including a fatal road accident and the ensuing paper work. Then at the end of the shift we follow "Colin" home and meet the family.
The book is amazingly illustrated with photos depicting a wonderful insight into the 80's ambulance service now lost such as the old CF Ambulances. Some old hats may feel I'm looking back through rose tinted glasses, but I don't care! It's nostalgia from when the Ambulance Man was respected, wore smart uniform and had time to keep the chrome hubcaps clean!
The book had me intrigued and enraptured for my entire break, my tea even went cold. There were so many similarities to now, the VDI, the handover to sister, even the little hand gestures I have found myself using to indicate a red call (even that name hasn't changed in nearly 30 years!). But it also high lighted the stark differences in todays' modern ambulance service. The job titles, Paramedics after were devised in the 90's and only in the last decade have become a protected professional title. The Uniforms, the vehicles, the staffing. There wasn't a single female ambulance person in the book and the station officer only made a brief appearance to deliver a new great coat! This book also inspired me. Inspired me to write a modern equivalent, but in the form of the novice authors medium, the blog. I thought about what constituted the modern ambulance service and how best to highlight key differences. So I have chosen two shifts next week that I think will do that. Monday 0600 RRV and Tuesday 1400 Ambulance This time next week I shall publish it, with photos (where legally allowed).
In doing so I hope to give this wonderful little book a modern lift that can be enjoyed and maybe give younger people some information into a relatively mysterious service.