Tom Reynolds - The Complete Blood, Sweat and Tea

Sirens is not authorized or endorsed by the London Ambulance Service. The opinions expressed in this book are those of the author alone and do not necessarily reflect those of the London Ambulance Service.

There are a number of terms found in this book that may be unfamiliar; for the assistance of the non-medical reader there is a short glossary at the back.

In the interests of confidentiality patients have been made anonymous and identifying characteristics may have been altered or removed.

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Too Young

Yesterday started well, we had the only new yellow vehicle on the complex, and it really is an improvement on the old motors. But then we got a job that should have been routine, but unfortunately was not.

We were given a 34-year-old male, seizure at a nearby football pitch in the middle of a park. Also leaving from our station was the FRU (a fast car designed to get to a scene before the ambulance). As we had a new motor, we were able to keep up with the FRU.

Arriving at the top of the street, we were met and directed by some of the patients football team-mates. Unfortunately, the patient was 200 yards into the park, and there was no way we were going to get the ambulance onto the field the council had built a little moat around the park to stop joyriders tearing up the grass in their stolen cars.

The FRU paramedic had reached the patient first and I ran across the field to get to the patient as the paramedic looked worried, and this isnt someone who normally worries.

As I reached the patient, carrying the scoop which we would use to move him, the paramedic asked me if I thought the patient was breathing.

The patient was Nigerian, and it is not racist to say that sometimes detecting signs of life on a black person is harder than if the patient is Caucasian. White people tend to look dead; black people often just look unconscious. Also, a windy playing field at dusk is not the ideal circumstance to assess a patient.

Hes not breathing, I told the paramedic, just as my crewmate reached us. Shit replied the paramedic, I left the FR2 in my car.

I had to run 200 yards back to our ambulance to get this, now vital, piece of kit.

On my return my colleagues had started to bag the patient (this means using equipment to breathe for the patient and performing cardiopulmonary resuscitation, or CPR), which is the procedure to keep blood flowing around the body in the absence of a pulse. Attaching the defib pads I saw that the patient was in fine VF (ventricular fibrillation) this is a heart rhythm which means the heart is quivering rather than pumping blood around the body to the brain and other vital organs. Technically, the patient is dead and without immediate treatment, they will remain dead.

We shocked the patient once and his heart rhythm changed. It changed to asystole (this means that the heart is not moving at all, and it is much more difficult to restore life to the patient with this form of rhythm). We decided to scoop and run to the nearest hospital. The paramedic secured the patients airway by passing a tube down the windpipe, and we got the patient onto the scoop, all the time continuing the CPR and giving potentially lifesaving drugs. We then carried him, with the help of his team-mates, to the ambulance and rushed him to hospital.

Unfortunately, the patient never regained consciousness, and died in the resuscitation room.

Thirty-four years old, normally fit and healthy and he drops dead on a football pitch. Despite our best efforts there was nothing more we could have done for him; the treatment went according to plan and the resuscitation attempt went smoothly. This was a proper job, but one job we would have happily done without.

Why Wont They Let Me Do This?

Here is a moan about something that I am not allowed to do. Im not allowed to run people over in my job. I could really clear the streets of a lot of stupid people if I was able to do that.

Picture the scene: there I am, driving through the streets of London in a big white van, with blue flashing lights, loud sirens running and the word Ambulance written in rather large letters. As a pedestrian, what would you do? Would you think Hmm, being run over by that would really hurt, I think Ill wait the 12 nanoseconds that it takes him to drive past before I cross the road. Or would you, as most of the people in my area apparently do, think Hmm, an ambulance on his way to an important job, I bet I can run across the road in front of him before he can hit me.

During the last job, three people tried to dive under my ambulance. If I was allowed (by government grant or some such) to keep driving and splat them across my windscreen, that would mean three less idiots being allowed to breed tonight.

Oh well, I might get lucky later tonight.

Dear Mr Alcoholic

Can all alcoholics please just get drunk in their houses and fall asleep there? Why do you insist that you drink your Tennents Super in a public place where some do-gooder will think you are ill and call for an ambulance?

Can you also have a bath once in a while? I know its nice to roll around in the road while drunk, but it would be nice if you were at least a bit clean to start with.

Would you mind awfully not swearing at me, taking a swing at me or exposing yourself to me? I have quite enough abuse from the non-drunks out there Still at least your fists are easy to dodge, and if I stop holding you up, you fall over.

If you have a medical condition, please dont use it as an excuse to get taken into hospital. If you tell me Im drunk and need to sleep it off, I have less work to do than if you tell me that you have Chest pain, Angina, Cancer and Difficulty in Breathing. The more tests I have to do the longer it will be before you get to hospital, and the more I have to come into physical contact with you. If you are just drunk, then I can just be a taxi.

When you have been sick, at some point in the next week or so could you please change your clothing? Give them to someone who hasnt knackered their brain on booze to wash. Dry vomit on the clothing, while advertising your love for beer, doesnt endear you to me thankyouverymuch.

Please keep your weight down either through diet or through terminal liver failure. Im the poor bastard that has to lug the dead weight of your unconscious body into the ambulance.

You dont have to tell me Im an alcoholic, and sound so proud about it. I do have a nose, and can smell for myself.

Finally, although Tennents Super Strong lager, White Lightning, and for the rare rich alcoholic Stella Artois are perfectly acceptable drinks, could you please come up with something less damaging? I think lighter fuel is better for you and contains fewer chemicals.