Life of a Trainee Paramedic

Yesterday, I, along with my colleagues off the course, including the 2nd years, attended a Major Incident Exercise at the local airport.  Apparently the exercise needed to be conducted so that the airport could get some sort of license. It involved, as I am sure you can imagine, a place crash.  We were told to get there for around midday so that we could get some make up and prosthetics applied, depending on our ‘injuries’.  I was suffering from Shock, had suffered head wounds and had been knocked unconcious, causing me to fit.

I think the lecturer’s had great fun in applying make up to everyone and burning/cutting some of our clothes.  There was also a lot of fake blood around, which one of our lecturers wanted to completely empty before he was happy so there was a lot of stained skin afterwards.

It actually takes a lot longer than you would have thought to sort everything out before any medical personnel get on the plane.  The fire service have to come in and inspect the place, after putting out whatever fires there may be, and then they help assess the patients.  All the non-injured and walking wounded were ushered out of the ‘plane’ first’ and then those that had injuries were inspected by a medical professional and assessed as either Priority 1, 2 or 3, with 1 being the highest. I was a Priority 1, due to me still being unconcious and having a Respiration Rate of 34 and a pulse of 110.  Other priority 1’s were a guy who was having an MI, someone who had some shrapnel though their shoulder, possibly piercing their lung, someone with their intestines hanging out, someone with airway burns and a pregnant lady, as far as I can remember. 

This lady went into ‘labour’ and she started to have the baby.  Now they seemed to give her most of their attention, while I, who was still unconcious and the guy with the MI were left till later.  I honestly think that I would have died due to the wait for me to get treatment, as breathing at such a fast rate, I would not be getting a sufficient quantity of oxygen to survive, and coupled with the fitting, my prognosis would not be good.  Now I know the pregnant lady needed to be seen to, but it wasn’t a life threatening condition, as ours were.  Surely we could have been assessed and some first stage treatment begun, and then they could have continued with the lady.  I don’t know what really happens in these situation’s so if someone with more experience could comment I would appreciate it.

It was a fun day though to see how everything would hopefully work.  There was also free food supplied afterward, which we all enjoyed.  After all it would have been rude not to!

I’m finished as regards to placement as my mentor had some unforseen family commitments, and was unable to arrange cover in time.  This means that my parents get the pleasure of my company one day early!  Lucky them!

TP

Steve, a party magician, is carrying three pieces of gold each piece weighing one kilogram.

He comes to a bridge which has a sign posted saying the bridge could hold only a maximum of 80 kilograms.

Steve weighs 78 kilograms and the gold weighs three kilograms.

He reads the sign and still safely crossed the bridge with all the gold.

How did he manage this?

Well these past three day shifts have been quite eventful in terms of the types of jobs that I have gone to.  On tuesday, I had my first epileptic fit and I was able to see how those situations are managed.  This patient had the honour of being the first person I’ve been able to use my newly purchased pen torch on to look at her pupils.  After a little dose of diazapam, and 10 mintues in the ambulance, they had noticably come round.

Wednesday morning I had my first RTC.  This was when it was very icy on the roads, and the Highways agency in our area had decided not to go out and grit the roads, which made accidents inevitable.  However this accident occurred on an ice free road.  The first car was stationary, when another car went into the back of it, then another into that and finally a 5 tonne bus into that.  This caused the 3rd car to be pushed about 100m down the road and the 2nd car to end up way up the road.  When we got there, I presumed that the 2nd car was at the back, it was only when considering the power of a bus going at 60mph.  We got to deal with the patient in the first car, who was complaining of neck pain.  My mentor offered me the chance to put the collar on, and even though we have done it at Uni, I decided not to. As it was my first RTC, I wanted to watch how my colleagues handled the situation, so I got into the back and supported the patient’s neck while they worked.  When they were away, I had a good chat to the patient, who was on his way for a game of golf with his friends (he insists he would have won), when the accident happened.  Even though it was a bad accident, and the driver of the 3rd car should have bought a lottery ticket that night, I felt pumped up and focused.  It was very different from any of the other jobs that I’ve been to, and it was my first time seeing the Police, Fire Service and the Ambulance Service, all work together.  It really did loook like a seamless operation, and you could tell that everyone was quite aware of what everyone else was doing.

Today there were 3 first’s.  I went to my first dead body today.  Rigor Mortis had already set in so I asked if I could touch as I’d never felt it before and it would be good for me to recognise.  We have no idea how the patient died, although he did seem to have some form of rectal bleed, and had bashed his head on the bathroom wall.  He was found lying crunched up between the toilet and the wall.  How he ended up there I will never know.  He had a dog, which his neighbour kindly offered to look after.  The Police officer that was there was one I’d seen before, I’m beginning to recognise some of them now.  It seems the crew’s in my area have a good relationship with the Police which is always good.

Secondly I got to attend to my first patient.  I had wanted to wait a little longer, but when my mentor offered me the chance, I thought I might as well go for it.  It was only what is known as a ‘Class 2′ in my service.  These are generally GP referrals to hospital, which this was.  The lady and her daughter were very nice, and it seemed to go well.

Lastly, I had my first burn today.  Unfortunately it was to an 11month old baby who had had tea spilt on him, when he was reaching for a cup.  Obviously it was quite distressing for the parents, but the burns were only superficial and would heal quickly, not that you could guess that from how the child was, understandbly, crying.  It was actually quite sad, but at least there is a good prognosis.  I was told that the best treatment for children in Diesel.  This is because the quicker they get to Hospital, the better.

There are still quite a few other first’s left including Anaphalactic Shock, Asthma or some other respiratory attack, Stroke, any kind of trauma, and pregnancy.  I think I can wait a while for the last one!  I’m off now until wednesday night.  I should be in on tuesday night aswell, but the Uni had organised a Major Incident day for us which we have to attend which should be a good experience, so I had the night off as I think I would be knackered. 

Have a good weekend.

TP

Today we went to a patient who would be termed a ‘regular’, except they never made any of the calls.  It was to a 40 odd year old female who is an alcoholic.  She was found lying on a pillow in the middle of the street at around midday.  My mentor and his crewmate recognised her immediately and tried to persuade her to get up and come into the back of the ambulance.  She was verydrunk, and would be unable to get home by herself, and if we left her there, someone would have dialled 999 again and we would have had to attend again.  The only option was to take her to hospital so that she could sleep it off.  When we walked through the doors to A&E, she insisted that she didn’t want to go, and got off the bed and walked out of A&E still heavily drunk, and there is not a thing we could do about it.  Not even when another patient’s relative’s proclaimed ‘you can’t let her just walk around like that’.  There is actually nothing that we can do for her without her consent.

Around about an 3/4 of an hour before we finished we were again called to a unconcious female with ‘life status questionable’.  Now it turned out that another crew had been out to her again today when this time she refused to go to hospital, and this next call being in the same area, we were pretty sure that it was the same woman.  It was, and by this time it was getting bitterly, and I say bitterly cold, but as this was the 3rd time in less than 6 hours that someone had gone out to her, and knowing that there was nothing wrong, we left her in the hands of the Police Community Support Officer, who got some support and I presume that they took her home, but I’m not sure as I don’t know what they do in these circumstances.

Now this is only my opinion, but when I see things like this, I really wish that the Government would do something about it.  The Ambulance Service can’t do anything, neither can thePolice, but it’s obvious that this woman needs help.  She is not going to do anything about it herself, at least not for the foreseeable future , as alcohol is her daily routine.  I think that there should be some sort of hostels, for want of a better description, where people with such alcohol related issues are taken, whether they want to or not, to get the help that that so desperately need.  They should be kept there until they have sorted their addiction, so that it doesn’t rule their lives.  A form of rehab, but one where there is a set time that you have to stay and cannot leave before.  It may sound barbaric, it may be against their Human Rights (which I’m sure some lawyer would be happy to take up), but it would seem the only way that they would confront, and start to deal with their problem.  I’m sure at the end of it, they would be happy for the help.  It just makes you think of the waste when you see things this.  I would be interested to hear other ideas on the subject.

A good thing that happened today though was to an 92 year old lady who had broken her hip (not the breaking of the hip).  There was a lady with her, who she didn’t know.  This was because the number that she thought was for the flat upstairs must have been off by a digit or two, as the person she rang lived across town.  This has happened several times before apparently.  Now this lady, having no idea who the caller was, but knowing that she needed help, headed across town to help this elderly lady before we had got there.  I thought was a very kind thing to do, and I wondered how many other people who do the same thing in her place!

TP

Well I’ve got 6 shifts left before I finish for Easter and it has flown by. It doesn’t seem like only two weeks ago I was starting my first shift.  In that time, I’ve been all over the place, at all times of the day and I can say it’s been good.  I’ve been to some mansion type houses, spotlessly clean, and to other houses rather less so.  From the outside, when your driving past, all houses really look the same, it’s only when you get inside that you can tell the difference.  I can’t understand how some houses can get into such a mess. 

I know I can be untidy, I’m sure my parents would say that was an understatement, but then even I get fed up with it eventually and tidy it up.  It’s only my room that can get into a ‘mess’, I would call it decorative art, as I tend to put post, clothes, books, folders all over the place, there’s rarely an empty surface, but it’s what I’m used to, and I know where to find things.  I find it incredibly  irritating to come home and want something to only find that it has been moved from where I put it.  Is this a Mom thing?

I’m currently in the process of writing the last 1000 words of my essay, which should go quick really as I’ve got most of my information.  I hope to do a little better than the last one, but I shall have to wait and see.  I’m back on placement on tuesday for 3 day shifts so we shall see what happens then.

TP

Every day the man saw his dog ran into the woods. However, he noticed that the dog never ran more than halfway into the woods. Why?

I’m sitting here back at station at the moment while were on a break.  The first call of the night involved the dreaded snakes.  We were called to a 45 yr old female with chest pains.  She did not want to go to hospital so my mentor was going to give her an MOT just to check everything was ok.

I had only been talking last weekend about my fear of snakes, so when I was collecting the paper work and the defib from the ambulance, my mentor’s colleague, who had noticed the snake in a tank, asked this lady’s son to get it out, and put it round his neck.  When I came back through the door and saw the snake, I literally just stood there, and did not move any further.  I think that they did it on purpose, although they professed to have ‘forgot’ about our conversation. Yeah right!  My mentor came and collected the stuff off me, and I waited outside until it was safely back in its cage.

I know when I am actually doing this for real by myself, I will have to some how get over it, but until that time comes I will quite happily stand a good 10 metres away.

TP

Yesterday was my first shift where a death occurred while I was working on the ambulance.  I’ve been part of a resus attempt before when I had a day in A&E back in December, but then I was only controlling the breathing, this time I was also doing the compressions.  We’d been called to a 79yr old female who was having chest pain.  It was quite a way from where we were so it took us a while to get there.  Some RAF responders were already there before us and were dealing with the patient.  When they arrived, she answered the door and was talking to them normally until she collapsed. 

We arrived about 30 mins after their arrival to take over the patients care.  As this was my first ‘big’ job, I took a step back and tried to take everything in, getting whatever drugs my mentor required, getting the bed into the house, and talking to the Health Visitor who had just arrived to try and get a bit of history.  Once we had got her onto the ambulance, we set off for hospital, which was again, a good 20-30 minutes away, even on blue lights.

I was helping her with her breathing while my mentor was sorting out some drugs.  About half way through the journey, the patient crashed, she stopped breathing and her heart rate dropped and so we started CPR.  We were unable to shock her with the defibrillator due to her being in Pulseless Electrical Activity.  PEA is where there is a normal heart pattern but no detectable pulse.  She was given atropine and adrenaline to try and kick start the heart into beating again.  We were getting thrown around in the back of the ambulance at this point, and it is really hard to keep your balance.  When their is only one person in the back, all that would be able to be done would be CPR, as there wouldn’t be time to give any drugs.  When we arrived at Hospital, we rushed her into the Resus room, where the doctors and nurses continued trying to bring her back.  Unfortunately they were unsuccessful, and the patient had been down just over half an hour.  All this happened within 1.5 hours from the first responders getting there, to her death, it really can happen that fast.

It made me think that I need to teach my family how to do CPR.  Were having my nan come to stay with us from now on, as she’s 80 yrs old, is getting a little forgetful, and having trouble with her knee, who isn’t completely able to look after herself.  Were having the garage converted into a bedroom, so she won’t have to deal with stairs, and at least if she’s living with us, there will nearly always be help near by.  With this lady’s death, I thought it would be a good idea for my family to know what to do, just in case!

It was quite busy otherwise yesterday, my best day so far in terms of the number of jobs we had.  We had just got back to station when a job came through that said ‘pregnant lady, waters broken’. My first thoughts were ‘oh shit’ (I apologise for swearing), but thankfully we got stood down soon after due to another crew being closer.  Now I know it would have been a good experience but I would like a little more experience working on the ambulance before I have to help deal with a woman in labour!  I start nights again on tuesday for 3 days so we shall see what happens there.

 TP