Weak people

Five emergency calls; one ran away (!) and four required an ambulance.

It’s always a relief after a heavy couple of nights to end the series of shifts with a slow one.

First call was to a 30 year-old female who was fitting at a hotel. She was described as ‘hot’ and had been having a seizure for over five minutes. I arrived on scene with the ambulance just ahead of me and bowed out gracefully after asking if I was needed. One crew is enough for a job like this and it was a ‘hotel’ crew, so there was a paramedic in attendance in case any drugs were required.

I accompanied the same crew to my next job; a 22 year-old male who had ‘overdosed’ on 18 ibuprofen. His agitated mate came out to meet us and described how the patient had taken lots of pills and was not happy about us being there. I thought we were going to have trouble with this patient.

Inside the little flat were four people; the patient, who was sitting feeling sorry for himself, a young female who may or may not have been the patient’s girlfriend, the guy who had led us here and one other male - oh and a crying baby somewhere in the background. To be fair, they were all harmless and kind of helpful in a frantic, not forthcoming sort of way, so it was an easy job to handle. I did a few obs. but my colleague attended the patient. I got Control to contact the Poisons Unit for him so that he could establish what danger 18 ibuprofen posed to this young man. Personally, I didn’t think he had any real problems, especially after learning that his mate had given him salt water, induced vomiting and cleared his stomach soon after he had taken them. The pills wouldn’t have had any chance to become ingested at all.

My colleague was told by the Poisons Unit that the greater danger was the fact that he had been given salt water. Too much salt can cause cardiac problems and so he was to be taken to hospital for monitoring. I asked his friend how much salt he had given him and he demonstrated by pouring a little into a glass. The glass would then have been filled with water. It looked like he had been given no more than a saline solution; very little salt. Nevertheless, he was taken to the ambulance. Well, I say taken, I mean he bolted down the stairs in an attempt to escape. His friends caught up with him and pleaded for him to go.

I waited outside the building with the newly-captured patient and handed him back to the crew when they got down in the lift (I took the stairs – often quicker in these places). They took him aboard the good ship NHStaxi and left.

I found out later on that he absconded the second he got to hospital. My personal opinion is that he is a little time-waster who, for reasons unbeknown to the rest of mankind, wants attention from his little gang…and gets it whenever he plays the suicide card. Our involvement makes his demonstration of pity null and void because we expose the reality of his good health, thus he runs away from definitive care. My only hope is that he has a job somewhere, doing something, so that his taxes cover the cost of his adventures.

After a rest on station I went on stand-by and was called to my next job – an unconscious 25 year-old male. He was lying in the street outside a bar when I arrived. His friends were standing over him and one of them became very annoying over the course of my management of this patient.

The guy on the floor loves to pop Valium, his friend told me. He also likes to take cocaine and ecstasy – he is a real party animal. That’s not all. He'll wash all of this down with a bottle of wine and some beers. The he will generally kick off, become violent and end up unconscious or arrested. All told, this gent lying in front of me is an all-round man’s man and everyone’s hero. I would love to have pulled a book of tickets out of my coat, written one up fining him £500 for the cost of the ambulance and served it to his friend.

I did my obs., declared him unconscious and I listened to his friend going on and on about how he (the patient) had taken ten Valium before coming out, followed up with a line of coke (just one line, he emphasised), knocked back a bottle of wine, then went down the road to a bar where he caused trouble with the door staff. Now he was resting in peace on the pavement, awaiting his redemption.

I protected his airway, monitored his breathing, which was changing and advised the crew when they arrived that his friend would be trouble.

We got him into the ambulance and I set about getting his airway and breathing sorted. It had become quite noisy, so an OP was put in and that solved the problem. IV access was gained, Naloxone was given (just in case) and fluids were put up. His GCS was 3, he had pinpoint pupils and his BP was dropping. He wasn’t doing well. Soon he would lose all airway reflexes and intubation would be on the cards. Luckily, after we had spent ten minutes sorting him out, his condition improved a little. He was still unconscious but his vitals were coming out of the red.

During the entire period in the back of the ambulance when all of this was going on, his little friend knocked on the back door repeatedly, asking inane questions and generally slowing us down. He wanted to know if he could come with us and if he did would the ambulance crew take him home again? I knew he’d be trouble.

We left for the hospital without him. He was told to get a taxi.

Not long after that, a panic attack in the street was resolved with relaxation exercises, provided by the ambulance crew who arrived after me. The young man had started panicking in his car and was wandering the streets. His breathing was rapid and he had all the classic signs and symptoms of hyperventilation. Not much we can do except to bring him back down to Earth. I spent less than five minutes with him and started the breathing exercises he needed. The crew completed the job on the way to hospital.

My last call was for an assault in the same street as I had been in for the unconscious O/D earlier. On scene I found a Russian man with head injuries a crying woman with her boyfriend (on the other side of the street) and a couple of police officers. The Russian man had allegedly sexually assaulted the crying woman and her boyfriend had responded by punching his lights out. The initial punch or punches had given him a black eye. He fell hard to the ground during the assault and sustained a second injury, on the other side of his head, which was now bleeding.

There was no difficulty establishing who did what here; it had taken place in front of the police officers, who just happened to be on patrol. Clear cut I would say.

The Russian man spoke very poor English (or pretended to) and it took a while to establish what he remembered. He had been knocked out, according to the police officer, so his memory of events was understandably foggy. Either that or he wasn’t prepared to compromise himself. The only part of the incident that had been witnessed by the police was the assault on him…not the alleged prior offence.

The ambulance took him away and I completed my paperwork. My last night shift was coming to an end. I received no more calls after that, so I got a bit of a rest at the station and got very bored. Just as well because the electrical system in the car is playing up again and the MDT keeps shutting down. Not fit for purpose.

Be safe.