In reality there is no such thing as a 'typical shift'. There are aspects of the job and patients who are similar in presentation but no two days are ever the same. Its the unpredictability and not knowing from one minute to the next what you're going to be doing which first attracted me to a job in the ambulance service. You never know where you're going to end up or who you might meet and that put together with the possibility that sometimes you can make a difference and help someone in need makes it in my eyes the best job in the world.
Sat 0500 - Alarm goes off. I like my sleep and bed so hit the snooze button and close my eyes for another 5 minutes
0505 - Time to get up, quick wash, get dressed, feed the cats and out the door by 0535
0545 - Arrive on station. Priorities first, i make myself a cup of tea and then check the board to see who i'm crewed with and which truck we're on. The notice board and station log book lets us know of any other useful information such as local road closures or issues with certain vehicles or pieces of equipment so a quick glance of that on the way to the garage is a good idea too.
0555 - Book out drugs - Morphine and a Paramedic drug bag and then secure these in the safe on the ambulance before starting a vehicle kit check with my crewmate.
0600 - Book on with control, ensure we both have a radio and then finish completing vehicle check and our cups of tea! After that to the crewroom to catch up with everyone else working before we get sent out on jobs or standby.
0613 - First job - Red2 - 86yo Fall (Injuries Unknown). We arrive at the address and let ourselves in using the keysafe code given my control. We find the elderly lady on the floor by the side of her bed, she tells us she's been there a few hours after falling on the way to the bathroom in the dark but only just remembered to press her pendant alarm to get help. She's been incontinent of urine but is otherwise uninjured and in relatively good spirits. We help her up and get her changed into some clean clothes before completing a set of observations. Everything is fine, she shows us she can mobilise as normal with her frame and we suggest maybe leaving a hallway light on so she can see more easily if she needs to get up in the night. Her carers will be in at 0800 to get her up and breakfast so we leave her in bed to get a bit more sleep until they arrive. I leave a copy of the paperwork and inform the GP non-conveyance line that we attended and give details to pass onto her own GP. We then 'clear' on scene at 0702 and make our way back to station on standby.
0712 - Standby on station - Decide i'll risk trying to get some breakfast, amazingly today i manage to cook and eat my bowl of porridge without any interruptions from the radio. Success!
0730 - Dispatched to standby in the city centre
0735 - Red2 - Didn't make it to our standby point - got a job instead. 6 year old male has fallen down the stairs and bumped his head. Turns out today is his birthday, he's got a bit over excited running down the stairs and fallen down the last 5 hitting his head on the radiator at the bottom. He has a small laceration and a nice lump appearing as we check him over. Not knocked out, no other injuries and his observations are all ok too, he's obviously upset so we let mum give him some calpol and then after a discussion with mum and dad about what they want to do we all agree that A&E isn't necessary right now, especially on his birthday! Instead i call our Emergency Care Practitioner (ECP) and he agrees to come out to glue the cut on his head. We're still there completing paperwork when he arrives and it takes less than 5 mins for the laceration to be glued resulting in a much happier patient. We give head injury advice to the parents and then leave a copy of the paperwork and say goodbye leaving him to try and enjoy the rest of his birthday!
0845 - Standby in the city centre...doesn't last very long!
0852 - Green2 - From NHS111 - 30yo male with diarrhoea and vomitting. We buzz up control on the way and ask whether this can not be dealt with by the Clinical Supervisor or a GP...apparently he's 'feeling dizzy' so we have to attend. Its a village outside the city so it takes us 15mins to get there. Bottom line is he needs to 'Man up.' Yes he has a sickness bug but he's only had it for 12hrs and he's not dying. We advise him to keep drinking clear fluids and stay in bed. If the symptoms persist for another 48hrs we suggest speaking to his GP or the Out of hours (OOH) service. He apologises for having us attend, we cant blame him, it's not his fault - the NHS111 service is still experiencing triageing and teething issues.
1013 - We arrive back on station and its time for our break. We get one period of 30mins undisturbed 'Rest' during a 10hr shift and two on a 12hr shift. Today its a 10hr early shift so this is our only opportunity to be guaranteed time to cook and eat anything without being disturbed by control.
1048 - We're now off break and get given an 'Urgent' call which has come from a GP to take a 65yo female with abdominal pain into the Medical Assessment Unit. The GP has already been out and assessed her at home and we're basically there to give her a lift to hospital. She's taken all her pain killers before we arrive so is relatively comfortable en route to hospital. The journey is spent with her telling me about her life breeding and showing springer spaniels - my favourite breed of dog!
1200 - We clear at the hospital and get dispatched back to standby on station.
1233 - Red2 - Backing up an RRV already on scene to a 71yo male with an exacerbation of Chronic Obstructive Pulmonary Disease (COPD). He is normally on home oxygen anyway but today he is really struggling to breathe with the slightest exertion. We suspect he has a chest infection as he's developed a productive cough over the last couple of days and he has a raised temperature. On route to hospital i adminster a nebuliser to ease his breathing and help shift some of the mucus on his chest. He is struggling to maintain his oxygen saturations above 86% so we take him into Majors in A&E where they can continue his treatment and likely start him on some IV antibiotics and possibly steroids for his infection.
There are 5 other ambulances at A&E so we're almost guaranteed to be given another job straight after clearing. Sure enough we do...
1353 - Red1 - Dispatch for Potential Cardiac Arrest - In the High street - We're just ahead of another crew also just cleared from hospital on the way to the same job. More details are passed saying that the patient is a 30 something male and is slumped against a wall down an alleyway behind a major department store. We get on scene first and grab the defib and oxygen as well as the response bag. We also take the torch (this can come in handy as a good defensive weapon to protect ourselves if things turn nasty!) There is no one else around but as we approach our slumped figure i recognise him as a 'regular'. He lives on the streets, spends what money he comes by on alcohol and drugs and to find him in this state is nothing unusual. Today he's unconscious surrounded by empty cans of lager and drug paraphernalia. We have to be careful so as not to give ourselves a needle stick as we get him onto his back to properly assess him. He has a reduced respiration rate of about 8 breaths a minute, is cyanosed around his face and extrematies and has pin point pupils - all the signs of a Heroin overdose. Whilst my colleague starts 'bagging' and assisting his breathing with ventilations of oxygen via the bag-valve-mask (BVM), i draw up the drug Naloxone which we will use to reverse the overdose. As the second crew arrive I give him an injection into the top of his arm before i begin looking for any elusive vein on his arms which hasn't already been destroyed from his excessive drug use over the years. Into the muscle Naloxone takes about 5mins to begin working and is more slow releasing than if it is given into a vein. I've always used the basis that best practise is to give intramuscular first so it can begin working whilst looking for a vein to possibly given any additional if needed. I also tend not to cannulate but instead inject straight into the vein if i need to. This way if the patient comes round quickly and gets violent or runs off we haven't provided a easy access point into his vein for future drug use - that's if there are any veins visible of course! On this guy there are no veins - he normally injects into his groin and i wasn't going there! He'd begun to come round after 5mins so happy the second crew could now leave us to it i gave another dose into the muscle of the other arm and we then waited for it to work its magic...within 10mins he was sat up chatting to us like nothing had happened. As with all Heroin overdoses i advised him he should attend hospital where he can be monitored for a few hours as its possible to relapse back into the same state once the Naloxone has worn off. However he refused as he always does so instead agreed to sign a 'refusal' form and we let him go on his way. No doubt we'll see him again.
1440 - Red2 - Backing up the RRV normal road speed. This time to a 75yo who has had a collapse in a restaurant. The Paramedic on the car has already been on scene about half an hour in which time the patient appears to have made a good recovery from what was a suspected vaso-vagal (fainting) episode, however to rule out anything more sinister and cardiac related he's requested a vehicle so that we can carry out an ECG in the privacy of the back of the ambulance. The patient and her daughter have been out shopping and had been for a late lunch before they were going to go home. The episode happened as they were getting up to leave. The ECG shows up nothing suspicious and we all agree it was most likely a faint. The patient is adamant she doesn't want to go to hospital so we are happy to let her go home with her daughter who can keep an eye on her. I suggest maybe making a doctors appointment sometime in the next week for a check-up as she hasn't been in over a year and then inform the non conveyance line so that her GP will already be aware.
1528 - Back to station for the end of shift, we replenish the bits and pieces we've used, top the vehicle up with fuel and then we wait for the relief crew to take over from us. Luckily they are both in 15mins early so by 1555 after signing over drugs i'm in my own car driving home. Back again for another early next day.
Stay safe, Titch x
Sat 0500 - Alarm goes off. I like my sleep and bed so hit the snooze button and close my eyes for another 5 minutes
0505 - Time to get up, quick wash, get dressed, feed the cats and out the door by 0535
0545 - Arrive on station. Priorities first, i make myself a cup of tea and then check the board to see who i'm crewed with and which truck we're on. The notice board and station log book lets us know of any other useful information such as local road closures or issues with certain vehicles or pieces of equipment so a quick glance of that on the way to the garage is a good idea too.
0555 - Book out drugs - Morphine and a Paramedic drug bag and then secure these in the safe on the ambulance before starting a vehicle kit check with my crewmate.
0600 - Book on with control, ensure we both have a radio and then finish completing vehicle check and our cups of tea! After that to the crewroom to catch up with everyone else working before we get sent out on jobs or standby.
0613 - First job - Red2 - 86yo Fall (Injuries Unknown). We arrive at the address and let ourselves in using the keysafe code given my control. We find the elderly lady on the floor by the side of her bed, she tells us she's been there a few hours after falling on the way to the bathroom in the dark but only just remembered to press her pendant alarm to get help. She's been incontinent of urine but is otherwise uninjured and in relatively good spirits. We help her up and get her changed into some clean clothes before completing a set of observations. Everything is fine, she shows us she can mobilise as normal with her frame and we suggest maybe leaving a hallway light on so she can see more easily if she needs to get up in the night. Her carers will be in at 0800 to get her up and breakfast so we leave her in bed to get a bit more sleep until they arrive. I leave a copy of the paperwork and inform the GP non-conveyance line that we attended and give details to pass onto her own GP. We then 'clear' on scene at 0702 and make our way back to station on standby.
0712 - Standby on station - Decide i'll risk trying to get some breakfast, amazingly today i manage to cook and eat my bowl of porridge without any interruptions from the radio. Success!
0730 - Dispatched to standby in the city centre
0735 - Red2 - Didn't make it to our standby point - got a job instead. 6 year old male has fallen down the stairs and bumped his head. Turns out today is his birthday, he's got a bit over excited running down the stairs and fallen down the last 5 hitting his head on the radiator at the bottom. He has a small laceration and a nice lump appearing as we check him over. Not knocked out, no other injuries and his observations are all ok too, he's obviously upset so we let mum give him some calpol and then after a discussion with mum and dad about what they want to do we all agree that A&E isn't necessary right now, especially on his birthday! Instead i call our Emergency Care Practitioner (ECP) and he agrees to come out to glue the cut on his head. We're still there completing paperwork when he arrives and it takes less than 5 mins for the laceration to be glued resulting in a much happier patient. We give head injury advice to the parents and then leave a copy of the paperwork and say goodbye leaving him to try and enjoy the rest of his birthday!
0845 - Standby in the city centre...doesn't last very long!
0852 - Green2 - From NHS111 - 30yo male with diarrhoea and vomitting. We buzz up control on the way and ask whether this can not be dealt with by the Clinical Supervisor or a GP...apparently he's 'feeling dizzy' so we have to attend. Its a village outside the city so it takes us 15mins to get there. Bottom line is he needs to 'Man up.' Yes he has a sickness bug but he's only had it for 12hrs and he's not dying. We advise him to keep drinking clear fluids and stay in bed. If the symptoms persist for another 48hrs we suggest speaking to his GP or the Out of hours (OOH) service. He apologises for having us attend, we cant blame him, it's not his fault - the NHS111 service is still experiencing triageing and teething issues.
1013 - We arrive back on station and its time for our break. We get one period of 30mins undisturbed 'Rest' during a 10hr shift and two on a 12hr shift. Today its a 10hr early shift so this is our only opportunity to be guaranteed time to cook and eat anything without being disturbed by control.
1048 - We're now off break and get given an 'Urgent' call which has come from a GP to take a 65yo female with abdominal pain into the Medical Assessment Unit. The GP has already been out and assessed her at home and we're basically there to give her a lift to hospital. She's taken all her pain killers before we arrive so is relatively comfortable en route to hospital. The journey is spent with her telling me about her life breeding and showing springer spaniels - my favourite breed of dog!
1200 - We clear at the hospital and get dispatched back to standby on station.
1233 - Red2 - Backing up an RRV already on scene to a 71yo male with an exacerbation of Chronic Obstructive Pulmonary Disease (COPD). He is normally on home oxygen anyway but today he is really struggling to breathe with the slightest exertion. We suspect he has a chest infection as he's developed a productive cough over the last couple of days and he has a raised temperature. On route to hospital i adminster a nebuliser to ease his breathing and help shift some of the mucus on his chest. He is struggling to maintain his oxygen saturations above 86% so we take him into Majors in A&E where they can continue his treatment and likely start him on some IV antibiotics and possibly steroids for his infection.
There are 5 other ambulances at A&E so we're almost guaranteed to be given another job straight after clearing. Sure enough we do...
1353 - Red1 - Dispatch for Potential Cardiac Arrest - In the High street - We're just ahead of another crew also just cleared from hospital on the way to the same job. More details are passed saying that the patient is a 30 something male and is slumped against a wall down an alleyway behind a major department store. We get on scene first and grab the defib and oxygen as well as the response bag. We also take the torch (this can come in handy as a good defensive weapon to protect ourselves if things turn nasty!) There is no one else around but as we approach our slumped figure i recognise him as a 'regular'. He lives on the streets, spends what money he comes by on alcohol and drugs and to find him in this state is nothing unusual. Today he's unconscious surrounded by empty cans of lager and drug paraphernalia. We have to be careful so as not to give ourselves a needle stick as we get him onto his back to properly assess him. He has a reduced respiration rate of about 8 breaths a minute, is cyanosed around his face and extrematies and has pin point pupils - all the signs of a Heroin overdose. Whilst my colleague starts 'bagging' and assisting his breathing with ventilations of oxygen via the bag-valve-mask (BVM), i draw up the drug Naloxone which we will use to reverse the overdose. As the second crew arrive I give him an injection into the top of his arm before i begin looking for any elusive vein on his arms which hasn't already been destroyed from his excessive drug use over the years. Into the muscle Naloxone takes about 5mins to begin working and is more slow releasing than if it is given into a vein. I've always used the basis that best practise is to give intramuscular first so it can begin working whilst looking for a vein to possibly given any additional if needed. I also tend not to cannulate but instead inject straight into the vein if i need to. This way if the patient comes round quickly and gets violent or runs off we haven't provided a easy access point into his vein for future drug use - that's if there are any veins visible of course! On this guy there are no veins - he normally injects into his groin and i wasn't going there! He'd begun to come round after 5mins so happy the second crew could now leave us to it i gave another dose into the muscle of the other arm and we then waited for it to work its magic...within 10mins he was sat up chatting to us like nothing had happened. As with all Heroin overdoses i advised him he should attend hospital where he can be monitored for a few hours as its possible to relapse back into the same state once the Naloxone has worn off. However he refused as he always does so instead agreed to sign a 'refusal' form and we let him go on his way. No doubt we'll see him again.
1440 - Red2 - Backing up the RRV normal road speed. This time to a 75yo who has had a collapse in a restaurant. The Paramedic on the car has already been on scene about half an hour in which time the patient appears to have made a good recovery from what was a suspected vaso-vagal (fainting) episode, however to rule out anything more sinister and cardiac related he's requested a vehicle so that we can carry out an ECG in the privacy of the back of the ambulance. The patient and her daughter have been out shopping and had been for a late lunch before they were going to go home. The episode happened as they were getting up to leave. The ECG shows up nothing suspicious and we all agree it was most likely a faint. The patient is adamant she doesn't want to go to hospital so we are happy to let her go home with her daughter who can keep an eye on her. I suggest maybe making a doctors appointment sometime in the next week for a check-up as she hasn't been in over a year and then inform the non conveyance line so that her GP will already be aware.
1528 - Back to station for the end of shift, we replenish the bits and pieces we've used, top the vehicle up with fuel and then we wait for the relief crew to take over from us. Luckily they are both in 15mins early so by 1555 after signing over drugs i'm in my own car driving home. Back again for another early next day.
Stay safe, Titch x
