The secret paramedic's diary: 'The worst part is knowing it's likely …
There is nothing more satisfying than a positive resuscitation result. Illustration: The Guardian
Thursday 6am to 6pm
As soon as my crewmate and I sign on, our dispatcher (the person who sends us to 999 calls) sends us straight out on a job. It s a cardiac arrest. The patient is elderly and it s clear the prognosis is bad. We start resuscitation and I try to insert a breathing tube into her mouth to give her oxygen. Her airway is blocked and I can t get the tube in. Her heart is in a rhythm that means we can t shock her with the defibrillator so we carry on with compressions. A second crew arrives. They can t get a needle into the patient s veins, so put one into her bone to give her drugs. After 30 minutes, it s clear there is nothing more we can do. The worst part of these jobs is that you know it s likely the patient will die when you start, but you still do everything you can. I wish more elderly patients were offered do not resuscitate orders so we didn t have to subject them to this undignified treatment.
Friday 6am to 6pm
Today s task is to get all the patients who can t cope over the weekend into hospital. They are all elderly and go to A&E, despite a community hospital being more appropriate. We moan about these non-urgent transfers, but it s an easy shift, no emergencies today.
Saturday 6pm to 6am
Tonight I m on my own in a car. Crews are often split up at night to cover more ground quickly, but it means fewer ambulances are available to take patients to hospital. Halfway through my shift, I have a patient who needs to go to hospital. It s not safe to take them in a car. I call for an ambulance, but the dispatcher has to keep sending them elsewhere. My patient is fairly stable. I bundle them and their spouse into my car and drive them in. If their condition changes, things could go wrong quickly. It s occasions like these when the grey hairs start forming. The dispatcher apologises and thanks me it s one less backup for him to worry about.
Sunday 6pm to 6am
For my second night shift I m back in an ambulance. We are called to a dying patient who is supposed to have palliative care set up at home on Monday. They don t want to go to hospital and are just conscious enough to make that decision. We leave, but if the patient loses consciousness and the family calls back, the next crew will have to take them in.
Later, we are on the way to another job when we are diverted to a cardiac arrest just around the corner. We get there just two minutes after the call was made. A bystander is doing excellent CPR. We get the patient into the ambulance. Two shocks and their heart pumps blood again, but they are still critically unwell. We take them to a specialist hospital, and a couple of hours later the patient has surgery. The next day they are conscious with no brain damage. I am really pleased; figures for surviving cardiac arrest can be as low as one in 14 people.
Most difficult decision: Deciding to take my patient into hospital in the car when I was alone. Needing backup and none being available is stressful. Too often, calls stack up because there are not enough crews to respond.
Most satisfying result: I enjoy my job and there is nothing more satisfying than a positive resuscitation result.
- ^ paramedics (interactive.guim.co.uk)
- ^ The National Health Service explained (www.theguardian.com)
- ^ Join the Healthcare Professionals Network (register.theguardian.com)
- ^ @GdnHealthcare (twitter.com)
- ^ via GuardianWitness (www.theguardian.com)