Reflections on Day 2 – the Project

Originally posted on November 20th, 2010

Today was my second day in Newcastle, UK but the first on the streets with Mark.  It is indeed a different world here.  the video from the end of today is linked at the end of this post.

We started early this morning and grabbed a coffee at the McDonald’s, then off to standby in a local neighborhood where we pulled out the laptops and discussed the day.

I was able to have a quick interaction with some of the Firefighters assigned to the station with Mark and the Ambulance crews, nothing more than a quick introduction between calls, but it was later in the morning when I learned I don’t have it nearly as good as I thought.

While heading out to the pouring rain, I bumped into the station cleaning crew mopping the floors.  The fireman don’t do the big housework.  No wonder mark was so surprised when I gloved up and cleaned toilets back home.

Later in the morning still, I met the Station’s French Chef.  They don’t cook their own food either.  These are two things I think identify the firehouse as a home.  It seemed more like a school than a fire house.

But, I have yet to see it through the eyes of one of the firefighters, that comes next week.

As far as impressions on the ambulance, I can say that some of my expectations were met while others missed completely.

For example, Mark can honestly tell people when they don’t need to go, then leave them at home to recover.  He can not only let them drink water, but take pain meds.  He can cancel the ambulance and drive patients into the clinic.

He also has to wait in the middle of the highway for a second ambulance when he has 2 patients in C-spine precautions.  You see, the European style ambulance is abundant on space on the inside, but so much of it is unused.  There are two chairs and a cot in the back of these rigs, no room for a second patient.  When we had 2, almost 3 patients to board, we had to wait, when most US services have the bench seat that can be used for that second patient.

He also gets to watch the fire brigade going the other way on that highway just looking.  They did not respond to the traffic collision.  Had I not been there he would have been alone, but I’m sure done fine.  The police and highway department arrived and had a cool hand with the traffic, no safety issues or requests to reopen the highway sooner.  In fact, where some of the agencies I have worked with would open the lane next to the accident, these folks kept it closed since we were close to it.

It is hard to draw any conclusions from a 12 hour shift in one station, but at first glance I want to have Mark’s training and options when encountering patients who don’t need an ambulance and I think he needs my ambulances to offer a better service to his community.

Deploying rapid response cars within the SFFD may not work after all without the clinical routing options he has at his disposal, not to mention an ENTIRELY different view of what it means to call an ambulance.  Each and every person I encountered today listened to Mark explain their situation, condition and options whereas most of my clients demand transport regardless of their condition.

The internet here in my hotel is not included, like their website would like you to believe so I am using Mark’s mobile USB adapter which uploads a single photo in 8 minutes, so the updates from here will be mostly in text, but I’ll film my video and give it to mark to upload at home each night.

And for those of you who think I’m in the bag for socialized care, I favor it because it makes more sense but I will be honest about what I see here.  Believe that.

The Day 2 Roundup Video

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22 thoughts on “Reflections on Day 2 – the Project”

  1. The cops will never reopen half the road, im currently sat watching them close the road near us as two cars have scrapped each other bumpers!!!!

    Good luck in the good old North East get Mark to take you into Durham to see a proper old English city or jump on the 21 from Newcastle city centre

  2. The cops will never reopen half the road, im currently sat watching them close the road near us as two cars have scrapped each other bumpers!!!!

    Good luck in the good old North East get Mark to take you into Durham to see a proper old English city or jump on the 21 from Newcastle city centre

  3. The cops will never reopen half the road, im currently sat watching them close the road near us as two cars have scrapped each other bumpers!!!!

    Good luck in the good old North East get Mark to take you into Durham to see a proper old English city or jump on the 21 from Newcastle city centre

  4. While I’m also in the bag for the NHS-style system, I’m looking forward to a first-hand american perspective of how care works.

  5. While I’m also in the bag for the NHS-style system, I’m looking forward to a first-hand american perspective of how care works.

  6. Glad Mark took you to see Gormley’s Angel of the North, but I didn’t see the obligatory photo of you at its base with arms outstretched.

    Just like if you ever go to Nottingham, you have to have a photo with the Robin Hood statue, it’s the law!

  7. Glad Mark took you to see Gormley’s Angel of the North, but I didn’t see the obligatory photo of you at its base with arms outstretched.

    Just like if you ever go to Nottingham, you have to have a photo with the Robin Hood statue, it’s the law!

  8. Glad Mark took you to see Gormley's Angel of the North, but I didn't see the obligatory photo of you at its base with arms outstretched.

    Just like if you ever go to Nottingham, you have to have a photo with the Robin Hood statue, it's the law!

  9. I wish American ambulances were more like the Brits. We give up so much in safety just to have that almighty second patient option, which we hardly ever use.

  10. I wish American ambulances were more like the Brits. We give up so much in safety just to have that almighty second patient option, which we hardly ever use.

  11. I wish American ambulances were more like the Brits. We give up so much in safety just to have that almighty second patient option, which we hardly ever use.

  12. I wish American ambulances were more like the Brits. We give up so much in safety just to have that almighty second patient option, which we hardly ever use.

  13. I wish American ambulances were more like the Brits. We give up so much in safety just to have that almighty second patient option, which we hardly ever use.

  14. Socialized medicine.. Yeah.. I too see its benefits, I am just concerned about the fallout when you throw in such a huge economic, social, and cultural change to a system that is so inbedded in the American public. Regardless of what you were capable of doing, I could imagine what that first situation would be like when you told a patient that they “didnt need to go to the ER” who didnt want to hear that.

    Mark, if you’re reading this, when you have a patient who insists on transport to the point of being difficult and argumentative, how do you handle it?

    Also, the RRC car in San Francisco would be interesting to see in action. Do you think it would be more cost effective to put a Medic in a solo fly car in the city? Now, I’ll be honest from doing that exact same thing in my city, I’m not always a fan of it simply from a safety factor. There’s a reason that PD works mostly two man cars here and that is there are probably some places where I shouldnt be walking into by myself. More times than not, I am very happy to see the “boys in blue” or the “big red truck” when I pull up on a scene, and I know I am not going to be waiting for an ambulance by myself.

    But I digress…

    What about taking a Firefighter or EMT and partnering them up with a Medic in an RRC for the purpose of reducing response times? Do you think that Urban Fire Departments send full engines because its harder to justify a fly car when you could just take those same two personnel that are assigned to it and put them in a transporting ambulance? I’ve had that debate too with one of our now defunct interceptor units. . . Two qualified, certified technicians who work two shifts a week on an ambulance anyway, sitting on scene with their Expedition parked outside waiting for an ambulance to come from another community? Well, it didnt always make sense to me..

    Again though, great reading, sir!!!

  15. Socialized medicine.. Yeah.. I too see its benefits, I am just concerned about the fallout when you throw in such a huge economic, social, and cultural change to a system that is so inbedded in the American public. Regardless of what you were capable of doing, I could imagine what that first situation would be like when you told a patient that they “didnt need to go to the ER” who didnt want to hear that.

    Mark, if you're reading this, when you have a patient who insists on transport to the point of being difficult and argumentative, how do you handle it?

    Also, the RRC car in San Francisco would be interesting to see in action. Do you think it would be more cost effective to put a Medic in a solo fly car in the city? Now, I'll be honest from doing that exact same thing in my city, I'm not always a fan of it simply from a safety factor. There's a reason that PD works mostly two man cars here and that is there are probably some places where I shouldnt be walking into by myself. More times than not, I am very happy to see the “boys in blue” or the “big red truck” when I pull up on a scene, and I know I am not going to be waiting for an ambulance by myself.

    But I digress…

    What about taking a Firefighter or EMT and partnering them up with a Medic in an RRC for the purpose of reducing response times? Do you think that Urban Fire Departments send full engines because its harder to justify a fly car when you could just take those same two personnel that are assigned to it and put them in a transporting ambulance? I've had that debate too with one of our now defunct interceptor units. . . Two qualified, certified technicians who work two shifts a week on an ambulance anyway, sitting on scene with their Expedition parked outside waiting for an ambulance to come from another community? Well, it didnt always make sense to me..

    Again though, great reading, sir!!!

  16. Socialized medicine.. Yeah.. I too see its benefits, I am just concerned about the fallout when you throw in such a huge economic, social, and cultural change to a system that is so inbedded in the American public. Regardless of what you were capable of doing, I could imagine what that first situation would be like when you told a patient that they “didnt need to go to the ER” who didnt want to hear that.

    Mark, if you're reading this, when you have a patient who insists on transport to the point of being difficult and argumentative, how do you handle it?

    Also, the RRC car in San Francisco would be interesting to see in action. Do you think it would be more cost effective to put a Medic in a solo fly car in the city? Now, I'll be honest from doing that exact same thing in my city, I'm not always a fan of it simply from a safety factor. There's a reason that PD works mostly two man cars here and that is there are probably some places where I shouldnt be walking into by myself. More times than not, I am very happy to see the “boys in blue” or the “big red truck” when I pull up on a scene, and I know I am not going to be waiting for an ambulance by myself.

    But I digress…

    What about taking a Firefighter or EMT and partnering them up with a Medic in an RRC for the purpose of reducing response times? Do you think that Urban Fire Departments send full engines because its harder to justify a fly car when you could just take those same two personnel that are assigned to it and put them in a transporting ambulance? I've had that debate too with one of our now defunct interceptor units. . . Two qualified, certified technicians who work two shifts a week on an ambulance anyway, sitting on scene with their Expedition parked outside waiting for an ambulance to come from another community? Well, it didnt always make sense to me..

    Again though, great reading, sir!!!

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