Working the South

Two emergencies, 7 Green and 1 running call. Five assisted and five conveyed - not a single ambulance required today.

I enjoy working the 'amber car' during the day. The variety of work is greater and, despite what is popularly assumed, I use a lot more of my basic and advanced skills. Most of my suspended calls have been during early shifts. I also get to meet a lot more people (and they are generally sober) and I can enjoy the sights and sounds of this iconic city. It also feels safer working in the daylight!

My Control desk requested that I stay in South London for the day as we were short of vehicles to cover the area. I think they hate me.

First call and I'm off to a 'BR' station for a female with abdo pain. She is pale, cold, has a low BP and low temperature when I examine her but after a chat and a rest, she recovers enough to confirm that she would rather not go to hospital and, instead, carries on to work for the day. As usual, she gets three opportunities to decline and I get a signature. She really looks much better when I leave her with the station staff.

Another abdo pain - this time a male at a hostel. He has a recent history of duodenal ulcer and it is giving him a lot of pain. He could have gone to hospital himself but he calls 999 because that's what he always does when his ulcer plays up. I am trying not to lecture people today about calling ambulances. I am trying to remember that I get paid to do this and I actually enjoy it, regardless, so I take him to hospital in the car and have a pleasant conversation with him.

Oh...another abdo pain. Another male but this time the pain is reportedly lower down, in the groin area. He works on a bulding site and I have to travel miles to get to him. He has recently had a hernia and he thinks this is the same problem. He is in a lot of pain and will not move, so I offer him entonox, which he declines because he doesn't like gas, then I offer him morphine, which he accepts. Unfortunately, he doesn't like needles either and when I cannulate him he writhes as if in agony (a little over the top I thought). He has just given me a pain score of 10/10 - that's the worst pain, for his lower abdomen and yet he considers a little sting in the arm to be worse. I can never fathom that out. What it does confirm, however, is that he is quite possibly NOT in as much pain as he is reporting. For that reason I ask him again if he is sure about pain relief and he declines. I thought he might.

In the car I could smell the problem. He didn't have a hernia, he had a UTI.

Control sent me a job 4 miles away for a sore throat. This call had been waiting 4 hours for an ambulance. Each time Control contacted the caller to ask if they still required an ambulance, they insisted that they did. For some people it still isn't sinking in. We are very busy and there are lives at risk when people do this. I got cancelled down when I queried it but this person will probably wait all day until a vehicle is free.

My running call was to assist a member of staff at HQ who was unwell. This happens every now and then. The irony is that they must call for an ambulance to attend, just like anyone else, even though they are surrounded by ambulances and crews. Even more ironic is that being on top of an ambulance station doesn't guarantee a faster response. I had to travel from Central London to attend.

I met a nice elderly gentleman later on during a call to the same 'BR' station I visited earlier. He had stumbled over a high kerb and had fallen into a wall, hitting his head on it. He had a bruised cheek, which may or may not have been fractured, but was otherwise unhurt. He was, however, very tearful and he drew me closer to tell me that he had lost his wife of 50-odd years just six weeks earlier. I told him I was very sorry to hear that and I showed as much compassion as I could during his treatment and the short drive to hospital. I asked him if he wanted me to note his recent bereavement on the PRF so that hospital staff knew and he said yes. I think he needed to talk to someone at length. I cannot imagine what it feels like to lose someone so close after so long - it must be devastating.

A call to a faint in the afternoon, as the temperature started to climb and I found myself in an office managing the recovery of a young woman who had passed out. The office was stuffy and had no air conditioning, so I suggested fresh air and a change of scene. She agreed.

Then off to a posh hotel, where a member of staff was in agony with back pain. He was down in the bowels of the place, (they have a red phone box down there for staff to use), in the changing room. He had been washing his face and had twisted his body to talk to someone when he heard and felt his lower back go. He couldn't move and was stuck to the bench when I arrived. I gave him entonox and this helped loosen him up enough to walk to the car. He continued with the entonox until he couldn't feel his lips, never mind his back pain.

An emergency call around the corner from where I had parked up to complete my paperwork. A female had fallen in the road and had facial injuries. I arrived to find a familiar face (bloodied face) looking up at me. She was known at the hospital and was currently an in-patient on one of the wards. She had come out for a coffee and had tripped on the kerb, falling into the busy road. She was lucky not to be killed. Bystanders had helped her to her feet and mopped up the blood around her mouth - she had a burst lip and a loose tooth. I got her into the car and took her the few yards back from whence she came.

Another faint at work because of the heat. It's not even May and I am already dealing with heat-related problems. This Summer is going to be extremely busy I suspect.

My last call of the day was to a back pain. The lady was recovering from 'flu and was now stuck on the floor, unable to move without pain. She had called NHS Direct (don't get me started) and they had advised her to remain where she was and to call 999 for an ambulance. Why had they done that? What did they think could possibly be wrong with her? Back pain during 'flu is common. Back pain occurs after heavy and persistent coughing. If there is no neurological deficit associated with it, then all that is needed is pain relief, in the form of paracetamol or Ibuprofen and gentle exercise. Or, if you live in London, an emergency paramedic response.

When I arrived on scene I heard a GB for a boy who had jumped into the Thames after his dog. I was only half a mile away and could have been there in 2 minutes. Still, I had a back pain to deal with. I went up to the flat and the patient's friend let me in. The patient was on her side on the floor. I chatted with her, stood her up, sat her down, chatted some more and left her at home with her friend. Got a signature, gave her advice, went home tired.

Be safe.