31 May 2005

Motorbikes, cycles, and copters, oh my!

We started today with a nice chat with the senior clinical advisor (or, assistant medical director, if you will). He was quite fascinated with the intricate idiocy that American EMS can sometimes resemble. He had a hard time getting his head around the fact that there is no national system, only national curricula. Their system is so simplistic (and smart) here now, (it became really organized in 2000) that it’s hard to believe that the US doesn’t operate in the same way. It was nice to have an opportunity to talk to him and further learn about their system. Their national registry is called the British Paramedic Association and the Health Professions Council is who registers qualified paramedics. Once you have an HPC number, you can take it anywhere in the UK and get a job as a paramedic. We also learned that it would be almost ridiculously easy to transfer national registry to here. (probably easier than transferring to Virginia (but don’t tell my parents)).
I’ve also learned that I am developing an affinity for tea. I know I like two sugars, (everyone asks how many) and milk, which I had never really tried before (and I call myself an anglophile!)
After this, we learned about their Motorbike Response Unit (MRU). This is a pretty cool idea, and has been around here for about 8 years. Every paramedic on this unit trains with the police out in the country. This training must be a pretty harrowing experience because the guy we talked to said he wondered if he would die while doing it. This, just after telling us he could go 100 mph through downtown London. We got to check out what the bike carries and sit on it too, what joy!
Then we went to visit the Cycle Response Units (CRU) which is located in the car park under the building. They have nice bikes, holding about 50lbs of equipment. Fully ALS equipped, with lights, and a siren, hilarious!
We had lunch and went to the helipad at the Royal London Hospital. London? yes, Hospital? yes, Royal? not so much. It’s in a pretty dodgy end of town, and from a distance it looks like the helipad is held up with 2x4s. But, once we got up there, it was pretty cool. There is only one helicopter that services London. It’s the large red one with Virgin on the side. It carries a doctor and a paramedic, and they can do basically whatever they want to. They often not only do RSI, but administer ketamine (what we call horse tranquilizers), put in chest tubes, perform thoracostomies, episiotomies, surgical airways, and amputations. We hung out in the helicopter, they got a call, and we watched it take off. (the call turned out to not be exciting) When it got back, we took some more photos of it. The weather was perfect, so we got some beautiful shots of it with London in the background including St. Paul's and the tower of London.
We came back to our hostel area for dinner and a pint, and went to the market for some dessert. (We saw a Ford streetka, I want that car!) I think we’ll make it an early night tonight, we are both feeling a bit run down from all the walking and all the bloody steps in the tube!
Cheers-

30 May 2005

999 where are you?

Today we hung out at the central ambulance control (CAC) or dispatch and listened in on 999 calls. Some pretty cool stuff, a cardiac arrest, a lightning strike, lots of little trauma, and various medical calls, all not requiring real care. They're dispatch system is very similar to ours. We met a doctor who runs with the physician response unit. This is a very clever idea where a doc responds to lower priority calls and diagnoses and treats people without the need for ambulance. My Briticism of the day is the phrase 'went wobbly' which means fainted.
We also hung out the HEMS or helicopter EMS desk and figured out how they decide which calls they go on. That consists of a paramedic and doc who respond to trauma only, land in places like Piccadilly Circus, and render care like thoracostomy tubes and chest cracking (apparently with good outcomes). That would be cool to witness. The helicopter says Virgin on it, but that is mostly for advertising purposes. They pay £450,000 per year to get their name on it. It is actually run by donations.
We later went to 'The Royal Borough of Kensington' where we saw some posh cars. I joked that if my friend Ewing had been here he might have needed a moment to himself. We saw Porsche, Ferrari, Mazarati and a really hot TVR Tuscan with chameleon paint!
Then we went for dinner to a pub around here, I got a half pint of Carlsberg (we have to get that in the states) and a really good breakfast sandwich with a big slice of ham and bangers on it, yum!
Afterwards, I went to the Tate Britain where I'll have to go back soon as it closed just as I arrived.
Tomorrow we'll be visiting the motorbike, cycle, and helicopter units.

28 May 2005

Yay, more free updating!

Here's another micro update. I'm here at Waterloo, the LAS HQ. I've been riding another rapid response unit tonight, mostly north of the river in the heart of London. We've had some good calls: a cardiac arrest, a stabbing, and various other drunk-related incidents. I learned that English AEDs speak to you in British accents (useless fact).
I know I look quite fetching in my LAS ballistic vest (stab vest) and I feel pretty damn cool too (haha). Some of the most fun of the night has been racing past Buckingham Palace (waking up the Queen), Trafalgar square, and St. Paul's, hanging out in Soho, and watching the sun rise over Waterloo Bridge. The sun rises quite early here, by 4:00 it is already bright. I also got to go fetch a patient off of the top floor of a double decker bus (first time on one of the busses here). I also got to go in an exclusive London club near Piccadilly Circus (a guy had been assaulted and cut in the face) so, another life goal fulfilled. (I hope you got the sarcasm in that one, but it was cool to go into the club.)
I slept until around 2pm today, then I went to Notting Hill, specifically Portobello road to enjoy the open market there. A crazy amount of people and antiques there, (some genuine, others not so genuine), but enjoyable none the less.
It's almost 5am here, for the record. For some reason, blogger keeps the times in EST. I have no idea what I'm doing the rest of the day besides sleeping.
Also, my parents are away for the weekend (I think) but happy anniversary to them! I remembered, yay!

English coffee, English tea, English soda = wheee!

Two posts in one day; well, sort of. It still counts as the same day if you never go to bed, right? This update is free. I'm here at the Oval Ambulance Station utilizing their computer. I've been doing a night shift with a 'Rapid Response Unit.' I'm with a paramedic and we respond to category 'A' calls or priority '1' as we say in the states. It's been awesome and I feel great even though it's almost 6 am here. I'm all hyped up on caffeine at the moment. Maybe I'll go straight to Portobello road from here. We've had a lot of calls, (17) and I got to draw up 'Daizamuls' aka Diazepam. Pretty cool. I've learned a lot about LAS and England in general. All different, but the same. Just with British accents and phrases like 'When did the poly start?' 'Shock box' and 'Sharp Scratch.' The people here are awesome, I can still barely believe it. They were worried I'd be bored because we've mostly had BS calls. I'm so excited just to be racing in and out of traffic in excess of 60 MPH that I can hardly stand myself. I don't even mind wearing the bright yellow observer vest solely for the fact that it says LAS on it.
They have a fantastic map system in each car and ambulance. It tells you where to go and how to get there. Also, all of the call info comes up on a different little screen, dead helpful.
Well, that's all for now. I can barely see straight from all the coffee, etc. But hopefully by the time I get dropped back at the hostel, I'll feel tired again.
Laters!

27 May 2005

50 p for 15 minutes!

Welcome to the most expensive and fast blog update ever! I'm here in London with Jon, things are going great! Living at a hostel is a new experience for me, but this one is really nice (as are our roommates). We arrived on Wednesday around 10, checked in, and found the closest pub for a pint. Expensive here, but Jon has learned that Guinness from the tap rocks his world.
Yesterday we visited a station of the London Fire Brigade. We saw all of their equipment, and it was so cool, even my squirrel tail went up! Then, we found our way to LAS headquarters and met with the kind people who have planned this for us. There is much in store, and just thinking of it makes me giggle. Tonight we are doing a night shift until 7am. That should be interesting. The LAS people have treated us extremely well, gave us a nice LAS pen, disposable camera, and other goodies. They also drove us around to see the sights in one of their haz-mat units. Being on the 'wrong' side made me a little nervous but I couldn't believe where we were.
After visiting them I went to evensong at Westminster Abbey (purely by accident, but the best way to get in there for free).
This morning I went to the National Gallery (awesome!). Here I met Sister Wendy (if this has any meaning to you, well done you.) She is ancient and never stops talking, just like the show! Don't worry mom and dad; I got the gallery book, so you can decide what to see (probably everything). It's a bit overwhelming there. Then, I ate lunch in Trafalgar square, and went to Harrods, (Saw a suitcase for £899.)
Now, to take a nap before the overnight!
Cheers!

16 May 2005

All study and no play make Ellie go something...something...

I'm convinced that the NREMT exams are designed not to test your knowledge of paramedicine, but you're overall mental health. If you can survive taking a 180 question/3 hour exam then, two days later survive going through about 10 practical stations in rapid succession lasting God knows how long, you should earn a stamp on your forehead that reads: “Sane.”
I love the practical critical fail points (meaning if you do or don’t do this thing, you fail the station) such as: “Did not indicate the need for transport.” Of course you’re transporting, that’s the job!
I’m really looking forward to what I believe will be the most torturous and uncomfortable 30 seconds of my life. During the ventilatory management station, you ventilate the ‘patient’ for 30 seconds while; I assume the evaluator watches you for mistakes. I think it’s designed to see how long you can go before cracking. I’ll be thinking: “The evaluator is still watching me, boy, this is uncomfortable. 1,2,3,4 breath…What if I mess up? Will they ask me to leave right now, and to not even bother to finish? 1,2,3,4 breath…Ooh, I think some air leaked on that one, crap! How long has it been? It seems like an eternity! 1,2,3,4 breath…They should just fail me now, I know I’ve made too many mistakes already.” Then the evaluator will finally say: “Breath sounds are present and intubation has been ordered.” I’ll think: “Woo-Hoo! Thank God that's over.”
We took a fake written yesterday so we could get an idea of how fun the real thing will be. Conclusion: loads of fun! Up to three hours in a lecture hall reading complicated questions that randomly jump from one subject to the next. You can be remembering the difference between asthma and bronchiolitis, then all of a sudden you’re trying to remember what a tertiary blast injury involves, then a random question about simplex or duplex communications. And the answer choices are really great too. Two of them you can eliminate right off because they’re totally dumb. Then the other two choices are so similar that you pull you hair out while thinking of a reason to chose A or C. (Well, I haven’t used A in a while) Then you try to suppress the horrible feeling that there’s no way they would have gone this long without having A as an answer. (C is a nice neutral answer) Then you realize you have four C’s in a row. There’s no way they would have a 5th one! That’s unheard of! (Hmm…well, maybe it’s B after all.) Such is the insane rambling that I anticipate to be going on in my head during the most important test I’ve taken thus far in my life. I can’t wait!
Wish me luck this week!

09 May 2005

Let the happy dancing commence!

All the IV flashes in the world could not yield the volume of happy dancing that I would like to do now. My classmate Jon and I have successfully coordinated a visit to London to ride with the London Ambulance Service (LAS) for two weeks. We’re also going to visit their university, helicopter EMS, communications center, and boat team, among other things. I am currently reading the indemnity form I have to fill out. My favorite part so far states that I cannot offer treatment to a patient unless asked to do so by the crew members: “Sure, I’ll drop that tube, no problem.” hehehe!
I’ve known for a bit, but because of my mild superstition I had to wait for the plane tickets to be purchased and the hostel booked to make it “official” (because blogging makes everything official.)
I am beyond excited about this, I can barely describe it. I try not to think about it too much or I may break out into song and dance at inappropriate times (at church, during NREMT exams, in class, etc.)

As a self-professed anglophile and I can’t wait to submerse myself in British culture...uh…..oh…sorry I glazed for a sec while thinking about ‘vanbalances,’ green uniforms, motorcycle chase vehicles, adrenaline, and ‘stretcher trolleys’…ahhh.
More details to follow, the excitement really starts next week with the NREMT-I written and practical. Plus finals, a project due, and packing, yipes!
My class is definitely in robot mode: BSI...scene safety…inflate bulb...SAMPLE...pad the voids...pinch the line... Do you think if I made a shirt that said “BSI/Scene Safety” that I wouldn’t have to say it? That would be nice.
Now, back to studying.

03 May 2005

Back into focus

Nothing cures the soul better than kayaking down a scenic river with one of your best friends. For me, at least. This weekend I went home briefly, went kayaking twice, visited my niece and nephews, and ate pizza…it was nice.

I love to kayak, and found a new place to go near my house. It’s my first river (about class ½) and it has taught me a bit about the logistics of parking one car at the end, and one car at the beginning, instead of carrying the kayaks back to the first car.
Or, you can drive both cars to the end then leave one, drive to the beginning, drop the kayaks off, drive back while someone watches the kayaks, get a sandwich, stop at the first car, change shoes, drive half way back, do a dance, drive the rest of the way, eat a sandwich, drive back to find a trash can, then drive to the kayaks, throw on a PFD, and get in the water. By then the sun is almost down. When you’re done you realize you can only put one kayak in the car at the end, so, you drive one kayak back to the second car, drive back, play some ping-pong, get the other kayak, drive halfway back, realize you left your friend at the other end, drive back, pick them up, then pack the kayaks in the first car that both of them will fit in (or was it the second car?) no matter, drive them home, hose them down, and go to bed. Just an example of the complexity of kayaking on a river.

We had to hike in a little to find a good launch spot. We must have looked quite comical walking though the woods carrying two kayaks. At one point we had to carry them over a downed tree. As I jumped over it, this huge thorn impaled right into my knee cap. My kit with tweezers (although we could have used grilling tongs, it was so big) was in the car of course, so I had to pull it out with my teeth (not really, but this story must get more fantastic with every telling). I’m fairly certain that I’m going to live, although it was all red and angry yesterday.

I love to be on the water; the quiet, the wildlife, the bond formed between you and a piece of plastic. (mine is named Kopapa) I’m glad I got to go since the next three weeks, and possibly the next six weeks are going to be pretty crazy.
Kayaking helps me to go forth and prosper.