Thought you might like a bit of insight into a typical paramedic call out.
I am as some of you know, a paramedic.
Last night I was called to attend a scene where an elderly female had fallen out of her wheelchair.
Now bearing in mind this had come in as an emergency call on the 999 system, I was dispatched the moment the call hit the switchboard. The address was only a few miles up the road from the ambulance station. I had to respond on blue lights and sirens as at this time the call takers had not managed to assess whether or not the old dear was injured. By the time they had come to the conclusion that she was not injured I was already on scene and in contact with the patient. This means I am now unusable for further emergency calls and my call sign drops off the system until I ‘clear’ from the scene.
I was met by two ‘carers’ who said they had not attempted to pick up the patient as they did not know if she was injured or not. I managed to assess that the lady was not injured in about 15 seconds. Firstly I asked simply if she had any pain anywhere, to which she answered no, and secondly, I asked her to show me she could move all of her limbs. She duly did so.
The carers then told me that they were not aloud to lift and that even if they could, they had no lifting aids.
I glanced back at the patient and estimated she weighed perhaps 7 stone. My offer to simply lift the patient up of the floor caused much alarm and posturing from the head ‘carer’, who insisted I fetch my air cushion and use that to lift the patient.
Still, off I trot and return with my air cushion. The cushion is to be placed under the patient before being inflated slowly. It can lift about 50 stone, which means if you are unlucky enough to find your patient is made of solid lead, you stand a reasonable chance of lifting them.
The carers were keen to help with the placing of the cushion, and so I handed the deflated unit over and asked them to place it under the old dears arse.
After about ten minutes they decided they couldn’t do it. They had tried rocking her from side to side to edge the cushion under her but that didn’t work. Then they tried asking the patient to shuffle herself onto the cushion. She moved about 1mm.
In exasperation, they turned to me and I have to say I was hoping they would. I can’t resist an opportunity to point out how ridiculous this kind of situation is and so leapt into action.
There are various methods to getting someone onto one of those cushions. They’d tried rocking her from side to side, edging the cushion a bit further under each alternately raised cheek. They’d tried getting patient to move herself (always my first choice) and they’d even fumbled about with a slide sheet for a while. None of these had worked. But then, it really didn’t matter because this was all a complete farce.
I placed the cushion behind the old dear…. And then lifted her onto it. I made a mental note that my earlier estimation of seven stone was far too generous.
I couldn’t resist a contemptuous sneer at the head carer as I did this.
We inflated the cushion and the old bird rose up into the air like a graceful animated corpse.
The thing is, we still haven’t solved the problem. Old dear is still not in her wheelchair, she’s just a few feet in the air now.
The carers had absolutely no idea how to transfer between the air cushion and wheelchair. I found this particularly strange as they were involved in every aspect of old dears care. Old dear couldn’t get onto the toilet, for example, without their help.
So after another ten minutes watching them try and convince the old dear she could perhaps levitate, I decided to step in. Once again, I just lifted her up and plopped her down in her wheelchair.
You see what a total farce this is? We have to be seen to using manual handling aids, but if you work on your own as I do and the available help isn’t trained, then what do you do?
The answer is that I should call in another ambulance resource. They might take an hour plus to get to me though as this is no longer deemed an emergency. When was it ever though? She’s not injured. She just can’t get up without help. I’ve known the arrival of back up to take up to three hours before. There just aren’t enough ambulances out there and so I am not going to call one of the few we have to assist me lift a sub seven stone woman.
So I take it upon myself to do what I feel has to be done. I take what I believe to be the common sense approach and I lift that frail old lady. I have performed a dynamic risk assessment on the fly and I feel I can confidently move that weight with little or no danger to myself or patient. What’s wrong with that?
So the old dear is now back in her chair, but I can’t leave yet. I have to complete my epcr – Electronic Patient Care Record. It used to be that we could complete a paper record of the event. Something along the lines of:
‘Non injury fall, assisted back into chair, nothing untoward found, left in care blah blah blah.’
Not these days though. Now I carry a little laptop type thing. I could write a paper form in about five minutes. This thing takes a minimum of thirty minutes.
By the time I have finished the care record and moved all my equipment back to car I find I have to stop briefly and reflect upon the amount of time spent with this patient and whether or not the call could have been completed quicker. I conclude that it could not have.
Put it this way. If the old dear was a member of my family, I firmly believe I could have assessed and popped her back into a chair in under five minutes. I would not have required any lifting aids and certainly no help from any other person.
As it stands, from call to finish, I have spent a grand total of one hour and forty five minutes dealing with this non injury fall.
This is apparently the way it has to be. Health and safety has gone completely nuts in my opinion.