Monday, 29 March 2010

Happy to Help

Public education should really be at the forefront of the campaign against misuse of the ambulance service. Huge posters, TV and radio ads, even, as far as I'm concerned, parliamentary debates.
Even the occasional blog post.
There's a relatively new law that could see a person fined, and potentially jailed, for obstructing an emergency ambulance in its duties. From the news that I've seen, this has been used precisely once in London since it became law over a year ago. This is probably because being deliberately obstructive, whilst potentially lethal and exceptionally obnoxious, is a very rare thing. More often than not, the obstruction is caused elsewhere, when an ambulance is called unnecessarily, whilst somebody else, in desperate need, lies waiting nearby.
The call was to an industrial site, a plastics factory, for a hand injury. The call taker has been told that there is serious bleeding. As per normal on these sites, the front gate security sent me the wrong way, but the array of white-overall-clad windmills soon had me turning 180 degrees and heading for the right factory. After grabbing the kit out the back of the car, I'm shown into the main office that doubles as the first-aid room. My tour-guide is walking double-time, and speaking twice as fast.
"I'm sorry we've had to call you. It's Stefan. He was slicing some plastic sheeting with a Stanley knife and it slipped. He's cut his hand. It's really bad! I've put some bandages on and tied them tight, but it's leaking through, so I've made him sit with his hand on his head!"
A first-aider with some knowledge, and putting it to good use. I'm impressed.
I find Stefan sitting on the office chair, feet up on the table, his right arm bandaged and resting on his head. Blood trickles out and drips down the side of his face, giving the impression that he's bleeding from his ear. He's paler than the overalls he's wearing, clammy and scared. I have to see the injury, so warn Stefan that I need to remove the bandages and he may want to look away. There's a definite reverse shuffle of feet heading for the door as I say that, as the few people who'd come to see what was wrong realised that they'd seen enough. With the bleeding still seeping through the bandage I presume an arterial bleed, and remove the bandages with some care to ensure I don't get covered in case of any spurting blood vessels.
The injury is serious. He has a deep laceration from the back of his hand by his little finger almost as far as his elbow, all along the top of his arm. It's like having a lesson in the anatomy of an arm - muscles, blood vessels, bone, all on view. The force being used on the blade to cut through thick plastic made easy work of Stefan's arm, as the knife slipped off its intended target and took out its venom on the next available one. With his arm re-bandaged even tighter than before, elevated in a sling, Stefan was blue-lighted to hospital for what would initially be an attempt to salvage his arm and its motor functions, and later on for the plastic surgeons to work their magic too.
As the back doors of the ambulance were shutting, Stefan looked up and said a drowsy "thank you".
"No worries Stefan. Happy to help."
One week later, almost to the minute, and I'm called to a private home, for a man with an arm injury, again with serious bleeding. These sorts of things tend to happen in blocks. There'll be a few people all having heart attacks around the same time, then I'll attend RTCs as though they are going out of fashion, and obviously now a few days of people slicing their arms.
Kev meets me at the door himself. His hand and arm are wrapped in a colourful array of tea-towels. He starts telling me how the accident happened, and only half listening (big mistake), waiting to see another anatomy lesson, I start unravelling the towels that seem to have stemmed the serious bleed. Four towels later I can see his arm, but no sign of any bleeding. I ask him once more what happened, and he tells me again of the new DVD player and cutting his hand on the box as he opened it. For a moment, I'm lost for words.
There's no cut, no blood, at a stretch there's a small scratch. A paper cut. That's why he called the ambulance. For a paper cut. Sometimes, most times in fact, if I'm on route to a call that I think isn't either an Accident or Emergency requiring an ambulance, I'll rant, rave, threaten to scream and shout, but invariably, as soon as the door opens, I'm polite, professional and calm. I'll politely suggest that if there is a "next time" other alternatives, a GP appointment, a visit to a minor injuries unit, even self-conveyance to the A&E department are all possibilities.
This was a grown man, in his late 40's, with a supposedly responsible job, runs his own home, and seemingly has at least a normal level of intelligence. His justification for calling an ambulance for his paper cut was because he was on Warfarin - blood thinning medication - and was concerned that he wasn't going to be able to stop any bleeding. I tried to point out, gently at first, the fact that he needed to have been bleeding in the first place to be worried about it not stopping. I tried to tell him, calmly at first, that despite the fact that he was on Warfarin, he was at no greater risk than the rest of the general population of dying from a paper cut. None of this was being taken on board. Kev kept repeating the same mantra over and over. "I'm on Warfarin. I deserve an ambulance. I know my rights and that means that you have to take me to hospital, otherwise I might bleed so much that I'll die!"
In one final attempt to explain who we are, what we do, and when is the right circumstance to call us, I asked Kev if he had any family in the area. "Sure. My parents live not far from here."

"And if one of them was to have a heart attack, what would you do?"
"I'd call an ambulance."
"Well, sir, you wouldn't get one."
He looked incredulous. "Why the hell not?"
"Because, sir", I tried to answer with all the composure I could muster, "I'm here dealing with your paper cut!!"
Finally, the penny seemed to drop.
"Ummm... Errr... Maybe I over-reacted a little."
I sighed.
"Maybe you did, sir. Just a little."
Fears allayed, Kev decided that he didn't really need to spend several hours in hospital for a paper cut, and after a short time and the traditional paperwork, he decided to stay home. We parted as friends, and he promised to think long and hard if he really needed to call an ambulance in future. I, on the other hand, after doing my little bit for public education, promised that if he did ever need us again, either for himself, his family or his friends, we'd be only too happy to help.


Sue said...

There's an article in today's Standard about 70 LAS ambulances that are going to have adverts on the side to educate people on what an emergency is, featuring someone being resucitated. Hopefuly it might get through to a few people.

I've had an ambulance called for me once, and I was so apologetic when they came. Wouldn't do it again, I've got the bus to A&E twice with bowel obstructions!

RD said...


flobach said...

Now that is cunning. I'll remember that for any future WOMBATs (Waste Of Money Brains And Time). Brilliant.

PS: Thanks for all the traffic :-)

taaurus said...

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Nikki said...

My daughter whom is 9 is a severe asthmatic, with a load of severe allergies thrown into the mix too. 2 weeks ago she had a real bad attack at home . She does use a home nebuliser ,but as she had already had 2 nebs and followed our protocol, she really wasn't getting better so I rang 999.we were blue lighted rather smartly to our local A & E.I couldn't believe it when in the space of 10mins 2 families followed us in one with a 7month old for whom had had olbas oil put up her nose and a 2yr old who had eaten some vicks vaporub because the mum had left the lid off the jar in the little ones bedroom in the hope that the aroma would help the little ones chest.both who had wasted an ambulance if they had taken the time to read a few instructions on a label!!!!. there was me worrying because I had rang one because her SATS were 78.I really feel for you at times when I hear some peoples excuses. Thanks so much for doing a great job

Jamrock said...

I'm sure you know you are preaching to the converted here. The things people call you and other LAS crews out for is a national disgrace. How were these people brought up?

I was taught that an ambulance is called when the situation is life threatening or worse. Unconscious, severe RTC or heart attack, that sort of thing.

I have got the bus to the hospital with acute appendicitis and after giving my self an epic head wound spent ages phoning round someone to drive me. I would have considered drving myself but I had to keep a towel on my head with one hand or have eyes full of blood. I never once considered an ambulance...I was bleeding not dying!

The only times I have been in an ambulance is where I was unconscious (car crash) and semi conscious (bike crash) and the call was made on my behalf.

The fact you are polite to these time-wasters and drunks is a tribute to you but you should be, by law, allowed to refuse then and give them an on the spot fine.