Nosey people

Ten emergency calls. One refused, one hoax and one conveyed.

My last night shift. Again, I am on a call before I have time to complete my VDI. I race off to a female having an asthma attack and find a woman in her thirties lying in bed, wheezing and struggling to breathe. Her boyfriend is with her and he tells me that she has been like this all day, on and off. She demands oxygen before I can ask her name and repeats her demand as I carry out my baseline obs. The clever people in management want me to carry out peak flow (PEFR) tests for every asthmatic before I start treatment, yet clinical common sense demands that I do something for the patient. I can only ever do a PEFR test if the patient is calm enough and stable enough to manage it so I decide to start the woman on nebulised Salbutamol, after detecting a wheeze in her chest. I skip the PEFR.

By the time the ambulance crew take her to hospital she is a lot better.

I complete my paperwork and try to do a bit of a VDI but it is all in vain. I get a call to a male with chest pain a couple of miles away in the other direction (of course). I arrive, get confused about which block of flats might be the correct location, reverse, look again and am prompted to re-locate by a pair of waving arms from a balcony - could have been washing flapping on a line for all I could see in the dark but luckily it wasn't.

I made my way up the stairs and into the small, cramped and full-of-people flat. The man, in his 60's, was lying in bed complaining of chest pain. He looked very pale and had been like this for hours apparently. I asked him my standard questions, which always start with "what's your name?" and I carried out my basic obs. He wasn't well and I prepared him for hospital.

The crew arrived and the chair was readied for the man to climb into but he refused to go. In fact, it took us (and his family) more than 30 minutes to persuade him to go to hospital. In the end, we had to carry out a full 12-lead ECG at his bedside, show him how badly damaged his heart was and explain to him what the consequences were of staying in bed before he accepted our offer to save his life. He was probably just scared or stubborn or both. Or stupid.

After that job, I got a chance to complete my vehicle checks and, luckily for me, the wheels of the car were properly attached and there was air in the tyres. Technically, you can refuse to start your shift until a proper VDI has been completed but it rarely happens.

A 16 year-old who was drunk and had fallen (almost into the river) was already being treated by the crew when I arrived on scene so I was not required. I turned around and headed back the way I came but was dragged the other way for a woman at a train station who was feeling sick and dizzy. I was comiserating with her in my head.

I arrived to find the British Transport Police on scene and attending. They explained that the young woman was about to travel and had suddenly collapsed, feeling ill. I spoke to her at length about her medical history and how she felt now. There was another woman there and she sat next to the patient and asked probing questions every time I said something relevant or pertinent. She was beginning to annoy me to be honest.

"So, you took these drugs and then you drank alcohol?" I said

"Is that bad then...should she not drink at all?" piped up other woman

"Erm, no" I said to patient via looking at other woman

A proxy conversation. Very strange.

The crew arrived and I explained the woman's problem. Then the police officer took me aside and commented on the other woman. He made a statement that shot a light through my feet which ended up as a glowing bulb above my head. I turned back to the women on the bench. My colleague was already discussing her personal details. I apologised to my colleague and interrupted.

"Is this lady actually with you?" I asked the patient.

"No" she replied, "she just stopped to help."

I turned my attention to the other woman.

"I'm sorry but you have to leave now." I said

"Really", she responded with a shocked look on her face, "can't I stay?"

"No, we have to consider this lady's confidentiality". I explained

"Couldn't I stay and help her some more?" she said desperately

"No."

"Can I just sit here then?"

"No. I insist".

Hilarious. This lady had absolutely nothing to do with the patient but she presented herself as if she was one of the family! She even asked questions and led the patient to reply to some! There was a lot of eye rolling going on during that exchange, let me tell you.

I spent a pleasant 20 minutes chatting to my colleagues (and completing my paperwork of course) before greening up for the next episode of the shift.

The next drama was a call to a male, fitting in the street. The area I was going to is a known haunt for foreign (mainly Polish) alcoholics, so it was fair bet that it would not be an epileptic seizure. I arrived to find a group of people gathered around a man who was jerking and flailing on the ground. A young girl was holding him down. This little group comprised two members of the public, who had stopped to help and three or four fellow Polish alcoholics.

Right from the start I could see the man was putting on a show. It was the most pathetic parody of epilepsy (or any other kind of seizure) I had seen in a while. It also made me a little angry because there would have been genuine epileptics out there waiting for an ambulance whilst I baby-sat this drunk until an ambulance arrived.

I tried reasoning with him, telling him that I knew what he was up to and that he may as well stop thrashing about and putting me at risk from his loose fists. I told him he would get his hospital bed, so he didn't need to carry on the pretence but he had an audience and he had to keep them convinced. He didn't respond because, apparently, he couldn't speak any English.

His friends weren't happy with my conduct and in between swigs of extra-strength lager they protested his innocence. Let me be clear. I was never rude. I was strict and stern. I was not about to be thumped by this man's stupidity in the street and I cannot tolerate time-wasting fools.

The crew arrived and we bundled him into the ambulance and that's where he recovered miraculously. He stopped flailing, he stopped moaning and, oh prize of prize, he suddenly discovered he could speak English. He still wanted to go to hospital...for a bed. The crew reluctantly obliged. I will try to remember this man's face. Next time, the police will be with me.

Then a 27 year-old female suffering an asthma attack at the bottom of the escalators in a tube station. It was pouring with rain outside so I was glad of the warm, dry environment. That, unfortunately, was the cause of this lady's discomfort. I nebulised her (after a failed PEFR attempt) and she felt a little better but she had a persistent cough and she probably needed steroid treatment for that, so off she went to hospital. I saw her later on and she had fully recovered. A pleasant woman who thanked me for my help, which was nice.

Each time I tried to replenish my bags (oxygen masks, nebs, etc) I got a job. I was running out of stock in the car. I made my plea to return to station and I got all of two minutes to re-stock before they called me again.

Another asthma attack, This time a 60 year-old at home. All she needed was a neb and she was happy. Her normal at-home treatment consisted of nebulisation and rest, so that's all she wanted from me. She was packed and ready to go on holiday and refused to go to hospital, despite my advice. She signed my form, chatted for a LONG time about stuff I couldn't keep my brain focused on and then, backing up to the door, I made my politest exit (escape). I was glad she didn't go to hospital - she talked a LOT.

A quiet few hours followed and I went back to my station to recharge. I got my break during this lull and took advantage of the chance to eat some food...and chocolate.

A call in the early hours to an 18 year-old with a head injury after a heavy, stock-laden cage toppled over on a ramp, falling onto him. His nose was bleeding and he had a bump to his forehead. He felt dizzy but he had not been knocked out and he had no neck pain or other associated problems. I took him to hospital in the car.

The next call was to a 60 year-old man who had somehow twisted and ? dislocated his knee in bed. He may have moved awkwardly and pulled his knee cap out of place but it was an unusual job. Together with the crew, I helped keep his pain level down and he was gently moved onto the chair and out to the ambulance. He refused IV pain relief, so it was all achieved with Entonox, which seemed adequate for him.

My last call of the shift was to a 30 year-old male who had been shot at an underground station in South London. I was given an RVP (you know how I love those) and warned not to go near the station in which the shooting had occurred. Of course, I drove right up to it because I didn't have a clear RVP (which was changed half way there) and I didn't know the area well enough to circumnavigate an avoidance route! Luckily for me and all else concerned it was a hoax. No shooting, no victim and no real danger. Just one out-of-place paramedic and ten or so armed-to-the-teeth cops. They smiled at me in pity. I left with my car's tailpipe between its tyres.

Be safe.