Language

Eight emergency calls. One cancelled on scene, one assisted but not conveyed, six required an ambulance.

The statues on Waterloo Bridge are beginning to suffer at the hands of a practical joker with a sense of fashion or decency (or both). This morning one of the figures was dressed in a skirt and blouse, much to the amusement of passing commuters, including myself.

My first call was to a RTC involving a cyclist and a car. When I arrived on scene the cyclist had taken off, preferring not to have the fuss of an ambulance, police and all those who gather around incidents like this. Apparently, according to the female witness who had called us and was now very apologetic for wasting our time, he was limping but claimed to be unhurt after the car knocked him off his bicycle. He limped into the sunset while the woman was left standing on the pavement, late for work and desperately trying to cancel the emergency services.

Onward. A 36 year-old female who was ‘unconscious’ in a shop. She was on the floor of the basement and was doing the not talking, not moving, not even able to open her eyes routine. I try to be patient with grownups who behave in this petulant manner but all the genuine patients I have dealt with flash through my memory and it becomes difficult to keep up my own pretence. I find a firm but professional voice gets results and so I told her that I knew she wasn’t unconscious and to open her eyes. She eventually complied. Eventually.

The woman had been upset over the past few days and was depressed about something, according to her colleagues. She came in to work this morning and just collapsed on the floor, unwilling to get up. Her friends were genuinely concerned and thought she was unconscious and seriously ill. I tried to get her talking to me but she seemed reluctant. When the crew arrived the paramedic chatted a little, realised she was Portuguese and began a fluent dialogue in her own tongue. I was impressed. I can do English, Scottish and a spattering of French – that’s your lot.

There are a few individuals in the Service who are able to speak several languages. One of my colleagues in particular seems to pick up a new language every month! I wish I had been more attentive at school – a multi-linguistic ability is a very useful tool to have in this town.

My next patient, a 17 year-old German student on a school trip, had collapsed outside a tourist attraction. He had been seen fitting and was post ictal when I arrived. He was very confused but had no history of epilepsy, or so his teachers believed, although they admitted that very little medical information was given to them prior to setting off on the coach journey to the UK.

Managing him was a problem because he didn't speak English and I don't speak German, so a translation process began between myself, the patient and the teachers - then back again. By the time the ambulance arrived, I knew very little about him but he was recovering and seemed more in tune with the world. The crew took over and I prepared for my next job.

Another fitting patient, this time a diabetic, had me wrestling to gain IV access. The 45 year-old woman had collapsed at work and was witnessed fitting for five minutes before I arrived. She was quite combative and her BM was high – she had probably suffered a seizure as a result of acute hyperglycaemia. The crew arrived a few minutes after I had established basic obs and they helped me to control her whilst I attempted to get a line in. Unfortunately, she flexed her elbow so aggressively that it kinked the plastic catheter I had placed in her vein, so fluids wouldn’t run properly. Luckily, she began to settle down on oxygen and a second attempt was made in the ambulance by the crew paramedic but that one hit a valve and failed too. Sometimes you have no luck with these things. It was time to get her off to hospital before she had another seizure.

A 25 year-old woman with severe pains in her sides explained that she suffered from fibroids and had recently had embolisation (UAE) carried out. She carried no pain relief with her, which I found odd and the manager of the bank where she had collapsed called an ambulance because she couldn’t move. She was cramping and became stuck in a semi-sitting position as a queue of customers looked on. She was persuaded to walk to the ambulance and was taken to hospital. No doubt they will simply reminder her to carry pain killers until she recovers.

Some people have genuine illnesses but use them to attract attention to themselves. I was called to a chemist shop in north London for a 25 year-old female who was fitting. When I got there the staff guided me to a woman who didn’t look as if she had any problems at all, except confusion. She stood in the middle of the shop with a surprised look on her face.

“I’m not dying”, she said

“I know”, I replied

I asked her about her medical history and she flashed a medic alert bracelet at me. I read it and it confirmed that she was an epileptic. I still wasn’t convinced that she had just been fitting though. I carried out my obs and found nothing untoward. The pharmacist sidled up as the patient produced a bottle of pills for me to look at (her daily meds) and I asked her if she would check them. There seemed to be a mixture of different drugs in the little bottle, which bore no name on the label. The pharmacist identified most of the pills but was confused about their relative use for epilepsy. The patient seemed to have collected drugs over the years and simply mixed them as she chose. None of this made sense – no G.P. would have given her this combination of drugs.

During our conversation the patient stated that she had ‘rapid acesolator’ (my spelling) and asked if I knew what it meant. I didn’t. Neither did the pharmacist. She then went on to claim that it meant her body was immune to drugs and that was why she had to take so many different types for one condition. I wasn’t buying this at all. I know the body becomes tolerant to drug levels but I had never heard of the concept of drug immunity! The pharmacist had a look of disbelief on her face too.

I decided to waste no more time here, so I asked her if she wanted to go to hospital (she didn’t) and I got her to sign my PRF. I cancelled the ambulance and agreed to drop her off around the corner. Before I left, I spoke again to the pharmacist and she confirmed that the condition the patient had named simply didn’t exist. The staff also stated that she had walked into the shop, grinned and flopped to the floor, pretending to have a seizure.

I dropped the patient off two minutes from the shop and listened to her current woes on the way. During her conversation, she told me of the numerous ambulance calls that had been made on her behalf, pointing out that this was the first time a car had arrived. She was thoroughly enjoying herself.

I searched and searched for the term she had used, just in case I was missing something but nothing came up. I looked into her claim of drug immunity and also found nothing. Maybe she had mispronounced it or misunderstood the concept. Perhaps you know what she was on about...

Another call to a diabetic in trouble; a 68 year-old who looked extremely ill. I arrived at the same time as my motorcycle colleague and we were shown to the patient by a security man. He was very confused, extremely pale and diaphoretic and his medical history led us to conclude he may be hypoglycaemic. However, when I tested his blood glucose level, it was normal. There was no chest pain and no cardiac history but it was beginning to look like an ECG would tell us more about his condition.

The crew arrived and that freed me up to ask his friend, who was on scene with him, a few more questions. He told me that the patient had collapsed and he had given him four glucose tablets to eat. This had taken place about 20 minutes before we got there. So, he may have been hypoglycaemic and his blood glucose had improved in that time – the patient’s demeanour, however, had not changed for the better and this was the reason an ambulance had been called. We were also told that he had cancer, although his friend wasn’t specific. My best guess is that he had pancreatic cancer, which would explain such a slow recovery.

My last call of the day was for a 52 year-old man who was suffering pain in his left shoulder and arm. He was sitting in his front room when I arrived and he told me that the pain had increased over the past two days. He was a reasonable person and didn’t strike me as someone who complains much about anything. His breathing was normal, his obs were good and had a history of arthritis – this seemed to be an exacerbation of his condition. There was no chest pain, nor had there ever been any.

He had called an ambulance when the shift change was about to take place. A lot of crews had finished early because they had been given no break and so there would be a delay before a vehicle arrived on scene. I spent the time chatting with him and repeating my obs a few times more. He was a pleasant, obviously hard-working family man and he was concerned about his health, so I did all I could to reassure him until the crew arrived to take him to hospital.

As I drove home later on, I noticed that the statue had been stripped of its clothing. I wondered what killjoy had decided to do that.

Be safe.