The sky's the limit

Alex Grant

Faculty: Medical Science
Course: BSc (Hons) Paramedic Science
Category: Allied and public health

25 April 2017

I recently embarked on an entire weekend of observational shifts with SECAmb (South East Coast Ambulance Service).

Living in Brighton and Lewes my whole life up until university, I have worked closely with a lot of the team in my ‘St John Ambulance years’. Many have gone on to work as 999 call takers or are now road staff. 

On a busy Saturday I visited the EOC (Emergency Operations Centre) in Lewes for a short 7am-2pm shift with my friend, Sophie, listening to the many 999 calls incoming. The call volume is drastically lower than with London Ambulance Service, where I've been on placement, which threw me off balance as I was confused as to how ‘quiet’ it seemed in comparison.

One emergency call made in the morning was by an extremely distressed lady who was panicking and unable to give us her exact location. By calling on a mobile phone, the EOC has a general idea in which 'cell' (area) the call is made from, but it is a huge area. After some minutes, a male's voice was heard in the background saying 'Pass me the phone'. It was her husband. He calmly told the call-taker what had happened: he shut the car door on his fingers and understandably, told us to stand down all assigned units immediately. This level of call is unfortunately a frequent occurrence and certainly a trend that persisted throughout our shift. However, we did take numerous calls that resulted in patients being blued in to hospital, as they were very sick. Our final call of the day was a young lad who had amputated a finger. We gave first aid advice over the phone and his friend drove him to the nearest A&E.

On Sunday, I ventured out to Hastings in East Sussex (where I've spent a lot of time, as I went to Battle Abbey School for sixth form, which is only down the road). This shift was 6am-6pm with a Clinical Team Leader (CTL). The official name for his role is AOCCTL, which as it sounds is very important! His role is operationally to respond to RED1s and Bronze call-outs only, and to carry out CTL tasks whilst on station. 

We were scanning ongoing 999 calls in the Sussex area and a RED call popped up in our dispatch area; an ambulance and Critical Care Paramedic (CCP) was sent. We monitored the situation from base and were soon informed the patient was found in peri arrest on arrival, and then arrested in front of the crew on scene. We were tasked the job on our MDT and we responded quickly to the call. Whilst en route, our CTL received a radio transmission from HEMS [Helicopter Emergency Medical Service] stating they had landed in a park nearby. We proceeded to the landing site and awaited the arrival of the patient on the ambulance.

The patient arrived in ROSC (Return of Spontaneous Circulation) but was combative and agitated with a low GCS score (consciousness level). The HEMS crew made the decision to RSI the patient prior to flying. RSI stands for Rapid Sequence Induction; this involves administering a number of anaesthetics and muscle relaxants in order to take over their breathing. As always, the helicopter brought a lot of attention and people even parked at the road and sat watching the crews treating the patient, which I strongly disapprove of. Sussex Police were amazing in scene coordination and our CTL positioned our vehicle onto the field to block the view. After stabilising, the patient was flown to a specialist hospital due to the suspected cause of arrest being a subarachnoid haemorrhage.

Our second patient of the day was an immediate dispatch to a RED1 RTC motorcyclist versus car, with a collision speed estimated around 50mph. The only available resources at the time were AOCCTL and myself along with an operations manager used for scene command. The nearest ambulance was running from a far distance and HEMS had been dispatched by air. The motorcyclist was thrown a small distance and bystanders couldn’t get a response from him. To our amazement, a passing CCP on his day off had come across the collision and assisted us until HEMS landed in someone’s back garden.

After taking off the motorcyclist's helmet and cutting his clothes off for assessment, he had global facial weakness and arm weakness with no other obvious injuries. Bilateral IV access was gained along with the application of a pelvic splint due to the mechanism. The HEMS team and paramedics suspected the patient to possibly have suffered a neurological event whilst riding. We brought him to the helicopter and he was airlifted to an MTC (Major Trauma Centre).

After all this excitement from observing these shifts with SECAmb, it has shown me just how differently ambulance services operate. I believe we can learn a lot from each other. The collaboration I witnessed between HEMS, CCPs and CTLs was incredible and the best possible patient care was given. I am certainly making a return to SECAmb for one more observer shift. I'd advise this to anyone looking for a change of scenery here and there.

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