Thursday, 10 May 2012


Having left the LAS for pastures new, I thought I'd look back on various aspects of a decade on the front line in London and suggest ideas or share various experiences for both the old and new crew staff out there as well as give the outsiders an insight into different aspects of ambulance life. This is hopefully the first of a series. 

Six months wasn’t enough – it was really just the beginning, but it was all I had and I hope I made the most of it. My time at the Neonatal Transfer Service, or the Baby Emergency Transfer Service (BETS as it’s affectionately known in the LAS), was easily one of my most enjoyable and rewarding periods in my time as a paramedic in London. It may well have been time away from the front line of A&E work, but there were so many benefits that I took back with me when I headed back to the streets.

It’s true. Normal Paramedic skills on BETS take something of a back seat for a while. However, the time spent learning new skills and gaining new knowledge was totally invaluable. These new skills weren’t just useful for the duration of my time on BETS – they were useful for the years that followed.

Dealing with premature babies, as well as full term but critically ill ones, alongside a team of dedicated, knowledgeable medical staff was not only inspiring, but educational too. Each case was reviewed and followed up, mistakes corrected, and positive action praised. The knowledge that any new skill was taught and supervised by a senior nurse or doctor gave rise to a new level of confidence in dealing with what many, if not most front line paramedics deem as the nightmare scenario.

Sick children, particularly babies, are notoriously frightening for most paramedics – not least of which because of the lack of exposure and training we have in that field. In my six months on BETS I had the opportunity to learn to cannulate the smallest of veins in the most difficult of patients and the chance to intubate the most delicate of patients. These are skills that came in useful on more than one occasion in the years that followed – just by building my confidence and skill enough to know that if I could perform these skills on the tiniest of patients – that back out on the front line, toddlers, children or even difficult adults with the same needs would prove so much less daunting.

I learned about the anatomy of the newborn by learning how to do baby checks, learned what signs to look for in a child that may be ill and how to distinguish them from a critically ill child. I learned how resuscitating a baby is both heart-breaking yet fulfilling at the same time, and more importantly how vital it is that when doing so, keeping a level head and not just rushing the treatment gives that baby the best chances of survival.
Suddenly, blood gases had relevance too, and with that relevance came understanding. You can’t ask a baby what’s wrong – and you can’t ask a ventilator why it isn’t doing what it should be. An understanding of gases helps solve both of those mysteries, whilst an understanding of ventilators and ventilated patients would help on many a critical transfer in the following years.

I learned about the effects that transport has on our patients, whether they are old or young. The benefits of a smooth drive were never more important than when dealing with a patient who had the blood volume of less than a bottle of calpol, but once again it reinforced and improved my driving skills and heightened my awareness.

I can’t recommend a period of time on BETS enough. I can only begin to express in words what it did for my confidence, for my skill levels and for my knowledge base. Any student who has ever asked about secondments, about extending skills and knowledge, or about career pathways in the LAS, has always had the same answer.

Go spend six months, at least, on BETS.

If you want to read about just one of my experiences there - click here for the story on the Baby Bus, and don't forget to click the link at the end for part two of the story. 


eddie said...

Really moved by your post.

Dan said...

Having spent a great deal of time at the Evelina Childrens Hospital when it was at Guys, I have seen these BETS Paramedics a LOT when bringing in the sick babies, either into Intensive Care, or into the Paediatric Cardiology Ward. I know several parents that have had their child transferred this way too.

I was always impressed with how the paramedics carried themselves, how - even with all hell breaking loose - they managed to deal and cope with everything AND keep an air of cool calmness about them... Which is exactly what the parents need when the proverbial is hitting the fan.

Kudos to you on being one of these medics :)

Anonymous said...

IMHO it should be compulsory as part of our CPD to do a stint with BETS. I did it about a year after my probation and like you found it was the best thing I ever did.
The staff at GOSH are always brilliant as are ALL the NNU/SCBU staff everywhere who take the time to give you guidance and support.
Thanks for highlighting this aspect of training that is so easily overlooked.