The Complete Blood, Sweat and Tea. Tom Reynolds

was a complete dead weight. Once more I nearly killed myself lifting her. All her body functions and observations were normal so it was a complete mystery why she was unconscious, although I could confirm that she had been incontinent of urine …

      … after I put my arm in it.

      All these problems throughout the day meant that we worked harder than we needed to – and yet, throughout the day we had a great time as we laughed and joked between patients and vowed never to work together again. I said that I’d take sick leave, saying I was ‘stressed’ and ‘Team Leader’ said she would make sure I got sent to the other side of London before she worked with me again.

      And so, at the end of the shift we parted, laughing at the thought that it was possible we could be repeating the experience tomorrow.

      I’m looking forward to that possibility.

      ‘Team Leader’ is still on our complex and is still a good laugh. Thankfully, I haven’t had to work with her again.

      

Broken Ambulances

      One of the main problems with the LAS at the moment is the lack of vehicles. In the past this has come to mean that there are not enough staff to man the vehicles that we have, or fill the rota to maintain safe cover over our area. Lately, however, we haven’t had the vehicles physically present. At the moment, I am typing this from work and looking out the window at the fitters whose job it is to maintain the fleet in our area of London. There are 13 ambulances waiting to be fixed. There are 3 crews sitting on station unable to take any calls because their vehicles have broken down.

      Someone has just visited us in the staff car (a nice little Corsa) and, on attempting to leave, its clutch has broken.

      Today I took an ambulance from West Ham over to Poplar to replace a vehicle whose steering had broken. Two management brought over a spare vehicle from Newham for me to work on – a vehicle that had just had a broken rear suspension fixed.

      Let me tell you, riding on an ambulance with no suspension is an ‘interesting’ experience – you get thrown around and the cupboards fly open spraying bandages and other, less soft, equipment around the cabin.

      This ‘fixed’ ambulance lasted three jobs before the suspension died again and I was bouncing around the cabin. It also stalled if you closed the choke.

      So now I’m sitting on station twiddling my thumbs, unable to continue my daily grind of saving lives picking up drunks.

      The fleet is just falling to bits, the new Mercedes have faults developing around the 5 000 miles mark and the tail lifts are extremely temperamental (like my experience yesterday – they fail at the worst possible moment). The LAS needs a cash injection so that it can have a fleet of basic, but reliable ambulances, fully equipped and fully manned.

      Things haven’t changed much since I wrote this, although with a few extra vehicles the turnaround for crews without a vehicle is a bit better.

      

An Apology to A&E Departments

      I would suggest that a lot of the people who read this are doctors and nurses of one persuasion or another. I also guess that many of these readers have some experience of A&E departments.

      So, as an EMT I wish to apologise.

      I’m sorry that throughout the shift I will continue to bring fresh meat to the grinder, that is, I will be forced to transport patients from ‘outside’ into your department, where they will need to be looked after and assessed by your own good selves.

      I’m sorry that I have to sometimes bring their relatives who will harass you about waiting times, the pain their relative is in and about why you are drinking that cup of coffee while their dearly beloved is ‘at death’s door’. I’m also sorry that sometimes I couldn’t bring the only relative who can translate the patient’s moaning and groaning into English, thus making assessment a thousand times easier.

      I’m sorry for the dross that I bring to you: the cut fingers, the bellyaches and the spotty backs. I’m sorry that the primary health-care workers (the GPs) are often so useless as to be a liability. I’m sorry that you have to cope with the fallout that occurs because there are so few good GPs and you have to become the first point of call for coughs, colds and diarrhoea

      I’m sorry that the schools don’t teach basic health and first aid to their students, preferring to waste time on the history of glaciers or the solving of quadratic equations. This means that the population wouldn’t know the difference between a minor cut and an arterial spurt if it jumped up and hit them over the head with a hammer, neither do they know which of these two injuries warrants a trip to the local Emergency Department.

      I’m sorry that our communities where our Elders teach our Youngsters and the Youngsters listen no longer exist, resulting an influx of first-time mothers who think that when a baby vomits it is a precursor of death.

      I’m sorry that the protocols and guidelines that we adhere to don’t allow us to leave patients at home. In England at least, we have to transport to hospital. The government thinks that we cannot tell the difference between serious cases and the aforementioned cut finger.

      I’m sorry that the police cannot look after drunks on a Friday night; they worry that they will choke to death in the cells, and so we get called. We have nowhere else to take them to but your department. Sorry.

      I’m sorry that I bring in those serious cases 5 minutes before your shift finishes. If it’s any consolation it’s probably 5 minutes to the end of our shift that people decide to have their heart attacks, their amputations and their dissecting aortic aneurysms. Like you, this means we get off late as well.

      I’m sorry, but it’s not my fault.

      I wrote this in part because we do sometimes get dirty looks from A&E staff as we drag in the umpteenth drunkard of the shift. It’s not my fault that the government made 999 so easy to dial.

      

Knee Trouble

      Gillick competency is the ability of youngsters under the age of 16 to give informed consent for medical treatment. Essentially, we have to assess whether a child is competent enough to make decisions about their own body. This is, as you might guess, an ethical minefield.

      Back to work with the rather enjoyable 18:00–01:00 shift, where you tend to get lots of drunks, and very few serious cases that require me to do some actual work.

      However, you do occasionally come across a job that is tricky, not because I worry about the patient’s illness, but instead for reasons that to the non-ambulance person are hard to understand.

      Our first job of the day was one of those very jobs. The call we were given was 13-year-old female with a dislocated knee. Nice and easy I hear you say, but lots of minor problems can build up to make a job less than ideal.

      We arrived on scene and found a patient who had a rather obvious dislocated knee – just imagine your kneecap shifted 2 inches to the left, so much so that it casts a shadow on the rest of your leg. Simple enough to deal with: if you are feeling brave you can slide it back into place yourself, or go the more recommended route which is to take the patient into hospital and let the doctors fiddle with it.

      Then the problems started piling up. To start with there were no adults present, just another (unrelated) teenager; neither the patient nor this other teenager were what you would exactly call brain surgeons. We are not supposed to deal with children without an adult present, but what else can you do in those circumstances? The father had been called, but he was travelling from another hospital where he had been undergoing outpatient treatment. So we had to decide whether