Eight emergency calls. One refused. All others taken by ambulance.
Another rushed start and off to deal with a 58 year-old homeless alcoholic with chest pain. He was lying in an alleyway with his mates, one of whom was sensibly helpful whilst the other was just annoyingly irritating. I had to ask him to stop talking a number of times while I tried to determine the patient’s condition.
The patient had a long history of heart problems, claiming three heart attacks and he was on a lot of drugs for high blood pressure and various other afflictions. His pain was convincing enough and he didn’t look too well, so the crew took him off to hospital after my obs and handover. Control sent an ambulance, another FRU and a cycle responder one this one, although I have no idea why.
A short spell on standby and a call ‘up north’ for an 87 year-old male who was ‘not alert’, which can mean anything you like. I never got to deal with this patient and spent all of five minutes in his presence because by the time I had found the correct address, the crew (who had also struggled to find this flat) had arrived. I spent ten minutes trying to locate the exact flat in one of Camden council’s finest modern complexes. What a nightmare these places are for us. If this man had been having a heart attack, or worse, had been in cardiac arrest, his chances of survival, at any age, would have been next to nil. Councils have a lot to answer for when designing these stupid places. Even one of the locals who lived in the place couldn’t work out how to get to the particular flat number I required. Worse still, the guy who lives almost directly below the flat I was searching for didn’t know where it was!
I met colostomy man again. He is a notorious regular and I have had the displeasure of dealing with him on a number of occasions. The last few times I have taken him to hospital myself in the car and have spent more time cleaning it afterwards than I care to talk about. Never again.
This time he was wedged in between the seats of a bus, feigning epilepsy (very badly) – he usually tries Hep B and wears a mask for effect but everyone knows he is not infected. He always smells very bad and his attitude changes from docile to aggressive and abusive if he isn’t taken seriously. When I recognised him I attempted to help him because there’s no point in having an aggressive waste of space lying on a bus from which he will refuse to move, causing all kinds of problems and delays. So, I was nice to him; I always am (at first).
When the crew arrived, they too recognised him and were a little less inclined to pander to him (which is fair enough), so he became abusive – no change there. I gave up the mister nice guy act and left him on the floor (I had been trying to help him up). I handed over to the crew and let them deal. I’m sure I will meet Mr Colostomy again, we seem to get on.
I rushed down to a potential assault in south London after that. The call described a ‘male, collapsed ? chest injury ? assault’. Of course the police hadn’t been activated for me, so I had to request them as I had no idea what I was driving into.
When I got on scene, I was waved down by a bus shelter cleaning operative (got to get his title right) who had come across a man lying flat on his back on the shelter bench. He was in a lot of pain and complained mainly of chest pain and shortness of breath. His obs were all over the place, so I put him on oxygen and kept him still whilst I checked him out physically. He had not been assaulted but he had renal failure and was being treated for it. He had a history of hypertension associated with this, so I assumed, reasonably I believe, that his problem was probably PE relevant.
The crew arrived after a short wait, during which I completed my obs and physical exam (and interrogation, although he was too breathless to answer questions). They loaded him into the ambulance and checked him all over again. His blood pressure was through the roof and his ECG was abnormal so no time was wasted in getting him to hospital. The man was in real trouble.
My next patient, said to be ‘unconscious’ was in fact asleep. He was a local alcoholic who had chosen the wrong place (and time) to lay down and snooze off the effects of his recently consumed White Lightning. The empty bottle was lying next to him. He was obviously asleep but it didn’t stop someone from dialling 999, claiming an unconscious person had been discovered and then clearing off to let me find him in the dark. Again, the address was vague and it took me five minutes to locate him on the street, under a bridge where he was, quite sensibly, staying out of the night drizzle.
I feel sorry for some of these people. He was trying get a sleep – he has nowhere else to go but because he doesn’t look good (let’s say outside a smart restaurant), we will be called to clear him away like someone else’s rubbish. Most of these individuals leave a clue so that you (the general public) can tell the difference between dead and drunkenly asleep. The empty lager cans, the bottles, the rank smell of booze drifting towards you with every grunt and snore. Please, please take the hint. If you want a filthy, smelly drunken alcoholic removed from the general area of your snooty establishment, at least have the decency to stick around and own up when I get there. Watching from a safe distance while me and my colleagues do the job for you is just plain bad manners and another example of how little you think of us as professionals.
Off into the city for a 23 year-old female with a nut allergy who ate a peanut earlier by mistake. She was treated in hospital with an antihistamine and had flared up again. Not really a shocker that one. Anaphylaxis can recur again and again because the body is in a state of self-defence for hours or days (or weeks) after an assault on it by an allergen. Giving someone Piriton and a pat on the head will not always be enough. This young lady was in a bit of trouble; her oesophagus was closing up and she had a pretty generalised rash with itching. She had a coughing fit and her airway could easily have become compromised – a potentially fatal complication. She had a history of such reactions and yet still had not been given an Epipen.
I found out later that the patient was just about to qualify as a doctor. I wondered why she hadn’t insisted on an Epipen when she herself must have understood the implications of her condition.
After my break I was sent east again for a 28 year-old female who had chest pain. I found her sitting in the hallway of her flat, struggling to breath and complaining of left sided chest pain, radiating to her left arm. I know it’s presumptuous but I asked her (instinctively) about cocaine use, and she confirmed that she had used recently and was a past habitual user. So this is where my diagnosis was taking me, although I was still aware of other possibilities.
The patient had a lovely young daughter who just lit up when she was woken up and brought out of the bedroom by one of the female crew who arrived with me. Most children bear a worried frown when their parent is being treated by us but this little girl loved the adventure; she even helped put the ‘dots’ on for her mum’s ECG!
I accompanied the ambulance to hospital with the patient, who went straight to resus and her daughter continued to enjoy herself, playing with the nurses who took to her immediately. Later on, when I returned to check on mum’s condition, we played pass the balloon with a glove that had been blown up and had a face drawn on it earlier by one of the crew.
My last call of the shift was to a 40 year-old male who had fallen off his motorcycle. It was early in the morning and there was very little traffic about. Rain had made the roads slick and hazardous. The man had simply slipped when he tried to get through the traffic lights as they were changing to red. He fell off, scraped his bike and banged his knee. He didn’t need to go to hospital and decided to carry on his short journey to work instead. I agreed with his plan and he signed my form. Easy.
I always feel tired by the end of a stint of nights but I appreciate busier times – at least the shift goes quicker and I don’t get bored, or fall asleep. The run in with Mr Colostomy, having to wake up yet another poor drunken sod who just wants to be left alone and the giggling, heart-warming encounter with the well-balanced little girl who lit up an A%E department for a short while made this a contrasting night for me. I was glad of it.
Be safe.
Another rushed start and off to deal with a 58 year-old homeless alcoholic with chest pain. He was lying in an alleyway with his mates, one of whom was sensibly helpful whilst the other was just annoyingly irritating. I had to ask him to stop talking a number of times while I tried to determine the patient’s condition.
The patient had a long history of heart problems, claiming three heart attacks and he was on a lot of drugs for high blood pressure and various other afflictions. His pain was convincing enough and he didn’t look too well, so the crew took him off to hospital after my obs and handover. Control sent an ambulance, another FRU and a cycle responder one this one, although I have no idea why.
A short spell on standby and a call ‘up north’ for an 87 year-old male who was ‘not alert’, which can mean anything you like. I never got to deal with this patient and spent all of five minutes in his presence because by the time I had found the correct address, the crew (who had also struggled to find this flat) had arrived. I spent ten minutes trying to locate the exact flat in one of Camden council’s finest modern complexes. What a nightmare these places are for us. If this man had been having a heart attack, or worse, had been in cardiac arrest, his chances of survival, at any age, would have been next to nil. Councils have a lot to answer for when designing these stupid places. Even one of the locals who lived in the place couldn’t work out how to get to the particular flat number I required. Worse still, the guy who lives almost directly below the flat I was searching for didn’t know where it was!
I met colostomy man again. He is a notorious regular and I have had the displeasure of dealing with him on a number of occasions. The last few times I have taken him to hospital myself in the car and have spent more time cleaning it afterwards than I care to talk about. Never again.
This time he was wedged in between the seats of a bus, feigning epilepsy (very badly) – he usually tries Hep B and wears a mask for effect but everyone knows he is not infected. He always smells very bad and his attitude changes from docile to aggressive and abusive if he isn’t taken seriously. When I recognised him I attempted to help him because there’s no point in having an aggressive waste of space lying on a bus from which he will refuse to move, causing all kinds of problems and delays. So, I was nice to him; I always am (at first).
When the crew arrived, they too recognised him and were a little less inclined to pander to him (which is fair enough), so he became abusive – no change there. I gave up the mister nice guy act and left him on the floor (I had been trying to help him up). I handed over to the crew and let them deal. I’m sure I will meet Mr Colostomy again, we seem to get on.
I rushed down to a potential assault in south London after that. The call described a ‘male, collapsed ? chest injury ? assault’. Of course the police hadn’t been activated for me, so I had to request them as I had no idea what I was driving into.
When I got on scene, I was waved down by a bus shelter cleaning operative (got to get his title right) who had come across a man lying flat on his back on the shelter bench. He was in a lot of pain and complained mainly of chest pain and shortness of breath. His obs were all over the place, so I put him on oxygen and kept him still whilst I checked him out physically. He had not been assaulted but he had renal failure and was being treated for it. He had a history of hypertension associated with this, so I assumed, reasonably I believe, that his problem was probably PE relevant.
The crew arrived after a short wait, during which I completed my obs and physical exam (and interrogation, although he was too breathless to answer questions). They loaded him into the ambulance and checked him all over again. His blood pressure was through the roof and his ECG was abnormal so no time was wasted in getting him to hospital. The man was in real trouble.
My next patient, said to be ‘unconscious’ was in fact asleep. He was a local alcoholic who had chosen the wrong place (and time) to lay down and snooze off the effects of his recently consumed White Lightning. The empty bottle was lying next to him. He was obviously asleep but it didn’t stop someone from dialling 999, claiming an unconscious person had been discovered and then clearing off to let me find him in the dark. Again, the address was vague and it took me five minutes to locate him on the street, under a bridge where he was, quite sensibly, staying out of the night drizzle.
I feel sorry for some of these people. He was trying get a sleep – he has nowhere else to go but because he doesn’t look good (let’s say outside a smart restaurant), we will be called to clear him away like someone else’s rubbish. Most of these individuals leave a clue so that you (the general public) can tell the difference between dead and drunkenly asleep. The empty lager cans, the bottles, the rank smell of booze drifting towards you with every grunt and snore. Please, please take the hint. If you want a filthy, smelly drunken alcoholic removed from the general area of your snooty establishment, at least have the decency to stick around and own up when I get there. Watching from a safe distance while me and my colleagues do the job for you is just plain bad manners and another example of how little you think of us as professionals.
Off into the city for a 23 year-old female with a nut allergy who ate a peanut earlier by mistake. She was treated in hospital with an antihistamine and had flared up again. Not really a shocker that one. Anaphylaxis can recur again and again because the body is in a state of self-defence for hours or days (or weeks) after an assault on it by an allergen. Giving someone Piriton and a pat on the head will not always be enough. This young lady was in a bit of trouble; her oesophagus was closing up and she had a pretty generalised rash with itching. She had a coughing fit and her airway could easily have become compromised – a potentially fatal complication. She had a history of such reactions and yet still had not been given an Epipen.
I found out later that the patient was just about to qualify as a doctor. I wondered why she hadn’t insisted on an Epipen when she herself must have understood the implications of her condition.
After my break I was sent east again for a 28 year-old female who had chest pain. I found her sitting in the hallway of her flat, struggling to breath and complaining of left sided chest pain, radiating to her left arm. I know it’s presumptuous but I asked her (instinctively) about cocaine use, and she confirmed that she had used recently and was a past habitual user. So this is where my diagnosis was taking me, although I was still aware of other possibilities.
The patient had a lovely young daughter who just lit up when she was woken up and brought out of the bedroom by one of the female crew who arrived with me. Most children bear a worried frown when their parent is being treated by us but this little girl loved the adventure; she even helped put the ‘dots’ on for her mum’s ECG!
I accompanied the ambulance to hospital with the patient, who went straight to resus and her daughter continued to enjoy herself, playing with the nurses who took to her immediately. Later on, when I returned to check on mum’s condition, we played pass the balloon with a glove that had been blown up and had a face drawn on it earlier by one of the crew.
My last call of the shift was to a 40 year-old male who had fallen off his motorcycle. It was early in the morning and there was very little traffic about. Rain had made the roads slick and hazardous. The man had simply slipped when he tried to get through the traffic lights as they were changing to red. He fell off, scraped his bike and banged his knee. He didn’t need to go to hospital and decided to carry on his short journey to work instead. I agreed with his plan and he signed my form. Easy.
I always feel tired by the end of a stint of nights but I appreciate busier times – at least the shift goes quicker and I don’t get bored, or fall asleep. The run in with Mr Colostomy, having to wake up yet another poor drunken sod who just wants to be left alone and the giggling, heart-warming encounter with the well-balanced little girl who lit up an A%E department for a short while made this a contrasting night for me. I was glad of it.
Be safe.
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2 comments:
You said "all taken by ambulance" in the beginning, but then:
"He didn’t need to go to hospital and decided to carry on his short journey to work instead. I agreed with his plan and he signed my form. Easy."
And what about the fake guy on the bus? Did he go to hospital?
Oops. Published it without looking properly. Amended now.
Mr. Colostomy always goes to hospital.
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