Tag Archives: Christmas

The Christmas nightshift

…”should be easy”, I hear you say.

“Pop your feet up and watch some James Bond, maybe nip out to pick up granny who’s fallen after one to many sherries. Or maybe a drink driver crashed into a lamp post.”

Well, yes. It should have been something similar to that, but instead, it was a rather intense shift.

Our first call (admittedly almost an hour after signing onto the Ambulance) was to a lady who has possibly had a stroke. She was 84 years old. Now, we don’t play God. We don’t think “ah well, she’s had a good innings, lets leave her to slip away peacefully.” Especially when this particular 84 year old still cycled everywhere in the village she lived in, and WORKED 2 DAYS A WEEK!!

She was sat on the sofa at her daughters house where she went every year to celebrate Christmas, when suddenly, she listed over to one side. Her daughter asked if she was ok and the mumbled reply confirmed her suspicious; she was having a stroke.

We arrived quite quickly considering the narrow lanes surrounding the village, to be met by her daughter outside in a bit of a panic.

“Through here please!” We just caught what she said as she scurried into the house. We found the living room and saw our patient in quite good spirits, considering. She had a right sided facial droop, slurred speech and was unable to move her right arm – all the classic signs of a stroke.

If caught within a certain time frame, some strokes can be treated and in many cases, the patient will make a good-to-full recovery. But not all the time.

We were well within this window, so basically ‘scooped and ran’ (a term often used to mean just that: scoop the patient up and run to hospital on blues.

I put a needle into a vein in case we needed to give her any drugs and my crew mate blued us to A&E. It was an uneventful journey, but I pre-alerted the hospital staff anyway, as is protocol for stroke patients.  We arrived to be met by a doctor who sent us into ‘Resus” (where the illest patients go) as the CT Scanner was in use – another stroke patient brought in by Ambulance who’d arrived not 5 minutes before us!!

I later found out she was Thrombolised (treatment for a specific type of stroke) and was making a good recovery. Good times!

 

Next patient was a Priority 1 backup request from an RRV Paramedic on scene back in our home town. We darted through the empty city streets and out onto the country road leading to our station, which we sped past on the way to the address.

It was a 44 year old man who was a chronic (and still functioning) alcoholic. He had End Stage Liver Disease and many other health problems. He was completely unconscious, very jaundiced (yellow skin associated with liver failure), and barely breathing. Not a well man.

The RRV Para’ had given oxygen, gained IV access and was giving fluids as we arrived. We lifted him from his bed to the stretcher (thankfully he lived in a bungalow) and wheeled him to the Ambulance. We blued him in as well. On the way to hospital, he developed a dreadful habit of not breathing every now and then, meaning I had to ventilate him with a BVM. He remained unconscious the whole way to hospital.

I handed him over (to the same doctor as earlier) who very quickly set to treating him with the expert nursing team. Once his family arrived, the doctor had the discussion with them that he was unlikely to improve and if his heart stopped, they would not attempt to restart it. The family were in agreement and were in fact relieved that his agony would not be prolonged. He died a few hours later, peacefully and in no pain with his family by his side.

 

We then did a few ‘normal’ jobs – too much sherry etc etc.

Then we got sent to the next town for “18 year old male, stabbed”.

Now, that would fill most people with dread, but I’ve been sent to so many ‘stabbings’ that have in fact turned out to be paper cuts and not much else. One man had a graze on his arm, the sort you get from scratching an itch too hard!

Nonetheless, put down your dinner and pick up the Ambulance keys, blue lights on and off we go.

We arrived to see 2 RRV’s, 3 Police cars and Police dog team on standby. We walked into the house and followed the blood trail…..ah, first clue that this might be serious.

There were our two colleagues dressing wounds, taking vital signs and details while the Police tried to gleam information about his attackers.

We quickly grabbed the stretcher and wheeled him to the vehicle for a proper assessment (cut all his clothes off for a top-to-toe inspection to make sure we haven’t missed any stab wounds) in better light.

He’d taken a fair beating:

Black eye, presumed fractured cheek bone, fractured jaw, laceration to his neck, significant cuts to his hands (typical defensive wounds), cuts to his legs and a pretty nasty stab wound to the knee, of all places. He had lost a pretty decent amount of blood and was an unhealthy shade of white.

Despite his serious condition, he was reluctant, in fact he outright refused to give any details of his attackers to the Police.

We blued him in as well, with a Police escort which was rather exciting (I’ve never had one before). Pulling up at A&E, guess which doctor was waiting for us? “You guys are proper sh*t magnets tonight!”

“You’re telling us?!”

The last I heard, he was OK. It took over an hour to clean all the blood off of him. We hadn’t missed any wounds and he was preparing to go to theatres to have his hands operated on. We spoke with the Police later that night, who told us that when the searched his clothes that we’d cut off, they found a cocktail of drugs. They suspected it was a drug deal that went wrong, which would explain his tight lips!!

 

Even on Christmas Day, you can’t guarantee an easy ride. Still, mostly genuine jobs this time 🙂

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“Winter pressures”

This could well be the winter that breaks the NHS, or which has come the closest to it.

Every year, there are “winter pressures”, this refers to an expected uplift in work for NHS teams across the country, in particular front line services like Ambulance Services and A&E departments. However, this winter (and we’re not really even at the busiest bit yet), has been borderline ridiculous.

As an Ambulance Trust, we have REAP levels (think of them as Def-Con levels all the American films have). We usually bimble around at REAP 3, this is where everything is at its normal; many many calls, but just about enough resources to cover it, enough vehicles and enough staff.

REAP 4 is slightly more chaotic. The sheer volume of 999 calls puts serious pressure on everyone and there is a really struggle to find resources (by which I mean Ambulances) to answer the calls. Staff sickness/absence means that shifts are dropped as there are no medics to cover them.

We’ve spent a large majority at REAP 5. There are only 6 REAP levels, and at level 6, the trust is in melt down. At REAP 5, there are not enough ambulance, not enough medics, not enough call takes and not enough dispatchers to cope with the huge volume of calls we receive. Calls come in faster than we can triage them and the difficult decision is made not to respond to low priority green calls (such as non-emergency transport to a department, minor cuts to limbs or vomiting).

At this point, our trust was on the verge of declaring a Major Incident. I’m not wholly sure what happens at this point, but as a crew we can only do one emergency at a time, so there’ll probably be little change.

Let me give you some numbers. In our division, we normally receive around 1000 999 calls in a 24 hour period, lately, we’ve received over 1500 calls in the same period. There are no more Ambulance and probable less staff to answer those additional 500 cries for help. This is why we are REAP 5.

Hospitals have it just as bad. There are simply no beds for the patients that need to be admitted. At one point, I counted 17 patients on trolleys and in wheelchairs in the corridor of one A&E department, but let me say that. Every one of those patients was receiving excellent care. They were having medical obs’ done, Doctors were speaking with them, they were taken to a private room for examination. It was a joy to watch this level of organisation.

With all this in mind, I’m worried. January and February are typically our ‘busy’ months, and we’re almost at capacity now!!  Lord help us and all NHS Staff!

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A message to shift workers.

My dear shift working colleagues. As you awake on Christmas day, don your uniforms and head out into the cold for another hard days work, please spare a thought for the poor, poor souls who are forced not to be at work.

Many establishments choose to close over the Christmas period, meaning that workers are not allowed onto the premises, even if they wanted to work.

They will surely awake – not by the usual 0630 alarm, but with calls of “HAPPY CHRISTMAS” from exited children bouncing on their beds, then commence the Christmas routine:

  • Drinking alcohol in the morning inducing a hangover by 2pm which can only be cured by more alcohol.
  • Eating an enormous meal so large that you simply have no more room for food, apart from the Christmas Pudding, Chocolate, Cheese board, crisps and sweets. You’re so full you feel you may vomit, but have more alcohol instead.
  • Giving and receiving gifts aplenty, all the while with festive songs on the radio and blockbuster films on the telly.

Meanwhile, you will be undertaking your usual duties of the day – some may decide to wear a festive santa hat, or some tinsel in their hair, but many will simply wear their own uniforms in the normal manner.

As you maybe able to tell from the tone of this post, I am most certainly the latter. I’m on relief (relief is where they extract you from your rota for 2 consecutive weeks every 10 to work whatever days they have shortages due to sickness/holiday at whatever station they dictate within a 25 mile radius of your base station – it’s a ball ache!) and so working three nights on Christmas Eve’, Christmas Day and Boxing Day. Although all the core rota shifts are covered, my ambulance trust believes that these days are the busiest of the year and so insists on running an extra double crewed ambulance for the period. YES!!

Anyway, my bitterness aside. Have a lovely Christmas and stay safe – I’d like very much not to leave the Ambulance Station all night!!

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