Sunday, September 24, 2006

Sunday Morning Breakfast

Well I am sitting here after the best breakfast in the world.... Bacon, Banana, Brie, sweet waffles, maple syrup and bagels with cranberries and walnuts on the side with fresh coffee and tea.

We were treated to a lovely meal last night with a lovely friend of Kal's and her two kids, then we drank wine and went to see a show in the local village hall and had more wine after the show. We decided to invite R and her two kids around for breakfast this morning, so the kitchen was buzzing and the smell of fresh coffee and bacon was wafting around the house by 0930hrs and then I went for a shower and asked Kal to look after the bacon.... bad move, burn offerings were being pulled out the over, so Kal had to dash to the shop in the next village to get the extra emergency bacon.

So in the end all 7 of us had the best feast going and it all turned out alright in the end. Now the 4 kids are running around burning of the carbohydrates and energy they have just consumed and the 3 of us adults are sipping tea!

How nice :)

Saturday, July 22, 2006

I'm back again (part 2)

Well it is the morning after the wedding, everyone who stayed in the hotel meets up in the restaurant for a champagne breakfast, we all chat and remember the occurrences of the previous day and one by one the group gets smaller as we all drift off home. It was such a nice day; Kal and I set of and stop on the way so that I can take pictures of the countryside for Nursie999 (she forgot her camera the night before). Kal and I arrive back in Edinburgh and he starts packing for college, I head home and get an early night for my next week in Theatres.

Monday morning arrives and I’m back in theatres, I meet up with J and we both head into our allocated anaesthetic room to set up, now by this stage she is expecting some help, so I ask how many patients and what procedures etc so that I can gather up the necessary equipment, we are ready by 0845 so it's coffee and bacon rolls. This is our routine for the remaining two weeks, set up coffee, patients, getting the consultants to sign me off on my various required procedures on the way!

Week 3 arrives and this is my final week to make sure I am happy with my new found practical skills (totally different on a real patient). I had been working at T in the Park over the weekend and chat to some of the staff about the event and the workload etc. The patients start rolling into the 9 main theatres, consultant surgeons and gas men (anaesthetists) all arrive and we begin again, now over my last two weeks I have received comments of praise from some of the staff etc but now it comes to the final day and I have to see the senior Operating Department Practitioner (Manager) and await my feedback, now this guy looks frightening, but he is very pleasant and gives me my certificate of competence and tells me that should I ever wish to come back into HIS department then I am more than welcome!!

Week 4 sees me moving departments and I am now working in the Coronary Care Unit (CCU) of the Edinburgh Royal Infirmary, which is a busy 10 bedded unit with a ward attached when patients are deemed as fit to be prepared for rehab prior to discharge. I arrive and meet up with the Ward Manager (Senior Sister in old terms) who I know fairly well. I am given my tour and follow the ward round, where the new team headed by Prof N reviews the patients.

I have various skills and procedures which I must have signed of as competent in their appliance and I start these straight away by going on the "Bloods round", this basically means taking the requested samples of blood from the patients as discussed in the ward round for analysis at the lab to see how well the patient is responding to treatment. I assist in making beds, toileting the patients and providing general care with the nursing staff.

Day 2 sees me in the theatres following various procedures including a pacemaker insertion and the cardiac catheter labs where patients are taking to have their coronary arteries either expanded with a balloon or strengthened with a wire mesh tube called a stent. Back on the ward after lunch and I am half way through some paperwork when the "Arrest" bleep blips into life, telling me and the other staff that somewhere in the hospital there is a patient in cardiac arrest and we have been summoned to assist in their resuscitation, now not knowing the hospital that well I drop 2 steps behind the Registrar and the staff nurse as we sprint along the corridors to get to the patient. We arrive along with the rest of the "Arrest Team" and start working on the patient, now bearing in mind normally you are lucky to have 3 people helping at an arrest when out on the road I am a bit shocked to see 14 staff (including myself in that number) all around one bed doing various tasks. We are successful in getting this patient breathing and their heart beating and it is decided that the patient does not need to go to CCU (as it turns out to have been a respiratory arrest) so we 3 all leave the rest of the team with the patient and return to the ward to cool down (27 degrees C outside and ward with arrest had not air conditioning!)

Day 3 begins with hand-over and ward round, then down to the catheter lab again for a more challenging procedure on an elderly male, unfortunately it is suspended due to his condition worsening suddenly. The consultant who is carrying out the procedure decides to reschedule for Thursday, as he will then be able to get a colleague to assist if the patient is stable enough. So back to the ward with the patient and watch as his condition bounces up and down like a rubber ball, eventually he stabilises after much hard work on the medical and nursing staff side. We receive a new patient onto the unit and they are clerked in, I assist with bloods and ECG etc and even teach a student nurse how to use the ECG machine!

Day 4 I arrive onto the unit to begin and there are new patients, some of the others were transferred to the attached ward as they were more stable than the new admissions. The unit is now full and there are numerous tests and examinations requiring to be carried out so I ask the Charge Nurse if I can help and I am allocated the bloods and ECG's for all the necessary patients in the unit along with assisting the staff nurse and student I'm working with for that day. Just as lunch arrives "blip blip blip ... Cardiac Arrest on ward..." yes you have it, the arrest bleep so off we go like a well oiled team sprinting into action and sprinting along the vast corridors to the correct ward, we arrive, with the other team members and begin to swing into our allocated roles, orders are barked out and equipment is brought... unfortunately this time we could not save the patient and it is agreed after a considerably long time that we have tried everything and we should now stop. So back to the unit, feeling low, but knowing we did everything we could do for the patient. As we arrive back on the unit the staff nurse and myself go for some water to cool us down as the Dr had remaining on the ward to complete the necessary paperwork certifying death has occurred. Blip blip blip "Cardiac Arrest.... ward...." I look at the staff nurse and she and I are off again, sprinting along catching up with our Dr (who was closer because of the previous callout) and the full team swing into action again, orders are given, equipment brought, more orders, more equipment and with each new item another team member arrives until the room is filled with medical, nursing and associated staff making 19 of us in total, once again I think back to my last arrest on the road when there were two of us!

We are successful this time, the patient is stabilised and transferred to the Intensive Care Unit (ICU) for further treatment. Back to the unit again, lunch for us and time to relax. The afternoon finds me catching up on my outstanding procedures and getting them signed off by the Charge Nurse. I finish earlier that evening, as it is Kal's end of course drink, which I head down to.

Kal is now 7 weeks into his 9-week technician course; having completed his Ambulance Aid (the care side of things) he now only has his 2-week driving to go... The whole group are found in the bar of the college, I bump into some old friends who are there for various reasons, chat, drink my diet cola, chat some more and then head off as I have an early start the next day. I give Kal a small gift and card to congratulate him and leave him to his party.

Day 5 sees me back on the unit, after having called Kal to make sure he was up, even although unknown to me he had been woke at 6am with the fire alarms, I wished him well and let him get back to his "Long lie"

I now only have one week to go, I walk onto the unit thinking that I will miss the staff, as they have been very friendly and helpful. I am not more than 5 minutes on the unit when the ward manager calls on me and tells me that we have a shout in A&E for a fast track chest pain patient who needed to come up to the unit, so we take the equipment and go down with the Dr. We arrive and the patient is post cardiac arrest, now with classic signs of an MI. The patient is prepared for transfer to the unit and off we go. Back on the unit I am in time for the start of my final ward round and Prof N once again carries this out (as he has for the last 4 days), meeting the patients and putting them at ease with his manner and tone, I am then invited by him to come back to A&E to review a patient with him and the other Specialist Registrar (SpR). We wander down and assess the patient and it is decided that he does not need to come to the unit and can go to the ward for further care.

It is now lunchtime, I have completed all my necessary procedures and had my training record signed off and I bid my farewells to the staff and leave then with the thank you card and a box of chocolates.

Well one more week to go and I will be finished...

Sunday, July 16, 2006

I'm back again! (part 1)

Sorry that I have not updated for a while, but with my paramedic in hospital clinical placements, looking for a new house and making sure Kal is still relaxed (not sure if I'm managing that one) about his course things get a bit hectic.

Anyway, here I am so I will try and fill the gaps...

After completing my college based training for my paramedic qualification I had 5 weeks back on the road as a technician (with paramedic knowledge) I worked mostly nights and this was good because the shifts were such that I was rostered with another Qualified and Experienced Paramedic (State Registered in HPC Terms). My first night back started with a cardiac arrest; which had been an urgent GP call for a male with difficulty in breathing, then a couple of genuinely unwell patients and a male in his 50's having a full blow MI, which eventually caused him to go into cardiac arrest following Thrombolysis in the back of the ambulance (in fact he arrested as we entered the lifts to go to CCU!).

For the other 2 nights we were back and forward to Edinburgh Royal Infirmary, dealing with lots of genuine patients and having a good time.

The other 4 weeks seemed to bring out all the genuine patients for me to deal with and my colleagues seemed to be left to pick up the drunks, this was good because it gave me a chance to work with some highly skilled Paramedics and learn from them along with using my new found knowledge to allow me to care for the patients in a more in-depth manner than before.

I received a phone call from the Training Department Queen (Administration officer, she is the woman who sorts your career basically) telling me that she has managed to get a space for me to start my in-hospital clinical placements to finalise my training requirements and that the placement starts on the 26th of June...."Oh I see" is my reaction, I explain that I am on annual leave that week as it's my Birthday and I have a friends wedding (which I am an usher and Kal is the Best Man)... Right she says, well the next placement is probably going to be the end of AUGUST, "I see" I think quickly and offer to cancel my leave for three days if that would be of any help, she says that should be ok and I have to clear it with my station manager. I call into the station that day, speak with my boss, who tells me that's fine and to claim Overtime for the three days I am in hospital on my placement and wishes me luck! Score, I get my annual leave payment and now time and a half and travelling for going into hospital! ££££

My first week of the two on annual leave it taken up mostly with the Royal Highland Show (Big agricultural and food fair etc) over 5 days including a day setting up, I work in the Communications centre, out on patrol and then on the Saturday I work with Kal, now we have only worked together once before and even then it was slightly different, we walk around on patrol and get a patient who is unconscious (through alcohol) and as we arrive I tell Kal that "Your attending" meaning that he is looking after the patient and I will do all the radio work, gathering equipment etc. I do this to see two things (1) how he has developed whilst at the college and (2) if he can cope with sudden change in situations... he performs well, and even when I am taking the piss out of him for his airway management he remains calm. (If all the future Technician's are all as confident and competent as him then Scotland will be a safe place to live).

Having arrived at the hospital for my first day I am shown around the Theatre suites (which is where I will be based for the first 3 out of 5 weeks), I'm introduced as the "Trainee Para-headache" to the staff and then pointed towards the changing room to get into my theatre greens. I meet up with my ODP mentor and stand sheepishly in the background as the patients start arriving. My ODP (J) is brilliant, now she is not full time staff, she is employed by an agency but has worked in the theatre for the last year, she is bubbly, chatty, full of information and so willing to teach, by the end of the first day my head it thumping, but I am already 1/4 of the way through some of the necessary procedures that I must achieve whilst on placement.

I inform J that I am off for two days annual leave later in the week and she notes this on my theatre schedule and gets her senior to amend the master sheet, I have my two days off and enjoy them (down at Ambex which may sound dull but is an international ambulance conference and exhibition) meeting lots of friends and colleagues and on the day of my birthday I am drinking vodka with breakfast!!!

I arrive home and start preparing for the wedding on the Saturday, I go with Kal to the pre wedding friends and family get together in Pathhead (which not two hours previously I had driven through on the way home from Ambex) I am fed lots of food, offered alcohol (which I decline as I am driving) collect the necessary items that still require dropping off at the hotel for the reception and with Kal we take the Groom to be to his hotel for the evening, depositing him at Midnight Kal and I roll back to his and collapse into bed, exhausted and set the alarm for an early start the next day.

The day of the wedding, we wake at 7:30am, roam around the flat getting ready and not really talking as we are still half asleep and the coffee machine has not finished spitting out the black nectar of life yet!

We both have things to do; I drop Kal off in town, head home and get into my kilt, drive back to Kal's and collect him.... WOW how hot does he look in his Purple kilt mmmmmmm, drive to the hotel and collect the Groom, who is looking pale and slightly nervous. Driving around to the church we confirm that rings are with Kal? Check, G you had food? Nope, stop off at shop and buy supplies, Water, Bananas and ready salted crisps etc (all non staining foods since we are all in white shifts and kilts) Onward to the church again, we arrive G and Kal are getting things sorted in the back and myself and the other Usher are discussing tactics, who sits where etc.

Everyone is now in the church and the Bride arrives (Groom is BRC and Bride is St. Andrew's so plenty first aiders in the guests in case of accidents) She looks stunning, slightly nervous as well, but totally stunning. Her father and also her Maid of Honour and bride’s maid’s who are all in lovely purple dresses escort her in. The wedding goes well, the pictures are taken (G is project manager and R the bride is a teacher so everything is set out in time tables and schedules for us to follow). Time for the reception, lovely drive in convoy to the hotel in the Scottish Borders, beautiful weather, lots of alcohol, gorgeous food, more alcohol, Chocolate fountain, great music and ceilidh band. The evening goes on, the buffet comes out.... Bacon rolls Mmmmmm. More music and dancing and drinking. I dance with Kal to a song that summed up how I was feeling (Yeah you know the one boy) and the guests all drift off home. Only a small number of us were booked into the hotel, we all meet in the bar, tired, slightly tipsy (some more than others) and start to unwind with another drink. The Midnight munchies (hunger) arrive around 0130hrs for most of us and we get some pringles from somewhere, just as we open them the manager walks in with a tray of hot bacon rolls.... the pringles are left and the rolls vanish in seconds with moans and groans from the group now demolishing the hot food to soak up all the alcohol.

Saturday, June 03, 2006

Welcome back

I know that I have not been on in ages, well it feels like that anyway, but I have been quite busy with my life....

I have just finished my second week of shifts after coming back from the Ambulance college and on my first set of nights I had two patients who arrested on me (One was a GP Urgent call) and two patients who have met the Pre-Hospital Thrombolysis checklist for their on-going MI (Heart Attack). Now since I have not completed my hospital placements or received my state registration I cannot practice as a paramedic yet, this leaves you in a strange "Limbo" you have all the knowledge but are not allowed to use your skills until all the boxes are ticked. I have been lucky however as I have managed to work with fully qualified paramedic's and this has been interesting as I am now able to use my skills "Remotely" through them :)

I have just got to wait my turn now to do my placement and then I can apply for my state registration and be let loose on the public of Scotland.....

Oh poor them ;)

Saturday, May 13, 2006

Well after all the hard work and study....

I have as you know been away for the last 6 week (1080hrs classroom time) studying towards gaining my Paramedic qualification.

It has been an interesting time and there has been many highs and lows along the way, may late nights of studying and early mornings of not knowing anything from the night before.

Well it has finally come to a close, after 5 weeks of preperation and study, practice and sweating late into the night over the books I sat my final Module I (Paediatrics & Obstetric) assessments, which also included some stuff from Module G (Cardiology & Airway) and stuff from module H (Trauma).

Monday of week 6 starts with some mock assessments, written and multi choice and then a practical skill station, the Tuesday is much the same, early finish to facilitate for some last minute panic study and then comes Wednesday.....

0845hrs - "You have 30 minutes to complete your Paediatric multi choice paper...good luck"

0920hrs - "You now have 30 minutes to complete your Obstetric multi choice paper....once again good luck!"

1030hrs - You now have 2hrs to complete your written papers covering Paeds, Obs, Trauma and a General question, please ensure you answer all the questions or you will automatically fail!...Good luck"

1330hrs, after lunch it's back to the practical mocks to ensure you are up to speed on skills for the final assessment on Thursday.

Thursday morning seeing us all in the restaurant of the college for breakfast you would think we were all "Dead men walking" we sit quietly, not saying much, staring down at our food, not hungry but knowing that we should all eat something.

0900hrs and so it begins, I am first for my Paediatric skill station, which comprises of two cases my first is a lethargic, floppy 6 mth old who is "Unwell" not feeding and turns out to be a meningicoccal septicaemia baby who needs airway management, supported ventilations, IV access and Benzylpenicillin before the crew arrive to back me up.... oh yeah I forgot to say I was meant to be single crewed!

My second patient was a 5 yr old in Cardiac Arrest, who as per protocol required airway management, breathing and circulatory support along with IV access, blood glucose checks, capiliary refill and fluids and rapid transport to hospital, however I was still single crewed and had to wait on the responding ambulance..... oh the joys of assessments!

I was last to go in for my Obstetric assessment and this was once again, two patient skill stations, the first was a 35yr old who was in labour with her 5th child and had a history of difficult and fast labours!!! The baby in this was a breech birth, the baby then required to be resuscitated and my second scenario was a 17 yrs old with a cord prolapse. Both the skill station's went well, but no one felt totally confident in their and I was definately one who felt least confident.

Friday Morning was the day which we found out which one had passed, but since we had a small group the course director decided to tell us all on the Thursday afternoon our fate!!!

We well all summonded into the class after coffee break and one by one our names were read out..... Scotsmedicman PASS...... What?!?!?!? I passed I ACTUALLY PASSED YEAH!!!!!!!!!!

So there we go, I am now licensed to kill... erm save in some many more ways!!! 007 watch out!

Saturday, April 22, 2006

Module G - Cardiology & Airway Managment

Well it has been a while since I have communicated with you all, I can only apologise for this, but I have been studying and working hard. I have now completed my 3rd week and had my end of module exams....

The 3rd week of module G is a blur of activity, you start on the Monday with "Mock" exams to get you in the right mind frame for the written exams, this goes on until the Tuesday afternoon when you have now completed your written and multi choice "Mock" papers you are then put through practical assessments that are made to be difficult, awkward and stressful so that you are thinking in the right way to face your final practicals. Wednesday arrives before you know it and suddenly you are faced with 3 hours of written exams, this includes an hour to complete the multi choice aspect of the exam. Wednesday afternoon you feel totally deflated, washed out and thinking that you know nothing. You have to stop dwelling about your exams and now focus on the forthcoming practicals on the Thursday.

I had a break from the stress of the college on Wednesday evening when I was "kidnapped" and taken to Peebles to have a night out of the college and a meal with Kal and a colleage Ms A(who has recently completed her paramedic course and understands the stress). The meal is lovely, we sit and chat, go for a walk along the river and meet another colleage who is out walking his dog, we chat and then head back to the college for coffee. On arriving at the college, we grab a coffee and sit with the wife of one of my training officers (she has popped into the college to wish me good luck, as she is a friend and ex college of mine) we all chat and then Kal and Ms A bid me good luck and head home. I so want to be going with them, but unfortunately I have to stay and do my practical assessments......


We are all in the restaurant for breakfast, non of us eat much as our stomach's are churning, we walk strangely quietly in a single line to the classroom (if you were an outsider looking in you would think that we were going to the execution chamber), we arrive and are greeted by our instructor (0845hrs) and are briefed on the running order of the day, we are given our places for the assessments (I am the duty student and have responsibility to ensure that all the equipment is set out properly, this had been done at 0825hrs and checked by our instructor) and then he leaves. We all walk again in single file to the waiting area (which is the coffee lounge) and sit.... I am first and at 0905hrs I walk with an Officer to the Syndicate A room for my Airway assessment, I meet the Consultant Anaethnetist and start my 20 minutes of hell... I talk, I use the equipment with ease, I rectify problems thrown at me, I even begin to show off.... I think to myself "I'm good, I know this and I'm going to prove to you that I should pass!!!!" I finish the 20 minutes and I thank the assessment team and head out of the room back to the coffee lounge.

I arrive downstairs and enter my time on the sheet (We are required to sign in and out of the assessments to ensure that we are all given the same timescale and no one is grilled for any length of time), I tell my colleages that I am going for a walk around the building and with this I am off, walking the wooden area, the driveway the road around the college and then back into the college. I arrive back and there is conversations starting about the cardiology station, which I am last to go into, so I avoid this as I do not want to know about the 3rd degree heart block and Asystolic arrest scenario that the other student received as their assessment.


I am summoned to the cardiology station for my final assessment, now I have been waiting for nearly 2 1/2hrs and my stomach is doing the twist, I have been to the toilet 12 times for nervous peeing (maybe all the coffee didn't help either)....
I walk in, there is a dummy lying on the floor for my resuscitation assessment, and the Officer who escorted me in introduces me to the Cardiology Nurse who is doing my assessment. We chat and then she explains my scene, I go into auto pilot, once again showing that I know my stuff, I then deal with the second scenario which is a male with central chest pain and managed this, talking constantly, stating the correct dosage of drugs and explaining how this is calculated etc. I leave the assessment and feel confident, but know that I could have done better, I stumbled over my words when it came to rhythm recognition and didn't come across as confident as I would have liked to have been.... oh well that's it over with.

We all go for lunch, still not really eating much, start to chat and end up doing post mortum's on the scenarios we were all given. We go back to class and sit and wait, and wait, and wait. Eventually we are allowed to go to our rooms or leave the building and are told that we will get our results on friday morning.

Thursday night we are all at the bar in the college, some drinking more than others, still lots of talk about the assessments.

Friday has arrived, we are all sitting in the classroom and one by one are taken away for our results and feedback, no one is confident, no one is sure, but the smiles are laughter of relief start as one by one people start coming back in.... then it is my turn I am second last, as I stand up to go through, my colleague who is after me is up and out of the room, he takes my place HE JUMPED THE QUEUE!!! BUGGER!!! oh well so I sit and wait again, he returns, quiet, head down, we all think he is joking, but unfortunately he has failed.... It hits us hard, SOMEONE IN THE GROUP FAILED! It is my turn now, I walk the 5 feet from our class to the office opposite and it feels like an age to arrive. I knock, wait and then hear "Enter" I go in, The Officer who is giving the feedback is sitting head down, I think "Oh my god I'm next" He looks up from his mountain of paper and stands up pushes out his hand and breaks into a smile and congratulates me, now my brain is going slow and it takes a moment to understand, he said "Congratulations" OH YEAH I HAVE PASSED!!!! He explains my results, which are much higher than I expect and he goes on to tell me that I have been given a commendation for my airway as the consultant was so impressed with my knowledge and skills.

I return to the class, break the news and we all relax, we feel sorry for our colleague who is now leaving us, but are happy that we have passed. I start sending messages to everyone telling them the news and my phone is just about able to cope with the volume of texts I receive with various messages of congratulation.

Ah home time, I drive up the road from the college and think well only 3 more weeks to go and that means 2 more assessments!!

Keep your fingers crossed for me!

Friday, April 07, 2006

1 week down

Well as it says, I have just completed my first week at the SAC (Scottish Ambulance College) on my IHCD paramedic course, The first week as you can imagine begins with some introduction to the course ahead, so on Monday morning we are completing the necessary paperwork that tells you that should you leave the Service they can claim the £6,000 costs associated with your residential aspect of your training!!!!

I waken up on Monday, full of good intentions with regards to going to the gym, but I then try and get out of the lovely bed in my room to go to my en-suite bathroom and notice that I have problems breathing, I feel sore and generally ache all over, I look in the mirror and see that I have developed cold sores and my nose is now streaming like a flowing tap, Joy I have a cold before I even start my course, oh well only paperwork I think..... Boy was I wrong.

It is now mid morning and we are starting to look at intubation (passing a tube down a patient's windpipe to secure it and assist in their breathing), after lunch we learn needle cricothyrotomy (putting the biggest needle you can find into someone's neck to help them breath) and finally chest decompression (Once again putting the biggest needle into someone's chest to help re-inflate their collapsed lung) and this is only the first day........

For the rest of the week we go over various different aspects of the above skills, sit multi choice exams and short written papers and start to look at the drugs involved in dealing with a patient who is in cardiac arrest (or Advance Cardiac Life Support - ACLS for short). Finally today we get our test results and I am "Coming along nicely" and I'm to "keep up the good work with the practical scenarios" I feel a bit more happy tonight, knowing that I am on the right tracks and hopefully will still be there in another 5 weeks!

Ah well I am off to relax and remember the lovely italian meal that I have just had with Kal, Oh it is nice to be home for the weekend and to see him, oh and to be taken out for a lovely meal by him :D

Wednesday, March 22, 2006

I am still alive

Just a quick message to say that yes I am still alive and well, just studying for my forth-coming paramedic course....2nd of April, I never knew that adrenaline was brown!

Oh well back to the books

Monday, February 20, 2006

Paramedic Interview

Well today was the big day, 1110hrs in Galashiels, I arrived and waited patiently until I was called in, there on the panel was a Station Officer (Area Service Manager for A&E) from Edinburgh, the Training Manager for my Division and a Anaesthetic Consultant sitting behind the desk, I swallowed hard, took a deep breath and tried to relax as I sat down. The interview lasted 20 minutes (only scheduled for 10) lots of questions from them all and then it was my turn to ask them some questions.... I asked about the academic aspect of the paramedic course and will the service be going towards external recognition from universities for the training, I wanted to know what the service stance was in regards to staff looking to enhance their knowledge in relation to their continued personal / professional development and what support did the service offer to these staff.

The Training Manager told me that they would be calling all the candidates later today...

Well 1500hrs and "Ring Ring" Hi SMM it's Training Manager (aka GOD), I just want to say congratulations and I would like to offer you a place on the 2nd of April 2006 course!!!!! Is that ok? "Gulp" Eh yeah I think that should be ok.... (SILENTLY SCREAMING YEAH YEAH OH YES inside).

Oh well better dust down the books again!!!

Agenda for Change (New pay scheme in NHS)

Well I am sure that some of you will have received your A4C letters outlining your new salary.... for those of your who are not up to speed with the whole A4C fiasco it has taken nearly 3 years for the Service and unions to agree the terms and conditions of this new deal, there has been rumours flying all ways in regards to the payments that staff will receive and how staff will be better off because they are now getting paid for working "Unsocial" hours (between 7pm and 7am Mon to Fri and all day Sat and Sunday), disturbed meal breaks and public holidays. Well the big day arrived on Saturday and the brown stuff well and truly hit the rotating thing at a great speed... basically as a qualified Technician within the SAS you can expect to earn £22,271.00 basic salary, with my weekend hours I get a further £495.56 that gives me a grand total of £22,855.65 now that sounds not bad so you would expect that the A4C payment would match or better this.... Well my new basic salary is £19,248.00 YES that is £3,023.00 less than what I currently earn, once I receive my "Unsocial" payments which because I am relief is calculated on a 3 monthly period unlike the permanent board members who receive 25% flat rate payment, I come out with 17% which equates to £3,272.16 giving me a new grand total of £22,520.16, now for those of you who can count that is £335.40 less per year than what I currently earn so I have that difference protected. This means that I am no better off and potentially I will lose out if my "unsocial" % changes in the next 3-month reference period!!!!

We have also been offered a £250 per year payment for having our meals disturbed along with £5 per shift regardless of how many times we are disturbed, this means that technically you could work 12 hours and have 5 or 6 disturbed attempts at a break or no break at all and only receive £5!!! One of my colleagues worked it out that they would get 80 pence per shift if they continue to have their meal disturbed at the current level!! (Can't find anywhere that sells replacement meals for 80p)

As you can gather there is a lot of unhappy staff within the service at the moment and it seems that the unions have taken 3 years to negotiate a pay cut for Technicians!!!!

Thanks guys

Tuesday, February 14, 2006


Well this is the code that means you are going to a patient who is "Not Alert" following a CVA (Stroke).

So we arrive and because of difficulty in parking, I walk to the house with my oxygen and response bag and my colleague follows eventually with the defibrillator, once he can safely park the Ambulance without drivers thinking that they have the right to totally ignore all rules of the road and common courtesy. As I walk towards the house the patient's son tells me "I think my Dad is now dead!" so in I go and true to his word the patient was lying slumped in his wheelchair not breathing and no pulse.

I get the patient on the floor and start my CPR protocol, securing this 78 yr old mans airway with a plastic curved tube called an oro-pharyngeal airway (OPA), breathing for him with a Bag and Mask connected to my oxygen and start jumping up and down on his chest. As I am doing this my colleague walks in and quickly connects the defib to the patient and we find that he is Asystolic (flat line) so my colleague (who is a paramedic) confirms that I have a good airway for the patient and begins to cannulate (place a small plastic sheath and needle into a vein) him, we give some cardiac drugs and continue with CPR, because of the tightness in the house, we decide not to intubate (pass a larger tube into the patient's airway) until we are in the vehicle. Following this decision my colleague gets the son to help him gather further equipment and returns, but whilst my colleague is away the patient decided to change his heart rhythm and I am able to deliver an electric shock to stun his heart (defibrillate) into a rhythm that is able to sustain life! With one shock his heart starts beating normally and he slowly starts breathing!!!

Once in the Ambulance we intubate him to secure his airway properly as he was still not breathing sufficiently on his own, we blue light him into hospital and are met by the full resuscitation team in AE and hand over his care to them.

Upon cleaning and clearing I pop back in to check on his condition and his heart is still beating, he is breathing with less assistance and he is being prepared to be moved for further investigations.... as I walk out the Consultant who was looking after him says "Well done" now I know that it doesn't sound much but when you have worked as hard as my colleague and I did it is nice to feel as if you have at least given the patient and his family a chance!

Will see how he is getting on tomorrow and keep you all updated.... if you want?

Monday, February 06, 2006

Oh that's got to hurt

Well I was working 7-7 day shift at a neighbouring station today and it was your run of the mill calls, elderly patients who had fallen and possibly fractured their hips etc.

Well all that was to change, at 1330hrs we get the do do do doop noise as we are pulling into Livi to give the outside of the Ambulance a quick clean, so pulling back out of the wash bay we are heading out of the station lights and sirens going to a call at a local industrial estate for a 'Male hit by sheet metal' we arrive to be waved in the direction of the patient, who is lying on the floor beside a very large machine, in obvious pain, but still fully conscious.

I am driving for this half of the shift so my partner goes to assess the patient whilst I gather some extra information from the patients colleagues. My partner shouts to get another crew with a paramedic for pain relief, I head back and gather some further equipment and call up to the EMDC at the same time requesting the second 'paramedic' crew and head back.

Our patient is given entonox for the pain before we even begin touching him, but we can see that this will not work that well and hope that the second crew are not that far from us.

Now the patient is a male in his 30's who has been working at a machine when some sheet metal struck him in both the legs just above his ankles, this caused one of them to snap and the other leg ended up being fractured (#) and the foot was rotated 180 degrees, causing the bones in that leg to tear through the skin.....

The 'paramedic' crew arrived and gave the patient more stronger pain relief, set up fluids because of the blood loss and shock and we then had to gently move the fractured ankle into box splint so that we could then move this leg off the one underneath which was the rotated open fracture (more serious due to the possibility of loosing the foot if the blood supply is restricted beyond the site of the injury).

Once we had the # ankle supported and moved out the way we could then see the full extent of the injury and begin to manipulate it back into line (we had to remember and turn it the right way!!), now the feeling of crepitus is not a nice one and I have only felt it once before, but today I was supporting this limb as my colleagues applied traction above and below and we all turned together, straightening the patients knee out and making sure the foot was pointing in the same direction as his knee, my hands were under the fracture, holding on the sterile dressings to control the bleeding and supporing the bones and I can honestly say if you want to feel crepitus then get some chicken bones, snap them and then rub them together in your hands!!

Once our both the legs were stabilised and the patient was feeling the effects of the pain relief medication he was lifted onto the trolley bed in the Ambulance and the 'paramedic' crew transported him to hospital, leaving me and my colleague to tidy and re-stock our vehicle and reponse bag because we found out that the 'paramedic' had used all our equipment! Thanks mate!

Oh well I guess that the patient will now be lying in a hospital bed, possibly following surgery today and looking forward to a fairly lenghty recovery process, well at least we managed to do something good for a change :)

Tuesday, January 31, 2006

Paramedic practical

Well I have just returned from the one of the most stressful set of assessments that you would want to sit during an afternoon. There were two, one was a medical and the other a cardiac arrest scenario. I completed both and have found out that I have PASSED!!!! So now I have to attend an interview with the Training Manager, Training Officer and Hospital Consultant to see if I am a suitable candidate to complete the paramedic training course.

Fingers crossed!

YIPEEEEEEEEeeeeeeeeeeeeee!!!!!!! :D

Saturday, January 28, 2006

Can't sleep

Well here I am, sitting in my dressing gown, Kal is in bed, fast asleep and I am wide awake, I can't sleep... I don't know if it was all the coffee, the nerves about my forthcoming paramedic exam (2nd part) or what, but I just can't manage to close my eyes.

I have felt this before, but tonight, no matter what I do I just end up looking at the ceiling of my room, Kal is there beside me, warm, cosy, all sleepy and there I am turning in bed fighting with the pillows feeling all alone. I don't want to disturb him as he is teaching in the morning maybe I am overtired. I finished nights on Friday morning and managed to get a good sleep I then met up with Kal and two other friends and went to laser quest then bowling, via pizza hut for something to eat. It was a lovely night I was driving so I didn't drink, everyone else was indulging and then it was an early rise this morning as I was teaching on the First Responder Course in Penicuik.

I arrived at 0845hrs in Penicuik with Kal in tow, more rough than I because of the mix of red wine and beer. The class finished at 1430hrs, popped over to my folks to visit then back to the flat for tea, eventually sat down at 2030hrs and watched some TV before making pudding at 2100hrs, coffee was flowing and now here I am at 0005hrs on Sunday morning wide awake and feeling totally fed up and probably slightly jealous that Kal can climb into bed and within 5 minutes of his head hitting the pillow is breathing heavily and off deeply in sleep!!!

Oh well may I will try a horlicks to see if that helps, but knowing my luck it wont!

Monday, January 23, 2006

Let your fingers do the tapping!

You should check this out, it is fun... Song Tapper, it is where you can find the name of that tune that is stuck in your head.

Now everyone knows that is a good idea!

Sunday, January 22, 2006

NIght shifts

Well I am working the full weekend nights this week and it has been a fairly eventful set of shifts so far.

Friday Night:

It started out quietly, with our first call being that of an anaphylactic female, she was treated with epinephrine, salbutamol and oxygen and transported to hospital for further care. Our next call was some 2 1/2hrs later, now this is unusual for a Friday night, but it sometimes happens.

The calls started to pick up and the night started getting busier, we were sent to stand by at one of the designated dispatch points and after being there for a whole 15 minutes we were winging our way to a reported hit and run on a busy street near by, 4 minutes later we are pulling up to be met by a group of excited people standing around a male who is lying on his back with facial (minor) injuries. The Police quickly arrive on mass and we quickly assess and treat the patient, placing him on a rescue board and securing his head with a rigid collar and head blocks, once he was secured he was taken into the back of the Ambulance and was examined further to see if he had any other injuries. This patient was lucky and he had relatively minor injuries. We transported him to Edinburgh Royal Infirmary due to the mechanisms of his injury.

We were heading back after doing some 999 calls in Edinburgh and stopped to fuel up the Ambulance, as I was in paying for the fuel my colleague signalled that we had a call, this time it was a car that had left the road and rolled down an embankment landing on its roof with a report of 5 people trapped. When we arrived we were the second crew on scene and quickly found out from the fire service that there were only two trapped and a third patient in the back of one of the fire engines, my colleague went to check the person who was not trapped and I started to gather together all the necessary equipment for our trapped male patient.

Now picture the scene, dark slippery embankment with clio sized car on its roof, 8 firemen, myself and one paramedic all in the car with the two patients, it was like a Guinness book of records challenge for how many people you could get into one car... The male was eventually extricated from the car, placed onto a rescue board and with collar and straps etc all applied carried out and up the embankment to the warmth of our waiting Ambulance where we did a head to toe check to rule out any other obvious injuries.

The female was removed in much the same fashion and was taken to the other vehicle for a check over and she and the patient in the fire engine were re-united and both transported to hospital. Our patient was taken to the same hospital, I however did not travel, because the patient was requiring paramedic interventions en route (pain relief etc) I jumped on with the third vehicle which had arrived (bringing my replacement paramedic) and LS (paramedic) travelled with my colleague and patient.

Now by this stage it was 0545hrs and I was wet and muddy, once clearing on scene and updating the EMDC I was asked if we were able to do an urgent call or if we wanted our now long forgotten meal break.... as you can guess I plumped for the meal break so that I could get cleaned and warmed up.

Saturday Night:

This started out once again with us being sent out at the start of the shift for a diabetic male who had taken unwell whilst driving his car, when we arrived he was starting to respond to the chocolate that his father had given him, his blood sugars were still low so he was given an injection to raise his levels and we transported him to Livingston (St. John's Hospital) for further care.

Back on station for our vehicle check and once this is complete coffee!

The following calls were all relatively small in comparison to the night of car accidents, we did still manage to get a call that took us into Edinburgh and we were then captured for a couple of calls, one was a male found confused and wandering around in his underwear in the common stair well of his block of flats. We transported him to hospital to get him examined and to see if they could find out what had happened to him, as he was not showing any physical injuries.

We eventually got back on station at about 0400hrs and had our second break (tea and toast) and then got the chance to clean the outside of the vehicle and re stock for the day shift coming in. We were lucky that we did not get called out again and managed to finish on time this morning....

Oh well only one more to go then off until Tuesday NIGHTSHIFT!

Friday, January 13, 2006

What seat first?

This is the question I pose when working with a colleague for the first shift, it means what role am I fulfilling for the first part of the shift (work 12 hrs normally and therefore you change role halfway with your colleague to give them / get a break).

I asked that question today and was told, "You are in the back first" = I am in the attendant seat and have responsibility of the patient care. So it started well, kettle on after the vehicle being checked stocked and made ready for the road. Settled down in the reclining leather (ish) chairs and waiting on the phone to go... and waited and waited and waited.... zzzzz Ring ring! SMM, Nee Naw station (cheers Nee Naw for the noise!) It was the Police looking for information in regards to a call a few days ago, unfortunately I was not able to help but gave him the number of someone who could (The EMDC :) ). 1000hrs and the phone goes again, it is the EMDC Dispatcher booking us off for our meal break... porridge for both of us for our breakfast.... zzzzz 1130hrs Ring ring, Hi I have an urgent call (this is a call where a Doctor has been out (normally) to see the patient and has placed a time scale on them being into hospital for their care). Finished this call and cleared now in Edinburgh in the Western Triangle (You always get caught for a call when you clear at the Western General Hospital) and we are given the RTB = Return To Base Station, just as we are pulling out ... Do do doop! Another urgent call this time to go to Stirling Royal Hospital with a patient who is unwell and needs to be in hospital within 1hr.

We collect the patient, get her settled into the Ambulance and off to the hospital, upon arrival in the unit we are met with what looks like a scene from Casualty with patients lying all over on trolleys, sitting in chairs and relatives walking about, we are eventually spoken to by the nurse in charge of the bed in the hospital and she advised that our patient has a bed in a ward, now you would think this is good news and it is but not for us, we have to because of the lack of trolleys request permission from our EMDC to take the patient to the ward. This is not policy and when we advise the nurse of this she has a lot to say about the policy, we listen and then take our patient to the ward, explaining to the family what is happening.

We clear and are now returned to station for our second meal break (now 1530hrs), just as we pull up outside the station door Do do doop! An emergency call for a female who, when we arrive it turns out has been unwell for 4 months and decided that she did not want to wait any longer for her Doctor to refer her to hospital for an out-patient review of her chronic condition. We clear (now 1645hrs) and back for our second attempt of our second meal break.

Back in the station on the recliner again and just relaxing when (1800hrs) Ring ring.. Hi I have a fire call with persons reported inside.. Off we go again lights and sirens going, we arrive and park behind the 3 Fire engines and 2 police cars and make our way to the patient, who is a female not wanting to travel, we check her out and she still refuses to travel so we clear. Back in the vehicle we think 1830hrs and still a chance to finish on time, just as we get out of the village Do do doop, the same address that we have just been at, we call the EMDC to confirm if we are still to attend, they advise that a second patient has been found, so around the round about and back again.

When we arrive we are told that there is now a male with difficulty breathing, we check him and offer to take him to hospital for a further follow up and with this we also offer the original female patient the same again, this time she agrees so with two patients on-board we set off to the hospital. We eventually arrived back at station 45 minutes late and our colleagues were out in the spare, oh well hope they have a better quieter night!

Sunday, January 08, 2006

I survived!

Well my first night back on after my accident and I managed to survive and not have a panic attack or prange the Ambulance. I was working with a female paramedic who, informed me at the start of my shift that I would be driving second half of the 12 hrs, which is what I had done on the shift when I had crashed. She was considerate enough to ask if this would be ok after we had checked the vehicle and had our cuppa.

I did have a few moments of ...."Oh my god I remember this bit... this is where..." and "Are the wheels sliding again?" but I am happy to say that I survived and hope that this will be the last time I feel like this when driving on the Motorway, but I am not sure if it will be......

This is what saved my life....

You can't see it that well, but this is the wire barrier that stopped me from shooting across into the other cariageway.

Wingardium Leviosa?!?!?

Wingardium Leviosa?!?!?
Originally uploaded by scotsmedicman.
This is the new moving and handling equipment, swish and flick!

Thursday, January 05, 2006

Thanks for not hitting me....

That is the thoughts that were going through my head as I was being strapped to the spinal board yesterday morning, you may wonder why I was think this or even in fact why I was being strapped to a board, but it was because I was involved in a collision in my Ambulance returning back from a call as I lost control on the un-treated M9 motorway, spun 3 times on ice and collided with the crash barrier causing the passenger door to blow open and nearly ejecting my partner, who luckily was wearing his seat belt.

This all occurred at 0647hrs, 13 minutes before we were due to finish our night shift.

As we were sitting in the Ambulance we both called our respective “loved ones” to let them know what had happened, this was after we had placed a priority call to the EMDC informing them what had happened and that we were now facing on-coming traffic, in the outside lane of the motorway with only our roof blue lights working (Not very good considering the freezing fog gave you a visibility of 100 meters!)

The EMDC Dispatcher asked if anyone was injured and if we needed another Ambulance etc, we were both shook up and sore so we confirmed that this would be appropriate and that we urgently needed the Police to make the area safe. After several more phone and radio calls the cavalry arrived in the form of the Day shift at our station (I was never so glad to see the blue lights and flashing head lights of an Ambulance). They parked in the Fend-off position to protect us, put on all their outside lights to try and illuminate the scene and prevent any further vehicles nearly colliding with us. Whilst we were sitting waiting on the crew arriving we had witnessed 4 vehicles stomping along at high speed in our lane, heading straight for us and only noticing at the last moment that there was in fact a smashed up Ambulance facing them, they all managed to swerve to avoid us, both my shift partner and I had various moments of terror seeing this happening and we both discussed which would be safer, staying with the vehicle, belted in or getting onto either the hard shoulder or central reservation and taking the chance of being hit or aggravating any possible injuries further…. We decided to sit tight and pray for a quick response.

Once the first crew arrived, it was apparent that both of us were going to get the full treatment and would be collared and boarded as a precaution and because we were both complaining of neck / back and I had right shoulder pain. The second crew arrived and I was transferred to their vehicle for further care, whilst my colleague was secured to a spinal board, checked over and transported to Stirling Royal AE (Because we were facing that direction on the Motorway). I was given the same treatment, collar applied to my neck, placed on a board, blood pressure, ECG and Oxygen levels monitored, I even trusted my colleague who was attending to me to cannulate my arm and give me some stronger pain relief for my shoulder. I was taken on a strange journey to AE, when I say strange it felt strange because I was the patient, I was the one lying there being cared for and not being able to do anything but just lie there. When I arrived at AE I was undressed, examined and x-rays were taken, I had the AE Consultant looking after me, which was comforting, as I knew I was in very safe hands.

Throughout the entire process my Station Officer (Area Service Manager) was floating between me and my injured colleague seeing if we were ok and if we needed anyone contacted. My flat mate was the first to arrive as Kal had called her telling her what had happened and she offered to come to the AE until he arrived (Because the M9 was now completely closed and she could come via the back roads until Kal arrived by train). Kal arrived fairly soon after I had been assessed and was with me before I went for x-rays, My Station Officer went to my colleague to keep him company until his wife arrived. We were both given the all clear after our x-ray results had been checked and were discharged with information re ongoing care for neck / back pain.

I went home, via the station to collect my car, had a very long hot shower and a big mug of tea and went with Kal to Edinburgh to visit my folks, I dropped him off at his work (for which he was now 5 hours late) and spent the rest of the day with my parents being pampered and fed numerous cups of tea etc.

I met Kal after his work (for which he had stayed late to catch up on the stuff he should have done during his time in AE with me) and we had a lazy night in front of the TV with a Chinese take away and that is when it hit me, what had happened, what might have happened and how it could have turned out horribly different. I was glad to be safe in his arms, maybe a bit sore, but still safe….

Tuesday, January 03, 2006

The vampire shifts...

Well I have been the lucky one and over the Christmas and New Year period I had the pleasure of working NIGHTS.

I know that I should be happy because I got to go up North to see Kal and his family and friends between the shifts finishing on Tuesday 27th Dec and starting again on Sat 31st of December, and I am, it was a very pleasant trip north, the food was good, the alcohol was even better but most of all the company was amazing. I come from a family where less is sometimes more... i.e. SMM Mum "How has your day been SMM?" Me "Oh ok busy with calls etc, managed to get finished on time so that is a bonus" SMM Mum "Oh that is good, so what's your plans for your days off?" and so it goes on. Kal and his family on the other had have discussions that go off on tangents and force your brain to actually work and it is wonderful seeing how they interact as a unit, the discussions, the body language, the knowing.... I find it challenging at times to keep up with the two or three conversations that are happening at once (Yes I know men can't multi-task very well...I am slightly better than most I think because I have to at work), but it is enjoyable, fulfilling and enthralling to be part of this and you are definitely made to feel welcome with your comments, but be prepared to explain why you think something, or clarify your answer to the questions that are being posed.

I always look forward to my time up there because of the atmosphere and the people along with the beauty of the place and especially because I get to spend lazy time with Kal.