Blue Lights

Ambulance stories (33)

~ beetleypete ~ Leave a comment

On the Blues and Twos.

All emergency calls attended by the London Ambulance Service, should, as a rule, be driven to using the blue lights, and warning sirens, fitted to the vehicle. When I started work there, the siren was in fact a two-tone horn, giving a distinctive sound. This was universally recognised, and referred to by everyone, including children, as a ‘nee-naw’. Vehicles that I drove in my earliest days, also had a loud continuous bell fitted. This was a hangover from the time when crews would physically ring a bell, which was attached to the outside of the vehicle, and pulled by a rope. Luckily, the sounds emitted by all these devices, as well as the later adjustable siren sounds, are not as loud to those inside the vehicle, as they appear to anyone outside.

In London, in the central area especially, traffic is more or less at a standstill, for most of the day, and a good part of the night too; at least until the very early hours, just before light. Most of the normal streets are narrow, and even the larger, two or three lane thoroughfares, are clogged across every lane. In recent years, the advent of bus lanes has only served to completely fill the inside lane with great ‘crocodiles’ of nose to tail buses, making a left turn even more of a challenge. Drivers have a tendency towards selfishness, and are notoriously inattentive, particularly when listening to loud in-car stereo systems, in-ear music players, or when talking on mobile phones.

Then there are the black cabs, a law unto themselves. Doing their famous u-turns, stopping on a sixpence to grab a fare, or parking at a most inappropriate spot, to drop someone off. Add to this the hordes of cyclists, arrogantly ignoring all road signs and traffic restrictions, and the legions of motorcycle couriers, rushing like riders possessed of a death wish, in search of the next delivery. Then there are the drivers new to London; flummoxed and panicked by the lane changes, one-way systems, and suicidal pedestrians, they become unpredictable, like antelope fleeing a pride of lions. Into this maelstrom, we have to drive our top-heavy, unwieldy vehicle, laden with equipment, and with rearward vision only possible by using two small mirrors fixed to the front doors. The tightly packed, high buildings, all serve to bounce the sound of your sirens around, and you can see the spinning heads of the drivers, as they strain to ascertain your direction of travel.

Some drivers do try to help. They do their best to move their vehicles out of your path, often mounting pavements, sometimes going through red lights themselves, risking prosecution from traffic enforcement cameras, trying to do the decent thing. All you ever wanted them to do was to stop, and not to move in any direction. You can drive around stationery vehicles, but those that decide to move become dangerous, and offer a dodgem-car experience instead. Others often refuse to budge. London residents are jaded from familiarity with sirens, and are so used to the constant flow of emergency vehicles, that they become inured to them, and no longer see them as part of an event, something that they have to respond to. In extreme cases, they may even vent their own frustration at traffic conditions, by not only deciding not to move, but also going out of their way to be deliberately awkward.

Then there are the fleets of vehicles that find it harder, or downright impossible to get out of the way. Dustcarts in one-way streets, sluggish street cleansing vehicles, parked vans, their drivers away making deliveries; and huge lorries, wedged in the tightest of spaces, having to deliver bulky items, pump concrete, or off-load tons of bricks. All of these have to be reversed away from, or bypassed with constant right-left turns. One way streets have to be complied with, and going against the flow of a one-way street is taboo, whatever you see on the films. Red lights can be driven through, but only with the greatest care, and at reasonable speed. Have an accident in one of these situations, and you could find yourself prosecuted by the Police, and disciplined by your employer as well.

As a result, I usually favoured crossing to the wrong side of the road, and forcing my way against oncoming traffic. At least they could see you coming, and it was preferable to weave in and out of them, than to sit behind solid jams, with the lights on, and horns blaring, making no progress at all. It was not unknown, for us to take as long as 20 minutes to make a journey of less than two miles. No wonder it has always been so difficult to meet government targets, of an arrival time of less than 8 minutes. In the suburbs, on a nice day, with light traffic flow, and a fairly long run, of say five miles ahead of you, it can be exhilarating, of that there is no doubt. You can legally break every rule in the book (except those one-ways) and justify it, should the need arise. It is boy-racer heaven, dressed in uniform and responsibility.

In the centre, it is nothing short of frustration and stress, and it can also be incredibly tiring, as your attention levels have to be kept at an unnatural high, at all times. Pedestrians often become incredibly stupid, when faced with an oncoming emergency vehicle. It is as if their life suddenly becomes charmed by your presence, and they feel that they can do anything. They can hop across that main road with impunity, sure that you would never hit them. They might decide to walk straight into that gap, the one that you have just spotted, and decided to use as your way through the hold-up. Or, they will get out of a taxi, or step from behind a bus, just at the moment that they can hear your two-tones bearing down on them.

What is surprising, is how few are killed by ambulances, if any at all. I do not recall anyone ever killing a pedestrian whilst driving an ambulance, in all the years that I served. There were also some spectacular vehicle accidents during my service in London, and again, I do not remember anyone ever dying as a consequence. I was lucky, I suppose, as I could never claim skill as a reason. I had one or two damage-only accidents, that were never judged to be my fault. I never knocked anyone over, or suffered any injury personally, as a result of a traffic incident.

The saddest thing, is that after the first few weeks, the excitement of all that unusual driving just goes, as it becomes normal. You start to be pleased when you get a non-emergency call, and you don’t have to use the ‘blues and twos.’ So, don’t be envious, as they speed by, on the wrong side of the road; and never presume that they are going to get a meal, or a cup of tea. It is far too dangerous to muck around for the sake of refreshments, and just doesn’t happen. They would probably sooner be driving normally, sitting behind you in the traffic, shooting the breeze with their crew-mate, or eyeing up the girls.

Ambulance stories (9)

~ beetleypete ~ 24 Comments

The fainting woman

After a very short time in the Ambulance Service, you soon learn to disregard the diagnoses given by Ambulance Control. They are at the mercy of the caller, and their own desire to end the call, within their protocols, as soon as possible. So, there is a constant repetition of the same diagnosis given for the call you are being asked to go to. Others can be wildly inaccurate, perhaps because of language problems, or lack of observation on the part of the caller. After a while, you do not expect what you are told, to be what you actually see on arrival.

One morning, we were returning from the Charing Cross Hospital in Hammersmith, when we were called to a well-known high-rise estate, not far from our base. We were told to meet a caller outside the entrance to one of the highest blocks, and that he would take us to the victim. The job was given as, ‘Female fainted; possibly unconscious’. We understood that this could mean anything. She may well be unconscious, possibly not. She may have fainted because she was pregnant, or she might well have tripped over a kerb, and not have fainted at all. There was a good chance that she had suffered a cardiac arrest, and an equally good chance that there was nothing wrong with her whatsoever. Either way, we would not find out until we got there, so the sirens and lights were engaged, and off we went.

On arrival, we saw a man at the end of the service road, directly outside the block address given. Although there was no other traffic, save an ambulance making its way at some speed, lights flashing, heading directly for him, he still felt the need to wave frantically at us, his arms flailing as he repeatedly indicated the point that we should bring the vehicle to a halt. This behaviour was so common, that I gave these people the affectionate nick-name of ‘Wavy Daveys’. He was standing next to a woman in a collapsed state, crumpled on the floor, and looking very pale. On first examination, she seemed to be uninjured, though getting a history from her proved difficult, as, confirming her Mediterranean appearance, she was speaking in what I knew to be Portuguese. She was gesturing to her right, around the other side of the entrance porch, her mouth flapping like a puppet, as she repeatedly exclaimed something in her own language, that we could not understand.  We decided that we had best get her into the vehicle, out of the cold, and examine her further. The trolley bed was brought over, and she was blanketed, lifted onto the bed, and placed into the vehicle. She finally managed some English, interspersed between her Portuguese ramblings. She wanted us to open the back doors she said, there was something important to tell us.

We could not calm her down until the doors were opened. As we did so, she pointed again at the side of the entrance porch. “There, there, look there” she shouted, before sinking down onto the pillows, uttering a stream of religious incantations. To placate the distressed lady, I walked over to look in the area that she had indicated. Just out of sight of the road, in a corner aspect of the building, a few feet away from the entrance to the block, was the shattered body of an adult male. From the amount of blood and bodily fluids, and the bizarre positioning of the limbs, I knew at once that this was someone that had fallen from a great height. The briefest of examinations told me that nothing could be done, and I returned to the ambulance to summon the Police on the radio.  I also asked for a second vehicle to deal with this new job, and returned to the body, to carefully cover it with a blanket. We then waited the short time for the arrival of the assistance, and our lady in the back grew calmer during this interval.

She had indeed fainted. Then again, if you were just about to go up to your flat, and a body whistled past you, hitting the ground with a never-to-be-forgotten sickening crunch, you might well faint too.

Ambulance stories (8)

~ beetleypete ~ 28 Comments

Experience not necessary

This is another example of how experience does not always guarantee good performance, and how the wisdom of age can be cast aside by events.

One evening, I was working with the oldest, and most experienced man on our Ambulance Station. I was almost 40 years old, and he was over 50. Between us, we had some 38 years of experience in the job. Towards the end of the shift, which had been very busy, we were called to a traffic accident. It was described as a ‘hit and run’, a pedestrian had been knocked down, and the car responsible had left the scene. We had some way to travel to this job, and on route, we were updated on the radio; the situation was believed serious, Police on scene had advised us.

On arrival, things did indeed look serious. A man in his 30’s was lying across the road, which had been partially closed by Traffic Police. On examination, it appeared that the man was semi-conscious, smelt strongly of alcohol, and had a visible wound to his head. His shirt was wet around the abdomen, despite dry conditions, so my colleague removed it, to better examine the male. We immediately saw that he had organs protruding from a wound there, and soon ascertained that it was his intestines that were clearly visible. We applied a very large dressing, dampened to protect the exposed tissue, and advised the nearby hospital that we would soon be arriving with a seriously injured man.

I drove off, blue lights flashing, sirens wailing. In the back, my colleague administered oxygen, and closely monitored the patient, during the short journey to the local Casualty Department. Arriving at the hospital, we rushed him in to the Casualty, where a special Trauma Team was waiting. They quickly removed his trousers, to reveal a dislodged colostomy bag. What we had believed to be a torn abdomen, was in fact a surgical stoma, where a piece of intestine is left exposed to attach to the colostomy bag. The man was well-known to the staff there, and  he later confessed that he had been drunk, and tripped over the kerb, hitting his head, and detaching the bag attached to the stoma. There had been no car, and no traffic accident, all of that had been presumption on the part of the Police, and bystanders who had happened across him. Had we not allowed ourselves to get caught up in the drama, no doubt we would have worked this out for ourselves.

We both felt pretty stupid, and it took us a long time to live that one down.

Ambulance stories (1)

~ beetleypete ~ 29 Comments

The un-snippable turd

Sometimes, ambulances are called by other agencies, and not by the person in need of help. Railway staff make frequent requests for ambulances, whether in underground stations, or on the main line system. When you consider how many people are travelling on both systems on any given day in Central London, it is understandable, to some degree.

So, when we received a call on the radio to go to Paddington Station, it was not particularly unusual. We had added information, that a female was in a collapsed state in the toilets, in great pain, and unable to move. On the way to the job, with siren blaring and blue lights flashing,  we were in the habit of considering what we might be going to encounter on arrival. Using the basic information and diagnostics supplied by the caller, we could presume a whole number of things. Young female, toilets, great pain, cannot move. This could be a back injury perhaps, or maybe a gynecological problem. The pain of appendicitis, or kidney stones, could be very severe, and might impair movement. We would have to establish if the female was pregnant, as that could open up a lot more possibilities. Fortunately, Paddington Station is only a few yards from St. Mary’s Hospital, one of the biggest and best in London, with a very good Emergency Department, (which I prefer to call ‘Casualty Department’) so we would not be travelling far from the scene of the crisis.

On entering the station, we were met by staff, who quickly showed us down to the female toilets. They had thoughtfully closed that particular facility, to allow us to work in peace, and to leave room for the equipment we carried down, in case we needed it. It was soon apparent we were in the right place. Loud screams could be heard coming from a cubicle, and a worried-looking female Railway staff member advised us to ‘hurry up’. It is not easy to work inside a toilet cubicle that is already occupied by a sitting female, as I am sure you can imagine. Squeezing through the small gap available, I made a full assessment of the scene facing me. A shouting, near-hysterical young woman, aged about 25, was sitting on the toilet, legs splayed, bracing on the sides of the adjacent stalls. She was not wearing anything below the waist, and was yelling in a strange mixture of French and English combined. I have enough French to get by, and I managed a rough translation of her dilemma. ‘Get it out, quick, I can’t get it out, you do it, it hurts.’ She confirmed the location of the problem by raising her left buttock, and signalling between her legs with an agitated hand motion. I wondered what it could be. Perhaps she was trying to deliver a baby, not uncommon in toilet areas. Could she have sat on something sharp, or even been attacked, and have a foreign object impaled in her person? I managed to calm her down, stopped her screaming, and finally got her to co-operate. I gently lifted her from the seat, her arms around my neck, and I peered behind her, which given the physical restrictions of the situation, was not an easy feat.

What I saw, was a dark, hard stool, protruding from her backside to a length of some four inches. Or was it? It could have been a Mars Bar, or a Picnic, a Double Decker, or similar turd-like confection. It occurred to me that she may have been inserting it into her anus for personal reasons (not as unusual as you might suppose) and it had stuck there, unable to go all the way in, or come back out. But no, it was just a turd. Further questioning established that she was at the end of a short break holiday to London, she had become constipated, and tried to relieve herself, before travelling back to France. The recalcitrant bum-muffin had a short look at the outside world, viewed its fate, and decided to stay where it was. No amount of flexing of her young French sphincter would budge the first effort; it was literally un-snippable.

I decided that manual evacuation would be the only option, and handed her a latex glove, with instructions given to her in French to grasp the offending object, and snap it free. She refused, stating that it was too painful to contemplate. There was nothing left but to don the glove myself, and attempt the tricky manoeuvre personally. With no assistance from the panicking Parisienne, I was forced to crouch on the toilet floor, place my chin on her thigh, and reach around the rear of the toilet seat. This placed my face dangerously close to her arched pelvis, as she struggled to gain height from the bowl. No sooner had I come into contact with her stool, with no more than a brush of my hand, as light as a butterfly’s wing, she resumed screaming, and crying out that the pain was unbearable. By now, my temper was fraying. Her worried friend was yelling at me to leave the girl alone, and the Railway staff were asking how long would it be before they could re-open the toilets. I had to concede victory to the turd, and take it, and the girl, to the hospital.

I was far from happy. Although I am sure that it must have caused some discomfort, to have called an emergency ambulance to this nonsense was unacceptable in my view, and I told the Railway staff exactly what I thought of their actions. We had to wrap the girl in a blanket, place her into our small carrying-chair, and get her upstairs to our vehicle. She yelled all the way, as if we were deliberately hurting her, gaining the sympathy of the dozens of people on the main station concourse. There was increased volume as we transferred her onto our trolley bed, for the one minute journey to the Casualty Department. I handed over to the head nurse, unable to hide my annoyance at what I considered a complete waste of all our time. Luckily for the patient, nurses are unusually sympathetic by nature, so she was cooed over, and put into a comfortable cubicle. As the nurse unwrapped the blanket, to examine the girl’s nether regions, we could see the outcome of being carried upstairs in our chair, then transferred to the trolley. What had once been a proud, firm digit of a stool, now resembled a quarter-pounder burger, squashed flat against the young woman’s bum cheek.

I later found out that she had been given a laxative, and had manged to pass the rest of her package. Makes you feel all warm inside, for a job well done…

 

Ambulance stories (Introduction)

~ beetleypete ~ 12 Comments

It has been suggested, by family and friends, that I should add some stories of my experiences in the London Ambulance Service. These may be amusing or diverting to some, perhaps informative to others. I have added a new category for these tales, although they will also be categorised ‘Nostalgia and Reflections, for obvious reasons.

As many of the subjects of these recollections will still be alive, as will many of their families, I shall be careful not to identify them too clearly. I will be changing real names, omitting surnames, and not including actual addresses. Please be assured, that no matter how fanciful or contrived these incidents may appear, they will all be 100% true, memory permitting.

In recent years, television programmes, both factual and fictional, have sought to portray the life of Ambulance Crews and Paramedics as exciting and vital. They are seen rushing from one emergency to another, sirens wailing, and blue lights flashing. In reality, much of the job is repetitive and mundane. Attending the same addresses constantly, picking up the same vagrants and street drinkers on a daily basis, and being used to transfer patients from one hospital to another, or to take them home after treatment. Even when you are given a call that sounds serious, or potentially exciting, it rarely turns out to be so.

Of course, there are many incidents that call for complete professionalism, and the use of all the skills taught and acquired. Cardiac Arrests, Cot Deaths, Major Incidents, ‘Jumpers’ under trains, delivering a baby at home; these are just a few that spring to mind. However, it must be remembered that these are the exceptions.

With this in mind, you will appreciate that it was necessary to have a rather black sense of humour, a strong stomach, a tolerance of swearing and bodily functions, and the ability to deal with people from all classes, all races, and of all ages. If you are easily offended by descriptions of human waste, delicate situations, or upset by the reality of disaster, please avoid these posts at all costs, as I do not intend to apologise later for any of the content.

I once saw an American A&E Consultant being interviewed on a documentary about Cook County Hospital, Chicago. He summed it up very well, with the following comment.

” I spend fifteen minutes of my time, in the worst day of the patient’s life, and I do it for 12 hours a day, every day.”