Who you calling a Paramedic?
@Secret_Medic kicks off our debate over Channel 4’s new series, Party Paramedics:
2011 saw a slew of stories about what we call “alternative care pathways” for those a little more inebriated than they had intended. For a while I was beginning to think the London Ambulance Service booze bus had its own media team with it at all times!
But thankfully that is over no-….oh, not quite.
The first episode of Channel 4’s three-part Party Paramedics series was set in Colchester – a notorious party town where a bus has been equipped to deal with the weekend casualties of the UK’s binge culture. The SOS bus parks up in the town and helps give advice, look after and sober up a few of the revellers. It is manned almost (if not totally) by volunteers.
I should preface my comments by saying that volunteer groups such as St John’s and The Red Cross do some fantastic work. And the volunteers on this programme should be commended for going out on a Friday or Saturday night, giving up their time and helping what most people (and not just Ambulance staff) would see as money draining time wasters who have gone too far in the name of forgetting their 9-5 working week. However it appears that none of these people was a Paramedic and this is where the issues began for many people who work in the Emergency Medical Service (to use an American term).
For those that don’t know, the title of ‘Paramedic’ is a protected one. This means that no one can legally call themselves a Paramedic without being registered as one. In the UK you must be registered with the Health Professions Council after around three years of training.
Paramedics are able to perform procedures that previously would only have been done in hospitals and manage to perform those procedures often very effectively in a heated, uncontrolled environment. For any junior doctors struggling to put in a cannula, try putting one of your first in, in the middle of the street with a crowd of a couple of hundred watching while you, your crewmate and a responder try and revive a patient in cardiac arrest! And more often than not, it gets done and done right.
For this reason I think it was a bad start for most of us ambulance folk to see these people working under this title and it was an ill-advised choice by Channel 4. We shall see whether they rectify this with the next two programmes.
The first episode was a mix of the good and bad. It was lovely to see many caring, nice people looking after the drunks for no reward and I think this shone through the program. Initiatives like this are vital in the modern world, because these people would have otherwise called ambulances taking away the vital resources from someone seriously ill.
But despite this heart-warming act of charity, I have some real concerns. Let’s assume for now that what we saw wasn’t heavily edited, as I cast my critical medical eye over these practitioners. There were two key cases where I disagreed with the course of action taken:
The first incident was where a lad had been bitten. It looked fairly superficial, and in fairness after some cleaning there is little else that can be done with it. The patient was sent home with advice to go and see his GP the next day. This might seem like reasonable advice, but there are some issues with this.
Given he had been drinking, will he remember the advice? And will he care enough to go? If I take a human bite to Accident & Emergency they will often – if not always – be given a tetanus shot. This is due to the very real and dangerous risk of contracting tetanus. The advice should have been for this guy to go straight to A&E, even if they don’t take him there themselves.
The second issue came from the unconscious “Oompa Loompa”. I would say there is a very real chance this guy was on a substance other than alcohol. If you watch it again on 4oD you can fast forward to the part when he states he is an “Oompa Loompa on [PAUSE] alcohol.” The pause in that sentence is potentially very telling.
After the collapse, he is taken aboard the bus, but he is clearly confused. He doesn’t know where he is, doesn’t have a good grasp of simple information and in my professional opinion I don’t think this was simply drunkenness. The patient struck me to be in a similar state to what we call “post ictal”. This is a state of confusion after having a fit or seizure and is usually temporary. It takes a varied amount of time for people to come round and regular fitters will normally recover and make their own way home.
But he had not recovered and was being left in care of another drinker to go home with the same advice to perhaps go to his GP. This is flat-out wrong.
It would be nice to know if they checked his observations thoroughly, as well as how much they know in terms of interpreting those observations I will now give a quick list of possible reasons off the top of my head for why he could be like that: alcohol, drugs, seizure, diabetes (high or low blood sugar).
I’m sure a Doctor could give you a few more and for this reason that patient should have been conveyed to A&E.
My feelings on this kind of service are mixed. It is a marvellous service if done right. But I would have it run by a health care professional at all times, because although 999,999 out of a million times there will have been no issues, that one time they get it wrong (and I mean really wrong) it will jeopardise services like this across the country.
The media’s love of the booze bus could quickly turn to a hate for untrained staff treating people that need serious medical help. Channel 4’s programme highlights how easily an innocent documentary can turn against an otherwise good idea.