Omne trium perfectum – everything that comes in threes in perfect
After gaining some interesting insights how paramedics operate in London by riding out with Lysa Walder in 2009 and InsomniacMedic in 2011, the year has come where I put myself in the hot seat and actually work in London.
After two shifts in the capital of the United Kingdom, the largest city in Europe and one of the most vibrant and exciting cities in the world, what does Yours Truly think?
In brief: Yours Truly is happy. It’s busy, there’s traffic everywhere, there are people everywhere, and its not hot.
Some of my initial impressions in a bit more depth include:
- it’s much busier. Generally you will get a job the minute you begin your shift, and then when you clear or “green up” at hospital or whoever you left your last patient. This is good, this keeps me awake.
- in these two twelve hour shifts I’ve possibly encountered as much heavy traffic as I have in two years in Perth. Again, this is good (yes, I know you think I’m mad)
- Roll In, Roll Out stretchers are nowhere to be seen. The majority of ambulances have tail lifts, some have ramps. Much more back and shoulder friendly. This is good, obviously.
- whilst we’re talking equipment, the vehicles are bigger here too. Funny – when you think of it, in Western Australia (WA) we had wider roads and less traffic, but smaller vehicles…go figure. In the UK, at led thou can stand up straight in the back of the vehicle even if you are taller than 160cm. I like this. A lot. The only thing I miss are the red lights lunching off the walls at night – UK law states no forward facing red lights allowed on any vehicle.
- being a bigger city, there are obviously more ambulance on the road, and many more paramedics on shift. They’re everywhere, impossible to know all of them, which makes it all a little less personal…but on the upside you get to see and meet new people every time. And not only London Ambulance Service paramedics, there are various private frontline service staff (like myself), people from neighbouring services and patient transfer staff milling around too – an interesting mix. In Australia every state or territory has one single statutory ambulance service. UK ambulance services seem to like to contract private services to cover peak periods. A new concept to me.
- FRU, RRU, PRU: Fast, Rapid, or Paramedic Response Unit. Different names, same thing: single responders in a car that are sent out to get to patients quicker. Again, this doesn’t really exist in WA. A new experience for me arriving at a patient that is already receiving paramedical care.
- not only are there different response vehicle types, but also more levels of responders. Every frontline emergency ambulance in metropolitan Perth is either a double paramedic or a paramedic/student paramedic crew. Here, very rarely do two paramedics (as in UK HCPC registered paramedics) work together. Frontline crews are usually made up of either a Paramedic or an (Emergency Medical) Technician as the clinical leader, teamed up with a Technician or a driver with advanced first aid skills (ECA, Emergency Care Assistant). In WA, I was one of many paramedics. Here, I am one of many paramedics too, but also with many technicians and ECAs, who have a lower clinical rank. I was at a job where we were backed up by a double technician crew – I was the only paramedic on scene. New experience working in the city and being the only ALS trained person on scene.
- i=Information. We all know that the information sent to us by Comms/Control/Dispatch is hazy at the best of times…and that is not their fault (well, not always, but we all make mistakes occasionally!). Easy fix? Don’t give out much information. Typical call out info for me, apart from the address, was: “49M, sick” or “23F, OD”. No names, no background info, if there was any hint of danger on scene they would radio that information through. I was used to much more information being sent through (that was generally inaccurate)…after an initial light shock at the lack of information I started thinking this may not be such a bad idea- at least it gets you thinking in many more directions; especially as a student I noticed I (and many other colleagues) would easily be lend and fooled by on screen information that had nothing to do the the main condition the patient was presenting with.
- uniforms: yep, they’re dark green too, but that’s where the similarities stop. I’m wearing epaulettes (a word nobody seems to be able to spell correctly) again, but unfortunately UK paramedic uniforms don’t boast reflective strips anywhere except on the jackets.
…and what about the patients? A bit early to tell, but for a general summary: people are people. Same problems, slightly different way of tackling them. What I have noticed in some is the typical British stoic stiff upper lip and politeness, manifesting in a stubborn “I’m perfectly all right, thank you” (no, you’re not), and “it feels like I need to…well…this sounds rather awkward…like I need to fart. Sorry for being so rude!”
To which I reply: “Stop being so British!”
And then there’s the sightseeing. I going to parts of London I haven’t been before. I was telling my crewmate the other day what would be the peak of my paramedic career: driving around Trafalgar Square on Blues’n'Twos, followed afterwards by parking the ambulance up on Westminster bridge and getting a photoshoot of the “man and his van” with Big Ben in the background.
“You’re such a tourist!” she replied with a smile 
