The shift started off quiet with no calls from Ambulance control until Saturday morning, meaning that I could get a decent night’s sleep. Of course, a lie in was out of the question as the phone rang at just before 0900 for a call to an elderly lady with a PR bleed. I headed off to the home – it’s a fairly decent place, but it’s more of a sheltered home than a nursing home offering full medical care. Apparently, the lady had been sent home from hospital the week before with a perforated bowel, though that seemed unlikely. Either way, she was in pain and so after only a few minutes of getting her details the crew arrived and she was rapidly taken out to the ambulance. I headed back for some breakfast and a cup of coffee.

Off into Caerphilly at lunchtime to meet an old friend. We managed a decent meal without interruption and I started thinking that I might even be able to get some DIY done today. Of course, on the way back from Asda I had a call, so seeing as I was 20 yards from the house I dropped Sean off, he grabbed the shopping and off I went. The call was for a 54 year old female who’d fallen and had a back and shoulder injury. I found the house OK and headed in – the husband pointed me upstairs where I found the lady bent double over the bed. She’d slipped while showering in the bath and fell backwards onto the taps. She was fairly comfortable so long as she maintained that position and just as I started getting some basic obs the crew turned up. They listened to her chest and suspecting a pneumothorax caused by a broken rib, we got her out to the ambulance quickly and she was blued into A&E.

On the back from that call, I had another, this one to a 98 year old female who’d fallen. Off I went across Caerphilly to find the lady had fallen coming out of the kitchen and had bruised her knees. I took some basic obs, reassured myself that she was ok – the walking around the house proved that. Control called to get an update while I was there which is unusual – they asked if I could clear and since there was a crew pulling up and I said yes. Things had suddenly kicked off with an RTC, a collapse, chest pains, several Difficulty In Breathing calls and a “?CVA – unresponsive”. So I got the CVA. When I got there, the “unresponsive” part was true – he was sitting up and breathing fine but wasn’t responding to us. The crew was coming down the road as I walked into the house, so I gave the chap some oxygen and let the daughter bring the crew up to speed. I assisted in getting him out to the truck and headed back to the car. There was an RRV on as well and I heard him heading off to another job as I packed the car up.

Hoping to go home to get a cuppa, I was still a mile away when the phone rang again – 41 year old female, ankle injury. Ok, no worries I said, where? The answer – “The burger van, Caerphilly Mountain.” “Excuse me?” I queried how far from the road she was and was told that the caller said that she was near the road. I asked to put Mountain Rescue on standby, just in case. I got there quickly – it’s an easy run from where I was and traffic was light – the rain however, wasn’t. I got to the top and there was no sign of anyone with a broken ankle. Back to control who called the reporter, asking me to keep a look out for a woman with a dog. Spotting her across the car park, I asked her for some details. Apparently the lady was some distance from the road. I headed back to the car – by now the rain was heavy and the sky gray – or was it the other way around? Either way, it was cold and wet and getting wetter. I called control back and asked them to arrange for Mountain Rescue – I’d need some backup on this one especially if she was any serious distance from the road. I slung a decent coat on, grabbed my MR kit and my Ambulance bag and off we went.

She was some 500m from the road on a muddy and slippery path. The ankle in question was swollen and slightly deformed and moving it was causing some pain, so I got my KISU tent out (naturally, it was the first thing I thought about this time) and insulated her from the ground. There were 3 other family members and her son, so I put them under the KISU tent too. Meanwhile, I had Mountain Rescue and Ambulance control to coordinate. The ambulance arrived and held at the RV which was the burger van. Police arrived soon after with 2 WPCs slipping and sliding their way up. Helimed – the air ambulance – was rejected due to the fact that the casualty was in trees and Gwent’s helicopter couldn’t fly in this weather. Rescue 169 was an option and after a discussion between myself and one of our MR Incident controller’s, was stood to and asked to make their way to us. The police were happy to leave things to us – the terrain wasn’t good and although they offered the fire service, we really needed MR. Our stretchers are designed to have people strapped into them instead of balanced on top and on this kind of terrain I wasn’t happy with anything else. I had a few conversations people and I think it did show a little of the fact that people aren’t that aware of our capabilities as mountain rescue.

Pretty soon we had plenty of people there and with a blast of entonox, we packaged the lady’s ankle in a vacuum splint and stretchered her off. The team had assessed the path on the way in and stood down 169. Within half an hour she was in the back of the ambulance on the way to Cardiff. I called Ambulance control and advised them that I was going off-service for a while – I had to follow the vacuum splint to Cardiff to retrieve it and then head home to get changed out of my soaking wet clothes. I had a thanks from control and from the police Sargent whom I’ve now seen on a few incidents in the area. I had a chance to chat with the lady in A&E and found that she had indeed fractured her fibula right on the ankle. I wished her well and picking up the splint headed home for chips and a shower and some dry clothes. Despite going back on service the rest of the night was nice and quiet as was the rest of the weekend – I’ve even managed to (finally) finish painting the bathroom.

How was your weekend?

Tonight was agaKin out with the ambulance service – something I’m really enjoying though it is frustrating at times. It’s frustrating because the knowledge that I have in terms of diagnosing and treating some conditions through mountain rescue could be applied here – giving Hypostop to diabetic patients having a hypo; giving Entonox to patients suffering from painful trauma; giving aspirin to a patient suffering from a possible heart attack - just three examples where we could make even more of a difference to the community.

Take the last few calls for example. We had a two hour battle with a lovely old guy who was having a very bad hypo – only the second of his life and he’d had diabetes for some 20 years. When we turned up, the wife was able to take a blood glucose measurement for us and between us we managed to get him to take some sugar and some jam. We can’t perform blood glucose measurements ourselves and we don’t carry Hypostop (actually I do for mountain rescue but can’t use it for ambulance service calls). I’ve had a call to an elderly lady who fell – a “nan down”. She’d broken her femur, that much was obvious from the swelling and deformity, but she might also have done some damage to her knee. I had no analgesia – we don’t carry Entonox – and so I could do nothing for her other than monitor her and keep her company. The last 20 minutes of the hour-and-a-bit I spent with here were very worrying – she was starting to deteriorate and I had nothing I could do or give her to treat her. If the crew hadn’t arrived as I was getting my phone out, I would have been on the phone to control to ask for an RRV to back me up – I was concerned at that point about her slipping into hypovolaemic shock. Finally, a few weeks ago, I saw a gent who was complaining of classic heart attack symptoms, and all we could do was watch and wait. I did call for an RRV on that one because I was worried, possibly not necessary, but I’d rather be dragging an ambulance officer out of bed to come and slap on a 12-lead ECG for nothing than having my patient die.

So a frustrating time at the moment. If the ambulance service insist on sending us to these calls where we are currently achieving nothing but stopping the clock, then at least give us that tiny bit more in terms of skills and equipment that could make such a huge difference to someone’s life.

It’s quiet at the nursing home. We’re led to a room somewhere in the building- the place is a rabbit warren. “She’s very violent.” someone says. Joy. I head in and start talking to her. She looks confused and doesn’t register my questions. I’m just starting to gather the details when the crew arrive. Her right leg is obviously shorter than the left and rotated outwards – classic symptoms of a broken femur.

While we’re helping, the phone rings. It’s control – are we available? We take the details of another call - 6 year old child with breathing difficulties.

I’m more awake for this one and head across town. I get there as the ambulance is pulling up and jump out to assist. When we get inside it’s painfully obvious that this poor boy is having a severe asthma attack. The crew get some Salbutamol going with a nebuliser mask with oxygen. His respiratory rate is at 32 breaths per minute, and his oxygen saturation is down to 83% – both indicators that this kid is very ill. Packing their kit up quickly, the boy is swept up into the arms of a paramedic and taken out to the ambulance. Minutes later, we watch as the ambulance heads off to hospital, blue lights flashing.

I head back to my car and toddle off home, knowing that by the morning, these calls will seem like dreams to me. I just hope I get a decent lie in after this.