Spitting drunk

Seven calls today; 3 greens and 4 emergencies. One assisted only, 5 conveyed and only 1 requiring an ambulance (and that was only because she was too drunk for the car).

A quiet morning, so I used the time to research some material for my book. I'll be writing a few this year, one for the blog and a first aid manual (I've published before with some success). I also watched telly 'cos that's important.

Today wasn't about stress, it was about routine and I love routine. The early shifts provide me with an opportunity to keep my basic first aid and patient care stuff up to scratch because that's what it's all about. If you can't put a good sling on as a paramedic it can be rather embarrassing.

My first call of the day was to a lady who had ? sprained her ankle after taking part in a ballet workshop. She wasn't a ballet dancer and was doing it as part of a group with children. She hadn't warmed up before starting and that's probably why her muscles, tendons and ligaments weren't quite prepared or tolerant enough for the exercise. I put this to her (m'lud) and she agreed. I also told her I would write this up and she was quite happy about that! So, hello!

Remember the postings about shoplifters who feign illness in order to get out of their predicament when they are caught? I got another one today. He had been caught allegedly stealing from a shop and I was called because as soon as the police turned up he collapsed and pretended (allegedly) to have a fit. No ambulance was despatched; even EOC sensed a time-waster. I arrived to find him making moaning noises and clutching at bits of his body. The police were bemused and the shop staff confused. He told me that he now had chest pain - usually a gauranteed 'get out of jail' card but not this time. All his obs. were normal and I chatted to him about the situation, explaining that he would have a police officer with him all the way to and through hospital and he would be charged after he had been checked out. This is true.

The police were experienced enough to know the game we were playing and the man recovered completely (no moaning or clutching) when he was told that he could just go home if he didn't waste anybody's time. I know that this sounds crass and possibly risky but I had no doubt whatsoever and neither did the police. He was faking. He declined my offer of hospital treatment on the basis that he could walk away and that's exactly what he did. He walked remarkably fast for a postictal chest pain patient.

I was the only car on and there were few ambulances to spare for trivial calls, so I did my best to convey calls when I knew it was safe and appropriate to do so.

I got a half hour of stand-by in the sun at my usual spot at Trafalgar Square. The opera singer was there again, this time with blue high heels on. I wouldn't have noticed but they were very blue. She enchanted the crowd (and me) with a couple of beautifully delivered arias. I wish all buskers were this sophisticated. Class on the street, that's what she is.

My serenity was shattered by an incoming call. This time I was off to see a lady who had dislocated her shoulder. I arrived to find her sprawled in the doorway of a theatre. She had fallen hard and put her shoulder out. This was her second dislocation, the first had required surgery to repair and now the same shoulder was poking out abnormally. I gave her entonox, which brought relief from the pain and I knew I had to move her. I decided to take her in the car because I was literally 2 minutes away from hospital. Also, calls were being GB'd, so I knew she would be lying there for a while if I didn't. I put a splint on her arm and this had the effect of slightly extending and rotating her arm (without pain I should add). The shoulder popped back in on its own. Instant relief.

We are not allowed to reduce disloctions, lots of things can go wrong if you don't do it properly but I knew that a little manipulation might prove useful and it did. I was going to have to move her anyway, so she had to be in a splint or sling first. A sling was out of the question because she was lying down and her arm was straight. She arrived at hospital happy and pain-free. She will get an x-ray to check all is well but it sounds like her shoulder will be the bane of her life.

I had my break late in the day and then I was sent to a station to sort out a drunk woman who had refused to move from a train she had arrived in from up North. The police were on scene and LAS had been called because she had medical problems - alcoholism was one of them. She had recently been discharged from hospital after treatment for a head injury, sustained when she was drunk and incapable, so that added to the need for her to go and be checked out. I asked for an ambulance for her. She was far too loud and boisterous for me to convey in the car. The crew were very understanding though.

On the way to the ambulance she said something and sprayed saliva as she spoke. I caught a drop of it on my lip. I know it wasn't raining because there were no clouds up there, so I worriedly wiped my mouth and averted my face (proximity is sometimes a bad thing). I spat a lot after that.

I love to treat independent elderly people, they prove that old age doesn't have to be debilitating and that, sometimes, life can be good to you and serve you up enough energy to go on for much longer - Duracell longevity I call it. I went to a supermarket to treat a 90-year-old who had fallen down stairs and twisted her ankle. She had also bumped her head and hurt her wrist in the process. These are standard injuries for this type of fall. She had no significant medical history, which is astonishing. At that age blood pressure, the heart, the kidneys...something must be failing and causing trouble. For a lot of people the process of disease begins in middle age, yet this lady had me write something on my PRF that usually only applies to much younger people 'normally fit and well'. She was a lovely person too and I enjoyed chatting to her as I drove her to hospital.

At the end of my day I started driving towards base and was given one last call. The description sounded familiar and I sensed this was a regular. He had already called three times before and nobody had found him on scene. He was claiming that he had a burst hernia and that his bowel was spilling out.

I arrived on scene and couldn't find him. I asked a couple of traffic wardens and they pointed him out (after I gave a description relayed by EOC) in a call box further down the street. I knew him instantly. He was a real frequent flyer and even the hospital staff don't listen to him anymore. His colostomy bag had spilled over and he was covered in faeces. He smelled abominably and it took me a couple of tries to get in the phone box so that I could talk to him. I have dealt with this guy (and written about him) at least three times before. He neglects himself, that's all. Then he calls for an ambulance and goes to hospital and cleans himself up - the nurses refuse to do it now.

I asked for an ambulance but realised, at this time of day, I was unlikely to get one soon. Other crews would know this guy and I thought about my options. I didn't really have any. I wrapped him in a blanket (which will be burned I hope) and put him in the car. I drove him to hospital with the windows open.

I can still smell him on my uniform.

Be safe.