Here I go again on my own…

“Ambulances will never be single crewed”….promised one high powered ambulance service officer once on a public forum.

A single crewed ambulance isn’t always a good thing. In a true emergency, one crew member can stabilise a patient, but a single crew member will never transport a patient. Ever. No matter what the person in ambulance Control thinks. It is quite embarrassing to turn up at a patient’s house after they have been waiting a while, expecting to be taken to hospital, to have to tell them that you are not able to. There is little or no communication between a patient in the back of an ambulance and the driver. If the patient’s condition were to deteriorate, the driver would be unaware. Still controllers expected us to oblige. Then there was the standing around in the patient’s House uncomfortably waiting for a second vehicle to arrive, with two crew members.

Working from a small station, we only operated one ambulance so there weren’t many of us based there. The unexpected and sudden departure of one crew member, one I worked frequently with, brought on quite a lot of single crewed shifts for me shortly after I transferred there. This continued for an unexpectedly long time, until the service got around to arranging a replacement.

My first one was the day they departed. I turned up, on a hot summer evening, ready for my night shift to be told I was on my own. Our ambulance covered a rural area with a radius of around 30 or more miles, and a main dual carriageway. I had never worked on my own before….

The first call was to an older patient with breathing difficulties. They were asthmatic and known to me as a regular. I drove the short distance to their house quickly and went inside. A family member was there and they were as nice as the patient. I quickly set up a nebuliser to open up the patient’s airway a bit, and began to take some observations. Everything was improving well with the nebuliser, but the patient had raised temperature and a bit of a wheeze when I listened to their chest with my stethoscope – queried chest infection. They had to go to hospital, so I radioed control and requested a second ambulance. A disgruntled controller agreed to send one from the city, almost 20 miles away. “Better put the kettle on then” said the relative.

Having returned to base after seeing my patient taken away by a city crew, I felt the shift was going well. We operated a volunteer scheme from our station – ambulance service trained volunteers with basic life support skills who could attend certain types of job if the Ambulance was unavailable at the time. That night the two designated volunteers arrived in station shortly after I returned. We were chatting away when the next job came in.

It was a call to the river at one end of the town. A drunk had fallen down an embankment and had trapped a foot. ?# (? Before a word implies “queried”, # means “fracture”). I rushed down to the location, to discover I had been directed to the wrong side of the river.

It wasn’t a large river, and there was a small foot bridge next to where I had stopped. It would take too long to take the Ambulance to the next vehicle crossing, so I grabbed my equipment and carried it over the footbridge. As I was leaving the Ambulance, one of the local fire units pulled up behind me, having had the same instructions.

I arrived at the scene – the person had fallen down a bank approximately 2 metres, getting their leg stuck in the loop created by a tree root sticking out of the bank, almost doubling their foot back on their leg. The patients head was almost at the waterline, but being a seaside town, the river was tidal and the tide was coming in.

A quick head to toe confirmed no major damage, other than that foot, and the patient was in good spirits, having sobered up slightly. They had no feeling in that foot, but there was a good pedal pulse present. I examined the scene and began to put together a plan of action. Firstly, a second ambulance, this patient was going to hospital. Next, the two volunteers sitting at the station. They were experienced and their help would be valuable until the second ambulance arrived. I radioed control and requested both. Next, secure the patient’s head, safe from the rising waterline. One of the fire crew supplied a plastic pillow which raised to patient’s head acceptably (neck pain/trauma had been ruled out beforehand, in case anyone is concerned). I began taking some observations, all good. The volunteers turned up and stood at the top of the bank, handing me down equipment as I asked for it. By now, I was standing with my feet on two large rocks, an around a foot of water. A fireman had fitted the patient with a small life vest while I was talking to them and repeating my observations. Suddenly I felt a pair of hand on my shoulder. “You might need this”. One hand stayed on my shoulder and the other one appeared between my legs, as I was also supplied with a safety vest. “You could at least have bought me a drink first” I joked with the fire person. “Would you like me to?” they grinned back.

The fire crew successfully cut through the root and the patient’s foot was released. Miraculously there was only some nasty tissue damage, but no fracture. The patient was strapped to a spinal board, lifted up the bank and taken to the second ambulance that had arrived. One of the volunteers had directed them to the correct side of the river.

I got back to the ambulance station quite please with myself. I had managed that job quite well. The volunteers arrived back before me and, as as I walked in to the messroom one of them said “what happened to your arms??”. I looked at them – they looked like salami! Because we wore short sleeves, every insect in the area must have had a nibble at my arms.

There are rules about what type of jobs a single crewed vehicle can attend. Those were probably the reason the rest of my night was unbusy. That was the first of many on my own, but it’s a great way to learn fast…..

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