1. Dirty Ambulances
2. Waiting times
3. Paramedic struck off

Imagine my surprise when on this occasion I open up my bookmarks, click on Times Online and am presented with the headline – Murder rate drops as Paramedics get better at keeping people alive.

Finally a bit of recognition for the life saving skills that Paramedics and Technicians possess rather than being slated for not making the 8 minute target for somebody that has faked unconsciousness meanwhile somebody’s 50 year old mother lies on the floor in asystole.

The basic outline of the article is that although violent crime is at an all time high the number of deaths are at a 20 year low, a trend that is due mainly to the increased skill set of Paramedics, better equipment and faster response times.

Brian Moore, Chief Constable of Wiltshire, said that police believe that the main reason for the fall in murders is the speed at which paramedics now arrive at incidents.

He said: “We would say it is the faster and better application of medical skills and science by paramedics. They now get to the scenes of crimes very quickly. Faster medical engagement and the paramedic approach is a fact all of my colleagues mention as the key reason for the fall in the number of murders.” Mr Moore, the Association of Chief Police Officers’ spokesman on violence and public protection, said that the communications revolution was also helping to save lives. In the past it could take between 30 and 45 minutes for help to arrive at the scene of a violent incident but now paramedics are often there within 15 minutes, he said.

Paramedics are using fast cars, motorbikes and even helicopters to get to crime scenes. Mr Moore said: “People have mobile phones and so they can call the emergency services more quickly than in the past. The paramedics can get to the scenes more speedily, can stabilise the casualty and take immediate steps to protect life.

“They can open up somebody’s chest, work on the wound, sew it up there and then.”

Source: Times Online

I’m not so sure about the last sentence, maybe he’s referring to a Doctor there?

I’m just happy to see that after months of only ever reading about the negatives of the Ambulance service we finally have some well deserved recognition. A pat on the back to Richard Ford the Times correspondent and Brian Moore, Chief Constable of Wiltshire.

What do you think of the story? Do the press focus too much on the negatives with little regard for the tremendous efforts that 99% of the Ambulance service put in?

This time last year I was thinking the exact same thing. My thought process was something along the lines of – I’m early 20s, university has failed me, current job has zero satisfaction, and I want a challenging job with good career prospects.

So what did I do? After much deliberation I decided that one of the emergency services would be the answer and researched each one individually. There are numerous pros and cons for each that I could go into but on this occasion I’ll refrain. Ultimately, the deciding factor that tipped the scales in favour of EMS (Emergency Medical Service) was continued education and opportunities for research.

I anticipate that a great deal of people will be looking for a career change in favour of EMS and with Student Paramedic opportunities cropping up all the time there has never been a better time.

To help you decide whether EMS is for you I’ve compiled a list of reasons as to why you SHOULDN’T join the Ambulance Service:

1. You enjoy knowing what you’ll be doing on a certain day more than 4 weeks in the future – unless you have a shift, 4 weeks in advance is all you’ll get.
2. You need more than 6 hours sleep before returning to work for your fifth 12 hour shift in a row – sleep pattern disturbance is inevitable.
3. You buckle under pressure – nerves are normal but to act rationally at an emergency is imperative.
4. You don’t have people skills and the ability to talk to people – to obtain a detailed and relative history when a relative is seriously injured or even deceased requires tactfulness and empathy.
5. You are massively overweight and about as much use as a chocolate tea pot when it comes to lifting - despite a minimal lifting approach you WILL be manually handling patients (heavy ones).
6. You have an insatiable appetite for money – the NHS won’t accommodate it.
7. You don’t enjoy making decisions in the best interests of others – patients will trust your clinical skills, the decisions you make can be the difference between life and death.
8. You never were interested in self taught education – EMS need to know a little about a lot and in some cases a lot about a little. It’s up-to you the clinician to maintain your knowledge and competencies via self directed learning. “I forgot your honour”. Will not suffice.
9. You have delusions of speeding around the city and attending major incidents everyday just like they do on casualty -  it’s never like it is on the telly.
10. You don’t think you’ll like driving with blue lights and a siren – let’s face it, this is one of the main reasons people join the Emergency Services. When the job comes in and it’s a genuine emergency I defy you not to feel butterflies in your stomach.

So what do you think? Do you agree with my opinions? I’m sure there are plenty more reasons as to why you shouldn’t join the Ambulance service, what are you the most relevant to you? Feel free to leave a comment and voice your opinion.

I’ve never been in this situation before so I’m asking the more experienced amongst you what happens? Do I get to finish on BST time or do I carry on working for an extra hour to make a 13 hour shift? I’m really not sure. I expect the person I’m working with will know but I just thought I’d ask.

While I’m rambling about time and dates I might as well ask what it’s like working Halloween? This time of the year must be the busiest for all the emergency services. Particularly in Cities where there are large numbers of adolescents roaming the streets setting off fireworks and inevitably injuring themselves or others.

The same goes with Bonfire night but I can imagine the potential for injury span the ages. From the child with a burnt hand from a sparkler to the dad that poured petrol onto the fire from a ladder thus scorching himself. A simple search on Youtube throws up hundreds of videos of some of the things we can expect.

For example

I’ve just read this article about the calls to emergencies in Dublin.

Emergency services in Dublin were stretched to their limits last Halloween, with Dublin Fire Service called out to 800 incidents and the ambulance service receiving about 500 calls.

The cost of this was approximately €1 million with the vast majority of incidents being avoidable. How will the Ambulance service cope this winter with services at REAP 4, the second peak of Swine Flu and the usual shenanigans that lead to call outs during this season?

If you have any notable experiences then please feel free to share by commenting below.

One last point. Next month has a Friday the 13th.

I was driving under normal road conditions and speed with the usual commentary coming from the instructor. With no warning she’d flicked the switch and calmly stated “The blue lights are on and the siren is going on…now”. At that point the cars that were neatly positioned in front of me gradually deteriorated into a fine chaotic mess, I guess they were expecting the sudden onset of lights even less than I was (quite how I wasn’t expecting it is beyond me, the whole aim of the day was to practise blue light driving after all). After a few seconds of madness the cars had become motionless and I could make my way through the meandering mess of motors and through the approaching set of red lights.

Going through red lights was a tad unnerving if I’m honest. Even when the lights are green and I’m in my personal car I’m wary of the nutter that runs the orthogonal red (but only by a few seconds because that’s okay). I took my time (relatively) to approach the red light with a right-left-right look down the road I proceeded through the junction with hesitant caution. The volume of information at 4 way lights is vast, there are: cars, motorbikes, bicycles, and pedestrians that are all moving in some direction, then you have the parked and stationary traffic that at any second may decide to move into your path. The best way to describe that first set of lights is to say that it felt like luck more than judgement that I negotiated it safely. Of course that wasn’t the case. It was because I was doing no more than a few miles per hour until I was certain that the area was clear before I made any rapid progress.

On this run that can only have lasted a few minutes I negotiated umpteen obstacles in a busy town environment and at the end of it I remember feeling like I had just run a 4 minute mile. I was clammy, breathing fast, pulse racing and had a beaming smile or was it a grimace?

I could try and recall each and every obstacle, each stubborn driver that refused to budge, each clueless motorist that has disregard for the 3 shiny things attached to their car that reflect light and indicate that an ambulance is approaching, the overtaking of police cars (a strange sensation) and their invaluable use as a traffic clearing escort, or the ignorance and failure to reciprocate the odd hand wave of the fire service personnel as you politely acknowledge the fact that they are on the road, but I wont.

In summary the driving course has been a very useful three weeks. The variety of vehicles and situations that Ambulance workers have to drive under in wide and varied. The course has been useful in highlighting the main hazards and methods of driving but cannot begin to hope to cover the assortment of situations that will arise when driving to and from an emergency.

Was a night drive. We started late in the day in order for the Sun to go down and the stars to come out.

Prior to any driving we carried out the usual procedure of the vehicle daily inspections followed by a quick discussion of the dangers and principles of night time driving.

The Dangers:

• restricted vision
• estimation of speed and distance
• reflections inside and outside the vehicle
• dazzle
• fatigue
• moving from light to dark areas
• a film of moisture, grease or dirt on windows increasing glare

All very obvious dangers you may think. That may be true but how many of you actually consider them? I don’t know too many people that allow for restricted vision or diminished speed and distance estimation at night. In fact I’d say that a percentage of drivers will drive faster and more erratically at night due to the relatively emptier roads.

The advice:

• clean windows, lights and reflectors
• adjust angle of headlights for vehicle load
• ensure lights and switches, windscreen washers, wipers and demisters work properly
• use main beam when appropriate
• use dipped headlights on left hand bends, hump bridges, overtaking, heavy rain, snow and fog.
• avoid being dazzled by oncoming traffic by looking towards nearside (left in UK) of road and slow down
• observe other vehicles headlights and tail lamps, and cats eyes for clues as to direction of road
• If tired —>stop safely, get fresh air, rest and get refreshments

Due to it being summer we only had an hour or so of actual night driving with the remainder being dusk. To be honest I found that dusk presented the greater hazard. Driving in and out of the shadows and towards the Sun on the horizon presented a greater challenge than darkness. This was probably because my eyes were never afforded the opportunity to ‘get used’ to one light setting. However, at night your eyes become accustomed and things become a lot clearer.

A good tip was to use dipped headlights (rather than full beam) when turning a left corner as the lights are aligned slightly to the nearside. If you maintain full beam on a left corner the road is practically invisible as all the light is directed way ahead and elevated. This advice is good for humped bridges and hill crests too.

I enjoyed the change of setting from day to night. The day stuff was beginning to drain me to be honest. Night driving allowed me to scan into the distance looking for clues as to the contours of the county roads. The cat eyes are a great help when trying to use the limit point method. A good point to remember with cars eyes is: the more there are, the greater the danger.

Day 10

Motorways. Today was all about joining the motorway; on the motorway; and exiting the motorway. The IHCD Driving book devotes a large section of the book to motorways and this has been reciprocated by our instructors as we have been up and down the motorways since day one. In essence nothing new was taught to us today but pertinent points were revisited.

General motorway safety:

• maintain lane discipline
• maintain safe following distance
• do not reverse
• plan your exit route
• be alert

Motorways are excellent for practising overtakes and acceleration sense. I tried to combine the two without using the brakes. It can be done. One thing you notice about people driving along motorways is that they are mostly reactive and hardly proactive. If one person touches the brake it usually creates a wave effect. Within a split second five or so cars react and also brake creating a caterpillar effect where the traffic constantly closes up and spreads out again. Infuriating.

The end of day 10 signifies the half way point of blue light training. Hopefully, the next time we go out it will be on ‘blues and twos’.

For those of you that aren’t technologically savvy I’ll explain some of the features that you can find on my blog page. The page is split into two parts essentially. The large section on the left is where I publish my posts for you to read and interact with by leaving comments. On the right you find the sidebar and this contains different sections that make reading this blog a little easier.

What is RSS?

In the sidebar you should see an orange square that looks like this if you click on this icon or the text next to it you will directed to a web page that will allow you to receive my blog posts in a feed reader. You should be doing this with every blog and website that you read. Basically RSS has replaced bookmarks so no longer do you need to constantly recheck many blogs just to see if on the off chance a new post had been published. Watch this short video and I trust that you will see the error of your ways.

The Sidebar

Also contained in the sidebar is a Recent Posts section. This is simply a list of the last five posts that I’ve published. Feel free to check back over any you have missed. Below that is a Search box. Type in a topic into the box and you’ll be shown a list of posts that have connections. Last but not least is the Blog Roll, this is a list of clickable links to the EMS blogs that I read. Click on any of these for a new twist on all things EMS.

And Finally…

After reading this post and watching the video clip there are only two things left to do.

Firstly leave a comment below so that I know who you are and you get the chance to promote your own blog.

Secondly, click on this wonderful looking button and subscribe to my blog!

A good place to practise?

Day 6
Cornering. I made it in to work early today to get myself some breakfast from the canteen as I had nothing in the cupboards nor fridge. I settled for a nice bacon and egg toastie with a milky cup of tea. Also I wanted to make sure that the vehicle daily inspections were completed well in advance of 0900 as instructed by the tutor on Friday. Of course, a 0900 start never materialised as the tutor was collared by some colleagues. So I went to the canteen for another cup of tea, this time I made it a little stronger.

Eventually we set off for a day of cornering in the windy roads that interlace the local counties. We were briefed on the principles of cornering and reminded of the presentation that took place on Day 5 including: road camber and surfaces; centrifugal force; safety factors; and the system of car control for cornering. Fortunately (or more likely intentionally) the choice of roads afforded us plenty of opportunity to put the principles of cornering into practise. Over the course of eight hours we must have turned a couple of hundred corners and each time we used commentary to reinforce the learning. Commentating while driving is thirsty work too.

The most useful tool for cornering from my point of view is the limit point.

This is the point at which the nearside and offside kerbs appear to meet.

Therefore if the the distance between the limit point and the vehicle decreases, so does the speed of the vehicle. If the distance remains the same, so can the speed. If the distance increases you can consider increasing speed. Genius.

By the end of the day we were more proficient with our cornering skills and will be practising them for the remainder of the course. I read that the rule of thumb for mastering a new skill is 10000 hours, still a few to go then.

Day 7

Overtaking. First part of the day was vehicle daily inspections, no change there. We topped up the radiator fluid and pumped up the tyre pressures. Before we got  to do any driving we sat in the ambulance with the tutor and discussed the considerations and special hazards of overtaking. In a nutshell overtaking is one of the most hazardous manoeuvres that takes place on the roads. This is mainly because you can come into conflict with other road users and hazards.

After a good ten minutes discussion we set off to find some unsuspecting road users. No you might ask how unsuspecting we could be in 4.5 tonne bright yellow ambulance? That’s a good question. We used an unmarked lease car instead. This I guess was to withdraw the courtesy that the majority of road users afford ambulance when we get extremely close to them on high speed single carriageways.

The day was extremely enjoyable. We got to perform a vast array of overtaking exercises on all different types of roads. The main lesson learned for me was to always have an exit plan if the overtake suddenly becomes impossible.

Day 8

More of the same. Today we practised cornering and overtaking in a marked up ambulance. The differences between a car and these massive vehicles are vast. From the information you require and display, through position, speed, gear to acceleration sense there are no similarities. The only thing they have in common is the system of car control. The system works.

These past three days have been fantastic for opening my eyes to the dangers of large vehicular movements. Although we have learned a lot we need to practise these skills for a long time to come and maintain them for as long as we use the roads. I am a bit of a pragmatist and will make best use of a system, others are a little less anal and will allow shortcuts to creep in. I don’t understand why, but they do.

If you were to take a driving test how do you think you would perform? Leave an honest comment if you dare.

Day 4

As per usual the day of driving began with the vehicle daily inspections (VDIs), we found a problem so took the ambulance to the mechanics to get it rectified. A lesson was learned at the garage. I asked what the engine was on the new Mercedes that we were driving, thereby asking what I thought was a straight forward and obvious question. Of course the answer I received was “That’s it there.” as he pointed under the bonnet, knowing full well that I meant the engine size. I set myself up a treat for that I guess.

Driving wise we practised acceleration sense with greater pertinence receiving constant prompts from the tutor as to when and when not to change gear or break. Day 4 was also an opportunity for us to pull together all that we had learned throughout the week and revise all the highway code ready for the subsequent test the next day.

Day 5

Was test day. The test was the IHCD Highway Code test that consisted of 50 multiple choice questions to be answered in 30 minutes. It wasn’t too difficult but did have far too many questions regarding level crossings for my liking. As usual there were plenty of ambiguous questions with misleading and confusing possible answers. However, none of these posed any real difficulties as the whole group passed with good scores. For the second half of the day we revisited all the PowerPoint’s of the week as a quick refresher prior to the week 2 of the course. The final part of the day was  a PowerPoint of cornering, a prelude to day 6 of the course.

That was the end of Driver 1 training following the IHCD syllabus. The aims of the week were to highlight any driver errors that had crept into our driving styles, teach us the correct method of car control, and put the theory into practise. I found the first couple days quite boring in all honesty, probably due to the fact that I’m a relatively new driver and haven’t really had time to pick up many bad habits. The latter stages of the week were far more enjoyable as we got to grips with small bits of advanced driving techniques. I anticipate the second week to more demanding and to present a steeper learning curve.

Even bus drivers have lessons

Day 1

The first half of the day consisted of PowerPoint lectures teaching us about the Law and the Ambulance Driver; what makes a good driver; risk taking; positive attitudes; weather conditions; and the system of control. We were also taught how to carry out a full set of vehicle daily inspections (VDI) for an ambulance.

During the second half of the day we took the vehicles out for a couple of hours as an opportunity for the tutors to assess our driving abilities. There were no real dramas involved so we had a quick debrief and that was the end of day 1 IHCD Blue Light Driver Training.

Day 2

Started off with a short PowerPoint presentation on the system of car control which are:

• Stage 1 Information
• Stage 2 Position
• Stage 3 Speed
• Stage 4 Gear
• Stage 5 Acceleration

Then after a quick tea break we carried out the VDIs for our respective ambulances making sure that they were road worthy and prepared to set off. Our tutor taught us how to carry out the Pre Driving Checks (PDC) and to position the seat correctly. For the remainder of the day we drove around the county looking for obstacles and hazards to utilise the system of car control. I believe the system does make a huge difference to the quality of the drive and that a patient will benefit from a smoother more controlled driving style. That said, even though you try to be courteous and anticipate bad drivers on the road it can sometimes be in vain. Some drivers are absolute lunatics and don’t think twice about cutting up ambulances. After a few hours driving we headed back to the training school for our debriefs. A few useful lessons were learned that day.

Day 3

Today started with a PowerPoint lecture on acceleration sense. When to accelerate; effective use depends on; and poor acceleration results in, were the topics discussed. Some of the examples ring home very true. How many times have I accelerated from a set of green lights only to find myself braking a few seconds later at the next set of lights? How many often do you see a boy racer accelerate up the back end of a lorry only to brake heavily as they realise they can’t overtake? Both these examples show how poor acceleration sense can contribute to a waste of fuel and also be dangerous to over road users. Another lesson learned. That’s at least 3 and it’s only day 3 of driver training.

For the remainder of the day we drove around the area for a couple of hundred miles, putting into practise the system of car control and acceleration sense. To achieve this the tutor asked us to give a running commentary of the hazards and what we intended to do to avoid them. Trying to give a commentary and drive was initially a difficult task to complete, after a few hours it became a little more natural and was conducive to driving. To practise acceleration sense we were tasked with braking as little as possible while maintaining an appropriate road speed. Not that easy in a 4.5 ton Merc when descending huge hills.

Today was an enjoyable day and some valid lessons were learned. I look forward to the next couple of days and improving upon the skills learnt.

Thermal image of a person

On Friday I was issued two pairs of Technician epaulettes, a competence record book, given a final tutorial and shook by the hand just minutes prior to being ushered out of the training school. This it seems signified the start of my stint as a Student Paramedic. After eight weeks of clinical training, numerous tests and assessments, with plenty of hiccups I was deemed ‘able’ to be unleashed to the public.

But, am I? I don’t think so. Okay, so I have passed all the tests and practicals therefore demonstrating that I have the theoretical knowledge and practical ability to resuscitate a dummy, but, that is a far cry from reality I suspect.

A parting comment from my tutor was thus…

We don’t expect you to be an all singing all dancing technician from day one. What we do expect is that you pin your ears back and listen to your colleagues, for the next 12 months is when the real learning takes place.

I fully understand the sentiment contained within these words and am fully aware the next year or so of my career will present the steepest learning curve. I relish this challenge with gusto.

For now I have three weeks of driver training, a time to let the hair down, unless of course we stumble across an rtc on our travels.