Last November, Anne Reed, our Practice Educator Community Outreach, hosted an end of life out of hours’ event, which Paramedic End Of Life Coordinator from London Ambulance Service, Adam attended. Afterwards, Adam invited clinical colleagues to observe a shift with him to gain insight into the role. Anne facilitates ECHO sessions on Zoom for paramedics, where they bring case studies and decision-making issues to discuss, and was keen to experience a day alongside paramedics, to add value to her teaching knowledge. Here’s what she learned:

Anne Reid with two paramedics by ambulance

Paramedics working for the London Ambulance Service typically work a 12-hour shift. Anne joined paramedics Adam and Fabian on a shift from 6.30am until 4.30pm (slightly shorter than usual).

On her shift, Anne didn’t experience any life-threatening visits but attended to four different patients, two who were taken to A&E, one was transferred to the Royal Marsden and one was attended to, but remained at home.  Each time, she watched Adam and Fabian undertake observations, ask about their medical history and decide whether they needed to be taken to Kingston A&E. Anne found it exciting travelling with the blue lights on and she observed that drivers on the road were respectful of a blue-lit ambulance and cleared the road for the ambulance to drive through safely.

On one of the visits, the team was called to the home of a lady who had fallen and used a buzzer round her neck to call for help. Adam and Fabian let themselves into the house via a key safe outside and spent time getting the lady up, checking for injuries and her mobility, chatting and making her a cup of tea. She was assessed as being safe to remain at home and was very grateful. Her GP was informed.

Throughout the day, Anne observed that Adam and Fabian were cheerful and resilient, and treated all the people they saw with dignity. It highlighted how they are faced with making a series of quick decisions throughout their shift, from the moment they step inside a person’s home: they can face challenging circumstances and conditions and often have very limited information to work with. Anne reflected how paramedics need to decide quickly whether that person can remain at home or if they should be taken into hospital, based on what they see before them and also on the person’s own wishes. Anne also realised how long each call can take as it involves history taking, multiple observations such as ECG, blood pressure, recording everything on their iPad, and then the delays in handing over patients to a health professional in A&E.

Anne feels sure the experience will help her next time she teaches end of life care to paramedics and also to paramedic students at Surrey University where she also contributes regularly.