Tag: Ambulance Service

A Decade – part three

Seventeen years was enough. I wanted to experience living in Australia as an adult, not just visiting it. So I packed my bags and moved.

A massive leaving party, and a short holiday later, I arrived in Sydney with two suitcases, two guitars, and a bike. May as well do it properly and start from scratch!

Ambulance Service? A thing of the past. As much as I enjoyed it, being a paramedic is not a job for life, working in IT gives you more career opportunities, pays better, and is far more mobile. To be filed under “past experiences and enjoyments”.

I enjoyed the change in scenery. But I also remember spotting my first ambulance even on the taxi ride from the airport to the friends house I was staying at for the first few weeks. I just like the design, I thought. Just to look.

Work was good. I was getting paid, was getting experience, I had some pretty good colleagues (including the woman that used to sit opposite me who now sleeps next to me). It was on a holiday over to the west side of the country to visit my mum that I was able to organise an observer shift with the ambulance service – I was curious how the Australian system worked, and wanted to compare it to the German system I had experienced over the past three years.

I got dropped off at the ambulance station. The day crew weren’t back yet, and the night crew (I was going to follow them through half the night) hadn’t come in yet, so I waited for a few minutes until my aunt’s colleague’s flatmate (yes, you red correctly) turned up, who I had organised a shift with. In his final year as a paramedic student, he was happy to take me out and who me the Aussie way.

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A brief tour or the van, checking the drugs and equipment, I didn’t have much time to sit down until the first job came in. I can’t remember what it was, but what I do remember is that feeling of sitting in an ambulance again. This one was considerably smaller, made woo woo noise instead of neenaw, and had the addition of red and white flashing lights over the european blue I was used to – but each ambulance I have sat in makes a similar noise; the rattle of equipment in the draws, the crackling of the radio, the strain of the engine when the accelerator is mashed to the floor. In addition, all the other feedback was right too, the vehicle been thrown around corners at high speeds, the clinical white interior, the lights bouncing of the surroundings at night time. It all fit perfectly, a feeling and experience that I hadn’t had in a while. Quite nice, and good to know that it doesn’t differ much from Germany. Still hope that the university get back to me to tell me if I’ve been accepted for my bachelor in computer science, I’d like to progress my career in IT.

We drop our patient off at the hospital, and that is where I notice the biggest difference: it is all one service in the city. You see, in Frankfurt, the Fire Brigade had central oversight and control over EMS, and manned some ambulances. Additionally, the Samaritans, the Red Cross, St Johns and the Maltese Cross all ran ambulances in the city, under governance of the Fire Brigade. Five organisations, five employers – and people from different organisations didn’t mingle, it seems. But here, here in Australia, everybody knew their colleagues, they all wore the same uniform! I was introduced as the guy from Germany who wanted an insight in to the Aussie system, I was made very welcome by everyone else. The shift progressed, and I was able to have a good chat with the crew. Once again, we cleared from hospital, and were told that there were reports of a car crash coming in – one ambulance had already been dispatched, but in case backup was needed, we should head in that general direction. And sure enough, a few minutes later we were called to proceed under priority conditions to the scene.

And what a scene it was: The police had blocked the road, the fire brigade were cutting the roof off one car, whilst the ambulance crew on scene had split and were dealing with what was to become our patient, and another one who was in (what I now know as) traumatic cardiac arrest. Both young, having fun, but one of them had a bit too much of a lead foot for their guardian angel to keep up – even the paramedics weren’t going to change that. I was told to stay close to the ambulance, and was happy to do so – I was happy to take a back step on this chaotic scene, try and make sense of it all, get a general overview. A manager turned up, one that I had met earlier at hospital, who reminded me that if I didn’t want to see what was happening, I could sit in the back of the ambulance and shut the door; he made sure I was OK with the whole situation. I was.

After transporting the patient to hospital (I assisted, upon their request, by keeping the attendant up to date on the patients vital signs…OK I may have gone slightly overboard with the constantly changing heart rate until I was gently told to shut up ūüôā Iwas dropped off at a taxi rank. The crew took off for the rest of their shift, and I returned back to my mums place, deep in contemplation of my newly gained experiences of the life of a Paramedic in Australia…

 

A Decade – Teil Zwei

The next two weeks consisted of a lot of waiting around, reading the newspaper, reading magazines, looking through the ambulance bits, with the occasional call in between. I think we must have done approximately six or seven emergency calls in ten days.

I had become considerably calmer once I realised that I could handle the situations I was taken in to – I was only an observer, and not responsible for much except keeping my mouth shut when appropriate. Jobs I remember was taking an old lady a quarter of a mile down the road for a doctors appointment, a kid with anaphylaxis, an MI and a drunk teen at a foam party at the local disco.

I had tasted my first blood, and relished the flavour. But the waiting drove me crazy.

Later that year, one day after work, I had planned to meet a friend. I had finished earlier than he had, and so had some additional time up my sleeve – and instead of catching the train to out meeting point I did what I still do today when I’m in no rush: walk. Frees your mind, gives you opportunity to think, feel, appreciate, absorb…and walk past organisations that are involved in the cities ambulance service. With time to spare, I thought I’d pop my head in and ask what I would have to do to get on one of their trucks. The answer was simple: sign up, there’s a basic 40 hour course over four weekends starting in two weeks, after that you will be able to third man an ambulance and assist during event first aid work.

The course was interesting. To be honest, I can’t remember much, but there were a lot of concepts discussed. Confusing at the time, but somehow I managed to pass, and proudly received my first certificate relating to medical care. To stay in the organisations good books, it would be good to do a few event first aid services. I did more than a few, was good experience and I met some interesting people…

The tender beginnings in Frankfurt, Germany
…but my real aim was the big white truck with bright red stripes and flashing blue lights…

Photo Source: bos-fahrzeuge.info

For three years I volunteered for first aid and ambulance shifts, slowly getting to know a thing or three about the work, and meeting some interesting people Рboth colleagues and patients. I really enjoyed my time there, and managed to never be called to a cardiac arrest. In retrospect, I may have even placed a little bit too much emphasis on my volunteering in comparison to my IT training, finishing vocational school for the day, riding my bike to the ambulance station, doing a night shift (rarely doing more than one call after 1am), having a shower on station and riding back to school the next morning. One day, I was five minutes late for school because of a late job Рa drunk driver had ploughed in to another car, killing one person and seriously injuring three others (the driver remained unhurt). I can still vividly remember parts of the call Рthe Mercedes in the middle of the field, the other car absolutely smashed on the Autobahn, one dead body covered by a sheet in the middle lane, the fire brigade on scene, the early morning response prior to rush hour, our patient being on blood thinners, the handover at hospital, knowing that the patient is seriously injured, but not having much idea about the science and the medicine behind it, but knowing that if she survived, she would have two other family members who were also fighting for their lives, and another one who had already lost the battle. All because of one drunk driver in a Mercedes station wagon, with a scratched door and muddy tires in the middle of a field.

The only reason I got away with being five minutes late that day was because the teacher was nearly an hour late. She came in to the room, apologised and briefly explained that there was a horrific accident on the Autobahn that had delayed her.

I didn’t feel like saying anything.

A Decade – Teil Eins

Ten years. Looking back it is still pretty fresh in my mind, yet so long ago at the same time. Ten years ago I got a first proper insight in to the world of being a paramedic.

It began rather…well, decide for yourself. I had completed my mandatory 10 months of Zivildienst¬†(civilian service instead of going to the Bundeswehr, the German Army – at the time Germany still had conscription) as a patient transport driver, and had six weeks or so to kill before starting my Ausbildung (vocational training) in IT. I had been pretty much a wheelchair and stretcher taxi driver,¬†driving disabled kids to and from school, disabled adults to and from work, taking the less mobile to outpatient appointments and hospital discharges. The driveway where we parked our vans to access the hospital was a shared one with the driveway to the local Emergency Department…and with Emergency Departments come ambulances. I’d long had an (some would say unhealthy) interest in vehicles with flashing blue lights, but this was the first time I could actually look inside one for a decent amount of time. Interesting stuff! I’d see the staff milling about, mainly smiling, chatting. One image I will never forget is of a female paramedic sitting on the rear bumper of her ambulance, head in hands, with that powerful yet empty expression on her face – sad, uncomfortable, numb. I wanted to sit down beside her, ask her how she was feeling, what had happened…but one doesn’t do that as a shy 21 year old. I wanted to know what she had just been through, what had caused her so much grief, I wanted to offer any help – but most of all I wanted to do what she did, wear what she did (a paramedic uniform, not women’s clothing).

This desire was not a subtle one (come to think of it, that is one part of my life I’ve never held back. I once used up an entire 36 shot film within fifteen minutes trying to take pictures of emergency vehicles from a helicopter over NYC at the tender age of 7). ¬†The head of the station I worked out of, which was also an ambulance station, offered me a two week work experience, shadowing paramedics on an ambulance after I had finished my¬†Zivildienst. Hell Yeah!

First day. Poor sleep. Excited as a pig in mud, I get my whites (uniform consisting of white polo shirt, white tactical pants, white boots, hi-vis red jacket), and get shown briefly around the station. Every now and again the radio would crackle to life, and the crew would speak some codewords who they were, where they were going to, with the sirens blaring in the background – it all seemed really exciting! (Even today, hearing someone talk through the radio with the sirens going in the background adds a certain drama to the whole transmission). The crew was lounging around, reading, doing stuff on the computer, eating, whatever. I sat down, waiting for the first call.

And waited.

And waited.

And waited.

After five hours, I got excited, a call! No, it was for the other crew. So I kept waiting.

And waited.

And waited.

And whinged that nothing was happening. One of the crew told me that they will definitely be called out in the afternoon, rush hour means work. But I was sick of waiting! But had no choice, so waited a bit longer.

*DING DING DING*

Finally! A job! I am hyperaware and hyperawake, yet have no idea whats going on. I rush downstairs following the other two, and hop in the back of the van:

Photo Source: bos-fahrzeuge.info

The engine roars in to life, I’m strapped in the back of the box, and have no idea whats going on, where we’re heading, what will happen, what to do. I hear the crew talking on the radio. The attendant turns around, and informs me (shouting over the sirens) that there has been a motorcycle crash.

I still remember vividly that fear of panic and fear rising up through my body, up through my neck, in to my head. What the hell have I let myself in to? What in my right mind was I thinking when I signed up? What will I encounter at the crash sight? What do I do? Where do I look?

There was no way around it – I was scared. Really scared. If it was possible, I would have run away back to my car and driven myself home.

The response took ages. Windy roads, lots of accelerating hard, wild corners, sirens blaring, cars not giving way. I was completely lost. Finally, we arrive; all I can see is a small crowd of bystanders whilst I peered through the cubbyhole from the back of the ambulance. My colleague opens the door, I step out. Bright light shines upon me, in a kind of sun-dazed fashion I nervously hop out of the vehicle, and look around: a few people, a motorbike on its side with a few scratches. No mangled metal. No blood. No bones. No screams. The crew are tied up trying to find out what is happening. A bystander grabs me and points me towards something, asking me questions I have no idea what to answer to. I am an untrained observer, but am wearing the same clothes as that of the crew. They realise, and come to my rescue, one deals with the bystander, the other one tells me that the motorcyclist couldn’t bother waiting for us, so he hopped in another bystanders car who drove him to hospital.

Apparently he waved at us as he passed us going the other way.

to be continued…

Who you gonna call?

My friend had a heart attack at a party we were at. We were all taken by surprise, and I dialled the paramedics as quickly as I could.

As his wife knelt by his side, she was frantically screaming

“How long is the bloody ambulance going to be!?”

“About twenty feet” is apparently not the answer she was looking for.

 

Moan and groan as much as you like – I had to laugh the first time I read this.

And now, before you strangle me because of my percieved bad sense of humour (you wouldn’t be the first one), hear me out. This has a serious twist to it.

What’s in a name?

A clear misunderstanding – the first person dials for medical assistance in the form of Paramedics, whilst the wife of the victim asks how long the vehicle will be.

Why?

Why is it so engrained in to the public mind that if you need medical assistance, you call for a big box on wheels with flashing lights and some bright paint splashed on the side.

If my house is being burgled, I don’t want a police car, I want police officers. If my garden is burning, I don’t want a fire truck, I want some firefighters. If my toilet is blocked, I don’t want a van with a tap and some tools in the back, I want a plumber. And so forth, I could carry on¬†ad nauseum.

So why the fixation with our transportation device (which is in decline anyway, but Community Paramedicine, Paramedic Practitioners, treat and release is another story). Why the constant referral to our vehicle?

Any Paramedic is most likely to develop and burst an aneurysm very quickly if referred to as an “Ambulance Driver” all to often. We don’t like that. We do more than just drive the ambulance.

But no-one really bats an eyelid if the vehicle is called for assistance, without any proper regard to the professionals that actually staff the vehicle and perform the magic.

If you need medical assistance and call an ambulance, maybe the ambulance will help you get better. But since we don’t have vans that can drive autonomously, thats why we need “Ambulance Drivers’. They just drive the vehicle; they won’t attempt to help or heal you, the vehicle will do that. They just drive the ambulance.

Don’t believe me? Think I’m rabbiting on about nothing? Missing my point?

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At the Emergency Services Show 2012 (I wrote about it here and here) I came across many ambulances of all shapes and sizes. As you can see above, many things marked as an “Ambulance” had arms and legs, a torso, and a head on the top. But no flashing lights. Strange, since the Oxford Dictionary defines an ambulance as:

a vehicle equipped for taking sick or injured people to and from hospital, especially in emergencies

I doubt the bloke in the picture would really want to piggyback a sick or injured person all the way to hospital.

But the misnomers don’t stop there, oh no. What about “Ambulance Service”? Is this the local van dealership providing vehicles?

Here in the UK there is an organisation going by the name of NARU – the National Ambulance Resilience Unit. I suppose the splash very tough paint on the trucks, and maybe equip them with bulletproof tyres.

Then there is the AACE – the Association of Ambulance Chief Executives (also on twitter). When on shift, and I’m the clinically most senior person working, does that make me the Chief Executive on the Ambulance? What about when the ambulance is at the workshop? I take it the AACE are a bunch of people in charge of a lot of vans. Fleet managers I believe is what they call them.

Last but not least, the AACE have an “Ambulance Leadership Forum”. Sounds like an advanced driving course to me – how to lead my ambulance through heavy traffic, and around oddly placed cones on the ground.

I hope I have got my point across what we are not.

So then, if we aren’t a vehicle, what are we? Simple:

We are Paramedics.

We practice Paramedicine.

We study Paramedicine.

We (generally) work for Paramedic Services.

Canadians picked this up quickly (Ottawa Paramedic Services, Peel Regional Paramedic Services, to name a few). No matter what education, you are a Paramedic. Primary Care, Advanced Care, Critical Care…all just subdivisions: They are Paramedics. Some Australian states have picked it up in part (most notably New South Wales and Victoria).

I am aware of some of the legal minefields in different parts of the world (for example, the title “Paramedic” is reserved to those registered as a Paramedic in the UK, and anyone stating they are a paramedic without UK proper registration is committing an offence and can be prosecuted). But I will still refer to you all as Paramedics. You still practice Paramedicine.

Now its time for the rest of the world to wake up, and follow the naming guidelines from International Paramedic (I wrote about it earlier this year):

  • The¬†Paramedic¬†is the professional practitioner
  • A¬†Paramedic Service¬†is the provider of emergency medical services staffed by paramedics; and
  • Paramedicine¬†is the discipline and the area of medical study and knowledge.

What’s in a name? A whole lot. If we as a¬†want to be taken seriously, we need to be referred to by our professional title. That doesn’t incorporate our vehicle.

It’s our profession.

I am a Paramedic.