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Ambulances & Programming



It’s been six weeks since I last managed to write something, which is a reflection of how busy things have been recently. I’ve been going to work, working solid for the full shift, and coming home tired and wanting to get to bed. But even so, I still love what I’m doing, and I got something this week that reminded me why I do this job.

Epaulette of the London Ambulance Service, reading LONDON AMBULANCE at the top and EMERGENCY CALL HANDLER at the
  bottom. Pinned onto the epaulette is a badge showing the LAS logo, under which is a white inverted teardrop shape
  bearing a small embossed image of a stork.

I wrote about this briefly on Twitter as well, but I figured I’d put something here too.

Busyness as usual

Covid has been a really odd time for the service. March 2020 hit us with an unprecedented volume of 999 calls, and became our busiest month ever. Most callers were folks worried about a new unknown thing, but generally not very ill. Things died down again over the summer, and I joined at the end of summer as things were relatively calm. Then from November through to February, we were absolutely slammed — we went to the highest escalation levels we have; we declared critical incidents because of the demand, and we had several of our busiest days ever, with our busiest at almost 9,000 calls in a single day. On average that’s a call every 10 seconds, but calls aren’t evenly spread through the day — at peak, we were taking a new 999 call every single second, for hours on end.

We don’t have the people for that. Nobody does. We had 3 other ambulance services taking calls for us, and we still had 100+ calls waiting to get through to 999, people waiting for 40 minutes plus just for us to answer, in an environment where seconds count.

Then it died down again. We had two or three months off; we dropped down the escalation levels, stood down incidents. We had several weeks of under normal volume, taking around 4,000 calls per day compared to our usual 5,500. Now, we’re back to being busy again — not as ridiculous as the second time around, but we’re still regularly getting towards 7,000 calls per day.

Special Moments

There are moments and calls that are special or memorable to us as call handlers. First cardiac arrest. First ROSC. Lives saved. First babies. In the middle of the chaos of the second wave, I got one of those.

2020-12-05. 01:31Z. Beep. Female, mid-twenties, active labour. It was her first baby, and she was having contractions 3-4 minutes apart. At this point, I was still a newly-minted call handler of a whole two months’ experience, and I was sat out in our overflow space with nobody else around me. Family were on scene asking what they should do. I wasn’t too worried, contractions at that spacing usually mean there’s plenty of time, and the call is a category 2.

That said, our category 2 calls were taking up to 90 minutes to get to at this point because of the demand on the service. I sat on the phone with them and waited and monitored, and her contractions started coming closer and closer together with still no sign of a crew. That’s when I started getting worried — this was the first call I’d taken on this protocol, never given the instructions before or even really looked at them since training school.

Suddenly baby decides right now is a great time to show up, and I get a few screams as the family start seeing a head popping out. We have instructions for this, all I have to do is stay calm and read them out. The next 5 minutes are quite possibly the most terrifying I’ve been through on the job: baby delivers, not breathing, with the umbilical cord bleeding uncontrollably. Again, we’ve got instructions for all of this, but at the back of my mind is the thought that I’ve got two lives on the line here and they’re relying on me getting it right.

5 minutes later, we have a living, breathing, crying little girl, and I have to mute myself to mask a shaky almost-sob of relief as the weight lifts. I remember sending a message to the crew, now enroute:

BBA 02:41, C&B1

5 minutes of slightly calmer instructions later, the crew pull up outside, A232, and I hang up the phone and absolutely lose it.

Recognising Exceptional

The ambulance service is a pretty unique environment. Especially in the control room, we deal with life and death every single day, and that’s just… normal. It’s not something we do much to recognise, because it’s our job and we’re used to it; every shift I can be pretty sure I’ll keep at least one person alive and lose at least one other person.

But every now and then, we really do make a difference. Providing CPR and defibrillator instructions that get a ROSC pre-arrival and the patient survives to discharge is one of them — these calls are ridiculously rare. Likewise my call — it’s incredibly rare that we don’t get a crew there in time before a baby is born and the call handler has to deliver it over the phone.

When we get these calls, that’s when we do more to recognise the effort that’s gone into it. This call got reviewed by our quality assurance department and by senior managers, and they all signed off that it was done right, and more importantly done calmly and with plenty of reassurance for the family. That’s what got me the badge.

And wherever I am, in 10 or 20 or 50 years time, I can look at that badge and I will remember every detail of that call, and I can be proud all over again of the family I kept together that day.

  1. Born before arrival, 02:41, conscious & breathing 

development awards recognition
Written on August 7, 2021