A day in the life of a paramedic

Rachel Swain, Editorial manager
March, 2022

From an early start through to the end of shift, Megan Elsey tells the story of a day in the life of a student paramedic at Edge Hill University

During placement I usually work the 6am-6pm line with my paramedic mentor Sam. My alarm goes off at 5:10am and I roll out of bed, throw on my uniform, make sure I have everything I might need for the day ahead, such as my stethoscope and tourniquet and set off to station.

At 6am myself and the crew I am working with go into the garage to complete our essential checks on the ambulance. We check that we have everything we need for any type of emergency, check that all of our equipment works and that all our drugs are in date. As soon as you turn on your radio and sign on for the day, control (who allocate all of our jobs) voice us up to check we are ready to go. As soon as this is confirmed a job is sent through.

First jobs of the day

The ambulance service categorises all the calls that come through. Category one is the most life threatening and needs to be attended to within seven minutes. Category four calls have a response time of three hours. Although most people think that every day on an ambulance is different, there are typical jobs that you will be called out to to on a daily basis.

The first job of the day always tends to be elderly falls, this is due to the fact that carers go into the elderly for their morning visit and find that the patient has been on the floor all night. These are always nice jobs to attend to as you can get the patient up off the floor, and providing they have no injury's you can make them some tea and toast and sit and have a chat, a nice way to start the morning.

However, in this job it is easy to become complacent and then a category one will come through and get your adrenaline pumping. We clear from the elderly fall and a job is sent through straight away - 'birth imminent', your mind starts racing on the possible outcomes of this particular job. The ambulance lights are on and off we go. We arrive on scene to find a lady giving birth on her bathroom floor, straight away we're asking for extra resources as this baby is going to be delivered at home. Mum and dad are both going to be first time parents and require a lot of reassurance. Within five minutes baby is born and you suddenly start to come back down from all that adrenaline and take a minute to enjoy being able to be part of such a special occasion. Births are one of those jobs that are amazing when everything goes well and are such a privilege to be a part of, but they can also be some of the scariest jobs we attend.

Being ready for anything

Just like that you climb back into the ambulance, clear off that job and wait eagerly for another to come through. Sometimes what gets sent through to the crew via control can be completely different when you arrive on scene so you have to be ready for anything.

The job comes through as an 88-year-old male, shortness of breath/noisy breathing. Straight away as a crew we start discussing the possibilities of the job. When we arrive the patient's wife escorts us into the bedroom where we find the patient not breathing - we have to act fast.

As well as treating the patient it is also important to keep family members involved in what is going on. We explain to the wife that at the minute her husbands' heart is not beating for itself so we are going to help him. The PADS are applied and connected via the defibrillator and CPR is commenced. Straight away we all notice that this patient is in a shockable rhythm so the defib is charged to 200J and a shock is delivered to the patient. We then need some extra resources in order to give this patient the best possible chance of survival. CPR is a tiring procedure and so it's important that crew members take two-minute turns in order to give the patient good quality CPR. A senior paramedic arrives on scene and is able to attach a device called a LUCAS to the patient’s chest, which does the CPR for us. We can then focus on everything else that needs to be done.

The senior paramedic also carries a piece of kit that allows us to drill into the bone if we are unable to find a vein, this is called intra osseous access, we gain this and begin to give our adrenaline. After a second shock we get a return of spontaneous circulation, which means the patient's heart has started to beat on its own again. This is down to effective teamwork and treatment. The patient is transported to resus on lights and the hospital then takes over the patients care.

Time to reflect

After a cardiac arrest there is a lot of cleaning and restocking to do, it is also important as a crew to go back to station and have a debrief about the incident. Here you are able to reflect upon your actions and talk about what went well and what could have gone better. Its particularly important in this job to be reflective as it can really help to talk about incidents that might have been distressing or upsetting, as your crew are always there to support.

It's now 2:30pm and we are ready for our dinner, in this job you eat whenever you can. We have 30 minutes for dinner and we are back out on the road. The pace of the day slows down as we are going to attend a 20-year-old who has a headache. As an ambulance service, everybody gets sent an ambulance that rings for one; this is a category three call. We do a full assessment for the patient and advise regular pain relief and speak to the patient's own GP to inform them of our call out today. Not everybody that rings an ambulance requires hospital treatment and we are able to refer patients to appropriate services, which means we are free to carry on attending other incidents.

Last job of the day

Its 4:30pm and we clear off our latest incident ready for what will hopefully be our last job of the day. A category one job is put through to us - 'seizure'. These jobs are time critical due to the lack of oxygen supplied to the brain while a patient is having a seizure.

We arrive on scene and find the patient still seizing on the floor. It's important that we get a cannula in this patient in order to give medication to stop the seizure, however this is a difficult task when someone is not in control of their body and unable to keep still. As a crew we work together to try and keep the arm still and we insert the cannula, the medication is administered and the seizure ends. It is amazing to see how effective and efficient certain medications are for specific medical emergencies. Initially the patient is groggy as they are in a postictal phase, which is expected after seizures when the patient will be confused and may be agitated. In this time, we put the patient onto a scoop and carry them out to the ambulance.

However, you can never stop watching your patient as after being on the ambulance for five minutes completing our checks the patient begins to go into another seizure. This is now a time critical emergency and the patient needs to be transported to hospital, so a pre alert is put through to let the hospital know we are on our way and we set off. On route we are giving the patient some more medication and monitoring them. We arrive at hospital and doctors are waiting for a handover. Once this is done, we are free to go.

We finish half an hour late but this is the nature of the job, you cannot guarantee an on-time finish. We grab our things off the ambulance and head home, ready to do it all again tomorrow.

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