Aled Treharne on January 6th, 2010

A few months ago I walked into my first St John Ambulance evening in Cardiff. Last week I was a member of a 2-man St John crew on an ambulance helping out the Ambulance service on a 12-hour shift on New Year’s Eve. It’s been a very fast and steep learning curve to get here and I loved working the shift.

A number of cases stand out in my mind from a number of the shifts, some of which will make interesting blog posts, some of which will never make my blog for various reasons.

One in particlar sticks out. We’re called to attend a 999 call which has been downgraded to a Green call – an incident that requires a response without blue lights. We turn up and have a chat. The gentleman is in his 40s and has parasthesia from the waist down. He speaks very little English. We ascertain through pidgeon English and gestures that he’s urinating blood.

I’m not attending for this one, but something strikes me as odd. His feet are bandaged neatly – apparently he’s burned them and has been to hospital for his feet already. I look around the room and spot a box of tablets on the windowsill with a hospital pharmacy label. I point to them and he nods. Antibiotics. Paracetamol. There’s a letter with it and again he nods and I read.

His feet are injured from a scald and he spent a few days in hospital. Whilst he was there they noticed the complaint of haematuria and investigated, finding nothing and eventually referring him to a specialist in a nearby hospital. The notes go into more detail – his condition and pain seems unchanged from the time of admission. He’s also seeking asylum in this country but has had his application refused. He has multiple presentations to multiple services over the past 8 months.

On the other hand, he’s complaining of pain and does have some blood in his urine. His obs are fine and he seems comfortable unless we ask him about the pain, whereupon his face screws up. We have a quick chat amongst ourselves and we decide to try and see if we can get the out of hours GP to have a look, and control is informed. We explain to the chap who indicates that he’s happy with this – he doesn’t really want to go to A&E, it’ll be a several hour wait and he can’t afford the taxi journey home.

We hear a knock at the door and in walks a paramedic. We have a brief look between us before enquiring why he’s here. Control sent him. A handover is made and the paramedic asks the chap about his pain, then spends the next 10 minutes or so convincing him he needs to go to A&E, much to our confusion. We look confused but are happy to take him – obviously the paramedic is the senior clinician on scene here.

So we walk the chap out to the truck and drive him up to A&E. The charge nurse gave us a shitty look and we looked suitably apologetic as she tutted over the patient for a few minutes. She comes over to us saying that the best full-face helmet are not good. We explain what happened.

“Right, I see. Well, being here serves neither his best interests nor ours. I’m referring him to the out of hours GP.”

We left quietly.

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Aled Treharne on December 24th, 2009

“Dusk is falling and the lamp lighters are at work – it’s Christmas Eve for sure!”

Just finishing off the last few bits of shopping today and my thoughts are with those people who won’t be able to go home to enjoy Christmas with their families. An ambulance just went past on blues. There’s two policemen on duty over there. There’s firemen, doctors, nurses – all who’ll be missing Christmas with the family.

Here’s to you all, wherever you are. Merry Christmas everyone.

Aled Treharne on December 23rd, 2009

At around 1700 Monday night I had a text message – contingency plans were in place to assist the ambulance service, could I crew a vehicle?

So after work, I grabbed some food and ironed my uniform before de-snowing the car and heading into Llanishen. Once I got out of our village the roads were ok – probably because there was plenty of traffic to keep them clear. Our end of the street was awful, but then we only have about 10 houses there. The trip wasn’t helped by the fact that my car has developed a hole in the exhaust from all the salt. It’s in the garage being fixed today…

So we jumped on the vehicle and completed our inspection very quickly – it’s easier when you have two people doing it, and we had three on the vehicle last night. I decided that I’d had enough time driving and wanted more experience in the back, so arranged to be the attendant for the evening.

We logged on and immediately were asked to hold on for a second while control checked what we should be sent to first. They called back and asked us to back up an RRV for transporting a patient, but when we arrived on scene, the RRV reported that the patient had already made their own way to the hospital. Clearing from that incident, we were dispatched to back up another RRV, about half a mile down the road. There we picked up a woman in her 40’s with “nonspecific abdo pain”. Once I’d coughed my way through the cigarette smoke, we prepared the carry-chair and she stood from her armchair and sat herself down. Mike and I packed her and moved her out to the vehicle with some difficulty – a scenario not covered in training was using our equipment in snow and we found it sinking through the snow and ice.

Mike had already started to attend to her so I took the keys and prepared to drive when whe woman asked for “gas and air”. We looked surprised and asked her, on a scale of 1 to… “It’s 10.” she interrupted us, sitting comfortably and not showing any signs of pain. I blinked and sighed inwardly, leaving Mike to it. Apparently, morphine didn’t touch her pain (hence why she hadn’t asked the paramedic for any), but entonox worked wonders. It was a quick drive to the hospital and we passed her over to the care of the nurses in A&E. There followed a discussion between the three of us on the ethics of witholding pain medication if you believe that there was no clinical need for it.

The next job was for a young woman who really did need us. A transfer into hospital, the GP had diagnosed “?DVT R leg”. Her medical history was long and she was currently just 2 months out of her most recent encounter with chemotherapy. From the way she held herself I could tell she was guarding herself against pain and I asked if we could help, but she politely declined analgesia in stark contrast to our previous patient.

Our last patient was a hospital transfer for another “?DVT” patient. 97 year old lady, she was a real card. I had a great time chatting to her on the long trip to hospital. She reminded me a lot of my own grandmother (who’s 92) except that she got a little repetitive at times. She confided to me that she didn’t mind what we did to her so long as we told her first. She was a little deaf and I found myself being her closest friend as I was the one who got confirmation that she’d heard me before we did anything. We got to the hospital and found that there was no bed for her – a bit shocking as this was a transfer from another hospital. We sat in the corridor for a while, chatting with her until we were given a trolley for her. Her condition needed treatment, but it wasn’t a surgical emergency (according to the Surgeon who reviewed her later as well as the nurses) so there was some confusion as to why she had been transferred at that time of night. The constant bouncing around annoyed me, though not near as much as the paramedic who bumped our stretcher out of the way just to get past us, casuing our patient to call out in pain. We may only be “Jonnies”, we may only be carrying an old lady while you’re dealing with a patient going into resus – that’s no reason to hit our trolley out of the way instead of walking around.

We said our goodbyes and headed off for a break – things seemed to be calming down. We’d not long finished our break when we got our last job of the night – back to the hospital to pick the same old lady up. We looked at each other and shook our heads – this was the second time in two days she’d been passed back and forth from one hospital to another – completely unacceptable. We picked her up again, much to her delight, though this time I drove and passed the responsibility of looking after her to a colleague – I was tired and felt a bit drained from looking after her – she really did remind me a lot of my grandmother. My colleagues said that they’d transferred her less than a week ago as well.

We dropped her off and got her settled before cleaning our kit and checking in with control. They thanked us and sent us home, which was nice since the temperature was dropping fast.

This was the busiest shift I’ve had so far. I really enjoyed it, though it left me feeling drained both physically and emotionally. Looking forward to more shifts now.

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Aled Treharne on December 20th, 2009

Well, that was a bit quieter than was expected…by ourselves as well as pretty much the entire city.

South Wales police reported that it was quieter last Friday than a normal Friday night. The ambulance crews in the Millenium Staduim drank lots of coffee and dealt with the few incidents we were called to – we only had 3 jobs on our vehicle all night.

I got called last night while in Cardiff to work an ambulance shift for Mid Glam. The highlight of the shift until midnight was the free hot mince pies with cream we were so kindly served by the staff in the canteen at the hospital. Nomnom. We managed to finish them off before we were called onto the one job of the night.

This is of course, a Good Thing. People were sensible and remained uninjured. Hooray.

Let’s see what the rest of my shifts bring this Christmas.

Aled Treharne on December 18th, 2009

Today is Black Friday.

Most people won’t know and won’t care what that means, but if you work in or volunteer with the emergency services and you’re on duty tonight – you’re probably either sleeping in preparation or getting your stuff ready.

Black Friday is traditionally the last Friday before Christmas. It’s the day that large numbers of people organise to have a drink together before Christmas…and as a result, Cardiff alone will see 300,000 revellers partying tonight. It’s an incredibly busy night for the emergency services, busier even than New Year’s Eve.

So, what am I doing tonight? After working my day job, I’m on duty (as a volunteer) with St John tonight who have been asked to provide the Welsh Ambulance Service with assistance in Cardiff. We have around 10 extra ambulances on duty; we’re helping to staff the triage centers both in St Mary Street and in the Millenium Stadium. I suspect we’ll see everything from broken nails to alcohol poisoning and assaults, as well as the normal numbers of cardiac arrests and the usual calls because life goes on. I suspect we’ll get more RTC’s tonight because it’s cold and icy and it’s also going to be busy.

And Oh My God but it’ll be cold tonight. The MetOffice is reporting a low of -3 Celsius tonight, down from the dizzy heights of +2 Celsius, with wind speeds dying down from 23mph to 5mph (giving “wind chill” temperatures of around -6 Celsius). That means freezing roads and crashing cars. It means freezing pavements and falling drunk people. It means cold air and hypothermia in partygoers wearing very little. That “beer jacket” that keeps you warm when you’re drunk? It doesn’t – it just stops you from feeling the cold. It could kill you on a night like this.

So tonight we’ll be busy. Tonight we’ll be picking up, helping, trying not to get assaulted and trying to keep warm. I’ll be tweeting and possibly updating the blog where I can, you can follow me on twitter if you’d like:

Stay safe!

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Aled Treharne on December 2nd, 2009

Back in October of last year, I applied to join South Wales Police as a special constable. Thigns kinda came to a grinding halt over Christmas when the process stopped. It dragged on for a few months and the rumour I had from friends in the force was that all recruitment was on a hold for the time being.IAtentDead

I sat down and re-assesed my options, talking to Sean. I felt as though I was still missing something and Sean was still happy with me doing somethign in addition to Mountain Rescue. I’ve always enjoyed the medical side of Mountain Rescue and I really missed dealing with patients as I used to in the First Responders. So, what could I do?

Enter St John Ambulance. I called national headquarters, based in Cardiff and was referred to Father Andrew, the Divisional Officer In Charge (DOIC) of Cardiff Central. After a long conversation with him, it sounded like I’d hit on the perfect unit – they perform mainly front-line ambulance duties and don’t have a cadet contingent which mean the unit concentrates on training and duties for their adult members.

The first night set the tone really – they’re mostly insane, much like Mountain Rescue. I passed them all the information I could about the training I had complete with Mountain Rescue. Things were looking great…and then a letter came through the door.

South Wales Police had started up its recruitment again. This caused a bit of a dilemma – leave St John and concentrate on the Police? Stop the recruitment process with the police? What to do?

I carried on with both (well, all three including Mountain Rescue) for a while, but this really wasn’t sustainable. Coupled with the fact that I had changed jobs and was considerably busier than I used to be, something had to change. So, after a long conversation with Sean, I decided to withdraw my application to South Wales Police for now. It’s something I’d still like to do, but I’m limited in how much time I have in life – I do like to sleep occasionally!

Last weekend, I passed the 7th course I’d taken in 5 weeks. It’s been a hectic month, but passing my PTA course now means that I can go out with St John Ambulance to do what’s called HDS duties (High Dependency Service) – these are thigns like Doctor’s urgents (when a patient needs to go to hospital urgently but isn’t life-threatening enough to call 999) and hospital transfers. I’m also one of our division’s two drivers currently – so looks like I’m going to be kept busy driving a lot.

On Thursday my uniform arrived – that’s right, look out for me wandering the streets of Cardiff in a natty green uniform. In fact, my first duty is this Saturday, when I’m joining two experienced members for my first HDS duty.

So, er, yeah, that’s where I am, that’s why I haven’t been blogging much of late. Work is taking me to London again this week which means I won’t (again) attend Mountain Rescue on Thursday. Look out for updates on the weekend from the HDS duty, as well as a whole bunch of rants and other stuff I’ve got queued up ready to post.

Tally ho!

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Aled Treharne on November 24th, 2009

So I forgot I hadn’t posted this. Oops.

We left Todi and had a mammoth drive through Italy, Switzerland and France. It was slated to be 10 hours of driving, but things didn’t go to plan.

Leaving Todi, we hit Italian rush hour which was a bit interesting and I had to concentrate hard to avoid the other cars. It felt like the worst of London driving. We made it to Florence quite quickly though where we’d planned a quick stop to post some postcards that we’d not managed to get stamps for. Well, that was the plan. Our detour into Florence took an hour, going through some beautiful sights and via the main sorting office (that doesn’t sell stamps). Eventually, I dropped Sean off next to the main train station and kept running circles around the block until he came back. Turns out the train station sells stamps…

The weather closed in on us at this point, with heavy rain following us up all the way to Milan. Far from being an interesting and fun drive, this was a hard slog. It wasn’t until we started up into the mountains that the rain eased off a little, but we rapidly hit the clouds and so our progress was slowed down once more. We were aiming for the Gottard tunnel and after weaving my way around queues of lorries, we finally got there.

The tunnel is, I’m sure, a feat of engineering. I certainly appreciated it for that. The drive, though, is boring. It’s a tunnel. Think of the Limehouse link, only 15 miles long and you’re pretty much there. There is, however, a radio station broadcasting inside the tunnel with emergency information, which I thought was quite nifty, though it’s not signposted well enough for someone driving along the motorway.

We came out of the Gottard tunnel and started the journey towards France. It felt like we were past the crux now…which was the wrong feeling, since about 10 minutes north of the tunnel, we hit a traffic jam. There was traffic as far as the eye could see and it was all stationary. After sitting there for a few minutes I turned the engine off, as did everyone else. Within minutes, the road was packed solid in both directions and we settled down for a long wait, with no idea what was going on. Luckily, we’d packed some food for the journey, so we had somethign to eat. It was quite surreal – high in the Swiss mountains, in a picturesque valley with chalets all around us….and cows. Now, I though the Swiss cow bell was a cute little tourist trinket. Turns out, they actually use them. So we’re sat there with a herd of cows next to us, all of which wear bells. Who knew – after a while, that noise gets intensely irritating.

Eventually, after about two hours of delay we got going again – the road narrowed ahead due to roadworks and just at the entrance were some fresh skidmarks and broken glass by the side of the road – which answered the question of what was going on.

By this point the journey wasn’t so much fun as “let’s just get there”. We were both ready to go home and it was only necessity that made us stop in some services just inside Switzerland near the French border. We were starving and needed something, even if it was service-station sandwiches. What we got was just incredible.

We walked in and looked around, getting our bearings. To our right was the restaurant which, at ten o’clock local time, I was expecting to be closed – but it wasn’t. We shrugged and wandered over, before being assaulted by an incredible array of sights and aromas. They had a number of areas, each selling a different kind of freshly cooked food. We looked on in amazement and chose Chicken Cordon Bleu which they cooked in front of us. It wasn’t a five star restaurant, but it was certainly something that Little Chef and Moto could learn from. It sure as hell was not Burger King or McDonalds.

We set off again and got to the hotel just around midnight, having had to call them en route to find out why they weren’t where TomTom said they should be – turns out this is a common problem and her first question was “Do you have satellite navigation?”. She gave us directions from there to a village with the same name as the street we were on about 2 miles away. Reception had closed down for the night when we arrived – this was a small local hotel and our keys were waiting for us on a piece of paper with my name badly mis-spelt.

Thursday morning, a quick breakfast after not enough sleep and we set off again, determined to have a better day. The weather agreed and after some patchy showers, opened up into a beautiful if slightly windy day. We make great progress through the French motorways and hit Calais almost 2 hours earlier than our ferry. A quick stop in a supermarket to take advantage of the cheap diesel and we drove down to the terminal. Without blinking we got put on the next possible ferry leaving in about 30 minutes and we mooched around for a bit admiring the drugs dogs at work. We even managed to get BBC Kent on the radio. We both smiled – I think we were both glad to be going home at this point.

We had a lovely dinner on the ferry – we stood outside Langan’s Brasserie for a bit before threw caution to the wind and decided to end the holiday in style with steaks on the way home. Very nice indeed, as was the creme brulee and, by this time, it was nice to have English accents around us.

It was getting dark by the time we got to Dover and with a reminder from TomTom to drive on the left again, we were back on British soil. Not quite home yet though – we drove to Slough where I met up with some of my work colleagues for a conference the following day. I was far mroe tired than I expected and on Friday, by lunchtime, I was falling asleep in the comfort of the conference and decided that I wasn’t doing any good here. I took off, met up with Sean in Leicester Square for some lunch and we drove home.

We both had an absolutely awesome time and certainly clocked up some miles. I’d like to do something similar again, though in a more comfortable car and with more time to spend in each place. Brussels was lovely and we want to go back there. We never really saw Zurich, and Strasbourg was a lovely surprise. I’m not sure I’d want to drive in Italy again – the other drivers make it very stressful. We’re already putting ideas together as to our next one, suggestions so far include the UK, north or eastern Europe and the USA/Canada.

Aled Treharne on September 15th, 2009

I’ve always said that the marque of a good holiday is when, halfway through, you realise that you have no idea what day it is. What the date is, what day of the week it is, how far into your holiday you are. When you’ve reached that point you’ve relaxed completely – you’re no longer tied into the weekly grind.

It’s actually day 12 today – I had to count that on the calendar! Staying in Todi has been fantastic for the both of us. The house we’re staying in is incredibly relaxing with fabulous views and peace and quiet abound. We’ve mostly read books, hung around the house and the swimming pool, had a bit of a walk and driven to town for dinner or grocery shopping once or twice. We’ve slept without alarm clocks waking us up. I feel more alive and refreshed than I have done for a long time. I do feel a little regret for not spending more time exploring the surrounds, but we needed the break to be honest. Besides, we’ve been invited back again next year – I don’t think we’ll drive next time.

We’re staying here with John (Sean’s Dad) and Sophie (his wife). They happened to have two friends staying at the same time (Bill and Sue) which wasn’t a problem – the house is a 3-bed Tuscan villa with a large living and dining room. So evening meals have been a mix – John cooked spaghetti bolognese one night and Bill and Sue cooked another night. So a few days ago, Sean and I announced that we’d cook – spaghetti carbonara. So we prepared, we got a recipe – it didn’t seem too difficult. We then had a bit of a spanner in the works with concerns over the eggs – you mix the spaghetti into the raw eggs and they kinda cook from the heat. So we moved on from carbonara and Sean and I scoured the internet and decided to stick with an Italian staple – Lasagne.

To be fair, I’ve made lasagne before, but only with the help of Mr. Ragu and Mr. Dolmio. This recipe called for making the ragu (the meat/tomato sauce) from fresh as well as the white sauce (actually a bechamel sauce). So, when we got the ingredients, we never realised how much of an epic it would be. We started cooking at just before 7pm and finally served a huge lasagne to serve 6-8 at 9pm – and we cut out quite a lot of the time the ragu is supposed to cook for! It was, however, an absolute resounding success. I served full plates for everyone and had plenty left over…until everyone asked for seconds. I don’t think I’ve ever had a meal go down quite so well. I also learned how to make a bechamel sauce – here’s a hint folks: make sure you have a whisk before you start. Doing it with a fork is bloody hard work.

So today is our last full day in Todi. We’re packing the car tonight for an 8am departure tomorrow. We’ve found a little hotel just south of Strasbourg which means we have some 8 hours of driving to do tomorrow (not including rest stops). Thursday night we have a ferry crossing to Dover and we’ll be in London for Friday where I have a work event. We had plans for the weekend but having experienced a long day’s driving on the way here, we decided to try and leave the weekend to recover and catch up on household chores – we’ve got almost a full suitcase of laundry! I think we’re both actually looking forward to going home now – to more familiar surroundings where shopping isn’t quite so much of an adventure and you can recognise “beef stock” (and not “beef soup”)!

Aled Treharne on September 13th, 2009

We woke up fairly early in Grenoble and had some breakfast before heading off – we did find out that she hadn’t waived all the charges, just given us a credit towards our room of the amount we’d already paid – the night we stayed was some €20 more than our original room. Still, better than no credit at all.

It was a pretty long journey down to Marseilles, mostly on motorways. The terrain got progressively more yellow as we went, the trees and buildings becoming more meditaranean and the temperature rising. We found ourselves stopping for water a few times.

Driving in Marseilles was a nightmare and the route in to the city showed it to be a rough, industrial port. I’m sure there are nice areas of the city for tourists to see during the day, but having been through so many beautiful places, we decided to grab a quick sandwich and a drink in a little patisserie before getting back on the road.

It was a few more hours before we finally arrived at Aups having spent the last half hour or so travelling on smaller, provincial roads through some of the stunning Provence countryside. Aups is a beautiful small town which brought to mind memories of French towns from black and white wartime films. I fully expected to see a crowd of French resistance slinking around a corner away from a couple of German generals – my first impression wasn’t helped by the fact that as we got out of the car, an air raid siren sounded. Apparently it’s used to call the local fire brigade out…

We wandered around a little before meeting up with Sean’s cousin and headed over to their house – a beautiful little cottage. We spent a day and two nights here, just chilling out getting to know Eve and Patricio and the kids, Ishmael and Irene. We ate good food, drank good wine and beer and swam in a nearby lake.

Day 7 was yesterday, Thursday 10th, and we woke up early and got ready to leave. We had a long day of driving ahead of us and after saying goodbye to everyone, we packed the car and hit the road. By 10am the overhead signs were telling us it was 27 deg C and we soon stopped for a break on the mountains above Monaco. We hastily grabbed a few photos and took off again. The principle behind building this Italian road seems to have been to pick a point between the bottom of the valleys and the tops of the ridges and build a road along that line, building tunnels and bridges as necessary.

It was a long, long drive down to Todi and the roads got worse and worse as we went before finally ending on the dirt track that served as an access road to the villa. It had been a long day and it wasn’t long before we were crashing out on the sofa watching the sunset.

This morning we woke up to this view (picture to follow) from the balcony of our bedroom. I’m actually sat on the bed taking that one. It’s an incredible place here and we’re loving just chilling out and relaxing and NOT driving. We popped briefly into Todi today to do some shopping and pottered around before heading back and spending a lazy afternoon just chatting. I’m sat on the terrace writing this with the sun slowly falling towards the distant mountains and Sean playing on the guitar behind me. I’ve not had a watch or mobile on me today. It’s been magic. My biggest dilemma is currently whether I pop down to the swimming pool for a quick swim before dinner. I could get used to this.

Miles travelled: 1855

Our route so far (Google maps)

Aled Treharne on September 7th, 2009

Waking up on Sunday in Luxembourg, the weather was overcast with low cloud, so we dressed up warm and headed into the center of the old town. Stopping outside the cathedral we took a few pictures but couldn’t head in as it was closing. We pottered around the shops for a bit with the cathedral’s bells ringing across the city and picked up a little breakfast before finally heading south, back on the road again.

It was a long slog down to Strasbourg with both of us quite tired. We pulled in and headed to the tourist inforation center in the main station. The station itself was incredible – they’ve built a glass lozenge over the old station which protects it. Modern meets traditional. From there we walked over to Petit France for lunch. This is the older part of Strasbourg and is absolutely stunning. We walked around, had some lunch and listened to a bagpipe player (he must be very lost) for a bit before getting back on the road again.

Next stop was Zurich although by this time we were exhausted. We looked at our options and realised that with a long day of travelling ahead, exploring the city was likely out of the question. We had a fantastic night in a very upmarket Holiday Inn before getting back on the road in the morning.

As we headed through Switzerland, the terrain changed from the soft undulating hills to steep, craggy mountains with near-vertically sided valleys. The scenery kept surprising us and we climbed up from Martigny and crossed the Swiss/French border somewhere high in the pass before dropping down into Chamonix. We decided to grab some time here and took the Montenvers train to the Mer-de-Glace Glacier. It was an awesome sight and we even got to walk inside the Glacier where they’d dug out a “grotto” and sculpted the ice.

It was probably gone 5pm before we left for the short drive to Grenoble and this is where we got unstuck. In booking all of the hotels before we left, I’d managed to book the Grenoble hotel for the Sunday night instead of the Monday night. Expecting to pay for another night, we dragged ourselves into the hotel and had a wonderful surprise when the woman on reception convinced her manager to waive any charges and just let us have the room tonight. Fab ending to an incredible day.

I’ve uploaded some photos to flickr already – there’s more to come when I have time and a decent Internet connection.

Miles so far: 1,163