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	<title>Hypoxic witterings &#187; shift</title>
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	<description>Do mountains need rescuing that often?</description>
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		<title>You wait ages for one and then a whole bunch come along at once!</title>
		<link>http://www.thinknuts.net/2008/05/21/you-wait-ages-for-one-and-then-a-whole-bunch-come-along-at-once/</link>
		<comments>http://www.thinknuts.net/2008/05/21/you-wait-ages-for-one-and-then-a-whole-bunch-come-along-at-once/#comments</comments>
		<pubDate>Wed, 21 May 2008 05:13:34 +0000</pubDate>
		<dc:creator>Aled</dc:creator>
				<category><![CDATA[Callout]]></category>
		<category><![CDATA[First responder]]></category>
		<category><![CDATA[Mountain Rescue]]></category>
		<category><![CDATA[mountain]]></category>
		<category><![CDATA[sean]]></category>
		<category><![CDATA[Aberystwyth]]></category>
		<category><![CDATA[Ambulance]]></category>
		<category><![CDATA[Brecon team]]></category>
		<category><![CDATA[diesel]]></category>
		<category><![CDATA[exercise]]></category>
		<category><![CDATA[food]]></category>
		<category><![CDATA[Greek restaurant]]></category>
		<category><![CDATA[hanglider]]></category>
		<category><![CDATA[ice cream]]></category>
		<category><![CDATA[rescue]]></category>
		<category><![CDATA[reservoir]]></category>
		<category><![CDATA[search]]></category>
		<category><![CDATA[shift]]></category>
		<category><![CDATA[Storey Arms]]></category>
		<category><![CDATA[waterfalls]]></category>
		<category><![CDATA[Ystradfellte]]></category>

		<guid isPermaLink="false">http://www.thinknuts.net/2008/05/21/you-wait-ages-for-one-and-then-a-whole-bunch-come-along-at-once/</guid>
		<description><![CDATA[The past few weeks have been mostly unbroken by shrill beeping of the pager with the exception of the regular Thursday night tests. That is, until Saturday. And it&#8217;s been a bizarre series of callouts.
After doing my Ambulance shift on Saturday, I headed up to Aberystwyth. Sean and I headed out to a Greek restaurant [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.flickr.com/photos/aledt/2510440061/" target="_blank"></a>The past few weeks have been mostly unbroken by shrill beeping of the pager with the exception of the regular Thursday night tests. That is, until Saturday. And it&#8217;s been a bizarre series of callouts.</p>
<p>After doing my Ambulance shift on Saturday, I headed up to Aberystwyth. Sean and I headed out to a <a href="http://www.qype.co.uk/place/58224-The-Olive-Branch-Aberystwyth" target="_blank">Greek restaurant in town</a>, where I think I surprised the waitress by actually knowing what I was ordering and pronouncing it fairly accurately too. It was a cracking meal and as Sean and I were relaxing in his room later on, the pager went off for the first time in a while. This one was for a search in Penarth for a missing elderly gentleman. Weighing up the options, I decided to not attend &#8211; it would be a 100-mile journey to base, 2 hours minimum. Not really worth it &#8211; a decision that&#8217;s becoming harder to make with rising fuel prices, since I have to pay for my own diesel for going to callouts.</p>
<p>The search continued into the early hours when it was stood down &#8211; the team had an ex on Sunday which was supposed to go ahead until the pager went off again at 1000 &#8211; a continuation of the previous nights&#8217; callout. Whilst my colleagues were scouring scrubland in South Wales, I was eating ice cream and relaxing on the beach in Mid Wales (sorry guys!). The afternoon peace was broken by another pager message &#8211; this time for an area call in the waterfalls which finished fairly quickly. With the afternoon dying away, the search was finally stood down and I enjoyed a peaceful night.</p>
<p><a href="http://www.flickr.com/photos/aledt/2510440061/"><img height="375" alt="Sunset on North Beach" src="http://static.flickr.com/3289/2510440061_7a010241b6.jpg" width="500" /></a></p>
<p>Until last night when, as I was pulling away from Tesco&#8217;s, the pager went off. I headed up to base, vaguely concerned about my frozen pizza in the boot. Once there, I found that we had a sighting of a flare in or around the <a href="http://www.streetmap.co.uk/streetmap.dll?G2M?X=294709&amp;Y=218088&amp;A=Y&amp;Z=3" target="_blank">Ystradfellte Reservoir</a> and so we headed up to Storey Arms to meet the Brecon team. With people approaching the valley from all directions, it wasn&#8217;t long before we stumbled across some people who had been setting off flares for no good reason and should have known better. I can&#8217;t go into detail, but suffice to say, they&#8217;re probably not having a good day today.</p>
<p>As I was about to pull out of the layby after packing up, the pager went off again, this time for a possible downed hanglider north of Cardiff. By the time I got to base, we&#8217;d been stood down since no actual evidence of the crash had been found. We packed up and headed home where, at 2300, I finally managed to cook my now-deformed and defrosted pizza. I finally collapsed into bed around 0100 and fell deep asleep&#8230;</p>
<p>&#8230;until about 0145 when the pager woke me &#8211; search for a misper in Porth. With feet of lead, I dragged my reluctant self downstairs and headed off to base again. Not much to say about this one, there wasn&#8217;t a huge amount of information, it was a horrendously shitty area to search and he was found outside of our search area. By the time I&#8217;d packed up the vehicle in base and reached home it was 0600 and I managed a few hours&#8217; sleep before I had to get up for work.</p>
<p>I just hope that this isn&#8217;t the trend for the week.</p>
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		<title>Rescue at 900 feet!</title>
		<link>http://www.thinknuts.net/2008/03/30/rescue-at-900-feet/</link>
		<comments>http://www.thinknuts.net/2008/03/30/rescue-at-900-feet/#comments</comments>
		<pubDate>Sun, 30 Mar 2008 17:38:34 +0000</pubDate>
		<dc:creator>Aled</dc:creator>
				<category><![CDATA[Callout]]></category>
		<category><![CDATA[First responder]]></category>
		<category><![CDATA[Mountain Rescue]]></category>
		<category><![CDATA[medical]]></category>
		<category><![CDATA[mountain]]></category>
		<category><![CDATA[169]]></category>
		<category><![CDATA[Ambulance]]></category>
		<category><![CDATA[ankle]]></category>
		<category><![CDATA[bleed]]></category>
		<category><![CDATA[broken]]></category>
		<category><![CDATA[Caerphilly]]></category>
		<category><![CDATA[CVA]]></category>
		<category><![CDATA[entonox]]></category>
		<category><![CDATA[First Responders]]></category>
		<category><![CDATA[nan down]]></category>
		<category><![CDATA[pneumothorax]]></category>
		<category><![CDATA[police]]></category>
		<category><![CDATA[rescue]]></category>
		<category><![CDATA[shift]]></category>
		<category><![CDATA[splint]]></category>

		<guid isPermaLink="false">http://www.thinknuts.net/2008/03/30/rescue-at-900-feet/</guid>
		<description><![CDATA[Ok, so it&#8217;s not that impressive, but it was a busy shift today. 4 calls, one mountain rescue callout.
The shift started off quiet with no calls from Ambulance control until Saturday morning, meaning that I could get a decent night&#8217;s sleep. Of course,&#160;a lie in was out of the question as the phone rang at [...]]]></description>
			<content:encoded><![CDATA[<p>Ok, so it&#8217;s not that impressive, but it was a busy shift today. 4 calls, one mountain rescue callout.</p>
<p>The shift started off quiet with no calls from Ambulance control until Saturday morning, meaning that I could get a decent night&#8217;s sleep. Of course,&nbsp;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 <a href="http://www.wrongdiagnosis.com/medical/pr_bleeding.htm" target="_blank">PR bleed</a>. I headed off to the home &#8211; it&#8217;s a fairly decent place, but it&#8217;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 <a href="http://en.wikipedia.org/wiki/Bowel_perforation" target="_blank">perforated bowel</a>, though that seemed unlikely. Either way, she was in pain and so after only&nbsp;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.</p>
<p>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&#8217;d fallen and had a back and shoulder injury. I found the house OK and headed in &#8211; the husband pointed me upstairs where I found the lady bent double over the bed. She&#8217;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 <a href="http://en.wikipedia.org/wiki/Pneumothorax" target="_blank">pneumothorax</a> caused by a broken rib, we got her out to the ambulance quickly and she was blued into A&amp;E.</p>
<p>On the back from that call, I had another, this one to a 98 year old female who&#8217;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 &#8211; the walking around the house proved that. Control called to get an update while I was there which is unusual &#8211; they asked if I could clear and since there was a crew pulling up and&nbsp;I said yes. Things had suddenly kicked off with an RTC, a collapse, chest pains, several Difficulty In Breathing calls and a &#8220;?CVA &#8211; unresponsive&#8221;. So I got the <a href="http://en.wikipedia.org/wiki/Cerebrovascular_accident" target="_blank">CVA</a>. When I got there, the &#8220;unresponsive&#8221; part was true &#8211; he was sitting up and breathing fine but wasn&#8217;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.</p>
<p>Hoping to go home to get a cuppa,&nbsp;I was still a mile away when the phone rang again &#8211; 41 year old female, ankle injury. Ok, no worries I said, where? The answer &#8211; &#8220;<a href="http://www.streetmap.co.uk/streetmap.dll?G2M?X=315585&amp;Y=185210&amp;A=Y&amp;Z=3" target="_blank">The burger van, Caerphilly Mountain</a>.&#8221; &#8220;Excuse me?&#8221;&nbsp;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 &#8211; it&#8217;s an easy run from where I was and traffic was light &#8211; the rain however, wasn&#8217;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 &#8211; by now the rain was heavy and the sky gray &#8211; 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 &#8211; I&#8217;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.</p>
<p>She was some 500m from the road on a muddy and slippery path. The <a href="http://www.emedx.com/emedx/diagnosis_information/foot-ankle_disorders/fibular_fracture_surgery.htm" target="_blank">ankle</a> in question was swollen and slightly deformed and moving it was causing some pain, so I got my <a href="http://en.wikipedia.org/wiki/Survival_bag" target="_blank">KISU</a> 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 &#8211; the air ambulance &#8211; was rejected due to the fact that the casualty was in trees and Gwent&#8217;s helicopter couldn&#8217;t fly in this weather. Rescue 169 was an option and after a discussion between myself and one of our MR Incident controller&#8217;s, was stood to and asked to make their way to us. The police were happy to leave things to us &#8211; the terrain wasn&#8217;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&#8217;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&#8217;t that aware of our capabilities as mountain rescue.</p>
<p>Pretty soon we had plenty of people there and with a blast of <a href="http://en.wikipedia.org/wiki/Entonox" target="_blank">entonox</a>, we packaged the lady&#8217;s ankle in a <a href="http://www.neann.com/Vacuum%20Splints.htm" target="_blank">vacuum splint</a> 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 &#8211; 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&#8217;ve now seen on a few incidents in the area. I had a chance to chat with the lady in A&amp;E and found that she had indeed fractured her <a href="http://www.patient.co.uk/showdoc/21692493/" target="_blank">fibula</a> 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 &#8211; I&#8217;ve even managed to (finally) finish painting the bathroom.</p>
<p>How was your weekend?</p>
<p>&nbsp;</p>
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		<item>
		<title>Apathy and frustration</title>
		<link>http://www.thinknuts.net/2008/03/04/apathy-and-frustration/</link>
		<comments>http://www.thinknuts.net/2008/03/04/apathy-and-frustration/#comments</comments>
		<pubDate>Tue, 04 Mar 2008 01:14:23 +0000</pubDate>
		<dc:creator>Aled</dc:creator>
				<category><![CDATA[Callout]]></category>
		<category><![CDATA[First responder]]></category>
		<category><![CDATA[Mountain Rescue]]></category>
		<category><![CDATA[medical]]></category>
		<category><![CDATA[mountain]]></category>
		<category><![CDATA[rant]]></category>
		<category><![CDATA[Ambulance]]></category>
		<category><![CDATA[diabetes]]></category>
		<category><![CDATA[First Responders]]></category>
		<category><![CDATA[nan down]]></category>
		<category><![CDATA[search]]></category>
		<category><![CDATA[shift]]></category>

		<guid isPermaLink="false">http://www.thinknuts.net/2008/03/04/apathy-and-frustration/</guid>
		<description><![CDATA[I&#8217;ve been rather apathetic about my blogging recently, sorry about that. I had a pretty busy week last week, including a search for a misper in Mountain Ash on Thursday which left me exhausted for Friday. Friday night was on shift with the first responders right through until Saturday night and what a busy shift [...]]]></description>
			<content:encoded><![CDATA[<p>I&#8217;ve been rather apathetic about my blogging recently, sorry about that. I had a pretty busy week last week, including a search for a misper in <a href="http://maps.google.co.uk/maps?f=q&amp;hl=en&amp;geocode=&amp;q=mountain+ash&amp;sll=51.60193,-3.27572&amp;sspn=0.013354,0.039954&amp;ie=UTF8&amp;z=12&amp;iwloc=addr" target="_blank">Mountain Ash</a> on Thursday which left me exhausted for Friday. Friday night was on shift with the first responders right through until Saturday night and what a busy shift that turned out to be &#8211; 11 calls in total according to my notes. At least I had a bit of a lie in on Saturday.</p>
<p>Tonight was agaKin out with the ambulance service &#8211; something I&#8217;m really enjoying though it is frustrating at times. It&#8217;s frustrating because the knowledge that I have in terms of diagnosing and treating some conditions through mountain rescue could be applied here &#8211; giving <a href="http://www.glucogel.co.uk/" target="_blank">Hypostop</a> to diabetic patients having a <a href="http://www.bddiabetes.co.uk/cgi-bin/bd/bdweb/eservices/content/show.bd?Program=A5B9591C1305A17300256E35005FD44A&amp;Channel=%2fKnowledge+editorials%2fUK+BDM_DC+Documents%2fC5E4415B8066C9EF00256E35005F2421%2fA352CD1C21CEBEA800256E35005F2438&amp;BD_SID=UWtSVlN5NUNSRTFmUkVNPTpNQT09Ojo&amp;BD_SID=UWtSVlN5NUNSRTFmUkVNPTpNQT09Ojo%3d&amp;RootChannel=%2fKnowledge+editorials%2fUK+BDM_DC+Documents%2fC5E4415B8066C9EF00256E35005F2421" target="_blank">hypo</a>; giving <a href="http://en.wikipedia.org/wiki/Entonox" target="_blank">Entonox</a> to patients suffering from painful trauma; giving <a href="http://en.wikipedia.org/wiki/Aspirin" target="_blank">aspirin</a> to <a href="http://en.wikipedia.org/wiki/Aspirin#Therapeutic_uses" target="_blank">a patient</a> suffering from a possible <a href="http://en.wikipedia.org/wiki/Myocardial_infarction" target="_blank">heart attack</a>&nbsp;- just three examples where we could make even more of a difference to the community.</p>
<p>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 &#8211; only the second of his life and he&#8217;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&#8217;t perform blood glucose measurements ourselves and we don&#8217;t carry Hypostop (actually I do for mountain rescue but can&#8217;t use it for ambulance service calls). I&#8217;ve had a call to an elderly lady who fell &#8211; a &#8220;nan down&#8221;. She&#8217;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 &#8211; we don&#8217;t carry Entonox &#8211; 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&nbsp;I spent with here were very worrying &#8211; she was starting to deteriorate and I had nothing I could do or give her to treat her. If the crew hadn&#8217;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 &#8211; I was concerned at that point about her slipping into <a href="http://en.wikipedia.org/wiki/Shock_(medical)#Hypovolaemic_shock" target="_blank">hypovolaemic shock</a>. 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&#8217;d rather be dragging an ambulance officer out of bed to come and slap on a <a href="http://en.wikipedia.org/wiki/Ecg" target="_blank">12-lead ECG</a> for nothing than having my patient die.</p>
<p>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&#8217;s life.</p>
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