Nick's Blog

Remembrance Sunday

2009-11-11T11:00:00.000+01:00

A disappointment

2009-09-22T19:36:00.002+01:00

I know that first and foremost, I'm a software engineer. It's something that I'm good at, and that I do on a day-to-day basis. But I'm also an Emergency Transport Attendant (ETA) with St John Ambulance. That is something I don't do on a day-to-day basis, but which I do as a hobby. Consequently, it's something that I work incredibly hard to keep my skills up to date, and my knowledge moving forwards. I take this role seriously. And I work hard to ensure that I'm good at what I do.

That is why it annoys me whenever I hear of tales of others in the organisation who are clearly not up to scratch, and who show us up. We want to be taken as a professional organisation, but we can not be taken as such if we're being let down by others.

Take for example, the following situation:

30 year old female, early stages of pregnancy, suffering contraction-like severe abdo pain which are getting worse, with PV bleeding. This patient was transported to hospital, but not with the same sense of urgency or severity that it should have attracted:

Taken in under normal road conditions (20-25 minutes through heavy traffic)
No pain relief given, despite the pain getting worse
Obs taken before transport was pulse, resps, BP and GCS. One set taken in transport, consisting of only a pulse. Yes, one set during the entire 25 minute run

When myself and a couple of other ETAs found out, we were shocked and appalled. There is the time and the place for going slow with jobs, but this was not one of those circumstances. And our ETA training teaches us to consider carefully what is best - to scoop and run, or to wait for a Paramedic. It often depends on how close we are to A&E, and how close the nearest Para is. In this case, A&E would have been obtainable in less than 6 minutes.

Unfortunately, cases like this do a great deal of damage to our reputation. So why have I spoken publicly about it? Mainly because this sort of thing winds me up so much, and because I feel that if just one person can take this tale and use it to help somebody else not make the mistake again, it will have been to our benefit.

There has been active drives within the organisation to improve the quality of our members, and this needs to keep happening. We have to do this, if we are to be taken seriously by others, and to stop the more offensive and derogatory comments being levelled as us.

"A Drop Too Many" by Major-General John Frost

2009-09-10T18:59:00.000+01:00

Major General John Frost's autobiography, "A Drop Too Many" was first published nearly 30 years ago. It tells the story of birth of the Second Battalion, The Parachute Regiment, which was formed September 30, 1941 as the Second Battalion, 1st Parachute Brigade.

Born in 1912, Major General John Dutton Frost had an illustrious career in the British Army, earning "the Military Cross, the Distinguished Service Order and Bar, and was a Companion of the Bath and a Grand Officer of the Sovereign Military Order of Malta." This book, his memoirs, was first started while he was a POW and was eventually published in 1980 following the success of Cornelius Ryan's, A bridge too far. Frost is best known for the action that he led at Arnhem, where less than 800 lightly armed paratroopers held the north end of a key road bridge over the Rhine for 3 days and 4 nights against repeated counterattacks by German forces. However, the story doesn't start there.

It starts with his time with the Iraq Levies, an aspect of World War II that I know nothing about, and yet I probably should. It describes his transfer into the 1st Airborne Division, and of how he came to command 'C' Company, 2nd Battalion, whose first active operation was Operation Biting (sometimes known as the Bruneval Raid), which greatly aided Britain's involvement in the radar war.

It goes on to tell about their involvement in Tunisia, Sicily and Italy. By the time of Tunisia, Frost was in command of the entire of 2nd Battalion, and he lead them against a series of airstrips near Depienne as part of Operation Torch. This plan went disastriously wrong, and the battalion was left 50 miles behind enemy lines. They eventually fought their way out, and took part in the rest of the campaign, proving themselves to be worthy adversaries during the Battle of Tamera. They were pulled out of action March 29, 1943.

However, nobody at home knew of their involvement in Africa,as the press were not allowed to report on their presence. Their involvement was kept strictly secret, and nobody, not even their friends and family knew.

On July 12, 1943, after rest and refit, 2PARA was dropped into Sicily as part of Operation Fustian with orders to form a defensive perimeter whilst the remainder of the 1st Parachute Brigade had orders to capture and hold onto a road bridge called Ponte di Primosole. The operation did not go as planned, and the 1st and 3rd Battalion were eventually forced by counterattacks to retreat to 2nd's positions overlooking the bridge. However, a combined attack by tanks and elements of the Durham Light Infantry retook the bridge on July 16. However, Sicily had cost the battalion dearly.

After a short stint in Italy during which time they did very little, the battalion were recalled to the UK. They were not involved in the D-Day landings, and it was only after a significant period of rest and refit that they were involved in Operation Market-Garden; and given the important task of holding the bridges at Arnhem. Much has already been written about this operation, and its failings. The failings were with the original plan, a plan that Frost appears sceptical of right from the start.

The last chapters outline Frost's time as a POW, and describes in brief the reformation of the battalion after the war.

Sadly, Frost died in 1993 at the bag of 80, as he would probably have some interesting political views on the current situation regarding Iraq and Afghanistan.

The book is very well written, and well worth reading, although the later chapters are a bit short. The description of the Arnhem operation is incredibly short, which is a tragedy. Frost's thoughts on the operation should by rights be truly illuminating, and while they are, the reader is left craving more!

"The Dam Busters", by Paul Brickhill

2009-08-25T19:49:00.000+01:00

Originally published in 1951, this is the story of 617 Squadron. Yet it is more than just the story of the raid on the Möhne Reservoir, which earnt the squadron its nickname. It is the story of the formation and operations of the squadron, right up to the end of the war, during which time the squadron earnt itself a reputation as being a truly remarkable fighting force.

The book starts with the history of Barnes Wallis, and his quite novel ideas for a new range of weapons - the bouncing bomb, the Tallboy and the ten ton Grand Slam. Development of each of these are described in some depth by the author, Paul Brickhill, who also served in the British Army during World War II. This makes it a fascinating look at how the squadron and its weapons and tactics all matured together. Few books are as well rounded as this, tending to consider just one aspect at a time.

What the men of 617 squadron achieved is just incredible. And what they endured is also remarkable. They were bombing targets with very rudimentary equipment and achieving bombing accuracies that are still remarkable even in the of laser guided smart bombs, etc. No wonder then that they had to make their story into a movie - it has all of the necessary elements! The near-suicide mission (low level approach over heavily-defended enemy terrority at night), the characters (Barnes Wallis, numerous charismatic squadron leaders, Bomber Harris, Winston Churchill and a dog) and the gut wrenching plot.

It is definitely a very good book, and well worth reading.

"D&V"

2009-08-23T19:27:00.001+01:00

The job was given as a 'simple' "Diarrhoea and Vomiting" run. A GP had been out to the lady and had requested that a non-emergency ambulance take her into hospital.

We turn up at the address, and I start talking to the patient. Firstly, turns out there's absolutely no history of diarrhoea. So where that came from, I just don't know. Secondly, it's been over 10 hours since the GP was on scene, even though they only booked the ambulance transfer 2 hours ago. Why it took them 8 hours to book the transfer, I don't know.

But the fun doesn't stop there.

I'm talking to the patient, and thinking to myself, "God this lady looks pale."

I ask where the pain is.

"In my chest. Right in the middle."

On further questioning, it turns out to be a central crushing chest pain, radiating into the back, rated 8/10. There's no history of cardiac problems in the lady's family, but rather upsettingly, it turns out she was a grey/blue colour this morning while the GP was on scene. She's now either pale or starting to turn jaundiced (it's hard to tell in the poor light!)

Maybe that prognosis should have been, "? cardiac problems which I'm going to leave at home for 10 hours so she can slowly die whilst in pain." That would have been more accurate.

We scoop and run with the patient, and the nurse at hospital looks appalled when we turn up with the patient at A&E. I think the sanitised version of he said goes something like: "That's no £$%^&*@ GI tract problem! £$%^&*@ GP!"

Private Ambulance Service

2009-08-18T20:58:00.000+01:00

So a while back, I encountered a Private Ambulance Service whose staff were fantastic. In contrast to the post about that, I thought I'd describe one of the horror stories that I have about other Private Ambulance Services.

St John had been contracted to provide First Aid and 2 Ambulances at a Motocross, but about a week before it, we'd been contacted and told that our services were no longer required. They'd organised a Private Ambulance Service, who were apparently a lot better than us. It was a bit of a blow to us, but never mind.

Instead of being on duty at the Motocross, the road crew ended up doing A&E Support. And in the earlier afternoon, they were passed an Emergency at that very same Motocross. A teenage rider had caught his thumb in the sprocket of his bike, and had amputated it. The Private Ambulance Service Paramedic and other staff were dealing on scene, but they required somebody to transport the casualty to hospital...

Good start, right?

So the crew turn up at the event. The patient is ready to travel, and his thumb has been dealt with. It's in a bag, ready to be transported along with the casualty. The crew are then handed the patient report form. It was the size of an A5 piece of paper, and was lacking in all but the most basic details. The reason the Private Ambulance Service aren't transporting? Because they're not insured to do so. They've not got insurance to transport patients on the Public Highway.

Tell me you're impressed, now.

The crew transport the patient, and are meant at the receiving hospital by a surgical trauma team. Who open the package containing the thumb (which was not touched by our crew at all), to find a single disposable ice pack wrapped around the thumb. Which is now entirely blue.

So, let's recap. These "Paramedics" failed to treat even a simple amputated thumb, causing a 14-year old boy to lose his thumb. His right thumb. And he was right-handed. I'd say that's pretty bad, wouldn't you?

When God Made Paramedics

2009-08-14T22:38:00.001+01:00

Dedicated to the Paramedic (and those like him) who helped us out the other day:

When God made paramedics, He was into His sixth day of overtime. An angel appeared and said, “You’re doing a lot of fiddling around on this one.” God said, “Have you read the specs on this order?

A Paramedic has to be able to carry an injured person up a wet, grassy hill in the dark, dodge stray bullets to reach a dying child unarmed, enter homes the health inspector wouldn’t touch, and not wrinkle his uniform.”

“He has to be able to lift three times his own weight. Crawl into wrecked cars with barely enough room to move, and console a grieving mother as he is doing CPR on a baby he knows will never breathe again.”

“He has to be in top mental condition at all times, running on no sleep, black coffee and half-eaten meals, and he has to have six pairs of hands.”

The angel shook her head slowly and said, “Six pairs of hands…no way.” “It’s not the hands that are causing me problems,” God replied. “It’s the three pairs of eyes a medic has to have.” “That’s on the standard model?” asked the angel.

God nodded. “One pair that sees open sores as he’s drawing blood, always wondering if the patient is HIV positive.” (When he already knows and wishes he’d taken that accounting job) “Another pair here in the side of his head for his partner’s safety. And another pair of eyes here in front that can look reassuringly at a bleeding victim and say, “You’ll be alright ma’am when he knows it isn’t so.”

“Lord,” said the angel, touching His sleeve, “rest and work on this tomorrow.” “I can’t,” God replied. “I already have a model that can talk a 250 pound drunk out from behind a steering wheel without incident and feed a family of five on a private service paycheck.” The angel circled the model of the Paramedic very slowly. “Can it think?” she asked.

“You bet”, God said. “It can tell you the symptoms of 100 illnesses; recite drug calculations in it’s sleep; intubate, defibrillate, medicate, and continue CPR nonstop over terrain that any doctor would fear… and it still keeps it’s sense of humor.”

“This medic also has phenomenal personal control. He can deal with a multi-victim trauma, coax a frightened elderly person to unlock their door, comfort a murder victim’s family, and then read in the daily paper how Paramedics were unable to locate a house quickly enough, allowing the person to die. A house that had no street sign, no house numbers, no phone to call back.”

Finally, the angel bent over and ran her finger across the cheek of the Paramedic.

“There’s a leak,” she pronounced. “I told You that You were trying to put too much into this model.” “That’s not a leak,” God replied, “It’s a tear.” “What’s the tear for?” asked the angel.

“It’s for bottled up emotions, for patients they’ve tried in vain to save, for commitment to that hope that they will make a difference in a person’s chance to survive, for life.” “You’re a genius!” said the angel.

God looked somber.

“I DIDN’T PUT IT THERE” He said.

-- Author unknown.

Stolen from Medic999.

Disgusting

2009-08-12T20:27:00.000+01:00

Unfortunately, myself and my crew mate saw the disgusting side of what happens when the health care referral system in the UK fails the other day.

Doing A&E Support, we were asked to collect and transport a gentlemen who was anaemic and lethargic. He had been booked in by his GP for an appointment in the outpatient's clinic for later that morning, and so, despite it seeming more like a Patient Transport run than anything, we said we'd do it. We dutifully collected the patient, and arrived at the relevant hospital in plenty of time. Let's call it A-time.

My driver went into the clinic to ask for a wheelchair, as the patient would be a little unsteady on his feet if we made him walk. She returned at A+5minutes - the clinic had no idea that the gentlemen was coming in, and could find no record of him having an appointment at the stated time.

So, thinking we'd made a mistake, we rang control. No answer.

We waited.

We tried again. And again, no answer.

At about A+15minutes, we finally got through. Who confirmed that we were in the right place, and who said that they'd double check and ring us back.

At A+30minutes, we had still not heard back from them. My driver went back in, and checked again. Still not on the list. The receptionist even tried phoning a number of the other clinics in the hospital that may have accepted him. None of them had accepted him.

I tried control, and I couldn't get hold of the usual bunch, so I tried the alternative number (the number that we're not meant to use!). They answered, and still didn't know anything about the patient. They also told us they'd look into it, and they'd get back in touch.

At A+45minutes, I tried control again. The woman who answered knew absolutely nothing about our plight, as she'd "Only just returned from my break, but I'll get onto it right now."

At A+1hour, she got back to me. She couldn't find a clinic that would accept him, and she couldn't get hold of the original GP. So, instead we had to drive 20 minutes across town and leave the patient at the nearest A&E department.

No, honestly.

As we couldn't find out which clinic had accepted him at hospital A, we had to leave him in A&E at hospital B. Oh, and I doubt I have to tell you, but the nurses in A&E were not impressed!

I was really quite horrified by this state of affairs, and very disgusted.

Embarassing

2009-08-10T20:32:00.000+01:00

Paramedic to me after attending in the back of a St John vehicle in reference to our third man, "What the hell is [s/he] good for?!"

D'Oh.

JRCALC Update

2009-08-06T20:37:00.002+01:00

As a result of being rather bored on duty, myself and (another) Nick ended up coming up with a new treatment option that we feel should be added in the next revision of the JRCALC Guidelines.

The update can be downloaded from the original post at Nick's blog (as a PDF File), and added at your leisure to your copy of JRCALC. Although please note, you should only use treatments in which you have been formally trained, and in accordance with your local policies.

"Forgotten Voices of the Secret War", by Roderick Bailey

2009-08-04T20:44:00.000+01:00

This is another in the series of books written based upon accounts held by the sound archives of the Imperial War Museum, similar to Forgotten Voices of the Great War that I reviewed previously.

The truth of what these young men and women were doing is revealed in these accounts. And while modern popular culture may glamourise what it means to be a spy, the truth is far from glamourous. The horrors of the reprisals against Oradour-sur-Glane, Distomon (Greece), Lidoriki (Greece) and Kalavrita (Greece) are recounted, and these are rather sobering.

In general, it's a very good book. It's not too long, it's not too short. It's not to sombre, it's not too happy. It's everything a book like this should be - clear and concise, and makes no judgements or assumptions. The accounts included stand for themselves. What these people went through is incredible, and the accounts show that, even though each and everyone is written with humility.

I would definitely recommend reading it, especially as an introduction to the activities of SOE. It's certainly made me want to read more about them!

Time wasters

2009-08-03T18:53:00.001+01:00

In contrast to the posts I had about how the Ambulance Service manage to waste their own resources (parts 1 and 2 respectively), we had a delightful job a few weeks ago.

Friday night, we're on standby in the town centre (meaning we're parked by the taxi rank, as it seems to be the centre of everything, and is a convenient place to park), when we get a job - "Unconscious male outside of [Fast Food Restaurant]. Caller no longer on scene."

Of course, this provokes a category A response. We have less than 8 minutes to race across town on blue lights to try to find the patient.

The racing bit goes absolutely fine. The finding the patient bit doesn't go so well. No matter where we look, including the nearby river, we can't find the patient. Nor can the Paramedic Responder who arrived on scene a minute after us, nor the staff from the [Fast Food Restaurant].

As we're busy searching the area, shining torches, etc into doorways, bushes, etc, a man identifies himself to the Paramedic. He's had quite a lot to drink. And then some more. And he wants a lift home.

After a bit of rather confused dialogue, it turns out that he rang 999 himself and reported the presence of an unconscious patient. Himself.

The only problem with that - we'd arrived on scene before he'd managed to stumble from the phonebox to the location he'd given to the call taker. Obviously he didn't know of the use of 'call connect' - that the job was being passed to us by the dispatcher while the call taker was still taking details. Consequently, he stumbled around the corner expecting to find somewhere he could collapse, and nearly walked into the Paramedic in his drunken stupor.

While he half confessed, we could not really trust what he was telling us, so we had to wave him on his way, and then spend 10 minutes driving around the area having a good check to make sure that he really had been the guy!

All because one idiot wanted a free lift home.

"Collapse, ? cause"...

2009-08-01T18:47:00.001+01:00

... was how the job was passed to us.

Dutifully, we Blue'd up, and went racing around to the given address - a car park outside a night club. We were less flagged down by somebody at the side of the road, and more forced to stop by the mass of people in the middle of the road who were all vying to out do each other in their efforts to attract our attention. I must admit, the mob approach works.

We jump out, and about 10 people all start pointing in sort of the same direction. I can't see a patient, but that may be because of the cars in the way. I head off through the first row of cars, and there she is. Laying majestically on the cold tarmac of the carpark. But at least she's awake.

One of her friends starts blabbling information into my ear at the rate of a thousand words a second. I stop her. I tell her to slow down. And I ask her the patient's name.

"Georgina".

Marvellous. I kneel down next to Georgina, who is clearly very distressed, and most definitely breathing*. She's too scared and bewildered to know what's going on, and there's a friend leaning right over her stopping her from getting up. I do the less than subtle thing and take her hand (while surreptitiously also taking a pulse), and she looks at me. I introduce myself and my crew mate, and ask her what's going on. She can't remember any of it. All she remembers is waking up on the floor, dazed and bewildered with a bunch of screaming, panicking friends around her.

I look up again. We're surrounded by a veritable mob of people. I assume some of them are friends. Some I also presume are also just bored and probably wandered over to find out what is going on. Either way, not the best place to be for a panicked and confused young lady.

I test the waters by asking her to sit up. She keeps telling me that she's fine, and that she doesn't want to go to hospital. I do the less than honourable deed and tell her, "OK then. What we'll do then is we'll get you into the back of our Ambulance, check you over and if everything is OK, you can be on your way."

She agrees to this, and I ask her to stand. She does this, although she is quite unsteady on her feet. I end up half holding her up, and half ~~pushing~~ encouraging her in the direction of the Ambulance. We manage to navigate through the cars without hitting them too many times, and into the back of the Ambulance.

After an uneventful check up with just the patient's sister in the back of the Ambulance, we manage to persuade Georgina that we really should take her to the hospital. Unfortunately, she won't go unless we take her sister, and one of her friends. So it is that we end up with the patient on the trolley and her friend and sister in the back with me.

Normally, not a problem. The three girls were ~~talking~~ shrieking amongst themselves as only those who have savoured the delights of a few alcoholic beverages can. I'm sure some of what they were saying only a bat would have been able to hear.

But if I thought that was bad, I was mistaken. She started fitting on route, and I'm not sure what would have been louder - the screams from the friend/sister, or the siren box. I'm not convinced that it was the siren.

For future reference, I think the new JRCALC guidelines for a patient fitting, falling unconscious, etc which induces screaming from their friends / relatives should be to gag said friends / relatives. Having two 25+ woman screaming in your ear, again at a thousand words a second, does not help you to calmly and coolly make decisions. It does however give you a cracking headache.

* I challenge anybody to tell me now that it's possible to keep talking and crying while not breathing. I dare you.

Pain Management

2009-07-30T19:49:00.003+01:00

In this post, I intend to start with a little bit about pre-hospital pain management. In order to do this, I'm going to consult an old post from Medic999, and then relate it to my involvement with St John Ambulance. After that, I'm going to have a rant about GP's, and why they're rubbish. And then I'm going to post a photo, simply because I can. So, sit back and enjoy!

Pain Management:

As Medic999 has spoken about before, the image below shows the Pain Management Ladder (I've also seen it drawn as a triangle):

This provides guidance for administering the appropriate type of analgesia for a patient suffering from acute pain, based on the severity of it. It is less useful for pre-hospital care, but it shows the general trend of the more pain that somebody is in, the stronger the painkiller has to be. Hopefully that's just common sense.

Within St John, I have access to just two painkillers. Paracetamol for mild pain, and Entonox for moderate pain. For severe pain, the best I can give is Entonox and hope and pray that it's effective. Which it often isn't.

So, for severe pain where Entonox is ineffective, our only alternative is to request a Paramedic who can come out and give Morphine (all assuming that we're in a part of the country where the Ambulance Service carry Morphine...)

Why GP's are crap:

Now, I've spoken about appalling examples of GPs before. I saw another example of this again the other day, which relates to the topic of pain management.

While on A&E Support the other day, we were given an urgent detail to transport a middle-aged woman from her home into A&E with severe kidney pain. Please note the use of the word, "severe".

We get there, and assess. The doctor is right on the money with his diagnosis by the looks of it. There's some pretty severe kidney pain. When asked to rate the pain, the lass reported that it was about 12 out of 10. And I believed her. She was in agony. Just leaning on the edge of the bed she was laying on caused her to howl in pain.

It was blindingly obvious that our Entonox would have absolutely no effect, and that we'd need something a tad stronger. So, it ended up that we had to request a Paramedic RRV to come out to assist us. He agreed with us entirely, and gave Morphine. Unfortunately, having done that, it meant that he had to travel with the patient.

So the sum total of the job was that we (the St John crew) were busy for about 3 hours, as it was a long drive there and a long drive into A&E. The Paramedic and his student were busy for over 2 hours of that, and even then they finished a very long way away from home! All for Doctor's Urgent. The Paramedic did not look happy to be honest, especially as he pointed out that the patient's pain would have been much better managed with IM Voltarol and would have saved her pain while waiting for us to arrive, and would have saved a lot of Ambulance Service time and resources.

Random Photo:

It did however mean that I got to drive the Paramedic's very nice Skoda 4x4 RRV into hospital. Oh, and God did it drive well.

Apologises for the rubbish image quality - it was a camera phone photo taken in a hurry!

First job of the day

2009-07-29T19:38:00.000+01:00

So, if we're due to start an A&E Support shift at 16:00, what time do you reckon we end up with our first job of the day?

As it was, it was at about 15:05, on the way to my colleagues house (so that he could pick up some uniform), about 30 miles from where we were due to be working...

We were merrily making our way to his house, when we get flagged down by a Paramedic responder who seems quite relieved to see us. He asks us, "Chaps, are you busy, and would you be able to help me transport this lass to hospital?!"

He'd only been on scene for half an hour with a collapse ?cause, and there had been absolutely no vehicles available to back him up. We agreed to help out (we couldn't really have said no, but...) and so me and the Paramedic transported the patient while my attendant drove his very nice RRV into hospital.

A good job to be honest, but nevertheless, we hadn't been expecting to be waved down!

Waste of Time, part 2

2009-07-27T18:35:00.001+01:00

So, in Waste of Time, part 1, we witnessed an Ambulance being sent on a 3 hour round trip to perform an inter-hospital transfer for an Ambulance Service that was under pressure.

But the story didn't end there. Oh no.

After the 90 minute drive down to the first hospital, we walked up to the ward and were greeted by the nursing staff with a cheery, "The patient has just gone down for a quick scan. Shouldn't be long." That type of phrase always gets me on edge, as "Shouldn't be long" tends to mean, "They're going to be ages, mwahahahaha!"

So, after an hour of twiddling our thumbs, we were a little dumb struck when the patient's doctor turned up and told us that we weren't needed anymore. The only reason that the patient was due to be transferred was for a scan, as their scanner was broken. As it turned out, the scanner had been fixed in between the hospital asking for the transfer and us arriving. In this example though, it's not the Ambulance Services' fault that resources had been wasted, more the Doctors/Nurses on the ward. Oh, and it would have annoyed the receiving hospital too, as they'd kept a bed free so that they could receive this patient!

End result? Over 3 and a bit hours of our time wasted doing nothing. Our normal controllers weren't too impressed either, as they too had been really struggling, and we would have been able to help them out a great deal!

Nurses

2009-07-25T11:22:00.000+01:00

My crew mate to me: "Why would a nurse be out here? Unless just to pleasure us two?"

The tank

2009-07-23T21:13:00.000+01:00

About the tank parked in the carpark next to a pub, "I know the price for a pint of beer is going up, but that's just taking the piss!"

CRUs

2009-07-22T19:01:00.000+01:00

I was doing some thinking the other day (scary, I know), and was trying to quantitively answer the question:

"Are Cycle Responders worth the expenditure?"

Firstly, what am I talking about? I'm talking about these:

(Note, photo of a random St John CRU. I would never post a photo of a friend of mine on it pulling a stupid face.)
A St John Cycle Responder Unit (CRU) is a St John member mounted on a push bike, with relevant equipment and training which can then respond to certain incidents.

To answer the question, the first shred of evidence is the fact that more St John counties are investing in CRUs, so people clearly consider them to be worth the money. Secondly, there are numerous Ambulance Services that have CRUs. York itself has the lifecycle, which regularly first responds to jobs in and around the city centre. Not that many people can be crazy, surely?

Now, what about the morale factor? Imagine you're a member of the general public at an event and you've asked security / a porter / a steward / a muppet to get you an Ambulance for your critically ill relative. A St John member on a push bike pedals up to you. What is your first reaction going to be? "Thank God, the Ambulance has arrived. Uncle Bertie will be OK now!" or is it going to be "Oh Sweet Mother of Mary, why've they sent a pimply youngster just out of diapers on a bloody pushbike when I asked for an Ambulance!" I can't envisage rational thought having too much involvement at this point in time.

Next, imagine the effect on the responder. I know of jobs where the Cycle Responder has had to wait a very long time to get a vehicle, despite the fact that the patient is critically ill. Tom Reynolds' regularly spoke of the frustation that he felt as a First Responder at having to sit with ill patients waiting for an Ambulance to arrive. The same is going to happen to the poor sod on that push bike. There's a limit to the number of times you can tell a patient's relatives/friends, "Don't worry. The Ambulance will be here soon".

So again, I come back to the question, should we be investing in them?

They're expensive. A proper St John bike with panniers, etc will cost you nearly £2000 to buy. And then it needs kitting appropriately. If you're putting an AED on it (and I sincerely hope that you are), that's at least another grand, depending on which model you go for. Oh, and then there's the cost of the training. IPMBA cycle training is about £500. Oh, and not to forget, there's the uniform! That's also expensive! So, even before we've managed to get the CRU out and about on duty, we're already pushing probably £5000s worth of expenditure.

5 grand. Can we not think of a better use for that money?

Realistically, I'd argue no. I can't actually think of a better use of that money. St John spend £70'000 or more on new Ambulances, Treatment Centres, etc. Some of that money would be much better spent on CRUs.

Oh, and like all good Goverment officials, I fiddled the figures. That's £5000 for a new bike and a single rider. The cost of the bike is probably around £4300 and the cost of a single rider around £700. So once the bike has been bought, it's cheaper to get more riders for it, in the same way that we don't buy each member an individual Ambulance, we shouldn't be buying each member an individual CRU (although I've been told some counties do, and which I think is an awful idea).

So why are CRUs so great?

They make very handy Logistics Support vehicles on busy duties. If you need to shift equipment between two locations, the CRU is a fantastic way to do that. As is regular demonstrated.

It can respond to most jobs faster than a person on foot, and can go through crowds much safer and faster than any Ambulance can. It can carry a lot more equipment than a single person can over much greater ranges, and thus makes a brilliant first responder.

And then there's the "Ooooh" factor of them. A CRU gets a huge amount of attention. Even on my CRU training, I was getting people admiring it, even though the rear panniers had been removed. When North Yorkshire and Teesside's CRUs went on duty at a cycle show recently, the riders were inundated in people coming up admiring them. The bikes that is, not the riders.

Some St John counties own First Response Cars, which I simply do not see the point in (Member Support Cars, yes - Fast/First Response Cars, no). But a First Response Cycle? Oh hell yes! I can see lot of point to that. Anywhere that we have a large presence is a potential candidate for fielding a CRU. If members of the public are likely to be walking around an outdoor event, chances are the CRU can be deployed there too. It's much safer to move a CRU through a crowd to assess a patient than an Ambulance, and faster than sending a First Aid team. The skill set of the rider may also be greater than that on the response team, allowing them to back up a team and determine whether an Ambulance is required or not.

So yeah, I'm definitely in favour of them. They are a great asset when utilised correctly.

"Do you wanna job?"

2009-07-21T20:09:00.001+01:00

To the patient's daughter after she's helped do most of the lifting onto the Ambulance trolley: "What you doing after? Do you fancy joining us on the rest of our shift?!"

The end of an era

2009-07-20T18:23:00.001+01:00

It is with great sadness that I write to announce the death of Henry Allingham, the world's oldest confirmed man, the last survivor of the Battle of Jutland and the last founding member to witness the formation of the RAF.

Henry died peacefully in his sleep at his care home Friday, and many news agencies have been running posts about his death all weekend. He was 113 years and 42 days old.

I would like to add my sympathises to his family, and to advise people if you're not heard about Henry, to do some further reading. I can whole heartedly recommend his biography - Kitchener's Last Volunteer.

With his passing, there are now only two surviving World War 1 veterans - Harry Patch, The Last Fighting Tommy (the title of his very good book), and Claude Choules, the last surviving seaman.

Consistency

2009-07-18T21:04:00.000+01:00

So, here's a photo of two British Red Cross volunteers outside 10 Downing Street:

And here's a photo of the prototype of the proposed new service uniform for St John Ambulance:

So, the point of this. Is the consistency between the designs a good or a bad thing?

"Forgotten Voices of the Great War", by Max Arthur

2009-07-14T19:08:00.001+01:00

This is one of a series of books written based upon accounts held by the sound archives of the Imperial War Museum, and is simply fascinating.

Max Arthur has compiled accounts from soldiers and civilians from both sides of the conflict, and has put them in chronological order with a summary commentary that allows the accounts to tell the story of the Great War.

The stories of these veterans, almost all of whom are now dead, are incredible. The detail of them is outstanding, and helps to bring the conflict to life. A conflict that should never be forgotten, but which is rapidly being pushed out of the modern consciousness.

I very much enjoyed this book, and have bought a couple of others in the series (Forgotten Voices of the Secret War and Forgotten Voices of the Somme) which I look forward to reading at some point! I do however find these quite hard to read, as the book jumps between different people's accounts too frequently, and there's so many contributors. As a result, it's not something that you can read lightly, but it is a very good oral history to read slowly.

Carers that don't care

2009-07-12T19:32:00.002+01:00

Tell me, why do people become 'Carers' when they clearly don't care?

We had a job the other day, where we were sent to take a woman into hospital who was suffering a lot a great deal from her arthritis, to the point where she was finding it very hard to move most of the joints in her body. As a result, she was bed bound, and was also incontinent.

She has a carer, who comes in three times a day.

When we pulled the bed sheets back to assess getting the patient out, the bed sheets were absolutely sodden with urine. Now, this was not simply a case of her having wet the bed since the carer had been in, there were multiple stains on it showing the tide mark from previous episodes of having been incontinent.

Additionally, this lady would normally get her own meals. Since having been bed bound, she'd not eaten anything. Despite the carer having been in 3 times daily.

So, back to the original question, why do people become carers if they just don't care?!

Waste of Time, part 1

2009-07-10T22:31:00.001+01:00

In this latest episode of Waste of Time, I shall point out again how Emergency Service Resources, and thus tax-payers money, is being wasted.

Our first job of the day was a doctor's urgent was some 25 miles away from our home station. So, we trundled out there and moved the gentlemen less than 2 miles into the local hospital. Once clear on that job, we rang up our controllers, and asked whether they had another one for us. They did indeed. Across the entire region, there had been a huge number of jobs come in, and they were struggling to find resources to cover them all. What was decided though was that we'd be passed to a neighbouring control centre who were in dire need of extra resources. This new control centre then asked us to do an inter-hospital transfer.

From a hospital nearly 70 miles away, to a hospital that would take us about another 20 miles away from our home territory! We reckoned that, without waiting times at either hospital, it would take over 3 hours alone to get there, to get the patient to the second hospital, and to get back. 3 hours.

So let's have a vote. Is this effective use of resources?

Oh, and the story continues in Waste of Time, part 2, coming soon!

Calder Response

2009-07-09T18:36:00.001+01:00

So, it's normal for myself and others to rant about Private Ambulance Services, as unfortunately, some of the ones that we've had dealings with have left rather lasting impressions. (Remind me to tell you at some point the tale about the Amputated Thumb, or the story about the crew who turned up on a duty and then asked us, "Do you have any spare fuel?") I am also well aware that Private crews probably also think that St John are less than perfect, and I'm also keenly aware that there are horror tales going around about how bad we are.

But, it was a real pleasure to attend a duty recently with Calder Response, a Private Ambulance Service (and much more) I now have real respect for. Steve, the Paramedic present, was a pleasure to work with, and clearly a very competent Paramedic. I must say that if Steve is reading this now, my thanks - it was an absolute pleasure!

And it's not just because I got to drive their absolutely amazing Ambulance, which I would normally have paid good money to do so. It's a Mitsubishi Shogun, and boy does it shift. I enjoyed driving that!

It's a great Ambulance, although suffering many of the same faults that the Challenger does. However, it is also a "Safety Stage Unit", a rallying rescue vehicle, so is also kitted out with additional rescue gear. It's all very impressive!

COPD and Oxygen Therapy

2009-07-08T19:48:00.001+01:00

As a bit of background to this post, my training for the management of COPD (Chronic Obstructive Pulmonary Disease) patients requiring Oxygen Therapy is to start them on 100% oxygen and monitor their respiratory rate and blood saturation levels and knock the flow rate down if either deteriorate. And as I was originally taught by the Doctor who taught my Ambulance training, the time that we have a patient on board is such that we're not going to kill them anyway.

I attended a patient recently who looked really quite ill, and was suffering probable heart failure. Because of their condition, 100% Oxygen was delivered. His Sp02 sats went up from 87% up to 98%, his colour improved a bit, he was finding it easier to breathe and was a lot more comfortable. Would you have said that I made his condition worse?

During the 10 minute run into hospital, he started feeling nauseated. As a result, his oxygen was removed and a vomit bowl provided (and promptly utilised). And almost as quickly as he'd improved on oxygen, he deteriorated once it was taken off.

The nurse on the ward then blamed me for making the patient worse, and tried to pin it on the fact that the patient had COPD (which neither the patient nor his relative thought she had). This annoyed me rather, as I work hard to ensure that I'm doing the right thing by my patients.

And yes, I'm very aware that the oxygen guidelines under which I work are likely to change at some point soonish, due to an update from the British Thoracic Society.

Whoops!

2009-07-07T21:48:00.002+01:00

We picked up a puncture while doing a routine transfer earlier today. Meant we waited for 2 hours by the side of the road for a tyre van to come out and help us!

Boiling

2009-07-06T21:40:00.005+01:00

So, the UK has just come out of a heatwave. And I was one of the poor suckers stuck in the back of an Ambulance with a patient who was complaining of feeling cold, and despite several blankets, still needed the heater to be switched on full.

God, that was an unpleasant 25 minutes into hospital!

Pneumonia or Stroke?

2009-07-03T19:51:00.001+01:00

If you have a patient who's presenting with signs and symptoms of both Pneumonia and a Stroke, which condition are you going to be more concerned about?

We were given an A&E Doctor's Urgent as: "Queried Pneumonia / Stroke". We turn up and collect a patient who over the past 48 hours has deteriorated significantly and is presenting as FAST-Test positive. He's unable to hold himself upright in a chair and his speech is abnormal.

As requested by the Doctor (who we never saw and hadn't left us any details), we transferred the patient to the local hospital. Neither me nor my crewmate were too happy about doing this though, as the patient was 'ill'. If it had been anywhere else, I'd have requested further assistance and run the patient into A&E; as it was, we transferred to the local hospital on the belief that they'd been notified, etc, and as they were only a few minutes away. As it turns out, they'd only been told that the patient had "Queried Pneumonia", and were very upset that the Doctor hadn't told them about the signs of a stroke.

As it was, they agreed with our assessment of the patient, and later transferred the patient to a better equipped hospital. So, why dear friends, did the Doctor fail to notify the hospital?!

"The Bruneval Raid", by George Millar

2009-06-29T18:12:00.000+01:00

While people may poke fun at "British Boffins", during the early years of the war, it was British Boffins, Dons and Professors who were at the forefront of the war effort. Without them and their intellectual efforts, the outcome of the war could have been very different.

One of the factors in this success was that the British won what is called "The Radar War" - the ongoing struggle between Britain and Germany to achieve radar superiority of the skies. A key factor of that was the British raid on the German radar site at Bruneval, Northern France.

The raid itself was a success, and greatly aided in the war effort. It was lead by Major Frost, who would go on to lead further remarkable operations later in the war. This could be seen as a pre-cursor for what he would later achieve.

This book gives the reader a fascinating insight into both that raid, and the radar war. My main criticism of the book is that there is significantly more focus on the radar war itself, rather than the Commando Raid on Bruneval. There's bits and pieces about the build up to the operation, but there is significantly more about the technicalities themselves. If you want a book looking at raid itself, you’ll need a different book I’m afraid.

Would I recommend this book? Yes, I would. It's more about the technicalities rather than the raid.

Team work

2009-06-28T20:53:00.000+01:00

"Isn't it nice, when things just work?"
... was the tag line for a high-profile advertising campaign that Honda aired for the new Honda Accord approximately two years ago. And it's the perfect phrase to express my sentiments of a recent car extraction that I was involved in with St John.

Now, a little bit of background. As a University student, I'm part of St John both at home and at University. Having essentially grown up with St John at home, I find it very easy to work alongside other members there, as they've had a similar set of training, etc to me. Whereas at University, I'm with people who have had a different approach taken to their training, and whilst we're meant to all be equal, we're not. There are skills that these people have that I don't, and likewise, there are skills that I have that they don't.

However, at this particular job, which was not with my home county, it was absolutely brilliant that as a team, we were all on the same wavelength and everything just worked perfectly.

Amongst the other members involved, there has been some speculation that this may be because we're all young (all three ETAs involved are 23), with which I concur - we've all had recent ETA training and we're all young and motivated and willing to learn new things whereas some of the older crews do get a little set in their ways.

The job was quite involved. Car versus a side wall initially, which then hit the back of a stationary car, and was then struck from behind by a second car. As a result, the driver's head would almost certainly have whiplashed, as although he was wearing a crash helmet, we wasn't wearing a shoulder harness for it*. He was complaining of central neck pain on the lumpy bit at the back of the neck (around about C5-C7). We would have no option but to board and collar him.

The collar went on not a problem, and the decision was made to KED^ him. This went straight on, and worked like a charm. The pain in his neck started to subside as soon as his neck was properly secured. This gave us more time to think, and helped to calm the patient down considerably. Next, the car was dismantled around me and the patient, and we were able to slide the patient straight out onto a spinal board.

Like I said, it was nice to see that every part of this scenario worked brilliantly. The use of a KED has been argued against by some, but there was no need for even a discussion in this case. All three of us were in agreement about its use. Oxygen went on at just the right point, although there has been some conjecture about its overuse.

For all of those involved, it just felt like it was a superb job well done.

* Stupid idiot, but that's a rant for some other time.
^ KED, the Kendrick Extrication Device, looks a bit like a straight jacket and can be described as a shortened long board that wraps around a patient's head and torso and holds a patient back and neck steady. Useful for car extrications, as it helps to immobilise the upper body before we start to move the patient out of the vehicle.

Let's all take a moment

2009-06-27T19:55:00.000+01:00

In the past few days, three celebrities have passed away. Firstly, Ed McMahon died on June 24th. Farrah Fawcett then passed away June 25th, and Michael Jackson passed away later that same day. Within hours of each of their deaths, it was widespread news. Google even struggled under the strain of large numbers of users searching for news about Michael Jackson's death:

Web slows after Jackson's death

The internet suffered a number of slowdowns as people the world over rushed to verify accounts of Michael Jackson's death.

Search giant Google confirmed to the BBC that when the news first broke it feared it was under attack.

Millions of people who searched for the star's name on Google News were greeted with an error page.

It warned users "your query looks similar to automated requests from a computer virus or spyware application".
Read more...

Yesterday, nickopotamus posted an insightful comment about people losing perspective with regards to the death of Michael Jackson. As he remarks, lots of other things happened on that same day that should have been equally news worthy. I will admit, Michael did a lot for the world of music, racial equality and for charitable causes (apparently he was listed in the 2000 Guinness Book of World Records for breaking the world record for the "Most Charities Supported By a Pop Star"), but I still think the sheer volume of news articles appearing on sites such as BBC News are a tad disproportionate.

My good friend Linda also posted a similar news article on MajorDickWinters.com, about the loss of Shifty Powers and the lack of reporting about it. How many people know the name Shifty Powers? Are there queues of people outside the hospital in which he died, crying over his loss? I doubt it, somehow. The article is thought provoking, and worth reading. I've reproduced it at the end of this post. Please take the time to read it.

Shifty was a good man. A good soldier. And a true American Hero. He served with Easy Company, 506th Parachute Infantry Regiment, 101st Airborne; the company who were immortalised by the HBO mini-series, Band of Brothers. Part of the original company founded at Camp Toccoa, Georgia in 1942, he took part in every action that Easy were involved in. He finished the war with an exemplary record. Yet for the majority of people, none of this shall ever be known. There is just not enough publicity about what this man did for his country.

Amidst The Death Of Celebrities, A True American Hero Passes

Ed McMahon died on Wednesday, June 24th. On the morning of June 25th it was announced that 70’s stunner Farrah Fawcett passed away. Then, before the sun could set on the East coast, pop icon Michael Jackson joined the other two. I was rather quick to report the deaths of Fawcett and Jackson, missed the McMahon death until after Jackson’s. While I was writing about the death of Jackson, I realized that in the overall scheme of things, one of America’s greatest hero’s had passed away last week and he left this world with little fanfare.

His name will only be recognized by a handful, not the masses that come along with the likes of the trio mentioned above. His name was Darrel Powers. To his friends he was called “Shifty“. A simple man from the hills and mountains of Virginia, Shifty Powers never recorded an album, never acted in a movie, and never sat on the “Late Show” or any other late night talk show. Instead, Powers was a part of a dying group of men and women who fought for this nation in World War II.

He will be immortalized however. Featured in the film “Band of Brothers” an epic 10 part mini-series on HBO, Shifty Powers was an “Easy” company man in the 506′th PIR (Parachute Infantry Regimen) “Screaming Eagles“. On a day when Jackson and Fawcett passed away, and McMahon the night before, I find myself not looking at the three of them with sadness but my own regret for not announcing the passing of an American hero last week.

Shifty Powers battled Germans and numerous medical issues in his later years. He was 86 and represents a continual increase in the number of WWII veterans who are leaving our lives. Unlike the above, these are our grandfathers and even our grandmothers. They represent a simpler time and even now, decades later, an era that today is hardly understood by us younger generations.

For those who are familiar with the “Band of Brothers” story, first brought to the public by the late historian Anthony Ambrose, then you too will know that even now, it seems that many of the fallen soldiers of WWII are once again re-uniting with their friends.

It is a sad day when 3 celebrities die, one at least completely unexpected. While we may think we know them through their popularity, it’s often the ones that we don’t know that have done the most for our way of life. It’s because of the sacrifices of those men and women, that I wrote this article. I’m truly glad you found it.

May Shifty Powers and all the men and women who have done so much for our country by putting themselves in harms way find peace in the here after. May they realize their childhoods and young adult lives that were so devastatingly taken away from them.

Perhaps I could have put this on the site as a front page article, honoring all of the American hero’s. Instead, I think much like they lived their lives, it’s a quiet tip of the hat in a way that many of them wanted to live. I put this article where it is at out of complete respect.

Rest in peace Mr. Powers, another Eagle has flown home.
~ Unknown Author, PhinPanatics

Armed Forces Day

2009-06-27T14:06:00.001+01:00

Today is Armed Forces Day. Please spend a few moments to appreciate what those in the forces are doing for us. Thanks.

"You’ll need your chair!!"

2009-06-26T19:06:00.000+01:00

Medic999 has posted a fascinating post about the number of times that he's encountered patient's relatives who say, "You'll need your chair!!" as a way of a greeting for the Ambulance arriving on scene. I too have encountered this phenomenon.

This is not merely trying to pimp Medic's blog. What I wanted to draw attention to is his remarkable paragraph justifying why he goes into a scene to assess whether the patient needs to be moved via a chair or trolley, or whether the patient can walk to the Ambulance.

This is not uncaring behaviour, it is not neglectful, it does not demonstrate poor standards of care. It does however, show a process of clincal assessment, risk assessment, and maximising the patients independance in a safe and supportive environment
~ Medic999: You'll need your chair!!

I think I'm going to just learn it verbatim for the next time! Especially the last bit - it's genius!

A Conundrum

2009-06-24T20:22:00.002+01:00

For those medical people out there who happen to read this blog, I have a discussion question for you.

Within the field of Pre-Hospital Emergency Medicine that I'm involved with, I hear a lot of people claiming that a Long Board and a Scoop Stretcher can be used interchangeably. As you may know these items by different names, these are what I mean:

Long Board and Scoop Stretcher respectively

However, from my experience, they aren't always interchangeable. Now, if we preclude the discussion of which is best for spinal injuries, and we consider both pieces of kit from merely a casualty handling perspective, which would you use to move the patient in the following scenario?

You're at a cycle event in the middle of the Yorkshire Moors. Your nearest help is the Air Ambulance, and you are a twin Ambulance Technician crew with limited kit on your vehicle.

You are called to a job by the organisers, and it's a male cyclist with a mid shaft fractured femur. Mechanism of injury is such that your not concerned with neck or back problems. What you concerned about is that leg. The guy is losing sensation in his foot, he's lost a pedal pulse and there's developing swelling around the fracture site. He's conscious when you arrive on scene (let's say, GCS 14), but his level of consciousness is dropping while your on scene (let's say down to GCS 9, Eyes=1, Verbal=2, Motor=4). Management of the fracture is by whichever means you prefer (and not under discussion for the time being).

You need him out, and for that, you're going to need to get him up off of the floor as you're going to be transporting him a couple of miles to a suitable landing site for the Air Ambulance. And that's where you have to make the decision, scoop or board? Which one, and why?

Demolition Derby

2009-06-23T19:35:00.001+01:00

If I said to you that I'd spent a weekend watching very expensive cars having very expensive crashes (and you didn't already know better), then where would you say I'd been? If you're said at a demolition derby, then you are wrong. Wrong, I say!

I was actually at the British Touring Cars Championship last weekend at Croft Race Ciruit, Darlington.

And some of those crashes were spectacular, such as these, taken by nickopotamus during racing on the Sunday. All credit to him for taking them. I love 'em!

Oh, and if you're the owner of that Civic and you want your nearside wing mirror back, talk to Nick about it!

No drivers were hurt in the making of this blog post.

Henry Allingham is world's oldest man

2009-06-22T16:36:00.000+01:00

At the age of 113 and following the death of Tomoji Tanabe, of southern Japan, Henry Allingham is the world's oldest* man.

First World War veteran Henry Allingham, 113, is world's oldest man from the Telegraph, where there's some great photos too.

* oldest confirmed man.

Smile, you're on camera!

2009-06-21T18:45:00.000+01:00

To the Eastern-European-looking tourist who took my photo the other day whilst I was driving through York, thank you. I must however ask, why? All I was doing was sat bored in traffic. If my Ambulance had been busy doing something awesomely-exciting, I could understand why you might want a photo of it. But it was doing little more than polluting the atmosphere at the time...

A letter to my colleagues

2009-06-20T18:46:00.000+01:00

Dear Colleagues,

Whilst I have every sympathy for those of you who suffer from this terrible affliction, If I hear one more person say, "Can I ride in the front, as I get travel sick in the back?", I think I'm going to scream.

Can I politely advise you that you probably want to find some way of dealing with this, as being qualified as an Ambulance crew usually means that at some point you'll end up attending in the back. And as most of our work is minor injuries, you're going to end up very bored in the back whilst having nothing to do. This can not be avoided, and thus you need to find a way to manage your travel sickness.

Yours sincerely and respectfully,

Nick

My brush with fame

2009-06-19T09:27:00.001+01:00

When on duty with St John, you learn to expect the unexpected.

What you don't expect is to be sat in the back of an Ambulance handing over a potentially very ill patient to an Air Ambulance Paramedic when you have a cameraman stick his nose around the corner of the door and start filming you.

(Said cameraman filming the Yorkshire Air Ambulance after our patient had been loaded. With thanks to nickopotamus, as he took the original photo.)

Meeting Trumpton

2009-06-17T20:55:00.001+01:00

(Interestingly, surprisingly few people know what I mean when I say 'trumpton'. I originally picked up the term a while ago, and presumed it was just common knowledge that it's a nickname for the Fire Brigade based on the 1960s children's TV show, Trumpton.)

I've worked alongside the Fire Brigade numerous times at car crashes and the likes, but I've never called them to a residental address to help extricate a patient. Until recently.

We were passed a doctor's urgent for a job that was described as "reduced mobility - unable to get off of the loo." Awww, crap. Literally.

We get there, and the patient is looking quite poorly. She is indeed stuck on the lavatory; she's suffering general weakness and she's quite large. We do a quick assessment, and we're not happy with her general demeanour at all. My colleague requests a second crew, firstly as we're already aware that she's too heavy for us to lift by ourselves, and secondly as we'd rather enjoy the company of a Paramedic.

I ask the patient, quite politely mind, "How much do you weigh?"

The reply given? "18 stone."

I'd like to say that I kept the look of, "As if!" off of my face. I hope I did. But thankfully, nobody could see my face at that point anyway other than the patient, and she had her eyes firmly closed.

I patiently explained that I needed to know how much she weighed, as it would affect how we could proceed with getting her off of the toilet.

"18 stone. When I was last weighed."

"When was that?" I replied.

"About a year ago."

"Have you put much weight on since then?"

"Yes, quite a bit."

Damn.

In due course, the second crew turned up and together we got the patient off of the toilet and onto a carry chair. We then tried transferring the patient to her stair lift, on which she wouldn't fit. The staircase was very narrow, as much of it was taken up by the stair lift. There was no possibility of us carrying her down the stairs on the carry chair, so the decision was made to ring the fire brigade.

They dutifully turned up, wrecked the joint (carefully though, in fairness) and brought the patient down the stairs for us. Marvellous, frankly!

I wonder whether I can request Trumpton for every job now?

Lyrca clad...

2009-06-16T10:13:00.000+01:00

I'm now a trained Cycle Responder Unit (picted below) rider, so this is a warning to all those members of the public who will have to see me in my very fetching CRU uniform in the future. I'm really sorry.

Sheer Stupidity

2009-06-15T17:59:00.000+01:00

Presume, for a moment that you are in charge of an Emergency Service. You have a new incentive come about that will help your service send a more appropriate resource to each job.

You train new staff in the skills they require to provide a middle-tier resource, and you find the two crews two vehicles. Unfortunately, these are quite old vehicles and have been out of use for some time. The shifts for these crews are such that during their 8 hour shifts, 6 hours overlap. Now, which of the following courses of action would you have chosen?

a) You ensure that your resources team have stocked and kitted both of these vehicles *fully* before they are due to be used, allowing your two crews to turn up for their respective shifts and work without any issues.

b) Anything else, which culminates in only one vehicle being kitted, while the other is left with absolutely no kit at all. The result being that the first vehicle is taken by the first crew, and the second crew are unable to do anything for the first 6 hours of their shift while they twiddle their thumbs due to lacking any kit.

Oh, and this is no joke. And thankfully, it was some other organisation other than St John Ambulance!

Firemen are funny...

2009-06-11T20:08:00.001+01:00

Me, to a fireman as he's unscrewing a stair banister and then starts dismantling the stairlift, "So, are you gonna put all this back together again later?"

Fireman, "Oh no. I just enjoy taking things apart."

Crap GPs

2009-06-10T18:37:00.002+01:00

I normally leave the GP-bashing to those more qualified to tell of it (such as the Grumpy Ambulance Driver), but this one I have to tell. I was enraged by it.

I was out with St John doing A&E Support, when we were passed a job at a GP's surgery that was described as, "Middle-aged woman feeling generally unwell and suffering from panic attacks".

We dutifully popped around to the surgery, parked up and walked in. I was expecting the patient to be sitting in a side room, or maybe to have a nurse sat with her. I was expecting the patient to be being cared for. Oh, how I jest!

I was not expecting them to be sat with just their relatives in the waiting room with just a scared, 12-year-old looking receptionist sat behind her desk. Her petrified look of, "God, I hope she's OK!" spoke volumes.

While my crewmate started his assessments (she was OKish, but was very panic stricken), I went to talk to the receptionist - "Has the Doctor written a note or anything for us?"

Her face was a picture. I might as well have been speaking Spanish to her. "Oh no. He's not come out of his office. I told him that she wasn't feeling well and couldn't walk to his office, and he told me that I should ring you guys."

Oh. Great.

So, the only reason that we've been called is because this lady is too panic-stricken to walk the 20 yards to the Doctor's office, and he is clearly far too important to come out here and talk to her. Now, we've got to take this poor lady to an A&E Department (which, lets face it, is probably going to terrify her even more). Oh, and she could have walked that distance, if somebody had just taken the time to calm her down.

Do you reckon it would be unprofessional to say which GP Surgery it was?

Chuck

2009-06-09T19:52:00.001+01:00

OK, so I finished watching Chuck Season 2 recently, and I've been weighing up writing this post ever since. Here goes. Although I will warn you, it's a long one! And full of spoilers if you've not watched the entire of both series.

Chuck is the fun story about a computer nerd who downloads a whole load of top secret CIA information into his brain, and in doing so, becomes property of the US Government. From that point on, he basically becomes a spy. Not a suave, sophisticated spy like James Bond, but more like an Inspector Closeau type of spy. He does however get the hot girl, the guns, the gadgets, etc. Even if he's not much good with any of them!

All in all, I enjoyed it. It's not the most clever of TV shows, but it's fun. If you want a healthy dose of humour, this certainly delivers. You really feel for Chuck, in a similar way that people felt for JD in early series of Scrubs.

The only thing that was a bit annoying was the sheer amount of romantic teasing that was going on. Time and time again I just wanted to smack Chuck's and Sarah's heads together and tell them to do the nasty at long last!

An honourable mention should go to Napping at Red Lights at this point, who posted a very insightful list of the top 10 reasons for watching it.

What about the cast? I'd never heard of Zachary Levi before, but he's perfect for this role. I can't even imagine anybody else playing it. He does remind me quite a lot of JD from Scrubs though!

Yvonne Strahovski (or Strzechowski) is simply stunning. I've yet to see her wear anything that she doesn't make look good! Plus her acting is pretty good, and she totally makes up for any shortfallings in that department in others! Oh, and she kicks ass likes a pro!

Adam Baldwin is a gorram brilliant actor, and I've missed him since he left Firefly. I'm glad to see he's found such a good part to get his teeth stuck into. And I love his shooting gallery!

As for the writing? It's pretty good. And there's some awesome one-liners in it!

Casey: "Don't you think I could kill you with my thumb or with my elbow? Nerd bludgeoned by radiator?"

Chuck: "What, no gun for me?"
Sarah: "Nope. You get to stay in the car."
Chuck: "Oh, come on. The whole stay in the car bit? Aren't we pass this? I think I'm perfectly capable of handling myself on a mission."
Casey: (With a gun to Chuck's head) "You were saying Agent Imbecile?"

Casey: "You made three crucial mistakes Bertowski. You didn't realise that you were being trialled for the last half hour. You didn't bring nearly enough firepower. And you didn't ask me to join."

Casey: "In case of emergencies. My personal number. But ... erm ... your fingers had better be on fire when you dial."

So, which bits did I enjoy the most?

The whole of episode S02E21 - "Chuck versus the Colonel". Adam Baldwin, like I said before, is awesome, and this episode really plays to his strengths. It's also the episode where Chuck and Sarah's relationship comes to a head, and it just seems so natural! It's a shame that their efforts are interrupted each time ...

Bits of episode S02E22 - "Chuck versus the Ring". It's a pretty average episode up to start with, but then it gets very good. However, I am confused why Bryce, a top secret agent, goes to attack Roark at the wedding with just a single pistol. There's a frigging arsenal of big guns right behind him that he could have taken instead! Although I did enjoy the bit where Casey's Special Forces team drops into the party, and seeing Sarah in a ripped off Bridesmaid dress. Wow! Oh, and apparently the US Special Forces team are a dab hand at arranging weddings... I wonder if that's on the recruitment material?!

But at the end, everything within the Intersect room might as well have been a rip-off of the Matrix:

Neo: "I know Kung Fu."
Chuck: "Guys? I know Kung Fu."

OK, so maybe not the most conclusive evidence. But that entire scene reminds me of strongly of the Matrix. I had kinda wanted Chuck to do the bit from the scene in the underground where Neo takes a fighting stance and then beckons Agent Smith towards him. It would have been in keeping with Chuck's nerdish background for him to have done so! Oh, and the Intersect room - everybody loves a glowing white room!

So what about Series 3? What do I want from it?

Well, Josh Schwartz posted the following spoilers:

Will Chuck and Sarah start the season off as a full-fledged couple?
SCHWARTZ: Chuck having the Intersect in his head will severely complicate their ability to be a couple. [And] look for a potential new love interest on the show.

Really? For who?
SCHWARTZ: Someone who could triangulate between a couple of characters.

Male or female?
SCHWARTZ: Gosh, isn’t it more fun to tease?

Source: http://chucktv.net - Season 3 Spoilers

Screw it, that first one is going to be unpopular. And I really, really, really hope that it doesn't cause Sarah and Chuck to split up. The entire two series has been the two of them getting closer and closer. For them to not end up together would be just ridiculous. And would definitely put me off watching it.

Regarding the second one. I hope that doesn't mean that Bryce is coming back. That would again be stupid. They can only kill a character and then bring them back from the dead once. More than that, it'll just get really annoying! (OK, so I'm not a big fan of Bryce anyway.)

Regarding the rest of the series, hopefully Sarah and Chuck will remain together, but will be active spies together. With Chuck's ability to learn new skills instantly, that should make for some really cool plot lines.

Oh, and I hope we get to see more of this sort of thing:

Why? Because I'm a guy!

Google Logo

2009-06-08T18:07:00.000+01:00

On special days of the year, Google rebrand their Search Engine(s) with a custom logo. Previous examples have included:

Munch's Scream:
http://searchengineland.com/munchs-scream-as-google-logo-10031

Halloween, 2007:
http://searchengineland.com/google-yahoo-askcom-do-halloween-logos-themes-12577

So, out of interest, what do you reckon they had on June 6, 2009? Just to put it in context, the 65th Anniversary of D-Day?

If you were as crazy as me and said something along the lines of "D-Day", then you were wrong. They went for:

The Tetris Effect:

The Tetris Effect?! I mean, what the duce?!

I'm normally pretty impartial to things like this, but naughty Google! Naughty!!

More Blood, More Sweat and another cup of Tea

2009-06-07T13:56:00.000+01:00

Tom Reynolds' sequel, "More Blood, More Sweat and another cup of Tea" has been released now. Tom has also put it up on Issuu, where you can read it for free:

Open publication - Free publishing - More tea

For more information, please see Tom's blog, where there are links to where you can buy it (which I would encourage you to do, as I am) and a wealth of material to enjoy!

Happy Birthday Henry!

2009-06-06T13:24:00.000+01:00

Happy Birthday Henry!!
How old do you reckon he is?

(Taken from an article on Lyneham Village News from last year.)

Would you believe that he is 113?! Yes, that's right. 113!

I've seen people who are half that age who look older!

As the oldest British man alive, he is 113 today. He was born 6th June 1896.

D-Day, H-Hour + 65 years.

2009-06-06T06:30:00.004+01:00

65 years ago today, D-Day was just starting for thousands of sea-borne troops due to the hit five landing beaches along the Normandy coast. Thousands more airborne troops had been dropped the night before, and were steadily securing their objectives.

By the end of the day, thousands of Allied service personnel had been killed. And many of those who survived would go on to die in the following days and months. But it was the beginning of the end of the Second World War.

And on this day, at this hour, we should remember all those who gave their lives so that we could live free.

For The Fallen
With proud thanksgiving, a mother for her children,
England mourns for her dead across the sea.
Flesh of her flesh they were, spirit of her spirit,
Fallen in the cause of the free.

Solemn the drums thrill; Death august and royal
Sings sorrow up into immortal spheres,
There is music in the midst of desolation
And a glory that shines upon our tears.

They went with songs to the battle, they were young,
Straight of limb, true of eye, steady and aglow.
They were staunch to the end against odds uncounted;
They fell with their faces to the foe.

They shall grow not old, as we that are left grow old:
Age shall not weary them, nor the years condemn.
At the going down of the sun and in the morning
We will remember them.

They mingle not with their laughing comrades again;
They sit no more at familiar tables of home;
They have no lot in our labour of the day-time;
They sleep beyond England's foam.

But where our desires are and our hopes profound,
Felt as a well-spring that is hidden from sight,
To the innermost heart of their own land they are known
As the stars are known to the Night;

As the stars that shall be bright when we are dust,
Moving in marches upon the heavenly plain;
As the stars that are starry in the time of our darkness,
To the end, to the end, they remain.

Source: FirstWorldWar.Com - Poets and Prose

To all those thousands who have travelled to Normandy today to mark this, the 65th anniversary of that fateful day, and to all those who intend to mark in their own way, good luck.

Blog search results 17

2009-06-05T18:16:00.000+01:00

This is a similar search to Blog search results 16:

St. John Ambulance HCP course, from google.ca:

St John Ambulance (Canada) offer a course called "the Health Care Provider
(HCP) Level CPR course".

A useful link that you might be interested in is this PDF:

Health Care Provider (HCP) CPR Information Bulletin (February 2009)

It gives details of what is on the course, etc and how to go around getting on a course.

"Kitchener's Last Volunteer" by Henry Allingham

2009-06-04T18:16:00.001+01:00

I've previously read, and greatly enjoyed Harry Patch's biography, The Last Fighting Tommy, so when I heard that Henry Allingham was releasing his, I was incredibly excited.

I got it and read it a while back, and I loved it. It's so incredibly easy to read, and I can't stress how good it is.

Henry is officially the oldest British man ever, at over 112 years old. As of June 6th, he'll be 113 having been born June 6, 1896. That's incredible, really! He has lived through so much, and he has witnessed so much. The tales that he tells are fabulous, and gives an insight into the average, daily life of people throughout the decades that he's lived through. And he does so with such modesty and authority. You feel that Henry is talking directly to you for much of the book.

It details his service during the First World War. He is the only survivor of the Battle of Jutland, which was originally witnessed by many thousands of men and was the last great naval engagement ever, and is the only man left who witnessed the birth of the Royal Air Force.

And the narrative is interspersed with short passages that give historical context to Henry's narrative. They are incredibly helpful and also very well-written.

I loved this book. And Henry is amazing. The fact that he is still alive and well, and looks so healthy is just incredible. He was still cycling up until a few years ago...

Blog search results 16

2009-06-03T17:26:00.000+01:00

ST Johns Ambulance CPR/ HCP course, from mywebsearch:

I'm a little unsure what you want with regards to a "HCP Course". To my understanding, HCP stands for Health Care Professional/Provider, so is basically a cover term used to describe a doctor, paramedic, nurse, etc.

St John Ambulance teaches all of our members how to perform CPR, as part of our Basic Life Support training. If you get in touch with your local St John county/unit, they should be able to provide you with details of a commercial training course you can attend.

Am I Invisible?

2009-05-30T18:15:00.001+01:00

I'm pretty sure I'm not. Nobody has ever come up to me and said, "Hey man. You know you're invisible, right?"

I know for a fact that my Ambulance isn't, especially not when it's lit up on Blue Lights and making hell of a racket because the siren is going!

I am of course glad that I'm not the only one who suffers from this mysterious ailment. Ambulance Nut also does apparently:

Its amazing how invisible we feel as people pull out in front of us and refuse to get out of the way.
~ Ambulance Nut: First Timer

So how is it that people fail to see (or hear!) it?

During the maternity transfer that I did a while back, I came up to a big three lane roundabout. A quick sketch will help!

I'm the blue arrow, and I had the intention of running the red light and going straight across the roundabout. I'd slowed and got my lights and sirens on as appropriate. Two lanes of traffic on the roundabout had stopped already, and I was keeping an eye on the third.

As I crossed the white line onto the roundabout, a Renault Scenic came past the two lanes of stopped traffic on the roundabout and headed across in front of me. I was already easing off the accelerator, and I knew that I'd be able to slot in behind the Scenic without any problems.

The driver then saw me, her car wobbled left and right for a few metres and then braked violently. I feel rather sorry for the kids in the back and the baby on the passenger seat - it was a shame that the driver hadn't seen me earlier, it would have been a much more comfortable ride for her children! Not to mention safer!

RLF - Run Like ...

2009-05-29T18:40:00.001+01:00

I was inspired to write about this following a post I read at Ambulance Nut recently entitled "Why Have You Brought Her Here?!"

We were sat on station, just having our break, when we were passed a Doc's Urgent. Not too serious apparently - a transfer of a lady who was 18-weeks pregnant suffering mild contraction like pains to the main maternity unit for the area. All pre-arranged and tickity-boo.

I was driving, and my female crewmate was attending. Thank god. I hate Maternity jobs. What am I, a 23-year single male meant to say to a pregnant lady?! "I know how you feel"?! Yeah, that'll go down well!

So, how'd the job proceed?

Danger - None. Household residence, polite patient, husband and Mum.
Response - Alert. GCS 15, no history of anything else.
Airway, Breathing, Circulation - No concerns at all. A little pale, but appropriate for pain.
Disabilities caused by condition - Lying on her side on a couch in a foetal position. Pain?

Provokes - Nothing really provokes it. Lying in a foetal position helps relieve it though.
Quality - Contraction-like according to the patient. Whatever that feels like!
Radiates? - Not really. Pain moving from mid-abdomen downwards during the contraction.
Severity - 5/10 during it, 2/10 (dull ache normally).
Timings - About every 10 minutes. Onset earlier that day. Each one getting successively worse.

Exposure - No noticeable deformities, etc. Vitals were OK. SAMPLE history taken, and didn't really give us any further clues as to what was going on.

At that point, we'd found nothing too serious. A full assessment had been completed, and she was OK to travel with us. We offered her Entonox and advised that it would be best for her if we were to Carry Chair her out to the Ambulance. She declined both, and said she'd rather walk. We advised her against it, but she insisted. Said she didn't want her neighbours to worry...

Well, we got her out to the Ambulance, and sat her down on the stretcher. We asked her to swing around and put her legs up, and she froze. Tensed. And then screamed. It was chilling to hear.

I swung around, and with one arm pulled the back doors of the Ambulance to whilst opening the Entonox cupboard with my other. My attendant was with the patient in a flash. She had her hands on her stomach, and was telling her exactly what to do. "Slow your breathing. Slow it. Breathe deep. Breathe with me. In ... And Out ... In ... And Out."

After what seemed like an eternity, her breathing slowed. She untensed. And started talking again. Pain? 11/10. She'd never felt anything like it. She gratefully accepted the offer of Entonox, and started sucking it down.

We got her loaded properly onto the stretcher, and got her husband in. We were moving quicker now. I knew what was going to happen, even before my attendant turned and said "Let's get going. Swiftly." Her eyes said something different though. They said to me, "Run Like Fuck."

I wonder whether the neighbours worried as we pulled away on Blues? Or what about when the sirens went on as we reached the main road? I think that might have caused a little bit of concern at least..

(OK, so why was I inspired to write this? Mainly because it contradicts Louise's post - we bypassed the nearest A&E and went direct to the maternity unit (despite it not being a maternity case technically). Should we have done this? Control were happy so I guess we didn't balls-up too badly!)

Multi-Purpose Vehicles

2009-05-28T18:45:00.004+01:00

St John Ambulance love the idea of standardised vehicles.

A few years ago, they introduced the Crusader and the Challenger - the on-road and off-road Ambulance that was to be standardised throughout the country. The aim? To produce a single unified fleet that showed that St John is one nationwide organisation, and to allow any crew member to be able to work on any vehicle in the fleet anywhere in the country.

That's a great idea in theory, and I applaud their efforts. The Crusader is, I feel, a very good vehicle for the purpose to which it was designed. It is a multi-purpose vehicle, allowing to be used for Emergency work, for Non-Emergency work, as an First Aid Unit, etc.

The Challenger though.

(Shropshire's KB140 on duty at Hawkstone Park Motocross, photo taken from http://www.ukemergency.co.uk/)

What can I say?

I've worked on KB140, and I do quite like it. When you drive it, it makes an incredibly satisfying roar if you get your foot down. But what about for the patient's sake? Is it any good?

If it's backed up by a road vehicle, it's not too bad. At motocross, we use it to retrieve patients that are boarded/scooped, put on the stretcher and off-loaded to the road vehicle.

Two limiting factors with it. The trolley on it is designed so it can be folded into a chair, which makes the wheelbase very small. Combined with very narrow wheels, it's not much use on mud. So we tend not to take the trolley off if we can help it - preferring to slide a board/scoop straight onto the bed.

The second is that the attendant does not have access to the entire length of the patient whilst in transport. You can only get at the waist upwards. Equally, the response bag is just inside the back doors, so you hope you have everything you need in the limited cupboard space available above you and the patient's head.

So, slightly limited. Especially as there's an alternative. The Land Rover.

I love these vehicles. In fact, KB101 was the first Ambulance that I worked on.

(KB101 on duty at Llan Farm Motocross in 2006)

Interestingly, Shropshire is not the only county in the country to own one. Cheshire own a similar one to Shropshire (NA101):

(NA101 on duty at a Mini-Moto at Rednal, Shropshire)

North Yorkshire and Teesside own one (BC108):

(BC108 before going out on duty at Thornborough Autograss)

And I found out the other day, so do Avon (GA105):

(With thanks to www.policespecials.com)

And there's older ones still hanging around, such as these owned by Shropshire (KB109) and Lancashire respectively:

(Photos taken from http://www.ukemergency.co.uk/)

All of these vehicles serve their purpose very well. So why is it that these vehicles are not "recommended"? They're more versatile than the Challenger. You can get full access to the entire length of the patient whilst in transport, allowing you to transport to hospital if required. And the ride isn't that uncomfortable in the back anyway. Plus there's a rugged trolley on them that can be used on mud!

I am a big fan of Land Rovers, and I think it's a real shame that counties are recommended not to get them. From my experience, they're the best vehicles for the job. I did my Emergency Transport Attendant Training on one of Oxfordshire's and I've crewed KB101, KB109, NA101 and BC108. I've also worked on Shropshire's Challenger, KB140, and I think I'd prefer to work on a Land Rover any day of week.

"The Fire: The Bombing of Germany, 1940-1945", by Jorg Friedrich

2009-05-27T17:10:00.000+01:00

"The Fire: The Bombing of Germany, 1940-1945", by Jorg Friedrich

This book is the translation of Jorg Friedrich's original German manuscript into English by Alison Brown. Whether the translation does justice to the original, I do not know, but I would recommend it to any 'fan' of the Allied bombing campaign.

It discusses the full horrible effects of the bombing campaign undertaken by the Allies against Germany and its civilian population. The end result was horrifying - the human losses were about 600'000 casualties, and numerous cities destroyed. The techniques developed over the course of the war are meticulously described, and rather ingenious to be honest.

But it is disturbing to notice the transformation in the target of the bombing campaign, from industrial production facilities to civilian population centres.

It uses personal stories and firsthand testimony of those caught up in the bombings to tell the story. The translation itself is rather dry, but it is very factual and reasonably enjoyable to read. Jorg Friedrich uses numerous sources, Allied and German, and layers information from all of them into a very cohesive manuscript.

Credit should also go to the American publishers who published this - no British publisher were found that would take it on.

"Dunkirk: The Men They Left Behind", by Sean Longden

2009-05-24T19:27:00.000+01:00

"Dunkirk: The Men They Left Behind", by Sean Longden

In the past, I've read books such as "Dunkirk: Fight to the Last Man" (by Hugh Sebag-Montefiore) and "The Sinking of the Lancastria" (by Jonathan Fenby ), so I'm aware of the back story to the rescue of the British Expeditionary Force following the Fall of France in 1940. What I was not aware of was the story of the men who were left behind. I'd always known that men had been left behind, I just didn't really understand how many of them were left behind, nor what torments they went through afterwards.

It's a little known subject, and this offers a horrific account of those men who were left behind. 300'000 were saved, but 40'000 were left behind. Most books on the topic concentrate on those who were rescued, not on those who were left behind. It makes good use of numerous sources and includes eye-witness accounts, and it makes for an incredible read. The section at the end covering what has happened to some of those men is also very interesting. There are a few cosmetic errors made, but these are not all that noticeable.

This book will have an impact on every reader, especially those who had relatives who served in the army at the time.

I would definitely recommend it to everybody, although I would recommend reading something like Hugh Sebag-Montefiore's "Dunkirk: Fight to the Last Man" first to get an idea of what happened before it. In fact, I would consider this to be the perfect follow up to Hugh's book.

"The Unknown Soldier", by Neil Hanson

2009-05-23T21:15:00.001+01:00

"The Unknown Soldier", by Neil Hanson

Of the millions of British dead from the First World War, only one was ever returned to Britain - the Unknown Warrior. The Tomb of the Unknown Warrior is the memorial to the British soldiers who fell during the First World War. The idea was first conceived in 1916 by Reverend David Railton, an army chaplain serving on the Western Front, who saw first hand that many of the fallen have no known grave.

This book tells the story of three previously unknown soldiers who fought and died during the First World War. It follows a British and German soldier, and an American airman and draws on their own letters amd family memories to reaccount their service during the war.

While you may have read similar tales of soldier's service during the war, I challenge you to find a book as poignant as this. The reaccounting of the birth of the idea of the tomb, how it was implemented, and the public mourning for the unknown soldier is incredibly moving. It is a heartbreaking story, and written with real feeling - it is a story of the tragic human cost of the war, not just the statistic results of it.

All I can say is that this is a very rewarding read.

WWII Russian Tank with German Markings recovered

2009-05-22T19:05:00.000+01:00

I came across this truly incredible story earlier, and thought I'd reproduce it here. Credit goes to Rogue Gunner though

WWII Russian Tank with German Markings recovered

A Komatsu D375A-2 bulldozer pulled the abandoned tank from its tomb under the boggy bank of a lake near Johvi, Estonia. The Soviet-built T34/76A tank had been resting at the bottom of the lake for 56 years. According to its specifications, it's a 27-ton machine with a top speed of 53km/hr.

From February to September 1944, heavy battles were fought in the narrow, 50 km-wide, Narva front in the north-eastern part of Estonia . Over 100,000 men were killed and 300,000 men were wounded there. During battles in the summer of 1944, the tank was captured from the Soviet army and used by the German army. (This is the reason that there are German markings painted on the tank's exterior.) On 19th September, 1944 , German troops began an organized retreat along the Narva front. It is suspected that the tank was then purposefully driven into the lake to conceal it when its captors left the area.

At that time, a local boy walking by the lake, Kurtna Matasjarv, noticed tank tracks leading into the lake but not coming out anywhere. For two months he saw air bubbles emerging from the lake. This gave him reason to believe that there must be an armoured vehicle at the lake's bottom. A few years ago, he told the story to the leader of the local war history club 'Otsing'. Together with other club members, Mr. Igor Shedunov initiated diving expeditions to the bottom of the lake about a year ago. At the depth of 7 metres they discovered the tank resting under a 3 metre layer of peat...

Enthusiasts from the club, under Mr Shedunov's leadership, decided to pull the tank out. In September of 2000 they turned to Mr. Aleksander Borovkovthe, manager of the Narva open pit company AS Eesti Polevkivi, to rent the company's Komatsu D375A-2 bulldozer. (Currently used at the pit, the Komatsu dozer was manufactured in 1995, and has recorded 19,000 operating hours without major repairs.)

The pulling operation began at 09:00 and was concluded at 15:00 , with several technical breaks. The weight of the tank, combined with the travel incline, made for a pulling operation that required significant muscle. The D375A-2 handled the operation with power and style. The weight of the fully-armed tank was around 30 tons, so the active force required to retrieve it was similar. A main requirement for the 68-ton dozer was to have enough weight to prevent slippage while moving up the hill.

After the tank surfaced, it turned out to be a 'trophy tank' that had been captured by the German army in the course of the battle at Sinimaed (Blue Hills) about is x weeks before it was sunk in the lake. Altogether, 116 shells were found on board. Remarkably, the tank was in good condition, with NO RUST, and alll systems (except the engine) in working condition. This is a very rare machine, especially considering that it fought both on the Russian and the German sides. Plans are underway to fully restore the tank. It will be displayed at a war history museum in the Gorodenko village on the left bank of the River Narv.

Source (with additional photos).

Incredible stuff, especially that it's in working order!

Who's that?

2009-05-22T14:05:00.003+01:00

Whilst innocently going about my business the other day, who do I notice coming screaming up the road towards me?

It's only the Grumpy Ambulance Driver and Nickopotamus.

(It's a shame that you can't really see the blue lights going, but that's a story for a whole different day!)

And this got me thinking. How often are St John vehicles actually photographed / video'd doing this type of work? And how many photos are there of the vehicles in real-life situations doing what they're designed to be doing?

Now, if you search for "st john ambulance crusader"* using Google Image Search, on the first 10 pages there are 35 photos. And yet none of these depict a Crusader on blue lights doing Emergency work.

This, I feel, is a real shame, as it does not fairly reflect the work that is done by our crews on a daily basis. It's also a real loss for the PR department. If I'd have a video-camera going, I could have got a lovely bit of footage showing how to approach a roundabout properly.

* 'crusader' being the name of that type of vehicle.

"Ark Royal", by Mike Rossiter

2009-05-21T20:36:00.000+01:00

"Ark Royal", by Mike Rossiter

In June 1941, the Ark Royal helped to sink the Germany destroyer Bismarck. Her swordfish torpedo-bombers flew the missions that finally sunk her. Hitler was furious with the loss, and demanded that she was sunk at any cost. Less than one month after sinking the Bismarck, the Ark Royal was sunk by U-81 in the Mediterranean.

However, her final resting position was uncertain. She lay in over a kilometre of water until she was found in 2004 by Mike Rossiter. This book tells of the search for the ship, and uses a couple of testimonials from survivors of the men who lived and worked on board to retell the story of her life and service with the Royal Navy.

It is well-worth reading, although there are a few minor mistakes which have been reported with it. However, as I'm not a Naval expert, I did not notice these originally and they definitely did not detract. It's an easy read, without too many technical details. It's only drawback is the lack of maps, which make some of the actions incredibly hard to follow!

News Video: "Jodrell Bank's Cold War history"

2009-05-20T23:06:00.000+01:00

There was an interesting 4 minute news video posted on the BBC News Website today about the use of the radio telescope at Jodrell Bank. It's a bit short, but still quite interesting.

http://news.bbc.co.uk/1/hi/england/8059107.stm

Star Trek Film Review

2009-05-20T18:44:00.000+01:00

I watched the new Star Trek movie a couple of days ago, and thought I'd let you know what I thought about it. To summarise, I enjoyed it! And although this may contain spoilers, it's probably best not to have read a spoiler heavy review before you go and watch it.

SPOILER ALERT

This film, directed by J. J. Abrams, is a re-imagining of the original Star Trek storyline, and is pretty good! I'm not a huge Trekkie, and have only vague recollections of watching The Original Series. However, this works, and works every well.

The cast is pretty ace; Eric Bana is superb as Nero, as he was always is (he was kick-ass in Black Hawk Down!). My only complaint is that he should have had more airtime really! Zachary Quinto, most famous for playing Sylar on Heroes, is freakishly good at playing Spock. It's incredible how alike he is to Leonard Nimoy, and he's captured many of Spock's mannerisms perfectly. He definitely stole the show for me!

Chris Pine is great as Kirk, and has loads more charisma than Shatner ever had. I'm also quite glad that Shatner didn't feature in the film - I think his presence would have spoiled it somewhat. Further, I rather hope he’s not involved in the sequel(s) either.

Simon Pegg (who I thought was ace in Hot Fuzz) is great as Scottie, and Karl Urban makes a very decent McCoy. Zoe Saldana is pretty good as Uhura.

The plot. Pretty good really. I'm glad that Captain Pike turns up, and Bruce Greenwood plays a very capable portrayal of him. The destruction of Vulcan is going to make any further films pretty interesting though!

Both Kirk's and McCoy's promotions seem implausibly fast though, and I do wonder a little about that. I understand that they needed to be promoted to that position quickly, but even still, that seemed pretty quick!

The subplot regarding Uhura's and Spock's relationship is just annoying, and I feel very unnecessary. There was absolutely no need for it. The relationship between Spock and Kirk takes on an interesting dynamic, and is enjoyable to watch as that develops.

Small points: I like the way that the skydiver in red (Chief Engineer Olson) dies. That's a nice throwback to the original series. I also like the guns - they are pretty cool! And Kirk ends up having sex with a green alien.

The Enterprise itself doesn't look anything like the original, nor its sequels. It looks way too Apple-product-like - lights and shiny surfaces everywhere. All other incarnations of the ship have contained a lot more grey!

The effects, and sound quality are both staggering and very nicely done.

I will admit, I had grown rather bored of the Star Trek environment, and have moved onto other Science Fiction. Deep Space Nine and Voyager weren't anything to write home about, and I never watched Enterprise. So I'm not sure what I was expecting from this film. But I enjoyed it immensely, and I would recommend it to all. New and old should find something in it that they enjoy.

Morphine, and a lesser known side-effect?

2009-05-19T18:43:00.000+01:00

This is the tale of a drug called Morphine, and one of it's lesser known side effects - the effect it can have on an injured motocross rider and his loved ones.

First, picture the scene.

He's riding down the home straight. The last lap flag is flying - he's got just one more lap to go, and he'll be done. The track has been good, as it always is. There are a few deep ruts forming, but nothing to be unduly concerned about.

With a jolt, his front wheel strays into a rut. Instinctively, his leg drops down low to counterbalance it. His foot drags through the clay, but his bike doesn't stop. With a sickening crack, he realises his folly too late as he falls from his bike into the mud, searing pain from his lower leg bloating out everything else. He flops about, trying to straighten his leg - trying to stop it hurting it so much. He rolls himself onto his back, screaming in agony.

Dimly, he's aware of a medic arriving and, over the noise of the bikes, asking him if he has any neck or back pain.

He replies, less than calmly: "No, it's my fucking leg! I felt it snap!"

He's aware that he's being talked at, but he doesn't care. He knows his leg is broken - it must be. But the pain? It's like nothing he's ever experienced before!

He bites down hard on his lip as the guy starts to undo the clasps on his boot. The world has gone silent, the red flags are fluttering in the breeze, telling the riders to stop. The world is temporarily at peace, but the pain hasn't stopped. Every tiny movement in his leg causes searing sensations to race along the nerve fibres in his leg to the pain receptors in his brain.

If he had been watching closely, he may have noticed the tiny ember of panic that developed in the pits of the First Aider's eyes as he opened the boot and looked in. The "Oh bollocks!" that every health care provider, from the lowly First Aider to the masterful A&E Trauma Consultant experiences at some point in their career. The First Aider knows that the injury is way outside of his organisation's resources - they're going to need some really funky pain killers to proceed further!

The world has gotten noisy again - there's the roar of a Land Rover engine and the wail of a set of Ambulance sirens getting closer, and the background hum of people talking as they stand just feet away from this gory spectacle. But the pain prevents his noticing much. He's barely aware of his fiancé turning up, and holding his head. Stroking his hair to calm him.

Mere moments later, the Ambulance arrives and the first bottle of Entonox reaches him. He's briefed in how to use it, and starts taking deep gulps of it - he's been told that it'll kill the pain, and he's more than willing to believe them. Anything to stop the pain.

But it doesn't. They're doing their best to immobilise the leg, but no amount of Entonox is sufficient to allow them to move the boot any further. It's neither on or off, and they're running out of options. There's a veritable crowd of medical personnel around him, and a second Ambulance, but it's all to no good. The pain wasn't easing at all, not even as he finishes off the first cylinder of Entonox and starts on a second.

He's plowing through the Entonox. His mind focused purely on that, nothing else. He doesn't notice the third Ambulance arrive. He doesn't notice that it's not a St John vehicle. It's an NHS West Midlands Ambulance Service (WMAS) vehicle. He doesn't notice the Paramedic talking to the St John crews; he's only aware of him when the Paramedic crouches down and talks directly to him.

He's only dimly aware of what he's being told, but the words, "We're going to give you some Morphine for the pain" cuts through everything. He hears that, clear as a bell. He's working through his third cylinder of Entonox as the first shot of morphine goes in. But it has no effect. They're still unable to get the boot off and a splint on.

A second shot goes in. But again to no effect.

A third goes in. Things are starting to feel real fuzzy! He looks around. What a strange bunch of people around him. He's lying in the middle of a dirt track, and there's a nasty pain in his leg. He rolls his head back, and see's his Mum stroking his hair. He murmurs, "Hi Mum."

His fiance gives his the dirtest look ever, much to the amusement of all present, although he doesn't notice.

He was going to pay for that one in the morning, I'm sure of it! She did not look even slightly amused!

(This story has been fictionalised for the sake of patient confidentiality, but the punch line happened. Trust me!)

"Flags of our Fathers", by James Bradley

2009-05-18T15:47:00.000+01:00

"Flags of our Fathers", by James Bradley

I will gladly admit it, I have never read a book about the Pacific Theater of Operations. I don't really know why though, as although the Americans bore the brunt of the fighting, the British too fought and died for liberty there. Yet of all the books in my collection, none are concerned with the PTO. That I now pledge to amend!

This book, even if you've watched the movie of the same name by Clint Eastwood, is horrifying. The film fails to portray fully the losses that the Marines suffered on Iwo Jima, and on all of the Pacific Islands. Whilst a film is typically more visually engaging, it suffers the constraint of not being long enough to tell the full story. The book amends that, adding greater detail and thus greater understanding for the viewer/reader. What it does portray well is the barren nature of the island, and of how effective the Japanese positions were. It has made me wonder though, have the positions there ever been mapped in their entirity? That too would be fascinating.

The book starts with the flagraisers early years; telling of their families and of their childhoods. What is stressed is how ordinary their upbringings were. Next comes their enlistment and their early military service, of Mike's, Ira's and Harlon's early military service prior to Iwo Jima. Of the hell-hole that Tarawa. And then of the massive training exercise that was mounted to prepare the troops for the attack of Island-X. Throughout all of this, the writing is precise and informative; a pleasure to read. There is no over-complexity; it is clear that it has been written not by a professional historian writing a textbook about the campaign, but by an amateur writing for the sake of expressing his admiration for those who were there. At times he repeats things in the narrative, especially near the beginning. But either I grew used to this, or he stopped doing it towards the end.

What is most sad is the post-war fate that awaited Rene and Ira. And the horrifying fate that awaited Iggy on that island. The film does not do credit to the suffering that he was forced to endure at the hands of his captors; the systematic torture that is hard to comprehend. It is no wonder that John Bradley chose to put the battle behind him. The suffering, both of Iggy and of all those that he helped in his role as a corpsman, is far greater than what most of us will ever encounter!

Would I recommend this to others? Yes, most definitely. It is an excellent. Even if you've watched the film, this adds valuable insight to the conflict in the Pacific.

"Colditz: The Full Story", by Major P.R. Reid

2009-05-17T18:23:00.000+01:00

"Colditz: The Full Story", by Major P.R. Reid

Written by Major Patrick Robert Reid (MBE, MC), a British Officer held at the notorious POW camp at Colditz, "Colditz: The Full Story" is a great read!

It looks at everyday life at Colditz from the point of view of the inmates being held there. Although it primarily focuses on the escape attempts of the British contingent in the camp, Major Reid does a very commendable job to ensure that the efforts of their allies in attempting to escape are also reported accurately.

It also provides an interesting (and refreshing) insight into the collapse of the Nuts forces in the last few days of the war.

My main critism is that Major Reid escaped from Colditz in 1942, and although he does a very, very good job at describing life in Colditz afterwards, the amount of detail provided is affected slightly. Regardless, it is excellent, and well worth a look, regardless of your interest in World War II!

Swine Flu Pooh

2009-05-16T14:36:00.000+01:00

(With thanks to kingmagic)

Lancaster Bomber

2009-05-15T11:00:00.000+01:00

I found this photo on a forum earlier today, and I loved it. It's great!

"Auschwitz: A Doctor's Eyewitness Account", by Dr. Nyiszli

2009-05-15T01:53:00.000+01:00

"Auschwitz: A Doctor's Eyewitness Account" by Dr. Miklos Nyiszli by is a harrowing tale of one man's struggle for survival against overwhelming odds.

When Dr. Nyiszli arrived at Auschwitz in June 1944, he was spared certain death by Dr. Josef Mengele and was put to work as both doctor to the Sonderkommando and as chief pathologist for Dr. Mengele's brutal experiments. In this position, he got to see all 6 extermination methods employed at Auschwitz, and was painfully aware of how vulnerable his continued existence was. The fact that Dr. Nyiszli survived Auschwitz is incredible; and given the information that he survived the war knowing, his survival is even more astonishing.

I have never been to Auschwitz, and never really had an interest in the history of the Holocaust, yet when this book was recommended by a friend, I immediately decided to buy it. Having started it, I found I couldn't put it down, despite the horrors it describes. It did not take me long to finish.

Sobering and horrifying throughout, this book is definitely not for the faint of heart or children, yet it is a must read. The writing is very precise, as you might expect from a doctor.

An interesting article about the authenticity of the book, which some doubt, can be found at http://www.ihr.org/jhr/v20/v20n1p20_Provan.html.

In addition, the book contributed to the 2001 film, The Grey Zone, although this focused more on the 12th Sonderkommando than on Dr. Miklos Nyiszli .

York LINKS

2008-10-29T18:16:00.002+01:00

Every year, LINKS units across the country attend their Universities Fresher's Fayre. The aim? To recruit as many fresh volunteers as possible for the upcoming year.

A couple of days later, the unit will then hold an Introduction meeting, where all of those new recruits come along, and we tell them what they can expect from their time with LINKS. York LINKS is no different. But how do certain members in the unit prepare for this?

By spending far too long the night before preparing a 3-minute video, and then winging the rest of the presentation.

The result? Well, see for yourself!

Driving crash course

2008-10-22T17:20:00.002+01:00

Thanks for your support folks - I am indeed back after quite a long break!

Upcoming blog posts may (or may not) cover some of the following cool things:
- A Berlin Heart
- Morphine, and the effects it can have on the relationship you have with your fiance
- Pillows, and how they're a currency in the NHS
- Why you should never spend 4.5 hours making an SJA video to the theme tune of Baywatch
- How some Hospital clinics seem to be absolutely useless

While I shan't regale you with the full tale of my summer (it was long and boring), I should point you in the direction of a good friend of mine, The Grumpy Ambulance Driver.

For the past fortnight, he has been crashing-coursing me (without any of the crashing), in the art of driving a Non-Emergency Ambulance. What this boiled down to was me saying to him, "I really enjoy driving. Please let me drive lots!". This resulted in me driving practically everywhere, with him either dozing off on our comfy pillow propped against the window of the cab, or playing on his Nintendo DS (whenever we didn't have a patient on board).

Before he makes a comment, this is not a whinge. I do enjoy driving, and I'm thankful to the assistance he has given me.

Now, I'm afraid you may all have to wait for a little longer for the next post, as I'm in the middle of some very important University work......

PTS 101

2008-10-10T12:49:00.000+01:00

What's the key thing to remember whilst doing any type of Ambulance work?

Never, ever leave the keys to the ambulance in the pocket of your fleece jacket that you take off whilst on a patient's ward... Whoops!

Oh, and apologises for the earlier pun - I couldn't help myself!

Pain Scale

2008-03-21T22:49:00.000+01:00

Whenever I teach (formally or informally) St John members about getting details from a patient who has "pain", I always use the acronym, PRQST. Originally taught to me whilst on my AA2 course by Dr. Rob Russ, it should stands for:

P rovocation (what caused it? Or what were they doing when it first started?)
Q uality (is it stabbing, aching, etc?)
R adiates (does it radiate anywhere?)
S core (on a scale of 1 to 10, where 10 is the most severe*)
T ime of onset

I also point out that patient's perceive pain differently, so the actual values are not so useful. I was on duty a few days ago, and a perfect example presented itself!

First patient was a 12 year old lad who with bruising to his ankle. Scored as a 7.

Second patient was a 40 year old man who had landed very heavily on his bum, causing bruising to his coccyx and lumbar spine. Scored as a 2-3!

So, remember folks, a single pain score is not useful by itself! (Same as BPs, etc, but that's for another time...)

*Interestingly, the same day that we were taught this, we were also taught that it's probably little use. A&E (apparently) only vary the amount of pain-relief given dependent on whether the pain is MODERATE, AVERAGE or SEVERE...

Likely to be busy?

2008-03-11T11:14:00.000+01:00

So, if you were on your way to an event in an Ambulance, pull into McDonalds to get breakfast and see a car parked in a hedge, how busy do you reckon you're going to be at that event?

I'd reckon pretty damn busy. And it's definitely not a good sign when you park up, walk into McDs calmly and you're met at the door by the comments, "Oh. You're arrived just in time."

Crap.

A few exciting heroics later, including boosting a copper over a toilet cubicle partition, and having kept a straight face whilst hearing a 5-foot nothing drunk* tell a 6-foot copper to "stop disrespecting me, yeah" and "arrest me if yah can, yeah" and then watching her get marched away under arrest, we left a little later than expected but with free breakfast...**

* And yes, it was 7.30AM. And she was still drunk. Which might explain the car. Although in actual fact, she hadn't been driving. The driver had left her behind when he'd legged it...
** Sorry for the terrible English folks!

Achmed, The Dead Terrorist!

2008-02-13T23:42:00.000+01:00

An RTC

2008-01-17T17:43:00.000+01:00

My housemate bowled through the front door: "Nick? Have you got your shoes on? There's been an RTC 30 seconds down the road. No Ambulance. No Police. Body on the floor."

I'd like to think my first response was, "Ah." It would have been in a PG-rated world. It probably wasn't.

I forced my feet into the nearest pair of trainers I could find - I simply didn't have time to find my boots! Going through the door to my room, I barked at James to grab his Hi-Vis. Thank God we'd been lazy and not returned it to Division yet.

I ran down the stairs and followed James out of the door. I headed straight for my car, and grabbed both Bomber Jacket and Parabag out the boot. I chucked my stuff into James' car, and we rolled. Sadly, there was no music playing in the background to make us look cooler - no heavy bass beat that we could work to. In hindsight, maybe we should have put an iconic tune on? Would it have helped?

28 seconds later, we pulled around the corner and could see the blue lights twickling through the hedges. Thinking we were too late, we pondered what would be our next step. As we got closer though, the lights turned out to be a single Police Car, parked across the road protecting the scene. James pulled his car to a stop, and I dived out. Bomber jacket on, Parabag on the back, I ran for the scene. As agile as a Gazelle. As fit as a marathon runner. As full of the brown-stuff as certain St John members ... *

Crossing the road, I could see a simple Police Officer kneeling next to the patient - a lad, with a number of blankets over his legs, his face obscured by the Policeman. Next to them was a Volvo XC90 - the backwindow was gone, smashed clean away. But I didn't notice that until later.

I tapped the Policeman on his shoulder as I got close enough, just at the point when I saw the lad's face. There was blood everywhere. Oh bugger. The Policeman was clearly relieved to see me. Or at least to see somebody clad in a well-used green and yellow Hi-Vis. I was less relieved to be there.

DRsABCDE flashed through my brain. The clever little abbreviation used by St John.

Danger. Am I likely to get run over? Nope, there's a cop car there. I'm safe. We're safe!
Response. Talk to me buddy; talk to me! Great, he was! GCS of 14. I'll go with that.
Shout. Fuck that! I am supposedly the help!
Airway. He was talking, but what about his neck? He's obviously been cycling. And now he's not.
Breathing. He was talking. Would that suffice?
Circulation. Illuminated by a couple of orange streetlamps, was he pale? Too early to tell.
Disabilities. Erm...
Environment. It was cold, admittedly. He was lying on the cold, hard tarmac, but there was nothing I could do about that!

And at that, I realised I'd run out of letters. Balls. And to think, a minute ago, I'd had plenty of letters running through my head. Computer Science abbreviations, all of them.

"Hiya mate, my name is Nick. Sorry to be rude, but who are you?"

"Bob."

"OK Bob, can you tell me what happened? Where do you hurt?"

Bob stammered a bit, trying to remember what had happened. But he couldn't. A bystander then told me:

"He's been knocked off his bike."

Descriptive, I suppose.

"OK, how fast was the car going?"

The bystander couldn't give me an answer, so I repeated my question to Bob:

"Where do you hurt?"

"My leg. My leg really, really hurts."

"OK mate, anywhere else? Does your neck or back hurt at all?"

Regardless, I'd already made my mind up. Until such time as somebody paid more than I am tells me otherwise, his neck is mine! Mechanism of injury, right?

"No," he replies. "Not at all."

"OK. I'm going to have to just hold your head for the time being Bob. I'm a little worried by how you've been knocked off your bike. OK?"

"OK mate. What's happened?"

Thankfully I was saved from having to answer that question by the timely arrival of James, and his question:

"What's going on? Anything I can do?"

"Check his leg for me please, James?"

Somebody in the crowd then, quite helpfully, told us, "Don't look mate, it's broken!"

Great! There's a medic in the crowd. Front and center, son!

Of course, James did look, as he should have done, and turning to me, said simply, "It's bust." I understood him perfectly. It was bad, but not life-threatening. Thank God.

I was just thinking about our next step, when I realised that James' face was being illuminated by another source of blue light - the Ambulance. It had arrived just behind me, and within seconds, the crew were on scene.

A quick hand over, Entonox, Box-splint, some screaming and a log-roll onto a spinal board later, the patient was safely stowed on the Ambulance, and on his way to hospital. The thanks of the Ambulance crew still ringing in our ears.

* Some, not all. Some are good people. Some are not so good.

Trailer: An RTC...

2008-01-10T20:28:00.000+01:00

So, how does the following sound for a nice refreshing break from revision?

My housemate bowled through the front door:
"Nick? Have you got your shoes on? There's been an RTC 30 seconds down the road. No Ambulance. No Police. Body on the floor."
"Ah."

Story to follow, after my exams!

"The Secret in Building 26", by Jim DeBrosse and Colin Burke

2008-01-09T17:39:00.000+01:00

In the top-secret world of Cryptoanalysis, little has ever been revealed about the codebreakers who made such a huge contribution to the Allies Military Intelligence during World War 2. Even nowadays, as previously classified material is being released, books on the subject are rarely commonplace. I have previously only read one on the subject matter - "Colossus: Bletchley Park's Greatest Secret", by Paul Gannon. And this is in a field that relates heavily towards my degree!

This book covers the contributions of the US Navy code-breakers to the war effort, and was very interesting. I had no idea of the level of work performed by the Americans. The book itself was easy reading, but some of the technical descriptions of cryptoanalysis methods are sadly lacking! Don't look here for a detailed description of how it was done, but instead, look here for a solid description of the sheer scale of the problem, and of the people and organisations involved.

Written by Dayton reporter, Jim DeBrosse and security historian, Colin Burke, I feel that the biggest problem with this book is that the authors seem to delight in black-mouthing the British. The relationship between the British codebreakers at Bletchley Park and their American counterparts was prickly, but the book contains constant jibes at the British, as if accusing us of causing all the problems!

That said, it is an interesting read. Definitely one to read if you're interested in the Military Intelligence side of World War 2.

"The Last Fighting Tommy", by Harry Patch

2008-01-08T00:10:00.002+01:00

What does the nation know about Harry Patch?

The first time I saw him, it was on TV, and he was over 100 years old, and sat small and frail in his wheelchair. But he was still a proud soldier to whom the Queen paid tribute. But I fear that is all the nation knows him as - as being "The Last Fighting Tommy", even though Harry is more than just that.

This wonderful book recognises that. It's more than just his wartime memoirs. It includes Harry's description of his life around Combe Down (Somerset) and it's quarries, which is teeming with local references and I'm sure will encourage some readers to go exploring! It includes details about his Edwardian childhood, which will be interesting for social-historians. It includes how his life was affected by World War 2, and in later years, by his son's drinking. The last few chapters are a sad reminder that at 109 years old, Harry has outlived most of his friends and family.

And it's all been with the help of Richard van Emden, a well-respected World War 1 expert and author of many WW1 books ("Britain's Last Tommies", "Boy Soldiers of the Great War" and "The Trench" to name just a few). The end-result is a beautifully written set of memoirs that I hope has done Harry proud, beautifully interlaced with historical notes. And will stand as a testimony to the truly incredible life of an ordinary man, but who is now a legend.

Would I recommend this book? Oh yes! It's a must read for anybody interested in World War 1. But if you're looking for a vivid account of life on the Western Front, then this may not be the best book for it. Harry's descriptions of his time on the front line are short, and understandly so considering he lost three very close friends there.

Merry What?

2007-12-26T12:26:00.000+01:00

So, Christmas Eve's A&E Crew? Attended 8 Emergency calls in the 11 hour shift, where most of them were minor jobs. One job was quite positive - an elderly gentlemen had fallen out of his chair and just needed a hand to be helped back to his feet.

But the others?

2 self-harmers and 2 ?-CVAs. And one of patient died later in hospital after midnight. So Merry Bloody Christmas all.

News Article: "Aboard the 'Booze Bus'"

2007-12-17T13:07:00.000+01:00

There's a very interesting News Article on the BBC News website this morning about an initiative run by the London Ambulance Service called the 'Alternative Response Vehicle' (aka, 'Booze Bus'):

Aboard the 'Booze Bus'

A "drunks-only" ambulance is mobilised on occasions of widespread drunkenness in central London. What's it like aboard the "Booze Bus" on one of the busiest party nights of the year?

"I love the job - I like being able to make a difference. No two days are ever the same," says paramedic Brian Hayes with a jovial grin as he describes his job.

Over the course of a 12-hour shift on Friday night, he and his two colleagues on the Alternative Response Vehicle - or Booze Bus, as it's more commonly known - draw on their reserves of composure, ingenuity and stoicism to treat more than 20 dazed drunks.

At St Thomas's Hospital, where some of these patients are taken, a visibly-frustrated doctor speaks despairingly of dealing with a tide of alcohol-related problems, instead of people who are seriously ill.

"Everyone I've treated tonight has been drunk - this is ridiculous," he says.

At about 0200GMT, he predicts things are only going to get worse as the night goes on.

"I have no beds in my observation units as we're full already. This is the calm before the storm - it'll go ballistic."

One drunk patient had assaulted him, he says, and the waiting room was full of people being sick or aggressive.

"Twenty-four hour drinking has made a huge, huge difference. The problem is that staff are dealing with people who are drunk and don't know what they're doing," he says.

"Doctors are run off their feet and in the vast majority of cases it is just alcohol. It is binge drinking. We don't see people who've had just two drinks. People have had 20 shots of vodka.

"They're generally 18 to 25, but it's all sorts - including lawyers and people in their 60s."

An hour later the stench inside the ambulance is thick and overpowering after three patients have been picked up.

The smell of stomach bile, excrement and stale urine fills the enclosed space as the vehicle speeds through the West End streets.

A scantily-clad 21-year-old woman lies motionless with one arm attached to a saline drip. She was found lying unconscious near a West End club and taken inside by a doorman.

Her stockings sag limply around her ankles and she occasionally stirs to vomit into a tray, her eyes opening briefly and rolling towards the ceiling.

On a seat next to her a man in his early 30s is being attended to. He was found unconscious in a corner of the same nightclub suffering from the effects of a cocktail of drink and drugs.

Another seat is occupied by a 60-year-old man, found outside Holborn Tube station, whose silver hair is matted with a layer of thick, crimson blood. He is slumped, with a steady trickle of saliva dribbling down his chin. The man has soiled himself.

The Booze Bus - or Vomit Comet, as it has also been dubbed - was Mr Hayes's creation three years ago. The three paramedics take the alcohol ambulance out at times of heavy drinking, such as the World Cup, Gay Pride and the festive season. On a busy night it treats more than 20 people.

"The idea was to make everyone's life easier and make handling Christmas drinking more manageable," says Mr Hayes, 37.

"Normal ambulances are freed up to do work that matters and can save lives. It also means there's a hospital bed free."

Unlike other ambulances, it does not carry an ECG machine because it won't need to treat chest pains and the extra space can be filled by a patient.

It can take up to five patients to hospital in one trip - if no-one is seriously injured - rather than sending multiple ambulances.

On a Friday night in mid-December, with Christmas parties in full flow, Leicester Square and Soho are packed with revellers, increasing the demand on London Ambulance Service by 10 to 15% compared to a normal Friday.

Exactly a year ago it received half its daily average number of calls in six hours, and this time the office party has again claimed a number of casualties.

Mark, a civil servant manager in his 40s who had been drinking since 12 noon, found himself slumped over his Chinese meal due to one such party - prompting his colleagues to tie him to a chair and carry him out of a restaurant.

And there was Sally, a 24-year-old accountant, who was struck by a glass which was either dropped or thrown at her firm's festive celebration and left a shard embedded in her forehead.

Meanwhile, Stephan, a Swedish special effects technician broke and dislocated his ankle after climbing over railings to get into Soho Square Gardens after drinking at least seven pints at his work party.

But 18-year-old James bucked the party trend and was instead a victim of pure violence. He was found wandering around Leicester Square shirtless, with one shoe and a bloodied face after being set upon by more than a dozen youths.

Throughout the night and early hours, the three crew members exchange rapid-fire banter and remain upbeat when faced with a procession of bleary-eye patients in all shapes, sizes and ages.

"It's about being tolerant. Most of the people we deal with have been vomiting on themselves," explains Mr Hayes.

But he adds: "It scares me that these young girls are getting into nightclubs. There is a massive problem with underage drinking.

"I don't know what's happening to society as a whole. It's scary - it's not just the kids. It's also adults. People in their 40s and 50s who you would think know better.

"But then you get a job where you make a massive difference, and you feel much better."

Source: BBC News Website

Terry Pratchett vs. Alzheimer's

2007-12-13T14:28:00.000+01:00

Terry Pratchett, one of my favourite authors, posted a message on Paul Kidby's website 2 days ago saying:

Folks,

I would have liked to keep this one quiet for a little while, but because of upcoming conventions and of course the need to keep my publishers informed, it seems to me unfair to withhold the news. I have been diagnosed with a very rare form of early onset Alzheimer's, which lay behind this year's phantom "stroke".

We are taking it fairly philosophically down here and possibly with a mild ptimism. For now work is continuing on the completion of Nation and the basic notes are already being laid down for Unseen Academicals. All other things being equal, I expect to meet most current and, as far as possible, future commitments but will discuss things with the various organisers. Frankly, I would prefer it if people kept things cheerful, because I think there's time for at least a few more books yet :o)

Terry Pratchett

PS I would just like to draw attention to everyone reading the above that this should be interpreted as 'I am not dead'. I will, of course, be dead at some future point, as will everybody else. For me, this maybe further off than you think - it's too soon to tell. I know it's a very human thing to say "Is there anything I can do", but in this case I would only entertain offers from very high-end experts in brain chemistry.

"A Willingness to Die" by Brian Kingcome

2007-12-07T13:13:00.000+01:00

This book was bought for me, so when I started reading it, I didn't know what to expect of it. After reading the blurb, and the Introductary pages, I was quite excited - I haven't read all that much about the pilots in the Desert Air Force, and so, reading the memoirs of a Group Captain who served in the DAF was appealing.

Overall, I wasn't disappointed. Brian's story was put together by Peter Ford using manuscripts that Kingcome had worked on just before his sudden death in 1994, and Peter did an excellent job.

The book starts with Brian's childhood, before moving onto his early RAF career. Having absolutely no knowledge of the pre-war RAF, this was absolutely fascinating for me, and the book was worth reading for this bit alone! Brian's account of his actions during the Battle of Britain are engaging, and his involvement in Dunkirk is a fresh reminder that the boys on the beach weren't entirely alone. Sadly, the account of his time with the Desert Air Force is cut short, due to Brian's death, but despite this, Peter presents a well-rounded narrative that was gripping from start to finish.

Would I recommend it? Yeah, especially if you're interested in the pre-war nature of the RAF and especially of Cranwell - the RAF's officer training centre.

Tackleberry

2007-11-18T13:36:00.001+01:00

Purpleplus, one of the bloggers that I read regularly, jogged my memory with regards to this problem.

Why is it that within St John, there are a certain subset of members who seem to consider that have to carry every piece of equipment imaginable? They end up coming on duty looking like Officer Tackleberry from Police Academy!

And it's all a matter of time seemingly! Members join the organisation and go on duty with very little equipment. They then start buying a lot of extra equipment and carry everything they have ever bought! And then they get tired of that, and start ditching equipment and revert to carrying as little as possible.

Now, I've been in the organisation for a while, and as an ETA, I tend to carry as little on me as possible. The majority of my kit can stay on the Ambulance until required! But I do always tend to carry the following:

- On my left arm, two black pens and a penlight
- Spare pieces of paper in my shirt pocket for taking notes
- Right leg combat pocket: Swabs and a triangular as an inpromptu FA kit and a green OP
- Left leg combat pocket: Lightweight stethoscope
- Utility belt with PPE pouch (gloves, a wipe and a vent aid), radio, alcohol-gel, scissor pouch containing tuffcuts, pen and mini-mag

Even when I go on walkies, I only do so with a small waist pouch containing the most simple major emergency aid bits and pieces.

Nouse-ance

2007-11-04T23:16:00.000+01:00

I hate it when St John Ambulance gets bad publicity, especially when the Press gets it wrong, and makes the organisation look like a bunch of untrained idiots.

For example, take a look at the following News Article, which was published in the student newspaper, Nouse, which is produced for and by students at the University of York:

Two ambulances called amidst fears of Club D drink spiking repeat

In particular, there are 5 key parts of the article that I object to, which are:

Two ambulances were called to the event before 11pm by York Links, the student paramedics who provide first aid for campus events.

I only know one Student Paramedic, and she is 300-odd miles away from me, and I'm missing her dearly currently!

York LINKS members', as with any St John Ambulance unit, are not Paramedics, nor even Paramedics-in-training!* Members are fully trained to provide First Aid; Care or even Ambulance Aid to others. We're not as highly skilled as a Paramedic, but we're not "in training"**.

Reports that the students taken from the event had their drinks spiked remain unconfirmed, as blood test results are confidential and not released to JCRs or college staff.

Maybe I'm reading too much between the lines on this one, but it sounds like the author is a bit annoyed that people's private blood test results aren't made available to other people?! Heaven forbid that these people have any sort of privacy!

Confusion over the number and identities of students hospitalised has arisen as a result of York Links’ policy of keeping confidential the circumstances in which they call for ambulance support.

Derwent Welfare Rep Charlie Leyland said that the policy led to a dangerous breakdown in communication between emergency services and student welfare.

Of course St John Ambulance keep patient details confidential! It's called "Patient Confidentiality", and any medically trained person will tell you how important a concept it is.

As for a breakdown in communication between Emergency Services and Student Welfare, what are you talking about? We, like the Ambulance Service and the University Health Centre are not answerable to Student Welfare. We don't report to them. End of story. Expecting us to report all of our patients to Student Welfare would be as illogical as expecting the Yorkshire Ambulance Service to declare every time they pick up somebody from town who's conveyed to Hospital!

As for a breakdown in communication, I don't know where this comment has come from. On the night, York LINKS' members were in touch with the Responsible Person for the event, with the event's Door Security and YAS's Emergency Operations Centre. That's plenty enough people looking out for the Student's welfare!

In a statement, York Links’ defended the organisation’s policy saying, "The reason we don’t give out names and circumstances of patients is that we must comply with the Data Protection Act. The only way we can issue names is if the person treated signs a form releasing that information.

That's an incredibly verbose statement for a St John unit to give out! It's normally "We can't comment. Please take to County Headquarters."

And finally, the last point is that photo of some girl curled up around a toilet. I seriously hope that wasn't taken on the night of an actual person being sick, as that's kind of wrong!

However, I do not speak on behalf of the unit, nor of the organisation (as usual). It's just very annoying to hear the good name of St John sullied so.

* With a few exceptions.
** Although, with anything like this, you're constantly seeing new things and learning as you go. Same for Paramedics, Doctors, Nurses, etc.

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2007-10-22T21:33:00.000+01:00

definition of role of "patient transport attendant", from Live Search:

As a PTA, you will be responsible for the transport of patients who are not in need of emergency care. If you take a look on the St John Ambulance Members' website, you'll find in the Member's Handbook that your role is described as:

Members undertaking this role may expect to receive requests to transport people who are not expected to require emergency treatment during the journey. However, the nature of their condition is likely to mean that you may have to provide care to them during transport. The individual should be assessed prior to undertaking the request for transport and if appropriate a more qualified person may also be needed.

There's also a massive list of things that you'll need to know.

"Snip, Snip, Snip, Snip"

2007-10-09T01:41:00.000+01:00

The most recent post on Tom Reynolds' blog (entitled "Snip, Snip, Snip, Snip") reminded me of a post I wrote at the start of this year, entitled (creatively maybe...) "Picture the scene...".

Reading back over it now, I noticed that I never once described the actual job in that post! (Whoops! )

It was a two car Road Traffic Collision (RTC) on a busy intersection. In it, they had clipped one another and one had ended up nose first into a brick wall.

When I arrived on scene, there were only two Fire Engines, a Police Car and a Paramedic FRU (Fast Response Unit). Ambulances were on route, but had still not arrived.

Both of the backseat passengers were evacuated without visible injury, and were ear-marked to go to Hospital in a High Dependency Unit. Both front-seat passengers were fully conscious but with neck injuries, and Fire Fighters were holding both patient's necks in neutral alignment.

My first job, as directed to do so by the Paramedic in charge, was to look after both of the backseat passengers, who were now sat in one of the Fire Engines, until their ride turned up. I had no actual work to do, except for talk to them and make sure they were fit and healthy.

Meanwhile, the Fire Service were doing exactly what they enjoy the most. They put a couple of big wedges under the car and the wheels to stop it moving; sliced and diced the windshield and then took a giant can-opener to the roof of the car. Within an incredibly short space of time, the entire roof was lifted clear. It looked so odd seeing the roof sat on the floor after that. It looked like the car had sank into the Tarmac itself!

I'd never done it before, not even in a practise scenario! Within a short space of time we had slid both patients out of the car onto Spinal Boards, and had they carted away to Hospital. All of the Ambulance Personnel on scene seemed to appreciate my assistance, and they trusted me to help out without too many prompts. Even better, the Paramedic in charge promised that he'd fill in a Letter of Commendation, but sadly, it's never appeared.*

Overall, it was such a great learning experience, and also, such fun. Unless we're working with the Fire Service, St John very rarely get to cut cars open in the aid of training!

*Although in hindsight, I don't think I want one to be honest. I don't do what I do with St John just so that I can feel good about myself. Yes, it's nice to receive praise, but it's not why I do it. And hopefully never will be.

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2007-10-07T17:55:00.000+01:00

flash thunder "band of brothers", from www.google.com:

Challenge: Flash
Reply: Thunder

Flash and Thunder were the challenge and reply used by the Allied Army in the first 24 hours after D-Day. After that point, the passcodes were changed every three days:

D+1 to D+3 = "Thirsty - Victory";
D+4 to D+6 = "Weapon - Throat";
D+7 to D+9 = "Wool - Rabbit".

These are taken from Mark Bando's very knowledge website, as referred to on this page.

Also, please note that the use of passcodes in a lot of very popular Hollywood depictions are wrong, including Band of Brothers and Saving Private Ryan.

Sexual Consent

2007-10-06T22:53:00.000+01:00

I was sent the link to this a while back on Facebook, and I came across it again today. Still made me laugh, possibly even more so than originally!

Oh, and I should warn you, it's clean!

"The Boys' Crusade" by Paul Fussell

2007-10-06T13:21:00.000+01:00

This incredibly short book (just 160 pages, and largish print!) tells the story of the American GI in Europe. This is no fairy-tale version of the war - the author portrays in vivid detail the hardship that troops in the ETO experienced. The horrors of friendly-fire, of men driven to cause self-inflicted wounds, of desertion, of desperate combat, and of troops so green that they weren't even shaving when they went to war.

However, I don't think there is anything new in this book. It's a story thats been told time and time again; the only thing that is new are the personal accounts being used. What is refreshing is that Paul Fussell served in ETO - many authors writing about the war do not have their own personal experiences to build upon.

Paul is a good author, but would I recommend this book? If you don't know anything about the war, then maybe. Otherwise, no, not really.

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2007-10-02T12:19:00.000+01:00

Lancastria film to be made, from live.com:

Although uncovered by the British journalist Jonathan Fenby, and brought to life in the book, "The Sinking of the Lancastria", ISBN: 0-7434-8943-8 (previously reviewed here), the sinking of HMT Lancastria is a largely unknown chapter in history for the British public. Both the Titanic and the Lusitania tragedies are better known, even though fewer lives were lost in them.

As such, the chances for a feature film being produced about the disaster is very unlikely. However, a documentary has already been produced on the topic by the French film maker Christophe Francois!

The premiere of the film was in April 2004 at the main cinema in St. Nazaire. A day later, the documentary was broadcast. In August 2004, it beat 100 other entries and won "Best Maritime Film of the Year" at the International Documentary Film Awards in Toulon.

In total, the documentary has been broadcast in 85 different countries. However, no UK broadcaster has ever picked it up, with the BBC, ITV and Channel 4 all having turned it down. This is incredibly disappointing, as you can imagine.

For more information, view the following page:

http://www.lancastria.org.uk/General_Info/Film_Review/film_review.html

"Dunkirk: Fight to the Last Man" by Hugh Sebag-Montefiore

2007-10-01T11:14:00.000+01:00

Firstly, I just want to say “Wow!” This book was clearly a labour of love for Hugh, and I hate to think how long it took him to write. It’s a monumental achievement!

It uses a lot of firsthand accounts to tell the story of what happened in those early years of the War, and is very, very interesting. The book stands as a memorial to all those who fought, won and lost.

The tale it tells is very personal, with the narrative frequently returning to the human cost. It’s of the heroism shown by ill-equipped men sent to fight in a country they had no personal interest in, purely for the sake of politics. And as always, it was the British Tommy who paid the butcher’s bill.

All too often the British people refer to the ‘Miracle’ of Dunkirk, as Churchill wanted it to be known, and it was clearly Hugh’s intention to dispel some of the myths associated with it. The success of the operation was not always so obvious!

But that doesn’t mean that it’s not without some drawbacks.

The title itself suggests that it’s the story of Dunkirk. For most people, myself included, this means the fight on the beaches, of the “little boats” who came to the rescue, of the problems embarking troops under heavy fire. But this side of the story is rapidly glossed over. It spends a lot longer focusing on the men fighting rearguard actions. Their stories should never be forgotten, as they are the true heroes of Dunkirk, but the evacuation should still have been covered in more detail.

At first, there is an even balance of firsthand accounts from French, Belgian and British sources, but towards the end, there are only British testimonies used. For example, the failing of the alliance is largely pinned on the French, but were they solely to blame? Hugh does try to give an unbiased view point, but there are still too few foreign sources included.

At Dunkirk, 288'00 soldiers were evacuated (according to Hugh). However, a further 191'000 were later evacuated, even though this book rapidly glosses over the operations involved to save them!

Nevertheless, who I recommend this? I would, but it’s not really designed as a casual read. You either have to be serious about learning more (as I was due to having a personal interest in the events leading up to Dunkirk), or a professional historian. It was a superb documentary, with excellent supporting notes, bibliography and maps.

Chain Mail

2007-09-26T14:48:00.000+01:00

I hate receiving chain mail, but I must admit that I found the following remarkably funny:

My thanks to all those who have sent me emails this past year...

I must send my thanks to whoever sent me the one about rat poo in the glue on envelopes because I now have to use a wet towel with every envelope that needs sealing.

Also, now I have to scrub the top of every can I open for the same reason.

I no longer have any savings because I gave it to a sick girl (Penny Brown) who is about to die in the hospital for the 1,387,258th time.

I no longer have any money at all, but that will change once I receive the £15,000 that Bill Gates/Microsoft and AOL are sending me for participating in their special e-mail program.

I no longer worry about my soul because I have 363,214 angels looking out for me, and St. Theresa's novena has granted my every wish.

I no longer eat at KFC because their chickens are actually horrible mutant freaks with no eyes or feathers.

I no longer use cancer-causing deodorants even though I smell like a water buffalo on a hot day.

Thanks to you, I have learned that my prayers only get answered if I forward an e-mail to seven of my friends and make a wish within five minutes.

Because of your concern I no longer drink Coca Cola because it can remove toilet stains.

I no longer can buy petrol without taking a man along to watch the car so a serial killer won't crawl in my back seat when I'm filling up.

I no longer go to shopping malls because someone will drug me with a perfume sample and rob me.

I no longer answer the phone because someone will ask me to dial a number for which I will get a phone bill with calls to Jamaica, Uganda, Singapore and Uzbekistan

Thanks to you, I can't use anyone's toilet but mine because a big brown African spider is lurking under the seat to cause me instant death when it bites my bum.

And thanks to your great advice, I can't even pick up the £5.00 I found dropped in the car park because it probably was placed there by a sex molester waiting underneath my car to grab my leg.

If you don't send this e-mail to at least 144,000 people in the next 70 minutes, a large dove with diarrhoea will land on your head at 5:00pm this afternoon and the fleas from 12 camels will infest your back, causing you to grow a hairy hump. I know this will occur because it actually happened to a friend of my next door neighbour's
ex-mother-in-law's second husband's cousin's beautician.

Have a wonderful day!

By the way....A South American scientist from Argentina, after a lengthy study, has discovered that people with insufficient brain and sexual activity read their e-mail with their hand on the mouse.

( Don't bother taking it off now, it's too late... )

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2007-09-10T12:15:00.000+01:00

st john's ambulance bad reputation, from CNN.com:

Sadly, St John Ambulance does have an incredibly poor reputation with certain people. It was only yesterday that I was talking to one of the Paramedics in the organisation, and we were having a joke about how some Doctors' perception of the organisation is incredibly out-dated.

In the past, we've been referred to by names such as "The Pad and Bandage Bridage", which was an indication of the limited treatment methods available to our members. Since then, our training and equipment have been updated to bring us more in line with the Statutory Ambulance Services within the UK. Of course, we're not as good as the "Pro's", but our members are still very, very good, and a far cry from the members of yester-year.

The vehicles that we've used up until recently have been a mish-mash of various models. It's been largely up to individual divisions to decide what Ambulance they buy, and what livery is applied to them. A few years back, a new "standardised" fleet of Ambulances was introduced, and this has been a resounding success. Wherever you get a gathering of St John vehicles from different counties you now have consistency. Most of the vehicles look uniform - they look like they all belong to the same organisation. Further more, the vehicles themselves look smart. If well maintained, which most of them are, they look good. And due to the limited number of miles that they generally do each year, they don't get the heavy beating that Ambulance Service vehicles get, and hence, the paintwork, etc doesn't get so scratched or faded. Generally, they look good!

Further, our uniforms are evolving. Traditionally, we've worn "Black and Whites". Black trousers with a white shirt with various black badges sawn on. For most operational work, this is changing. We're now wearing "Greens" - similar to the ones that they wear in Casualty, etc. This marks us out that more readily as being medically trained. Our old uniforms unfortunately make us look like either the Police Service, or Traffic Wardens. Plus, the newer uniforms are a lot more comfortable.

Some of the bad reputation comes from when we (St John Ambulance) were labelled as Scabs back in the 80's. I've written about this before, so if you want more information, read this post: Scabs.

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2007-09-08T21:18:00.000+01:00

People sometimes find blogs by the wierdest things possible. For example, Tom Reynolds' Random Acts of the Reality (about an Ambulance Technician based in London) is the number one search result for "Womble porn".

Mine doesn't seem to appear in people's wierd search topics though. Until today...

the best kiss of my life cpr, from Google.com:

Firstly, can I please point out, when doing CPR, you should not be attempting to kiss your patient! Not ever!

Secondly, erm....

"St John Ambulance staff"

2007-09-08T09:06:00.000+01:00

I'm in the news! Well, not by name or whatever, but I am credited as "St John Ambulance staff"!

Do you remember the post I made last Sunday entitled, "Yep, no problem."? And the patient that I mentioned that was airlifted? It appears that the BBC News Website got hold of the story somehow:

Elderly rider flown to hospital

An elderly woman who fell while horse riding at an event is in a critical condition in hospital.

The woman, who is aged about 70, fell while going over jumps at an event in Harmer Hill, near Shrewsbury, Shropshire, on Sunday morning.

She suffered a head injury and was treated by St John Ambulance staff at the scene.

She was then flown by air ambulance to the University of North Staffordshire, in Stoke-on-Trent.

Source:
BBC News Website

Harry Potter 7

2007-09-07T10:19:00.000+01:00

OK, so a while ago I posted my predictions of what was going to happen in Harry Potter 7. If you want to read up on it, read it here. Lets look at how accurate I was!

SPOILER WARNING

Who is R.A.B?
I predicted: "I doubt it's Regulus." WRONG!

Although my concerns of how Regulus would have known about Voldemort's horocrux were very deftly answered by JK Rowling!

What part will Fleur play in it?
I predicted: "I wouldn't be surprised if she's involved with bringing Voldemort down. And more than just to dab Bill's battle scars." WRONG!

Erm, she didn't really have that great a part in it. No more than any other of the supporting characters really.

I think the reason she was reintroduced in HP6 was for the Wedding setting, and was more a means of setting up a good environment for information passing. Oh, and it also gives Harry another safe haven.

Will Percy ever make up with his family?
I predicted: "I don't think so to be honest." WRONG!

A bit of a cop out at the end of the book, where he reappears and makes up with everybody all over again!

Why was Ollivander abducted, and not just killed outright?
I predicted: "I’m thinking he was taken alive because of his knowledge..." RIGHT!

Finally, got one right! Although it was a bit obvious really.

Will Dumbledore come back alive?

I predicted: "I don't think he should come back." RIGHT!

Dumbledore is included in the book with one noticeable appearance, but he never comes back alive. Hence, I claim that as a win! ;-)

Will Sirius come back from beyond the veil?

I predicted: "I've always suspected that Sirius might come back to be honest with you." WRONG!

Yeah, I was wrong. Sirius doesn't return unfortunately.

Will Ron and Hermione get together?

I predicted: "Yeah, I think they will do." RIGHT!

Need I say more?

Is Malfoy really bad?

I predicted: "To tell you the truth, I don't think that Malfoy is as bad as he sounds." RIGHT!

Throughout the book he stayed borderline. Definitely more on the side of bad, but he didnt seem to have the same evil malice in him that Voldermort's other Death Eaters had.

Is Snape really bad?

Unfortunately, I chickened out on posting a prediction on this one! But with regards to Snape's outcome in HP7, it's definitely a very interesting twist that I doubt many people could have predicted.

And to be honest, Snape's storyline was one of the most interesting in the book!

Complaints against the LAS

2007-09-04T12:22:00.000+01:00

Shamelessly going to link to Tom Reynolds' blog on this one. A couple of days ago, he posted a very amusing collection of complaints that the London Ambulance Service have received due to conduct of their crews, including:

Ambulance was parked in the middle of the road, when complainant asked for them to move it because his daughter had an exam and he was taking her to school, the female member of staff said she didn't care about the exam. Complainant finds this very rude.

Read his post here.