Oct 30 2008

The drugs don’t work.

Tag: AmbulanceKal @ 10:39 am

A thought inspired by a sixteen year old suicide attempt.

“I just thought if I took all the tablets in the bathroom…”

The problem was that “all the tablets” amounted to her granny’s iron tablets, a strip of out of date antibiotics and a pack and half of immodium.

Not likely to kill you.

Not likely at all.

She’ll not poop for a week…and when she does her jobbies will be like bitumen…but she’ll not die.

Which got me thinking.

I know I don’t know enough about over the counter pharmaceuticals to kill myself. Not by OD, at least. I’m pretty certain you don’t need to be a dispensing chemist to eat a 12-bore.

But to OD on OTCs? I’ve not a clue. If I sat down with some textbooks I reckon I could work it out so that I just slipped away and never woke up, a la Hollyoaks and other televisual dross.

So if I, an honest to god medical-type (kinda), can’t work it out; what chance does the man on the Burdiehoose omnibus?

I’d estimate that I treat at least one OD a week. I’ve only ever seen one of them die. Most of the time it’s a wee chat, a “‘mon then” and the three of us walk down to the vehicle.

Are those people too stupid to think about what they’re doing? They always swear to me that they want to die. Are they too emotionally wraught at the time to think it through? Is there insufficient public education about how un-fatal and yet perfectly horrible ODs can be as they work through your system? Are TV soaps to blame?

Should, we in fact, start publishing leaflets with tablets that tell you exactly how much you’d need to take, on average, to achieve: nausea, disorientation, coma or death? Maybe a graded traffic light system, like the supermarkets use for salt and saturated fats?

Cos if the paracetamol boxes said “You will require Xmgs of this drug to kill yourself, anything less will leave you with horrendous liver damage. PS. If you do take the lethal dose, it’ll take days of agonising waking pain before you die.

Then I think people might think twice.

Discuss.


Oct 28 2008

Jargon - Standby

Tag: JargonKal @ 11:50 am

When we’re not busy (because we never say the “Q-word”), when there are no patients to be had, or GP’s Urgent calls to attend, when you’ve had your break (or aren’t yet due it), then you get sent to some particular part of town to “Standby”.

Because there’s a computer, somewhere, that’s decided that in about twenty minutes, there’ll be an emergency JUST round the corner from the district it’s about to send you to.

Maybe.

But if there IS, then you’ll be in JUST the right place to get there within eight minutes and tick a governmental pen-pushing box somewhere, and we’ll all get a pat on the head from the MSPs and told that we’re doing everything right and won’t that feel nice?

What’s that?

More money and resources?

Ummm…HEY! What a nice head! Let me pat it.

Standby works at times, when the city is busy it is, of course, a smart idea to spread the vehicles across town, getting a response to folk quickly and smoothly.

But at four in the morning, when you’re comfy and warm in the station…getting sent to sit in a layby in the shittiest end of town is hardly an attractive concept. We have a deal with the fire service, allowing us to use their stations. Which would work fine, but for the fact that the fireys in all but two stations across Edinburgh appear to hate us. One station complained that we were waking them up with our inconsiderate coming and going at all times.

So we find spaces to hide, burrowing into the city’s dark corners like altruistic parasites. I like the Meadows, a vast green park in the centre of town. The car park of the prison is a nice place, too, quiet and dark. Other guys find all night garages in which to drink coffee, or drive into secluded housing estates.

It’s part of the job, it’s what we signed up for.

But it’s cold and dark and not a whole lot of fun.


Oct 27 2008

WCCGOHH - Round II - Week Three - Results!

Thanks to all that played this week - I’m wondering how thrilled CC will be to have this photo public on the internet…

Ahh, fuck ‘im, he modelled, he’s getting it.

The correct answer this week was, as can plainly be seen, a black leatherette kitten-ears hair band.

Astonishingly, nobody guessed correctly. So once again we fall back on “which post made me laugh hardest?”

Special mention must be made of H from Marsbarn Designs for her suggestion that “Prince Charming” was coming to “Climb his hidden tower.”

Congratulations, H, for inadvertently writing homo-porn-filth.

And we thought she was such a nice lady…

Kirsty of TwoLimeLeaves believed that CC didn’t have a hat on at all, but was, instead, the victim of feline head-rape.

And we thought she was such a nice lady…

The winner of the week, however, is NinjaMedic, with:

“It’s one of those big black turban-esque jobbies that the Ayatollah of Iran used to wear, but this one has a wee little choo-choo train on a track going around and around it, playing ‘She’ll Be Coming ‘Round The Mountain’ with tiny puffs of smoke coming out of the train stack.

Man, I need to never take Percocet again. It gives me some very strange ideas…..”

I do like the train thing, and the choo-choo thing…and the smoke, and the coming round the mountain.

But mainly, I’ve chosen her as the winner because, in this crazy WCCGOHH round of pornography and sex-crimes, it seemed nice to pick the guess that rounded us off with some drug hazed hallucinations.

Congatulations NinjaMedic! :D


Oct 26 2008

Clocks back

Tag: AmbulanceKal @ 1:20 am

I’m writing from the Station, it’s dark and cold and rainy. We’ve just been to the creepiest house in Edinburgh and, as of twenty minutes ago, the clocks went back by an hour.

All you diurnalites out there, spare a thought for your night shift workers who are doing a thirteen hour stint tonight.

And no, we don’t get paid for the extra time.


Oct 25 2008

In which Kal is a preachy little dick.

Tag: AmbulanceKal @ 4:00 pm

We’d brought her in from a night club, drunk and spitting when she wasn’t lolling, unconscious, over the edge of the bed.

She’d drunk more alcohol than I could take whilst remaining upright, but would probably struggle to weigh more than half of me.

Dumped on a trolley, we head out to pick up actually sick people.

-

Hours pass and, as the ED starts to empty out for the night, I bump into her sitting at the front door, resting her head on the shoulder of an older woman.

“Would you be Mum?”

She nods while I turn my attention to the lassie.

“And how are YOU feeling?”

She stares blankly at me.

“You have no idea who I am, do you?”

She shakes her head.

“You were calling me a dick just four hours ago.”

Her hands fly over her face as she moans out.u

“Ohhhh noooo….Oh God, don’t look at my face…I don’t want you to remember me.”

“Really? Your mates told me you’re a nursing student.”

“Noooooo!”

“Oh relax, see when you do your A&E rotation? You’ll see countless people like you and you won’t remember any of them.”

“But…but…”

She was so whiny, so “I’m not LIKE these guys.”, so desperate to be distinct from the rest of the jakeys that were stumbling into the car park.

I’d had enough.

“D’you know what, mate? You needn’t worry. By the end of my shift, I won’t remember your face, let alone your name. You’ll just be another drunken kid we’ve scraped off the floor on a Friday night.”

“But…”

“It’s true, I’m afraid. You’re just the same as all of them. And once you’re treating them, you’ll feel the same way…but if you’re really concerned, I’ll make you a deal. I’ll promise to forget all about you if you promise I’ll never again pick you up for being drunk.”

“Deal.”

I start away to the ambulance, but can’t resist a closing shot.

“Oh, and by the way?”

“Hmmm.”

“You ARE totally mortified, right?”

I head back to the vehicle, listening to her parents cackling at her embarassment.

Nothing like ganging up on teenagers :)


Oct 24 2008

Jargon - VDI

Tag: JargonKal @ 1:11 pm

I have no idea what VDI stands for, maybe “Vehicle’s Daily Inspection”?

It’s a word of itself “VeeDeeEye”, the check we run on the vehicle and its contents at the start of the shift. The first twenty minutes of each shift is meant to be sacrosanct, Control should only contact you for emergencies, no standby or simple transport jobs.

We check the equipment, supplies and drugs, the clipboard in the front for essential paperwork,the lights, siren and other functions of the vehicle. If you’re super-duper diligent you’ll check the oil and screen wash, pump up the tires and wash the outside.

And grab a cuppa.

To be sent out in this first twenty minutes makes crews antsy, unsure of what’s in the back, whether the bag is set how they like it. “Return for VDI” becomes a priority.

The easiest VDI comes when you relieve a trusted friend, who can tell you the jobs they’ve done and alert you to any short falls. Best of all is when that friend is on opposing shifts to you. You give them the vehicle at the end of your night shift, listing its deficiencies and foibles and, 12 hours later, they do it all over again to you when you start again for the evening. Falling into this pattern for a run of shifts is somewhere close to green suit nirvana.

We spend hours at college learning to check ambulances, a list on a clipboard, unsure of abbreviations or technical kit “Is this a flexible suction catheter?” “What the fuck is a Pneupac?”

Once you’ve been in the job for a while, you can almost VDI the back of a vehicle by touch, you know what to find and where to find it and the gaps jump out at you faster than the supplies.


Oct 24 2008

Hand-washing.

Tag: AmbulanceKal @ 12:36 am

“We’ll put Mum in the front seat… I want one of you guys in the back with us, she’s not too keen on breathing…the extra hands could be helpful.”

Together we winch the incubator into the back of the vehicle, a tiny person inside, her age numbered in hours, rather than days.

Scary observations and abnormal signs has earned her a host of diagnostic tests, some of which can’t be completed here at the maternity unit.  We’re called in to provide a short run across town to the paediatric unit and back again in time for tea.

We take spanners and grips to the bolts in the vehicle’s floor, adapting the fixing mechanisms to accommodate the incubator’s specialist clamps.  The terrifying concept of the equipment and patient coming loose en route are enough to equip our DIY skills with a paranoid ultra-diligence.

Myself, Anne the Baby-Boss and a nurse ride in the back, closing the bulkhead window between the cab and ourselves “To keep baby nice and warm.” we tell Mum.

It’s bullshit.  The incubator’s systems won’t even notice the difference between an open or closed window.  But the glass plate lets us talk freely, discuss our plans if the patient should stop breathing, as we fear she may.

The nurse is on her first transfer; she listens to Anne and I casually slinging insults at each other with widening eyes.

“Are you guys always so nice to each other?”

“It’s a love/hate thing.”

“Without the love part.”

She stares at the two of us as we cackle together, Anne explains.

“We’re allowed to slag each other off, I know him, he knows me.  He knows I’m in charge, I know I can trust him if things go wrong.”

I don’t let on, because it would be totally dorky to do so (and we all know I’m never, ever (except all the time) dorky, at all), but I get a ridiculous shot of chest-swelling pride at Anne’s nod towards me. It’s a funny thing, the local services’ response to us when it comes to little people. The Sick Kids, our paeds unit, is generally very positive towards us, recognises what we do and supports us in our training and development. Similarly, the Neonatal unit thinks we are all round good cunts, driving, as we do, their tiny little charges all over the country for them every day.

Midwives, bizarrely, slap in the middle of neo-nates and kids?

They hate us.

But, fuck ‘em. See how much use THEY are at an RTA in the middle of the night.

Regardless of these trends, it’s still awful nice to have the boss of a department (especially a department that you really, really want to work with more) say “I know I can trust him if things go wrong.”

Why thang-yew.

Our journey passes without incident and in a few hours we’ve delivered everyone safely back to the Neonatal Unit, scrabbling with those wrenches and clips, my fingers in the clamp-runners on the floor of an ambulance end up coated in grease and dust and everything else you fear you might find in the nooks and crannies of an ambulance’s floor, regardless of how well it’s swept and mopped.

By the time I’m done, they’re mawkit. We all troop back upstairs with the incubator. Anne sends Dad elsewhere “You go and get a cuppa, we’ll look after her.”

The results of the tests are not good. Not even slightly. The prognosis is grim, barely fitting the “pro” aspect of itself. There will be no birthdays for this lassie, no school, or college. No boyfriends or heartbreak or grandchildren for Mum and Dad. We all stare in at her in her sterile, bleeping box.

There’s a powerful human urge to make contact when you see someone dying. I close the eyes of cardiac arrest patients, it might look sentimental and mawkish, but I see it as a final, vital fragment of humanitarianism. We drop warm hands onto the shoulders of our sick patients, twine their fingers in ours, stroke their hair.

The first time I was in this department it took me over an hour to bring myself to touch the patients, latterly I’ve become more confident and comfortable.

I’ve no qualms about stretching a finger into that incubator to touch her forehead or caress her arm, it wouldn’t make a shred of clinical difference and I’m confident the staff around me would hardly notice, let alone comment.

But my knuckles are covered in grease. My fingernails are thick with dust and filth. I don’t want to think about the germs that are on my skin from crawling on the floor of the vehicle. I keep my paws in my pockets as the practicalities of my job preclude me from carrying out the most basic of human actions.

And sometimes, in this job, that’s just the way it is.


Oct 23 2008

Anyone clever out there?

Tag: PishKal @ 10:03 pm

Because my sidebar’s disappeared down below all the content.

It’s in the right place on individual posts, just not on the home page.

EDIT -

HAH! Genius! Steve at tewha.net rocks the house!

Go and tell him what a brilliant person he is!

Go!

Go!

(thanks Steve)


Oct 21 2008

Dear Bunny

Tag: AmbulanceKal @ 11:48 am

Running in front of the ambulance is rarely a good idea.

I’d typically swerve, or brake, watch you flash your fluffy wee arse off into the gorse bushes.

But the incubator wouldn’t like it, the transfer team would freak out and the top might blow off the patients head.

So instead?

I’ll just squish you.

Sorry dude.


Oct 20 2008

They always get their man.

Tag: Best Stuff, AmbulanceKal @ 9:58 pm

We’re way overdue a meal break and heading up town to pick up some munchies when the screen starts wailing. Officially we’re not available for the job, but the message makes us think twice.

“Patient unconcious and not breathing.”

“Fuck it - you happy to go?”

You’d have to be a hard-hearted cunt to choose your sandwiches over a cardiac arrest; Bryson punches the “Go Mobile” button on the screen, a navy line tracking across the map, leading us to a darkened towerblock.

The carpark is spread with shattered concrete, dogshit and glass, purple yellow security lights shine across the entrance from behind black mesh cages.

“I thought these were being pulled down?”

Bryce is attending, so he takes the bag and oxygen, I lift the defibrillator from its cradle and slip my Maglite horizontally across two belt loops under my jacket.

“Tooled up?” Bryson grins at me.

“It might be dark…” I answer, grimly. We both know I’m a chicken, that I want the security blanket of a big metal stick on my belt. Not that we’d ever admit to it, the line is always that “it might be dark.” It’s said with good reason, we’ve been here before.

We ride the lift, shuddering and shaking, all steel and sweat and fading council notices, up to the first floor. Our patient is apparently in 1/4, or floor one, flat four.

Flat four is boarded shut with sheet metal, rivets the width of my thumbs pounded into the concrete on either side.

“Four stroke one?”

“Could be…”

We tramp up the stairs, October’s wind hissing between the crazed perspex that passes for windows. Names are scratched into its surface, lovers and enemies, couples and hits, Croick Kirk resurrected with Stanley blades and needles.

The fourth floor has four metal doors, humming gently in the breeze.

“Nobody in here.”

“Bad pun.”

He stares at me.

“No…body?..Forget it.”

We slope back down the stairs to the vehicle, the radio boops rhythmically before our controller’s Irish tones come through the speaker, thin and sharp.

“403?”

“Yeah, nothing found at this locus. Can you call back and confirm the address for us?”

“Police are on their way, we’ve already tried to noise up the caller, phone’s dead.”

A sandwich and van pull up, five cops raise ten eyebrows at the two of us standing in the cold.

“Where’s the job?”

We explain, the unclear address, the boarded up flats. As a group we stare up at the blunt obelisk. Two windows are lit.

“Someone’s still living up there?”

His shoulder badge has five figures. Most cops have four. I’m confident he’s been working for less time than I have.

“Looks like it.”

As a group, we start up the stairs. The defib is heavy, its plastic handle starts to sweat and rub against my palm as I plod up the concrete steps.

At each floor, one or two members of our gang leave the stairwell, confirming that every flat is welded shut, prodding the doors to the bin chutes open with our feet, stepping around rusty puddles of effluent and damp, shining torch beams into dark corners where … something scrabbles down a hole away from us.

On the sixth floor we find our first wooden door, warm golden light spilling from its transom. The spyhole has been pushed out, a hole as wide as a pencil through the wood of the boundary. I close my eye to it.

A classic smack den. No floorboards, no furniture. The man of the house staggers to the hall wearing only ragged boxer shorts and a stained teeshirt in response to my knocking.

“Who is it?”

“Ambulance! Come to the door, please.”

“I don’t need an ambulance.”

“You didn’t call?”

“No. Fuck off.”

Good enough for me, I join the climbing party.

By the time we’re at the seventh floor, I’ve found myself with two officers, one male, one female and as a threesome we swing into a leapfrogging pattern. He checks floor eight while she and I climb to nine, she checks nine while I leave her to clear ten, meanwhile he passes us both and sweeps eleven.

The building is confirmed empty in minute, so the police search their database for anyone matching the patient’s name we’ve been given. His address is just round the corner, so the entourage troops round to wake him from sleep. He’s drowsy and angry at being disturbed, but clearly not in cardiac arrest.

There is nothing else to do.

We can’t reach the original caller, we can’t find the patient.

We climb back into our vehicles and drift off into the night. If the call was genuine, somebody, somewhere, is dying on a floor with an intoxicated friend staring over him.

We’ll find him some day.

We always find them in the end.


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