Ten emergency calls. One cancelled and one conveyed. Eight required an ambulance.
You should be seeing a trend. One of the reasons I started logging the number of calls I attend was to record, in some basic way, the trends in call volume, using my calls as a sample. Obviously, the ambulance crews are dealing with a few more than me simply because the FRU doesn’t get sent to anything other than emergencies whereas my hard-working colleagues also have to put up with non-emergencies, inter-hospital transfers and the categorised rubbish we run on because our service is too scared to say no in case we get sued. Long live the ‘sore tooth’ calls. Of course, I mustn’t be simplistic, there are other complicating factors but my sense is that someone, way up high, is just too scared to say no.
This is why you have seen a steady climb in the number of calls I am dealing with every shift. Summer is here and the weather is improving daily, this brings the masses out from behind their desks, the clubbers from their bedsits and flats and the tourists from their coaches into the streets of the West End – to drink themselves to death, or as close as they can possibly get. We also get the odd shooting.
I have designed a poster to hang on the walls of every pub and club in London (not that any sane, profit-minded publican will ever want to hang it). It has the picture of a drunken person (let’s say a female since we get more of them than men generally) on the ground with an ambulance crew standing over her. The caption says:
IF YOU DRINK SO MUCH THAT YOU NEED AN AMBULANCE, IT WILL COST YOU £100 -
TOO MUCH CAN BE EXPENSIVE
We really must start thinking about imposing fines on people with more money than sense. How much does it cost to get drunk and unconscious these days anyway?
Again, my VDI and equipment preparation went out the window because my first call, for a teenager who was stressed, came in before I had time to draw breath on-duty. I was half way there when I was cancelled. I was just getting the numbers you see, nothing more. I noticed that I had almost no fuel and so spent 30 minutes filling up and completing my VDI. I had bits of kit missing, including blankets but I never got back to the station to sort this problem out.
I was off to a 49 year-old male with chest pain. He and his family lived in one of those horrible flat complexes that councils think are trendy (and possibly were in the 70’s when all it took was a hallucinogenic to make it seem so). The first thing I did when I stepped into the lift was sniff the air; it was rank with urine. I looked down and saw that I was standing in a large puddle of fresh pee, especially made for me I assumed. It gave me a warm feeling to know that the locals felt it necessary to welcome visitors in such a fashion – I also felt I was in someone else’s territory.
This man, who is from Glasgow and didn’t realise I was too, had abdominal pain that radiated up into his chest, along the track of his oesophagus. My best guess was that he had an ulcer. This guess was reinforced when he told me it was a sharp, burning pain and that he had been drinking lager all day – ten pints to be precise. He also told me that his daily intake of alcohol was the equivalent (I worked it out for him as he could only measure this in pints and shorts) of 20 – 30 units, (Oh and I didn’t mean he was wearing shorts in that last parenthesis). This was all confessed as his adoring family stood around him. He was their hero and who was I to argue with that?
I asked him if he smoked (I noticed he had an asthma inhaler) and he looked at me as if I was from Mars (or Pluto). A lot of people actually absorb things like smoking, drinking and drug-taking into the fabric of their very being so much that a simple enquiry about whether they do or do not partake comes as a shock, I mean, surely you should know that they do?
He wasn’t having a heart attack; that much I was sure of. His ECG confirmed this when we got him into the ambulance but he steadfastly refused pain relief and insisted on walking, despite the offer of a chair. By the time he landed in hospital (I followed behind the ambulance), he was laughing and joking and still stinking of fags and beer. His proud wife stood by his side.
My next call took me to a part of the city I have never been to before on-duty. We were short of ambulances, due to the volume of calls, and so I was being sent out as far as possible. This call was very similar to the one I did last night when I dealt with banshee woman, remember? Again, the young girl had been drinking (but not very much this time) and again she was in a collapsed state in which she thrashed about, swinging her limbs wildly – almost smacking me in the face (when will I ever learn?). She was lucid momentarily and then would become quiet and semi-conscious. This was followed by an extreme flail of the arms and backward arching of the back. During her lucid windows I asked her questions and discovered that she was taking diazepam for depression, just as the woman last night was. She was also on her period. This is a question I ask all of the collapsed drunken young women I deal with because it’s extremely relevant; during a period, alcohol has a much more profound effect on the body. This would explain why some women swear that they have not had any more than usual when they get so drunk that they collapse.
I just couldn’t figure this out, so I asked a doctor friend of mine (later on) to see if any studies had been done on the effects of a combination of alcohol, (regardless of the amount), diazepam and women’s periods and although nothing specific came to light, there was at least one study showing an increase of the side effects of diazepam on the nervous system when taken with alcohol and if the effects of alcohol itself is amplified during a period then my guess is that the side effects, which include hallucinations, tremors and muscular activity, of diazepam are too.
She was taken to hospital but I don’t think the crew would have wanted to share my theory of her condition, so I reported it as seen – had a drink, collapsed, flailing like a wild woman, query cause.
A 22 year-old with a history of pneumonia twice in her life and who was now feeling unwell with ‘heavy lungs’ was my next patient. Her lungs were clear but she had a high temperature so she needed to go to hospital, given her history.
On my way back to the station (which I didn’t see until the big small hours) I was called to a shooting in south London (where else?). A 17 year-old had been shot in the leg and the assailant was still around so I was given an RVP. I have told you about RVP’s before and its not funny, I just can’t find the damned things and usually end up right in the war zone where I shouldn’t be. This RVP was changed three times as I struggled to find the little side streets they were sending me to. In time honoured fashion I rolled into the high street and on scene. There were armed police everywhere, one of whom was waving me down. At first I thought I was going to be told off for wandering into a dangerous area but I saw a crowd of onlookers and a young black man slumped on the pavement and realised he was the patient. This 17 year-old looked a lot older. He also looked disinterested but maybe he was just scared. He had allegedly been shot outside a youth centre – he had a bullet hole in his thigh. There was no bleeding and the hole was very small, with no exit wound. He was lucky I guess because, apart from the small risk of an artery being damaged, he was going to survive this.
I dressed his wound and asked him questions, none of which he bothered to answer. This isn’t just a different generation or culture, this is a different world. School kids use guns in this part of London just to settle scores – it’s not always about drugs. I could almost see him planning revenge as I patched him up and handed him over to the crew. His two mates wanted to travel with him but the crew refused (quite rightly) so I offered to take them to the hospital, thus removing the hassle the crew were getting and solving the problem. The trouble is, I wasn’t too sure about what I was doing carrying these two, possibly armed, teenagers in my car, so I made it clear that I wanted them to behave and that I was doing them a big favour – I didn’t feel as brave as my words so I also stuck very close to the ambulance as it made its way to the hospital.
I unpacked the lads from the car and watched as the resus team went to work on the injured boy. Armed guards were posted at every entrance to the A&E department in case the shooter decided to return and finish him off.
Last year I was at this same hospital when a fatal stabbing came in. The young boy died in resus and there was a massive response by his friends – they descended on the hospital and blocked up the ambulance ramp and parking area. It was a very threatening couple of hours and the police sent reinforcements to counter it. We are entering a new era of healthcare – fortress hospitals.
A 22 year-old drunken female, collapsed on a tube station platform next. She looked like a rag doll in the carry chair as she was lifted out into the world. Her boyfriend looked bewildered by her sudden loss of function.
Things started to get a lot more frantic after that. I was asked to run a long way out of my area (I didn’t even know where I was when I arrived) for a 25 year-old woman who was unconscious in the street. She was drunk and her friends had gathered around her in shock. I was now in a part of town where this sort of thing doesn’t happen very often and they were a bit upset that I was not taking them seriously. “She’s drunk” I said. “That can’t be, she must have had her drink spiked”, they replied, although not in unison – that would be like some bizarre opera.
She had been lying there for almost an hour and was now very cold. Her temperature was 34c, so I wrapped her up as much as I could with a quilt borrowed from a nearby resident who had come to help. In the West End, if you are drunk and unconscious people walk over your body, here in this part of London, people came out of their houses to help. The patient wasn’t wearing anything on her lower half and nobody had an explanation for this. No wonder she was cold. Had she really gone out drinking with a spangled top and no skirt?
A crew arrived after an even longer journey than I had and we bundled her into the warm ambulance; alcohol and cold are potentially fatal. I put her up on fluids and led the ambulance to the nearest A&E. She was still completely unresponsive when I left.
My next call was to a 25 year-old male who was found by two passers-by, lying on his back in the street, completely unresponsive. He looked dead.
I spent almost an hour with him, struggling to get him to respond. He was a tall man; over six feet and I couldn’t move him on my own. Control had no ambulances to spare and I made it as clear as I could that my patient was too cold to stay out here much longer – his temperature was 34.1c.
I wrapped him in blankets procured from the last hospital I visited and his temperature began to improve, resulting in a response from him at last. I managed to persuade him to stand up and go to the car where it was warmer but he shut down again as I propped his tall and very heavy frame in the door of the FRU. I couldn’t get him to stay awake long enough to follow my instructions; this was more the effects of hypothermia than of alcohol.
The two lads who had found him had stuck with me to help and they managed to get him into the car. He woke up again and this time he spoke to me. I explained what was happening and he agreed to let me take him to hospital. I could tell he wasn’t going to be aggressive, so I would take the risk.
Meanwhile, Control sent another FRU to my rescue but it was too late. I had already got my patient ready to go. I took him to hospital and into an A&E department that just didn’t need any more people. It was almost full.
Then off to a 15 year-old who was allegedly punched and kicked in the face during a mugging while standing at a bus stop. It was 4.30am and she was drunk and could barely walk straight. Her parents must be so proud. Again, armed cops all around us. She had minor injuries to her face and head.
My last call of the morning took me to another tall, grotty tower block for an 81 year-old with DIB. She didn’t have any real breathing problems but there was no way she should have been living like she was, so she was taken to hospital and to a cleaner environment. At least some good came out of this shift.
You should be seeing a trend. One of the reasons I started logging the number of calls I attend was to record, in some basic way, the trends in call volume, using my calls as a sample. Obviously, the ambulance crews are dealing with a few more than me simply because the FRU doesn’t get sent to anything other than emergencies whereas my hard-working colleagues also have to put up with non-emergencies, inter-hospital transfers and the categorised rubbish we run on because our service is too scared to say no in case we get sued. Long live the ‘sore tooth’ calls. Of course, I mustn’t be simplistic, there are other complicating factors but my sense is that someone, way up high, is just too scared to say no.
This is why you have seen a steady climb in the number of calls I am dealing with every shift. Summer is here and the weather is improving daily, this brings the masses out from behind their desks, the clubbers from their bedsits and flats and the tourists from their coaches into the streets of the West End – to drink themselves to death, or as close as they can possibly get. We also get the odd shooting.
I have designed a poster to hang on the walls of every pub and club in London (not that any sane, profit-minded publican will ever want to hang it). It has the picture of a drunken person (let’s say a female since we get more of them than men generally) on the ground with an ambulance crew standing over her. The caption says:
IF YOU DRINK SO MUCH THAT YOU NEED AN AMBULANCE, IT WILL COST YOU £100 -
TOO MUCH CAN BE EXPENSIVE
We really must start thinking about imposing fines on people with more money than sense. How much does it cost to get drunk and unconscious these days anyway?
Again, my VDI and equipment preparation went out the window because my first call, for a teenager who was stressed, came in before I had time to draw breath on-duty. I was half way there when I was cancelled. I was just getting the numbers you see, nothing more. I noticed that I had almost no fuel and so spent 30 minutes filling up and completing my VDI. I had bits of kit missing, including blankets but I never got back to the station to sort this problem out.
I was off to a 49 year-old male with chest pain. He and his family lived in one of those horrible flat complexes that councils think are trendy (and possibly were in the 70’s when all it took was a hallucinogenic to make it seem so). The first thing I did when I stepped into the lift was sniff the air; it was rank with urine. I looked down and saw that I was standing in a large puddle of fresh pee, especially made for me I assumed. It gave me a warm feeling to know that the locals felt it necessary to welcome visitors in such a fashion – I also felt I was in someone else’s territory.
This man, who is from Glasgow and didn’t realise I was too, had abdominal pain that radiated up into his chest, along the track of his oesophagus. My best guess was that he had an ulcer. This guess was reinforced when he told me it was a sharp, burning pain and that he had been drinking lager all day – ten pints to be precise. He also told me that his daily intake of alcohol was the equivalent (I worked it out for him as he could only measure this in pints and shorts) of 20 – 30 units, (Oh and I didn’t mean he was wearing shorts in that last parenthesis). This was all confessed as his adoring family stood around him. He was their hero and who was I to argue with that?
I asked him if he smoked (I noticed he had an asthma inhaler) and he looked at me as if I was from Mars (or Pluto). A lot of people actually absorb things like smoking, drinking and drug-taking into the fabric of their very being so much that a simple enquiry about whether they do or do not partake comes as a shock, I mean, surely you should know that they do?
He wasn’t having a heart attack; that much I was sure of. His ECG confirmed this when we got him into the ambulance but he steadfastly refused pain relief and insisted on walking, despite the offer of a chair. By the time he landed in hospital (I followed behind the ambulance), he was laughing and joking and still stinking of fags and beer. His proud wife stood by his side.
My next call took me to a part of the city I have never been to before on-duty. We were short of ambulances, due to the volume of calls, and so I was being sent out as far as possible. This call was very similar to the one I did last night when I dealt with banshee woman, remember? Again, the young girl had been drinking (but not very much this time) and again she was in a collapsed state in which she thrashed about, swinging her limbs wildly – almost smacking me in the face (when will I ever learn?). She was lucid momentarily and then would become quiet and semi-conscious. This was followed by an extreme flail of the arms and backward arching of the back. During her lucid windows I asked her questions and discovered that she was taking diazepam for depression, just as the woman last night was. She was also on her period. This is a question I ask all of the collapsed drunken young women I deal with because it’s extremely relevant; during a period, alcohol has a much more profound effect on the body. This would explain why some women swear that they have not had any more than usual when they get so drunk that they collapse.
I just couldn’t figure this out, so I asked a doctor friend of mine (later on) to see if any studies had been done on the effects of a combination of alcohol, (regardless of the amount), diazepam and women’s periods and although nothing specific came to light, there was at least one study showing an increase of the side effects of diazepam on the nervous system when taken with alcohol and if the effects of alcohol itself is amplified during a period then my guess is that the side effects, which include hallucinations, tremors and muscular activity, of diazepam are too.
She was taken to hospital but I don’t think the crew would have wanted to share my theory of her condition, so I reported it as seen – had a drink, collapsed, flailing like a wild woman, query cause.
A 22 year-old with a history of pneumonia twice in her life and who was now feeling unwell with ‘heavy lungs’ was my next patient. Her lungs were clear but she had a high temperature so she needed to go to hospital, given her history.
On my way back to the station (which I didn’t see until the big small hours) I was called to a shooting in south London (where else?). A 17 year-old had been shot in the leg and the assailant was still around so I was given an RVP. I have told you about RVP’s before and its not funny, I just can’t find the damned things and usually end up right in the war zone where I shouldn’t be. This RVP was changed three times as I struggled to find the little side streets they were sending me to. In time honoured fashion I rolled into the high street and on scene. There were armed police everywhere, one of whom was waving me down. At first I thought I was going to be told off for wandering into a dangerous area but I saw a crowd of onlookers and a young black man slumped on the pavement and realised he was the patient. This 17 year-old looked a lot older. He also looked disinterested but maybe he was just scared. He had allegedly been shot outside a youth centre – he had a bullet hole in his thigh. There was no bleeding and the hole was very small, with no exit wound. He was lucky I guess because, apart from the small risk of an artery being damaged, he was going to survive this.
I dressed his wound and asked him questions, none of which he bothered to answer. This isn’t just a different generation or culture, this is a different world. School kids use guns in this part of London just to settle scores – it’s not always about drugs. I could almost see him planning revenge as I patched him up and handed him over to the crew. His two mates wanted to travel with him but the crew refused (quite rightly) so I offered to take them to the hospital, thus removing the hassle the crew were getting and solving the problem. The trouble is, I wasn’t too sure about what I was doing carrying these two, possibly armed, teenagers in my car, so I made it clear that I wanted them to behave and that I was doing them a big favour – I didn’t feel as brave as my words so I also stuck very close to the ambulance as it made its way to the hospital.
I unpacked the lads from the car and watched as the resus team went to work on the injured boy. Armed guards were posted at every entrance to the A&E department in case the shooter decided to return and finish him off.
Last year I was at this same hospital when a fatal stabbing came in. The young boy died in resus and there was a massive response by his friends – they descended on the hospital and blocked up the ambulance ramp and parking area. It was a very threatening couple of hours and the police sent reinforcements to counter it. We are entering a new era of healthcare – fortress hospitals.
A 22 year-old drunken female, collapsed on a tube station platform next. She looked like a rag doll in the carry chair as she was lifted out into the world. Her boyfriend looked bewildered by her sudden loss of function.
Things started to get a lot more frantic after that. I was asked to run a long way out of my area (I didn’t even know where I was when I arrived) for a 25 year-old woman who was unconscious in the street. She was drunk and her friends had gathered around her in shock. I was now in a part of town where this sort of thing doesn’t happen very often and they were a bit upset that I was not taking them seriously. “She’s drunk” I said. “That can’t be, she must have had her drink spiked”, they replied, although not in unison – that would be like some bizarre opera.
She had been lying there for almost an hour and was now very cold. Her temperature was 34c, so I wrapped her up as much as I could with a quilt borrowed from a nearby resident who had come to help. In the West End, if you are drunk and unconscious people walk over your body, here in this part of London, people came out of their houses to help. The patient wasn’t wearing anything on her lower half and nobody had an explanation for this. No wonder she was cold. Had she really gone out drinking with a spangled top and no skirt?
A crew arrived after an even longer journey than I had and we bundled her into the warm ambulance; alcohol and cold are potentially fatal. I put her up on fluids and led the ambulance to the nearest A&E. She was still completely unresponsive when I left.
My next call was to a 25 year-old male who was found by two passers-by, lying on his back in the street, completely unresponsive. He looked dead.
I spent almost an hour with him, struggling to get him to respond. He was a tall man; over six feet and I couldn’t move him on my own. Control had no ambulances to spare and I made it as clear as I could that my patient was too cold to stay out here much longer – his temperature was 34.1c.
I wrapped him in blankets procured from the last hospital I visited and his temperature began to improve, resulting in a response from him at last. I managed to persuade him to stand up and go to the car where it was warmer but he shut down again as I propped his tall and very heavy frame in the door of the FRU. I couldn’t get him to stay awake long enough to follow my instructions; this was more the effects of hypothermia than of alcohol.
The two lads who had found him had stuck with me to help and they managed to get him into the car. He woke up again and this time he spoke to me. I explained what was happening and he agreed to let me take him to hospital. I could tell he wasn’t going to be aggressive, so I would take the risk.
Meanwhile, Control sent another FRU to my rescue but it was too late. I had already got my patient ready to go. I took him to hospital and into an A&E department that just didn’t need any more people. It was almost full.
Then off to a 15 year-old who was allegedly punched and kicked in the face during a mugging while standing at a bus stop. It was 4.30am and she was drunk and could barely walk straight. Her parents must be so proud. Again, armed cops all around us. She had minor injuries to her face and head.
My last call of the morning took me to another tall, grotty tower block for an 81 year-old with DIB. She didn’t have any real breathing problems but there was no way she should have been living like she was, so she was taken to hospital and to a cleaner environment. At least some good came out of this shift.
Be safe.
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6 comments:
Well...most student club nights offer a double measure of spirits and a mixer for about £2, so 10 doubles costs about £20. I don't know how many units it takes the average person to get drunk, but I'm guessing 20 is definitely going to have obvious effects.
So, in answer to your question, I doubt it costs too much to get unconscious!
Enjoying following your blog - cheers!
It does amaze me how much you get through in a shift, but it is scary how just about every call is to a drunk and incapable.
Don't people have pride anymore? I like a drink admitedly but not to the degree that I can't stand up afterwards.....it's a sorry state we live in really and it makes your job all the more difficult....excellent writing as ever though...xx
I feel really sorry for ambulance people, probably one of the worst jobs to be done. Im gunna start having to walk through licester sq to my new job, if I spot an FRU unit, ill offer a bribe (iv been known to do this when im out cycling, usually offering sweeties that I carry)
Lucy
Well, thanks for the math. I expect you are right. Explains a lot, doesn't it?
To be honest, I'm surprised the ambulance service doesn't already charge people who abuse the system. It would certainly help towards the NHS debt, wouldn't it? ;D
petrolhead
It certainly would but instead we will probably end up displaying advertising on hospital beds and ambulances - Burger King, Pepsi, real butter...that kind of thing.
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