Are We Helpful?

I’d like the impressions of professionals here.

CFRs, including me, believe we give a service to patients and therefore to our professional colleagues. I’d really like the (HONEST) opinions of ambulance professionals of their experiences with Community First Responders.

Do we do a reasonable job (considering our training level)? Are we of assistance to solo paramedics? Should we be trained in more – or fewer – techniques? If more, what should those be? Would you like to see us trained in other techniques than we are already?

I’d like to see CFRs trained to use Entonox and to be supplied with it. What do you think?

Your opinions would be really useful.

From a personal point of view, I’d like to see CFRs trained in Entonox. I’m fed up with not being able to give pain relief when the ambulance or CP are delayed becaues they’re already on a job.

What do you think?

Wrote this, then realised I was repeating a fair bit of the previous post. Can’t seem to be able to delete the whole post, just the content!

More Skills Please

CFRs are not trained in as much depth as ECAs, let alone paramedics. However, I feel that sometimes we let down patients because we cannot give them the care that they deserve, yet we could learn without too much of an issue. I live in a region of a 2-3.5 million people, within a conurbation of 2-3 million. OK, there are a few fields around us (it’s two main cities, some large towns and a scattering of villages with fields between) but essentially it’s urban.

Sometimes the professionals can take a fair while to get to a scene – the nearest one or two could already be on calls or there could be a major traffic holdup that even blue lights can’t get through (rare as that is) – and we need to do a bit more.

If CFRs were given further training, we could have a lot of the obs done before the professionals arrive. Sure, we won’t be carrying ECG machines (because most units couldn’t afford them) but there are other things.

For instance, I’ve been asked by paramedics to do the BM reading (after they’ve checked that I know what I’m doing) whilst they get on with other things. At one company I worked at, most First Aiders were trained in the use of Entonox, just in case a problem with severe pain came up whilst we had no nurse on shift (and shifts without a nurse were rare). As a CFR I can’t officially do either. However, these could benefit the patient.

Now, I’m very aware that not every CFR would wish to use these techniques. Some will be happy just to carry on with the skills they already have, and fair play to them. They/we are doing a good job.

However, for those of us who would like to go further, shouldn’t there be a possibility of doing so? We could deal with more cases thus often ensuring a faster response to a patient (and better times for our Ambulance Trust!). We’d also get more exprience – although my patch contains 50,000+ people, I can be on call for 12 hours and get ONE call (happened recently).

I know that not every CFR would be happy doing the extra, so I wouldn’t make it compulsory. We could have more than one grade of CFR, just as there are ECAs, Techs and Paramedics in the Ambulance Service.

I wouldn’t give us too many extra skills at first, just to see how things go. The Trust would also have to be careful as to how quickly they went along this route, and provide the relevant training. However, if the right people were picked, it would enhance patient care. Sure, we’d all like it if there was one ambulance for every 10 streets, but that isn’t going to happen.

You’d also have to pick the right people. I’d suggest a basic test and an interview to get on the course, with a rigorous but realistic exam at the end of it. However, I reckon the better CFRs would be well up to this. I can’t be the only CFR with a Science degree, and many have native intelligence anyway.

I’d definitely have two grades of CFR as well. Not every CFR would welcome the new skills or necessarily be able to do them. These people are still useful, as useful as we all are now. No, this advanced training would be an extra; you could have CFRs as now, and (say) AFRs – Advanced First Responders.

There should NOT be any reduction in manning levels within the Ambulance Service, though I can see this happening anyway in the near future as the public finances come under strain. CFRs are their to assist the service, not to replace it. We’d just be enhancing patient care and assisting our professional colleagues more.

(Incidentally, I’d like to say how great it is to address ECAs, Techs and Paramedics as colleagues. It’s a real priviledge – and I really mean that.)

Giz A Job!

I’ve recently been made redundant from my H&S job. It was just as well, as I’ve been really stressed and was within about 3 weeks of packing it in!

(I wanted to do H&S; my employers wanted me to spend the vast majority of my time recording accidents rather than preventing them. As there were three large sites, and I’m paid more than a clerk, go figure! With a bit of clerical input, I could have analysed the figures [I'm good at stats], and also got about to try to prevent more accidents occurring.)

However, I’d quite like to change direction. I really enjoy helping sick & injured people; I’ve been a works First Aider for over 20 years continuously, and a few (separate) times before that – a total of 30+ years. I’ve also been a Community First Responder for nearly four years.

I’d love a job with the Ambulance Service. I may be a bit long in the tooth to become a paramedic (not that I don’t think I could do it, but that I would be forced to retire before the Trust got their money’s worth), but I could do the ECA job, and even the EMT (or whatever fancy name it’s being given now) with the requisite training – less than that of a paramedic.

Unfortunately our local ambulance trust is not taking on ANYONE at the moment, or not, at least, in any kind of clinical role. I don’t want to move house again; I like where I live. I could access virtually anywhere in our Trust’s area in about an hour or so, being close to the centre of the region.

Can anyone suggest how I could get a sharp-end job with a good ambulance trust/company? I don’t want simply to do patient transport, out of preference.

I have considered doing First Aid training; I’ve done it before and enjoyed it, but I’d prefer a hands-on job.

P!sst

This evening I was called to a bloke who had “collapsed” in a residential road in town. Normally the people we go to are indoors.

I found him easily enough, along with his push-bike.

Initially, he didn’t respond to my questions, but then opened his eyes. There was something about the way he looked that brought out the Oh-ho reflex. He tried to sit up. After wavering about for 45 seconds, he gave up and lay down again. Essentially, he was soundly drunk.

He managed to tell me his name, and wanted to be on his way. I did manage to get him to wait until the ambulance crew arrived (just my luck for them to be called from the next district, as ours was already on a call).

Our patient was going to cycle home (he’d fallen off his bike) but we persuaded him to walk. He only lived about 300 yards away from where he fell off! Examination showed he’d no real injuries, he just had a blood-in-alcohol level, rather than the other way about!

One of the crew walked him most of the way home.

CPR!!!

That was the comment I got from the Community Paramedic when I walked in to the bedroom of the patient I’d been sent to who was “not responding”. She’d been doing it, but needed to do other stuff too.

I set about the job with a will. I’ve rarely had to do CPR whilst a Responder, and even then only for a few compressions. Mind you, I’ve been trained in it for over 40 years (giving my age away a bit) and before that I knew Holger-Nielsen (giving my age away even more! I reckon I could still do Holger-Nielsen if I had to.)

The paramedic did some paramedicy things with drugs etc whilst I was doing the CPR. I was going for about 4-5 minutes, during which time a crew arrived. Eventually the initial paramedic called it. We’d done all we could for the old chap.

Whilst I’m with John Donne, and believe that every man’s death diminishes me – just a little bit, we’d done everything we could for this old lad.

Afterwards, I was heartily congratulated by the professionals. The original paramedic said that she’d never seen CPR done as well except by professionals. Well, I’ve been practising for long enough! Still, it’s a shame it didn’t work – but you can’t win ‘em all.

I’m just pleased I gave the gentleman every chance I could, and walked away feeling I’d done a good job, even if the outcome wasn’t what we wanted.

Very Different People

Considering how many people are employed in the ambulance service, it’s amazing how the different types of people blend in so well.

In the vast majority of cases, they also appear to welcome the assistance of CFRs. If possible, they’ll also show you some techniques you don’t get to learn on the training course, and they’ll help you get better at what you do.

Of course, there’s always the minority.

Recently I was at a case where – well, the complaint isn’t really important. Enough to say that all I could do was try to reassure the patient. (Eventually the crew arrived and took her straight in, as there was little they could do either.)

After me, but before the crew, came a Community Paramedic. I’ve not seen him on our patch before and I’m hoping it’s a fair while before I see him again.

His attitude appeared to be “The professionals are here now – bogger off Amateur.”

Now, I don’t like to be in the way and there may be other reasons for me not to be there. At another recent call a lady had chest pains. The all-female crew asked me very politely to stand down as they would have to take the patient’s top off and didn’t want to embarass her. That’s fine by me; they had good reason for not wanting me around and the reason was the patient’s peace of mind. If she had chest pains, I didn’t want to cause her any extra stress.

The crew asked me in such a great way too, without taking ages, that I was more than happy to oblige.

In general, I have a great relationship with the professionals I’m priviledged to work alongside. Of course, I know most of the ones who work our area but even when we get a crew from further afield, they tend to be very Responder-friendly. We won’t, CAN’T take heir jobs – we’re only a stop-gap.

People like the first paramedic get up my nose! We are no threat to their jobs because, even if we stop the clock, there’s a limited number of complaints a CFR can treat. For instance, we do not knowingly get sent to trauma – we’re neither trained nor equipped for it.

Just because someone is “only” a volunteer doesn’t mean they should be treated as a nuisance.

I must admit that the vast majority, 99%, of the professionals I meet are either neutral or (mostly) really support CFRs and appear to value us. They are generally a great bunch, ready with a joke or a bit of ribbing when appropriate.

Shame about the 1%.