Ask a Paramedic anything at all...

[ashleyman]

Do you use ‘ambulance slang’ on the job or is it just a myth?

Stuff like purple plus etc...

[James2593]

numtumfutunch said:

Thanks for the thread

Having recently been caught in the position where I was sitting at a red light with an ambulance coming up behind with lights and sirens on how many and what percentage of your call outs are really so urgent that 30 seconds would make a real difference?

Cheers

Ray, please correct me if i'm wrong, but, I understand that if not life changing/threatening then at red lights the ambulance will turn off the siren and sit back from the queue, they're on blue lights but in no rush. If it is life threatening and very time critical then they will be very forward with their intentions and be much more active in dodging traffic and street furniture to get through the junction. (I'm being careful not to use the word forceful, as that's the way I want to describe it, but it's not as aggressive as that).

If you look out for it you can see it. Ambulance on blues vary from miss daisy to 'do anything that is reasonably safe to get to a hospital asap'.


While i'm posting I do have a question, I often see ambulances on motorways on blues travelling at 65mph, which will leave at the next exit and drive at the speed limit and will sit at red lights until they go green. If there is no rush then why the blue lights? Turn them off and drive just the same with them off. Is there a requirement that if the job is done via 999 then even if it's a low priority then blue lights must be used?

[Ray Luxury-Yacht]

ashleyman said:

Do you use ‘ambulance slang’ on the job or is it just a myth?

Stuff like purple plus etc...

I am lead to believe that this kind of thing DID go on a number of years ago - not just on ambulances but in hospitals......things like 'NFN' meaning normal for norfolk, right?! I have heard the stories, yes!

However I have to say - since I joined at least - this is a total no-no! Patients have the right to access any paperwork we write as well anyway, not to mention that it's completely unprofessional!

[anonymous-user]

James2593 said:

I often see ambulances on motorways on blues travelling at 65mph, which will leave at the next exit and drive at the speed limit and will sit at red lights until they go green. If there is no rush then why the blue lights? Turn them off and drive just the same with them off. Is there a requirement that if the job is done via 999 then even if it's a low priority then blue lights must be used?

Like any emergency service, the blue lights and sirens are just one aspect of emergency driving of an ambulance, and are used entirely at the driver's own discretion but under very clear guidelines.
There's nothing to say a vehicle going to an emergency must use blues but if involved in an incident en route it would take a serious bit of justifying as to why the full array of warning equipment wasn't being used. Arriving at a mental health call is one possible but rare example, where the blues and sirens could be deemed to be feeding a patient's condition, say if they're a known attention-seeker.
Similarly, having the lights on doesn't in itself exempt the driver from anything (dangerous driving most notably) so if a driver feels that, regardless of the nature of the call, the risk to his own vehicle or other road users is too great he or she can choose not to exercise an exemption, hence there may be times you'll see an ambulance on blues stopping for red traffic lights. We also have to stop for the red lights at level crossings, fire stations and airports, even if on blues.
In London, we specifically hold back at blocked junctions with the siren off as there are so many red light cameras, and that way it also doesn't pressure people in to creeping forward in to moving traffic (for which they'd be entirely liable regardless of the presence of the ambulance).
And driving style does change with the grade of call, deliberately or otherwise.
The last serious trauma I attended was a cardiac arrest following a bike v car RTC.
There was more than a hint of burnt brake linings upon our arrival.

Edited by anonymous-user on Thursday 4th January 06:28

[BRISTOL86]

I’m stuck in a career that absolutely bores me to tears (accountancy) and I’m genuinely interested in becoming a Paramedic.

At age 31 and no previous experience or knowledge in medical work, is this a non starter, or are there accessible routes in for those of my age?

[anonymous-user]

As RLY mentioned earlier there are a number of routes to Paramedic.
The most obvious is a three year Uni course but this isn't everyone's cup of tea and not everyone can afford it in terms of both time and cost.
Other routes include starting as an Emergency Care Assistant with a Trust (read: ambulance service) and work up, the advantage being you can usually progress to paramedic on some form of on-the-job course so you're getting paid as you study/train. The down side is it will invariably take longer.
There is a new entry-level qualification of Associate Ambulance Practitioner which is/was meant to standardise Ambulance Technician training and employment in much the same way that Paramedic is. The AAP qualifications counts towards a Paramedic degree too.
Thing is, a lot of Trusts are so bloody busy the new qual was thrust upon them without much notice or prep, so the course is a complete mess with the tutors not really knowing what they're meant to be delivering, and just fudging it using the old Emergency Care Assistant framework (which is significantly less academic) on the basis both are the entry point for eventual onward progress to Paramedic....or at least that's the case in London but then I'm lead to believe the LAS never really did place much emphasis on structured training and relied on an on-the-job approach to education.
Entry requirements vary from Trust to Trust but common elements include a clean license with a C1 (3500kgs+) qualification on it, good maths, English and a relevant science, and ideally some kind of previous medical experience, even if it was a First Aid badge in the Cubs.
Best bet would be to contact your local Trust and see what courses they offer, request a ride-out to see what the job really entails, and enquire as to volunteer posts as a First Responder which will stand you in good stead for a full time career in emergency medicine.

[BRISTOL86]

Thanks, that’s really helpful.

[HTP99]

Interesting thread as I applied to become an Ambulance technician about 20 years ago with a view to progressing to Paramedic.

I got as far as the medical (which I passed) and they then changed the way they recruited, you had to start off doing PTS (Patient Transport Service), do that for a minimum of 2 years and then apply to the Ambulance service, the money was awful so I had to knock it on the head.

[ikarl]

Ray Luxury-Yacht said:

From trauma jobs at RTC's to the elderly and everything in between - I rationalise that the poor person at that time in their life has suffered an event which was life-threatening. I've arrived after that fact, and all I have is my skills and my ambulance and equipment. I do everything I can to give them the best chance of survival, but it is only what I can do physically as a human being - I'm not God after all and have no delusions as such!

Hence, if after my interventions they still die, then that is that - they were unfortunate enough to have had to face that today. I'm quite pragmatic in that respect.

I was getting bored and slightly annoyed with all the "Ask a xxxxx anything..." threads, but this one piqued my interest

The post I've quoted above genuinely made me stop and want to tell you, and the other paramedics on this thread, that I'm massively grateful for the work you do and the manner in which you do it. Thank you.

[paul_y3k]

We've been watching a few of the Ambulance tv shows as well and have found them in the whole very interesting.
However one thing we dont understand is that on a lot of the jobs featured, the dispatchers are sending multiple ambulances when there is seemingly only need for the one (one person in trouble). The shows then go on to show other cases that are waiting for a free ambulance ..

if thats the case why do they send multiples ? I'm sure it's necessary but they never say why ?

[ashleyman]

Ray Luxury-Yacht said:

ashleyman said:

Do you use ‘ambulance slang’ on the job or is it just a myth?

Stuff like purple plus etc...

I am lead to believe that this kind of thing DID go on a number of years ago - not just on ambulances but in hospitals......things like 'NFN' meaning normal for norfolk, right?! I have heard the stories, yes!

However I have to say - since I joined at least - this is a total no-no! Patients have the right to access any paperwork we write as well anyway, not to mention that it's completely unprofessional!

Thank you. It's probably his way of trying to be cool.

I get a regular inside look at the life of a paramedic from the father in law and I have a friend who's a retired paramedic (PTSD) so I appreciate the stress and struggles you go through. As others have said, thank you for all you do.

[Tim16V]

Out of all the cases you attend, roughly what percentage do you think are alcohol related?

[Ruskie]

paul_y3k said:

We've been watching a few of the Ambulance tv shows as well and have found them in the whole very interesting.
However one thing we dont understand is that on a lot of the jobs featured, the dispatchers are sending multiple ambulances when there is seemingly only need for the one (one person in trouble). The shows then go on to show other cases that are waiting for a free ambulance ..

if thats the case why do they send multiples ? I'm sure it's necessary but they never say why ?

Each area is different but cardiac arrests elicit a multiple vehicle response. Often an RRV, Ambulance and an RRV are designated for cardiac arrests.

Also high risk jobs may get a junior management response. Theses include things such as hangings, paed arrests, stabbings, shootings and multi casualty incidents.

[anonymous-user]

paul_y3k said:

one thing we dont understand is that on a lot of the jobs featured, the dispatchers are sending multiple ambulances when there is seemingly only need for the one (one person in trouble).
......
if thats the case why do they send multiples ? I'm sure it's necessary but they never say why ?

Thing is, that's not really the case.
For the vast majority of callers, one ambulance crew of two or even a solo-crewed car or bike is sufficient.
But take a full cardiac arrest for example and it needs more people.
CPR alone is a two person job to be really effective and has to go on constantly, and I mean non-stop, all the while everything else is being done which then includes:
Assessing the patient as to the cause of the arrest, the effectiveness of the CPR and so on.
Preparing any drugs or other treatments, and gaining IV access.
Prepping the equipment to move the patient on to hospital once they're stable, and planning an extrication route from where they've collapsed to where the ambulance might be parked (often the most challenging phase)
Document/double check what's going on so nothing gets missed/duplicated.
Liaise with plod or Trumpton if required.
Manage the family.

All of that happens simultaneously and although two people could probably just about tick all the boxes it would be very slow, very demanding and not very efficient.
Additionally, with complicated cases like an arrest, they are actually pretty rare for a lot of crews, so it's always prudent to have extra hands on scene simply to consult and discuss, to reduce the likelihood of errors or omissions.

For the bloke who came off his Speed Triple that I mentioned above there were:
A HEMS crew
Three motorcycle responders
Two single-crewed cars
An off-duty non-emergency ambulance
A standard front line ambulance
(Plus about twenty police to manage the road closures.)

Twelve people for a guy who'd suffered high-energy mechanical injury, a serious head injury, active haemorrhaging and subsequent cardiac arrest.
It's not really any less than would be round the bed in a hospital given the seriousness of his condition.

[anonymous-user]

Tim16V said:

Out of all the cases you attend, roughly what percentage do you think are alcohol related?

Depends how you define "related"
Someone who's simply pissed after a night out or a non-functioning alcoholic who's lost all sense of self, has stopped eating, washing and even using the toilet like a "normal" person?

I've no idea of actual percentages but in London, it's at least one clear cut case per shift, with plenty of others where drink plays a part somehow but either isn't obvious nor too concerning at the time.

[geeks]

Have had to call you guys out a number of times over the years (thankfully never for myself) and I have to say that always you are professional, patient and a god send. So thank you for doing what you do, you are invaluable and worth every penny of the taxpayers pound!

Do you have to stifle the giggles from patients who say silly things once the good drugs have been administered? For example, wife had to be given gas and air and then was fed some morphine too for good measure (suspected ruptured ovarian cyst that actually ended up being sepsis from a tear in her womb, I was calm for her externally but it was terrifying and the doctors were having that "you might wanna call her family" discussion with me!!) anyway once drugged up and in the corridor with the paramedics waiting for hand over she was hilarious, from telling the paramedic his head was very shiny, to panicking because she hadn't washed her hair before leaving the house to flirting with her male nurse (who in her defence was the spitting image of Enrique Iglesias)

[Ruskie]

geeks said:

Have had to call you guys out a number of times over the years (thankfully never for myself) and I have to say that always you are professional, patient and a god send. So thank you for doing what you do, you are invaluable and worth every penny of the taxpayers pound!

Do you have to stifle the giggles from patients who say silly things once the good drugs have been administered? For example, wife had to be given gas and air and then was fed some morphine too for good measure (suspected ruptured ovarian cyst that actually ended up being sepsis from a tear in her womb, I was calm for her externally but it was terrifying and the doctors were having that "you might wanna call her family" discussion with me!!) anyway once drugged up and in the corridor with the paramedics waiting for hand over she was hilarious, from telling the paramedic his head was very shiny, to panicking because she hadn't washed her hair before leaving the house to flirting with her male nurse (who in her defence was the spitting image of Enrique Iglesias)

Humour is always an important thing but the timing is crucial. It can be a good ice breaker or used for building rapport.

Dementia is a cruel and horrible illness but the things those patients come out with can be hilarious. Plus often their long term memory is fine so you can have lucid conversations about their lives from decades ago.

[anonymous-user]

anonymous said:

[redacted]

In what capacity?
Patient, bystander/relative or (only on PH) driver?

[Ruskie]

anonymous said:

[redacted]

If you can either be alive or be dead for a few hours. It’s the inbetween bit that causes us issues.

[anonymous-user]

(on shift at the moment so I'll answer bit by bit...)

As a patient:
Basically, look after yourself. It sounds obvious but it's the single easiest thing that will have the biggest impact.
It's your body, you only get one and no one else is going to manage it for you over the long term.
If you feel ill, seek help and guidance and act early to prevent rather than wait until it needs a cure.
GPs, the 111 service, high street pharmacists...they all offer a service that can often sort a problem long before and faster than if it becomes a true emergency, if indeed it ever will.
Pharmacists are the most overlooked and underused resource going IMO. Phoning 999 won't add any priority to your case once your condition has been assessed, unless it transpires you do have a life-threatening condition, obviously. Going to hospital by ambulance doesn't jump the queue, it just doesn't.
Eat well, exercise, be happy.....all that good stuff.
It's not very PH but don't drink excessively, don't smoke excessively and never, ever touch illegal drugs, ever, no matter who they come from, what you think they are, how "safe" they've been in the past. Just. Don't.
It's Russian Roulette. No other way to describe it.
They'll fk you up in the end, physically, mentality, socially, financially....
Engage with your GP. That doesn't mean constantly phoning them, but at least know where they are and how to contact them, and if you are prescribed meds for something, take them as directed. Do not buy over the Internet.
If you do end up being assessed and treated by an ambulance crew, be patient ;-) and be honest. We've heard (almost) everything and it's all in confidence - asking lots of questions is a good sign as it means you're not being rushed off to hospital.
If you've taken anything, legal or not, if you're an alcoholic, if you have mental health issues, if you're HIV+, or anything else that might be relevant, then say so. Ladies....when asked if you could be pregnant, it really means "could you be?" in the clinical sense, not "Are you trying?" in the social sense.
The only time anything might get passed to the police is in cases where some form of abuse is suspected or evident, especially involving minors.
When it comes to trauma, it's more of a lottery....accidents happen. Try not to panic, follow what you're asked to do, and if you are worried.....tell the crew! Reassuring a patient or explaining what's going on is a key part of responding to an incident and a decent crew should be mindful of your anxiety.

Hope that helps. I'm sure there's more, and others will have other equally relevant ideas.