It’s the Friday night before the August Bank Holiday and myself, paramedic Steve Vanderbank and technician Pete Spencer are waiting for an ambulance to come back from a call before heading out into the night.
As the ambulance is driven into the station there is barely time for a ‘hello’ with the team we are relieving before a call comes in. There isn’t even time to check the kit on the ambulance and we’re off.
And that’s what it is like for the East Midlands Ambulance Service which responds to a call every 45 seconds. And it doesn’t matter if it’s a Saturday night or a Wednesday morning, no day is ever the same and nothing can be predicted.
Technician Pete Spencer said: “There is no difference between a weekend and mid week or day time and night time. The public don’t really know what we do. It varies so much.”
As we drive to our first job with Pete at the wheel of the ambulance and the blues and twos blaring, paramedic Steve explains to me the way in which ambulance calls are categorised.
If a call is Red One or Red Two (life threatening) they have eight minutes to get there, if a call is Green One or Green Two (serious but not life threatening) they have 19 minutes to get there and if a call is Green Three or Green Four (not life threatening) they can drive at normal road speeds.
Steve said: “Each call is assessed and given a category but we are only given a basic description.
“A call could come through as a ‘fall’ but a fall of an elderly person could be dangerous and they could have broken something, so we never really know until we get there what we’re going to be dealing with.”
As the work load increases, crew members can be called to cover shifts from different areas. For example, Steve has picked up this shift as overtime and it is not his normal base.
We arrive at the first call and head into the patient’s home. A crew member is already at the scene but they are unable to transport the patient to hospital. After a handover and assessment of the patient, a woman, it is agreed she needs to be transported to hospital as she has very low blood pressure and keeps blacking out.
The patient is helped to the ambulance and as we head to the hospital Steve checks her blood pressure and heart rate again, and gives her some fluids. All the way to the hospital Steve is talking to the patient, asking her questions about herself but also reasurring her and explaining to her what she can expect once she arrives at the hospital.
Steve said: “We have to give them our full attention and we need to make them comfortable, it can be draining. We need to gain their trust. We give them positives and try and relax them.
“We have to put so many different caps on.”
As we arrive at the hospital we go through to the Accident and Emergency department. There are three different wards: minors, majors and resuscitation which are for the different types of call. The patient is taken through to the majors department and a handover is given to a nurse who then takes over from the ambulance crew.
First call completed. Now there is a chance for a quick break. Pete said: “It is so easy to become dehydrated as you get so engrossed with what you’re doing that you forget to drink. It’s good practice to get a drink whenever you can.”
We take this opportunity to head back to the ambulance station so the kit can be checked and restocked and the ambulance can be refueled before another call comes in.
Steve said: “We need to carry everything for every eventuality. This is a mini hospital. We have to make people sustainable and get them to hospital. We have everything available to us to help keep a patient alive. The defibrillator is our bible. It can tell us everything we need to know about a patient.”
Now it is Steve’s turn to drive, as the pair switch between each call to ensure they both get a break from the wheel. Steve explains to me that you have to undertake blue light driving training before you can drive an ambulance which is a three week intensive course.
We arrive at the second call which is an elderly lady who has had a fall at a residential home.
On the first assessment it is thought the lady has just bruised her leg and it is not thought she needs to go to hospital. However on a further examination she is unable to straighten the leg she has fallen on so it is decided she needs an x-ray and she is taken to hospital.
We arrive at a different hospital this time, but the procedure is the same with the patient being taken to the majors department of Accident and Emergency.
The three of us head back to the ambulance and as soon as we clear this call, another one comes in. And it is very similar to the last - an elderly lady who has had a fall at her home.
There is a first responder on the scene when we arrive who explains to the crew that the lady fell over as she walked through her front door. The lady’s daughter is at the house and explains this is not the first time her mother has fallen in the last couple of weeks. The lady is in good spirits and is able to walk, with the aid of her walker. Her blood pressure and heart rate is taken. Her blood pressure is quite high, which is a worry for the crew and they want to take her to hospital. However the patient does not want to go.
Steve explained that if a patient is able to make their own decisions and doesn’t want to go to hospital they can’t force them to go. Steve asks the patient a series of questions to determine if she is capable of making her own decisions and she is deemed capable, but after some convincing from the crew and her daughter she is admitted to hospital.
After two very similar jobs, the next call could not have been more different.
It was to a young man who had returned from a night out and was high on drugs, believed to be M-Cat, and was being aggressive towards his family.
The ambulance crew are the first to arrive at the scene, but they have called for police back up as the young man is being very aggressive and is difficult to control.
Steve said: “We can be presented with a volatile situation. We have to make the decision if we need back up.”
Steve tries to talk to the patient and find out which drugs he has taken - but his answers are not making any sense and he is becoming very agitated and distressed.
The police arrive and the patient is given the option of calming down and going with the ambulance crew to the hospital or being taken away by the police.
It is agreed that the man will go to hospital and walks to the ambulance with one of his family members.
During a 12 hour shift the crew are given a 45 minute break and this can be assigned anytime during their ‘break window’.
Pete said: “On a 6.30pm to 6.30am shift you have a break window between 11pm and 2am but you might not get a break within that window.”
Our next call is to a man who has been vomiting and has a very high temperature and blood pressure.
After an assessment it is feared the man could have sepsis so it is vital he is taken to hospital to be treated, as Steve explains to me that sepsis is one of the biggest killers if not detected. We call ahead to the hospital to find out if we need to admit the patient to the majors or resuscitation unit and it is decided to take him to majors.
We arrive back at 2.30am and it is time for me to call it a day. After spending just a few hours with the crew I have to admire the work they do, they have to be constantly upbeat, talking to patients, keeping them relaxed while they are in pain or afraid while also performing medical procedures.