Nuts

I enjoyed this shift. A lot of people I like working with were on duty with me and so I was bumping into them frequently over the course of 12 hours. Its nice to work with good company.

My first call was to a hyerventilating man who had been seen just an hour earlier by another crew. He had been treated but the panic attack had started again and his friend was concerned, so she dialled 999 for the second time. The man was a mute and could only sign to communicate, something that takes a bit of getting used to. Its also quite bizarre to treat hyperventilation with a one-way verbal communication. Most of the time the length of the patient's sentences is a guide to how well they are recovering. I took him and his friend to hospital in the car. By the time he arrived, and after ten minutes of oxygen, he was almost fully recovered again.

My next call was to a female in a restaurant who was having an allergic reaction to nuts. The call description added 'she has taken her Epipen but it hasn't worked'. Its bad enough getting a call to what may be life-threatening anaphylaxis without the additional complication that the life-saving drug isn't working. I sped to the scene and arrived within a few minutes. A man was standing outside the restaurant waiting for me. He told me that the woman was in the ladies toilet (I find that a lot of females in trouble head straight for the toilets; men don't seem to do that so often - or maybe that's just coincidence).

I grabbed my bags and headed in the right direction - I had been to this establishment a couple of times before, so I knew the layout. I was expecting to see a collapsed, barely breathing person on the floor when I went into the toilet, if the call description was anything to go by. The man who met me also said that this was the worst reaction she had ever had. I walked in and she was standing in a cubicle with her friend. Her face was a little puffy but not the mass of swollen tissue that I had expected. Her breathing was fine - a little fast but she was able to speak in full sentences and she exercised that right a LOT as she panicked and demanded pain relief. She had abdominal pain, which can occur in such reactions but I wasn't going to give her any drugs at this stage, she simply didn't need them. I told her this and she seemed to understand.

As for the Epipen. She didn't have one. Hadn't taken one. Had never heard of it before. So, I wondered where that elaboration in the call had come from. This was NOT a life-threatening emergency, this was a moderate allergic reaction, mainly involving the gastro-intestinal system.
I walked her to the car and sat her in the back seat while I continued my obs. All of her vitals were normal. She probably required anti-histamine therapy and that could be done at hospital.

When the ambulance arrived I explained the situation to the crew and they took over from there. This call generated a Red2 and resulted in myself, an ambulance and the motorcycle paramedic attending. Elsewhere on the sector I was hearing of other calls getting over-the-top responses. Someone, somewhere was being a little too cautious.

Then off to another spectacular MOP call. This was for a 'male collapsed, caller thinks he may be deceased'. Now, the supposedly dead person was lying in a street at a busy bus station, so my first reaction was 'Yeah, right', but as I said before, I can't afford to be cynical, so I sped to the scene with the same determination as I would muster for a cardiac arrest. An ambulance was just in front of me as I left Leicester Square and I figured it was also going to this call. Together we headed to the scene.

This can be problematic. Sometimes the ambulance you follow is NOT going to the same call. There can be embarrassing consequences if you turn up at the wrong address. I decided to overtake the ambulance and keep to my own heading. I don't like doing this, it seems rude but I am supposed to get there first, so I went for it. In the event, the ambulance was on the same call. In fact, they took a shorter route and arrived on scene a second in front of me. Damn!

We arrived, jumped out of our vehicles and saw this lump of humanity lying in a corner with people hovering nearby, waiting for their respective buses. Of course the guy was going to be drunk. Of course he was. We approached, prodded and shook and he made non-death type movements and sounds. Even the police, who arrived soon after saaid he was very lively for a corpse.

The person who had made this 999 call had left the scene apparently. A lot of them do that. They call us, make frantic suggestions about death and serious injury, then they hang up and clear off.

We got the man, who was seriously drunk (and smelly) into the ambulance. His BP was very low, so I sorted that out with fluids. Then there was a tap on the ambulance door. One of the crew opened it and a voice said "Is he alright?" This was the 999 caller, who had returned to the scene and was showing concern!

Back in the Square and it was very busy tonight. Heaving is the word that comes to mind but not in a vomiting allegory. Plenty of people coming and going and standing. A little gang of 12-year-olds strolling by at 1am. Their parents must be so proud.

A man singing along, out of tune, to the music generated by his aged discman and delivered by his huge, floppy headphones "la la la, hey hey, la la la..." etc. I had no notion of joining in except to grin at the brass of it.

A beggar who uses his dog as a prop for gaining sympathy from passers-by, especially women. His dog, a lovely Staffordshire Terrier, lies like a big baby in his lap with a dummy in his mouth. The girls love it. Hats off to the beggar with an imagination - he gets to eat every night. So does his 'baby' I hope. Whenever he sees me, he nods, waves, gets his dog to wave a paw and then they both howl. I take all that as a compliment.

A call to a female, fallen down stairs at one of those 'school' clubs where middle-aged men and women can dress up as schoolies again but with the addition of legal drinking til you are sick. School was never quite like that...except for the drinking til you are sick bit. On the way, I was flagged down to attend a couple of doormen who had been assaulted. I called it in and asked to be cancelled for the school club job - I couldn't find the place anyway to be honest and was driving around in circles like an idiot. I checked the two doormen out - scratches really - then asked EOC if they wanted me to continue on the original call, since I was in the vicinity and the ambulance that had been despatched was lost too. They said yes.

Eventually I found the club and was met by one of the EMTs from the ambulance. She was about to get the board out of the vehicle because they were going to 'collar and board' the patient who had fallen down the stairs drunk. I went in and had a look. The stairs were dangerous and obstructed, very narrow and steep. The lady was at the bottom of them but was conscious and moving quite easily. No neck pain, no neurological deficit, no other injury - just a pain in her head where she had bumped it on landing. She was also very drunk and apologetic. I liaised with the crew and we agreed that she could walk up these stairs. So, we helped her to her feet, walked her to the ambulance through a crowd of barely dressed adults in school uniforms and pigtails (and that was just the men). :-) Then off she went to hospital, head in hands, still apologising.

I went back to my station and had a cup of coffee and a rest. Then I went back on stand-by because I was bored but the West End, particularly around Piccadilly Circus, was absolutely heaving with people and vehicles. There were traffic jams. It was 3am!

My next call came in while I tried to fight my way through the mess on the roads. I was going to a collapsed male. I arrived to find a little group of people gathered around a man lying in the street between two parked cars. They hadn't touched him or tried to rouse him - they never do. At least they hadn't called it in as 'possibly deceased'. Thank goodness we don't live in the bad old days of Burke and Hare. Unconscious drunks would be carted off and cut up for medical experiments every day of the week.

I gripped the man's shoulder tight and shook him until he made sense of the world. He was drunk and had been sleeping. He was now drunk and awake. The ambulance arrived and he got a bed for the night.

Immediately after that job, another call, This time to a police station I have visited a number of times (not as a criminal obviously). They had a young man in custody who was not responding. I arrived to find the police doctor (known as the Forensic Medical Examiner - FME) in the cell with the patient. He had carried out all my initial obs. for me and gave me a handover. I tried to get a response from the man but he was out like a light. Probably alcohol, I thought. He was in for being drunk and incapable so it made sense. He had also allegedly taken ecstacy and probably something else. I gave him oxygen and then used narcan to extract a possible cause but he didn't come round. All his obs. were normal so he was probably just sleeping it off. The crew arrived and he was taken to the ambulance where he began to wake up a little. By the time he got to hospital, he was on a higher plane of consciousness.

I went back to the station and made some more coffee. Two other crews were there and it was beginning to look like the end of the shift would be non-eventful. Instead the 'phone rings, dragging crew number one out. Then it rings again immediately for crew two. Then my service mobile goes and I am out. This call was to a male, unconscious on a bus. Whenever I get a call like that I know I am going to be waking someone up and telling them to get off a bus.

I arrived at the bus in question, walked on, woke the man up (he was a bit aggressive at first) and asked him to leave the bus...'sir'. I followed him out and the ambulance (from my station) arrived and went away again.

As the clock ticked by and I made my way to my base station across the river I got a call for another person 'unconscious' on a bus. I had to double back to New Oxford Street, where I was required to walk onto the bus, wake the patient up (a woman this time) and ask her to leave the vehicle. I did and she did.

Oh and in both cases I asked if they needed to go to hospital, I always do but on calls like these you wonder if you are tempting fate.

On my last attempt to get home, I was called to a drug overdose just South of the river. The call description added 'caller was aggressive and abusive'. Great, I thought. I'm going to get punched out before I go home to bed. I asked Control to send the police.

When I got on scene a large man was waiting for me at the door of the address. I become very cautious at this hour of the day with people like this. After a night of alcohol and class A drugs, they can be very dangerous. I smiled, remained friendly and put on my best 'not judging you' voice when I walked in. The young lad who had taken too much cocaine and alcohol (and dope) was not looking well at all. He was tachycardic, diaphoretic and very agitated - the latter is mainly down to cocaine. I found it very difficult to work with him, some of my obs. were incomplete because he moved and fidgeted a lot.

Then the police arrived. I had forgotten about them. This changed the atmosphere dramatically. All had been calm and I was hoping to hear an ambulance siren soon but when the police entered the big guy's house, he wasn't happy. I explained that they were here for my protection after abuse had been reported by my Control but he just wanted them out. The police, bless 'em, ignored the man and stayed with me while I finished what I had to do. Tense.

In the end, the young man refused to go to hospital. I have to tell you I was relieved, even though he didn't look good and probably should go, I can't sympathise, I'm afraid. It's drug abuse and self-abuse and when he gets hospital care he will simply go back to his drugs when he is better. He will end up in hospital of course - hopefully not via LAS but in the back of his mate's car. This is how a lot of them arrive.

I finished my shift, signed out and headed home. I noticed a lot of ambulance control vehicles around and there were dozens of motorcycle police arriving in town. I was leaving London on the morning of one of its greatest annual spectacles, the marathon. The sun was up and it was getting warm. Time for bed.

Be safe.