A day in the life of a paramedic

Dan Mason, Editorial manager
January, 2020

From an early morning alarm through to the end of shift, Danny O'Neil tells the story of a day in the life of a student paramedic at Birmingham City University

It is 4.30am on Saturday morning and my alarm goes off - time to wake up and get ready for my shift. I shower, iron my uniform, have some breakfast and make a packed lunch to take out with me. I am on the 6am-6pm Fast Response Vehicle (FRV) shift today.

The role of the FRV is to attend the more serious 999 calls. These are Red 1 and Red 2 calls where an ambulance is required at the scene within a target time of eight minutes. The FRV carries a LUCAS, a machine that automates chest compressions in a cardiac arrest patient. This allows the paramedic to carry out Advanced Airways and Intravenous Access for drug and fluid therapy if required.

The joy of living so close to the station is that it only takes me a few minutes to walk there. I arrive and have 15 minutes to complete vehicle checks. We start off with the Red checklist, which needs to be completed before we can book on with control. This includes defibrillator checks, gas checks and drug bag checks.

We book on with control and immediately our radios start vibrating and alarming. A case has been allocated to our vehicle. The message on the radio screen advises 'Return to Vehicle Emergency Call'. Back in the vehicle we have a look at the Mobile Data Terminal System (MDT) that gives us all the details we need.

This is a Green 1 call, also known as a G1. This is classified as an emergency call but not life threatening, meaning that an ambulance or FRV needs to be on scene in 18 minutes. As I get in the vehicle I read the screen and it states 'vehicle RTC (road traffic collision) rollover car on fire'. Before we set off to the job I swap my coat to my high visibility jacket and move my helmet to the front of the car.

On arrival we find one vehicle on its roof. It is ablaze. There is a group of people standing and kneeling to the left-hand side of the vehicle. We are advised that the vehicle had been travelling at speed with a single female occupant who was ejected from the car on impact.

The patient is quickly assessed for C-spine as she needs to be moved. My mentor immediately calls for assistance from Helicopter Emergency Medical Services (HEMS) and additional crew. He also checks that the fire service is en route and confirms the details of the incident with control.

Due to the vehicle being on fire, the patient needs to be moved. We get her up and start to walk her away from the burning vehicle. As we do this another crew makes its way through the tailback of traffic. Once it arrives we put the patient in the back of the ambulance.

The patient is covered in blood head to toe. She has sustained a facial laceration to the neck and face, and you can see the veins in her neck pulsating. She has sustained multiple body and arm lacerations, which are bleeding, and an open wrist fracture.

HEMS arrives on scene and the doctor comes on board the ambulance to assess the patient. He advises that we needed to transport her to our major trauma centre. We make a pre-alert call en route to the hospital and we travel in on blue lights. Our car, which we left on the scene, is brought in by one of the technicians from the crew.

We are ready to leave hospital. The next job comes through to the screen. This is a Red 1 call, also known as an R1. This type of call is classified as an emergency and is usually life or limb threatening. It requires an eight-minute response. The radio goes off with a call from control, who advise that we are attending the attempted suicide of a young male.

We begin our assessment and confirm that the patient is in cardiac arrest caused by lack of oxygen to the body. We begin CPR and place a defibrillation pad on the patient to assess the patient's current cardiac rhythm. The patient is in ventricular fibrillation (VF), which is a shockable rhythm.

We administer a shock to the patient through the defibrillator. We then radio to control and ask for a LUCAS and HEMS. I start to feel very anxious, adrenaline is running and I have goosebumps all over. We manage to get return of spontaneous circulation (ROSC) with the assistance of HEMS and a LUCAS device. The patient is transferred to a specialist paediatric intensive care unit (PICU) via helicopter.

As a team we hold a debrief afterwards with the police. This is to ensure that everyone is okay and to reduce post-traumatic stress. It's always good to talk things through after events like this, it helps a lot.

We need to return to the station to re-stock and clean down. We complete the re-stock of our response bags and cardiac arrest drugs roll, and change our oxygen cylinders over as they are low from the previous call. We are then put onto break.

Our break is about to end so we return our bags to the vehicle. Then the radios go off. 'Return to Vehicle Emergency Call'. I check the details on the MDT screen - we are off to a Green 2 (G2) call.

An elderly man has fallen and signs of severe bleeding have been reported. On arrival, the patient is found to be on the floor outside the front of his property. There is a lot of blood on the floor around the patient.

On completing a full assessment of the patient there are signs of epistaxis and a laceration to the left eyebrow. The patient complains of C-spine tenderness on examination. The patient is cannulated and we call for back-up for an ambulance to assist us in taking the patient to hospital.

Within minutes the crew are here. The patient is given IV morphine and ondansetron as an antiemetic for the journey. The patient is immobilised with a neck collar and a scoop and strapped in for transfer to the stretcher. He is then transferred to the stretcher and transported to hospital for x-ray and assessment.

It is the end of our shift so we return back to the station and complete a refuel and re-stock before finishing for the day.

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