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.

Discuss - 4 Comments

  1. scarletmanuka says:

    Oh dear… where to start on your ‘clearly know best’ approach? It’s TV, of course it’s edited, why would we even want to assume it’s not? Party Paramedics… like that was the choice title of the people who were filmed. Yeh if only everyone had the benefit of rewinding, pausing and generally replaying events on 4OD to get their diagnosis spot on, shall I suggest this to my local NHS A&E? And of course none of them would have the sense to refer serious cases to hospital, they’d just stick a nice Disney plaster on and send them on their way. Et Cetera… Nice provisos though. What’s your alternative proposal with the somewhat struggling NHS?

    • @Secret_medic says:

      As I do this for a living, I clearly have the chance to put an informed angle on this program, but I am not psychic, so I have to work with what I see.

      I make these sorts of decisions every day, and I can categorically say that if portrayed accurately they got them wrong. There is no hindsight required, no magic replays needed. With the information given the decisions were wrong, I along with loads of other people in my line of work were able to say that on first viewing.

      However I am prepared to admit that it would have had some editing. I asked the question about observations being recorded for instance because I am aware it would not make good television. Now if C4 have edited the program to the point where they have changed what happened then that is a fault on their part. The title is also down to them and the program makers and not once have I accused the people on the bus of being at fault.

      These initiatives are a good idea if executed correctly, but if poor decisions are made it is a matter of time in the current climate before lawyers become involved. The tide of opinion on a project can turn very quickly over 1 unfortunate incident and that is why I believe that at least one health care professional should be on these vehicles at all times.

      I feel like you have taken my post as a personal insult in some way. I apologise if I caused you offence, but I stand by my skill and knowledge when it comes to the job I do and therefore I have to stand by my comments.

  2. jabberwocky says:

    i emailed channel 4 about my concerns of the misleading use of the protected title of paramedic and below is the reply from them. In terms of what these people are doing they ought to be applauded and praised accordingly. I do, however, have an issue with the tv producers using this title which our HPC registration fees are supposed to protect for us.I mean just what else do the HPC do for us?

    Thank you for your e-mail around the use of the term ‘paramedic’ in the title of the series Party Paramedics.
    reply from channel 4-
    The use of the term ‘paramedic’ in the series reflects how the term is commonly used and no-one in the programme holds themselves out to be a registered paramedic when they are not. We feel confident that the audience would not have found the use of the word ‘paramedic’ in that context confusing or in any way misleading. We hope you will agree that the programme highlighted the fantastic work of the many health professionals and volunteers who deal with the consequences of alcohol abuse.

    Nevertheless, please be assured that we have noted and logged your complaint for the information of those responsible for our programming.

    Thank you again for taking the time to contact us. We appreciate all feedback from our viewers; complimentary or otherwise.


    Veronica Way
    Channel 4 Viewer Enquiries

  3. Don’t be afraid to edit a guest post – if they’re not a journalist they’ll look to you for some guidance. Add some subheads to break it up; split pars; add links. Move passages around if they’re OK with that. Also tell us a bit more about the poster and make it more explicit that this is a guest post.

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