The long Good Friday

Three emergencies, 1 green, 1 no trace, 1 assisted, 1 conveyed and 1 ambulance required.

A quiet day on the prairie for the first part of the shift. Londoners leave their fair city for greener fields far away whilst the option of sunshine and travel beckons, as they do during Easter time. The tourists move in by the double-decker coach load and English is replaced by German, Spanish, French and Italian. I get to drive down roads I can see the end of and my colleagues have the rare pleasure of moving their ambulances in straight lines for more than a hundred yards at a time. Its great.

My first call was to an underground station where, a mere two hours before, a woman had called 999 and requested an ambulance because she simply couldn't cope. She had complained that nobody took her seriously or cared about her problems. Ironic then that I should show up long after she had gone to assist her with her troubles. This was a green call and it had been a very busy night by all accounts (start of the serious drinking season - also called Summer), so there would have been no crews, or cars, available when she actually made the call.

I logged a no trace on that call and made my way to the station. Amazingly, I made it there and got settled with a cuppa...or two. Nothing happened except telly. Crews went out but not me, so I went on stand-by out of boredom. I put my sunnies on and left the confines of the car to go walkabout. The main reason I did this was that my right arm was in danger of burning in the sun, whilst my left arm paled by comparison. You know how it is when you are sitting in a car in the sunshine. The opposite detail applies if you are the driver of a continental vehicle :-)

A couple of tourists asked directions, as they do, and then a man approached me and told me that someone had collapsed in a doorway and was 'foaming at the mouth'. I called it in as a running call and went to the bottom of the road where I found another frequent flyer sitting in a doorway...foaming at the mouth. Well, he was dribbling thick saliva in a long stream from his mouth. He looked dazed.

I knew this man to be epileptic, asthmatic and have several other medical problems. I guessed the problem today was his epilepsy. He has absences and they become more frequent when he has been walking distances. Today, as it was sunny, he decided to go on a jolly long walk. I sat with him, did my obs., chatted and waited for an ambulance to convey him to hospital.

Then I went back to my little patch on Trafalgar Square. I find quiet days allow for more tolerance of frequent flyers, like my absent friend. I can spend more time talking to them and thinking about their perspectives without the pressure of worrying about getting on to the next call. As I pondered this a woman approached and informed me that she was on her way to a 'client' who had fallen. She was from the local Social Services and was answering an alarm call made by one of those around-the-neck buttons that elderly and vulnerable people wear. They certainly save lives (the button alarms, not the elderly or vulnerable).

I wasn't sure why she was telling me where she was going but I think she was fishing for a lift. By the time I worked it out (I might have had sun stroke) she was already gone, with the comment "Don't worry about me, you stay there" still floating in the air. I caught the sarcasm only after I got over the sun stroke. I sensed I was going to see her again.

The call for this fallen alarm patient came in ten minutes later. In retrospect, I should really have gone with the woman and called it in. I buzzed round to the address (which was incomplete, so I couldn't find it at first and had to wait for further information) and met up with the lady from the Square again, just as I had thought I would. On the floor, in the hallway of the flat was a woman with a head injury. She had fallen and hit her head on the skirting, causing a scalp laceration. They bleed a lot and this lady was on aspirin, so she bled a little more than normal. The wound itself was small and the bleeding was under control when I arrived.

The lady refused to go to hospital from the start. She had been drinking and, judging from the many bottles of alcohol on the premises, liked to drink a lot. This didn't help me at all. I was concerned about her and tried to persuade her to go to hospital. I tried for over an hour, during which time I took two full sets of obs. and watched her improve steadily until she was able, with a little help, to be moved to her chair in the front room.

There is nothing I can do beyond insistent persuasion in these circumstances but if a patient has capacity and says no, then no it is. She signed the 'get out of jail free' section of my PRF and I left her to wait for her daughter. I had spoken to her daughter on the phone and explained the situation and my concerns, so she had agreed to visit and try to persuade her mother to do the sensible thing.

Out into the sunshine and another call to a local walk-in centre for an 'unwell woman with a non-blanching rash'. This could mean meningitis. We don't get many of these and I have only given Benzylpenicillin twice so far, so I made tracks and got there in a few minutes. Fortunately for the patient, her rashes appeared to be urticarial and blanched for me when I pressed them. She didn't have a temperature, she wasn't photophobic and there was no neck stiffness or vomiting associated with her illness. In fact, as we spoke, she began to point out new rashes around her face and body which I just couldn't see. Maybe my eyes are going. Sun stroke again.

I took her to hospital and by the time we arrived I was quite convinced that this lady belonged to the group of people who come out into the world for attention when all else fails.

That was it. My day ended. It seemed long but that's because I had a good few hours of nothingness. You can be absolutely sure of one thing though - I got out of Dodge before the party people put on their party feet.

Be safe.