I'm a paramedic AMA

[Blobbyweeble]

I've been a paramedic for 10 years working for an NHS trust in England. Happy to answer anything whilst observing patient confidentiality.

what do you think about the state of the NHS and its future?

What would you say the percentage of jobs are real emergencies verses the jobs that are not?

@flaofno I think the NHS is surviving on the good will of it's staff and we are all going to have to pay more in some way to keep it free at the point of use. I also think the public's increased expectations have contributed in part to it's difficulties.

@BakerBear - on an average day, if there is such a thing, about 25% of jobs are real emergencies.

Thanks blobby, can I ask is there anything we can do as the general public to ensure its continuation? e.g. protesting, activisim, raising awareness etc? anything you think might help?

@ falofno I think managing expectations, particularly that everything should be cured/given medication and if it isn't then you're being 'fobbed off'. This seems to apply to colds/tummy bugs and chronic back pain amongst other things. Sometimes we have to accept that things can't be cured or they''ll get better on there own without medication.

How many people do you see die in a week?

@ncbecauseiadmittoomuch It varies, some weeks none, sometimes several in a single shift. With an increasingly elderly population it's inevitable.

what's it like seeing a dead body? do you get used to it?

do you get counselling or similar "debriefing" sessions to get past the stressful / traumatic elements of the job?

What would be your first actions on coming across a road traffic accident involving a motorcyclist who has come off? I'm always a bit worried about that!

What's the most disgusting place where you've been called to?
Any urine-covered alleyway?

Thank you so much for doing a very difficult job with very little recognition.

Do many patients refuse to go to the hospital even though they should? If so and it's incredibly serious, what do you do?

I had some amazing ambulance crew come see me when I had a kidney infection. It had got very bad and my temperature was 105. I was having rights and sweating profusely although I felt freezing. Those men were funny, kind and professional.

We get debriefing after particularly stressful/difficult jobs such as children dying/ major RTC's with fatalities but not after each cardiac arrest. Counselling is available if we find a job affects us in the longer term.
I don't find dead bodies scary , the living are far more scary! I had seen bodies before I started work and death is a part of life. My parents were always pragmatic about death which helps I think.

You guys are AMAZING!
No questions :-)

What is a good day at work like?

@Spottyarm Put my hi vis jacket on, do it up and take a deep breath. Do not panic, check for scene safety, never run. Check more help is coming and how much you need, assess number and severity of casualities. If its a major RTC then the first person should not be treating people but running the scene.
@babitababita At least urine soaked alleyways are outside, peoples houses where there are urine soaked carpets, shit everywhere and no clear space to put bags down. There are more of them than you think!
@NotAnotherNoughtiesTune Quite a lot of people refuse to go to hospital initially, if they have capacity then they have the right to make unwise decisions but I would make sure they understand the risks and refer to their GP. Most of the time I can persuade them if I can find out why but it can be frustrating especially if they are regular callers

Thank you @ineedwine99
@IfYouDontImagineNothingHappens A good day is where I feel I've made a difference, dramatic jobs can be a good day as I feel I've used the skills I have but sorting out a frightened elderly person and keeping them out of hospital is equally rewarding. I make a lot of tea and toast.

Do you find that any of your patients suffer with terrible anxiety or panic disorders. If so how do you handle that in an emergency situation?

How are you all just so damned nice, friendly, upbeat, cheerful? Made all the difference to DD being transferred for potential scary issue. (and apologies to the lovely trainee who was in the back with us who she interrogated!).
How do you manage on just 45 min break in a 12 hour shift which potentially you don't even get?

@pugalugs Yes we go out to a lot of people who are having panic attacks/ suffering from anxiety, it’s generally a matter of staying calm and coaching breathing down then discharging on scene with signposting to organisations that may be able to help.
@flatmouse It’s part of the job to be friendly, most of us genuinely like people and can talk the hind leg of a donkey. We only get 30 minutes meal break, you get used to it but it’s not conducive to healthy eating!

Working for the Underground, we get our fair share of people, some times under the influence of something, who have slips, trips and falls. Also people who may suffer a problem such as a fit, heart attack or mental health crisis. When I started the job 17 years ago, we would routinely offer people an ambulance. Now, we triage customers ourselves before ringing for one. So if they are mobile, and can get in a taxi, we ring for one. If a person cannot breathe, is unconscious or has another threat to life, we ring for an ambulance. Sometimes mobile people insist on an ambulance despite us saying it could be several hours before one comes but they're stubborn and prefer to wait (You are never more than 20 minutes from an A&E in Central London ). My point about this is I really appreciate the work you do, I think people's expectations outstrip what may be feasible, and I think if the NHS is to continue, we really need to be using it much more wisely.

How accurately do programme like 999 what's your emergency? and Ambulance portray your job?

I think you all do an amazing job, thank you.

What's the weirdest thing you have ever been called out for, if it is not confidential?

Thank you for risking your own lives , (sometimes having to get into dubious locations and situations) and saving the general public's!

How do you feel about being called out to situations, where you weren't necessarily needed?

E.g a child was choking and not breathing, but the foreign body had been removed/swallowed by the time you arrive

Or a person passing out with pain from injury, but after your assessment it is decided that transfer to hospital is not necessary ?

Do you feel like this is a waste of your time and resources, or would you rather be called if someone feels that the situation is life threatening , even if it turns out not to be?

@VanGoghsLeftEar Thank you, I wish everyone was so sensible
@TiredPony Probably calls to swingers parties, of which I’ve had several, they seem to cause chest pains.
@Bobbiepin Ambulance is very accurate for what it shows but programmes like that rarely show the really irritating/abusive patients, probably because they don’t give consent.
@falconrising Anyone choking and not breathing is always an emergency even if the obstruction is removed by the time we arrive. Passing out from pain is rare but, obviously depending on what caused the injury, it is rarely an emergency. I passed out as a result of pain fairly frequently way before I became a paramedic (period pain etc) but never felt it necessary to call 999. The fainting is explainable and people should be able to cope with it. Having said that, if they do call us I don’t get cross, there’s really no point. I do sigh inwardly when people call us and say they haven’t taken any pain relief because they either don’t like tablets or they’dont believe in it’ 🙄

Would you recommend your job? My DS is just about to start a paramedic science degree