Something wicked this way comes

Twelve emergency calls. Two dealt with by the police, one assisted only, one treated at scene and eight required an ambulance. Half a dozen cancellations can be chucked in for good measure.

So they’ve started using medical professionals to kill as many people as possible. Nice tactic. I am very confused about the conflict of interest that surely must be present in the very soul of a person who has studied medicine for years, is a scientist at heart and who still thinks that the widespread murder of innocent people is a solution for anything.

It is scarier than ever to think that we are no longer threatened by the stupid people of the Earth and that the highly intelligent have joined in. It is a sign of true dedication to a cause when you forfeit years of your life to study a subject that is designed to save lives and help people only to trash it all for a belief that’s tantamount to ethnic cleansing.

I journeyed in to work and heard about the car bomb on the radio. I was starting my final early shift of the week. The car was discovered by an LAS crew who reported it immediately. In my book, it was those individuals who potentially saved hundreds of lives. I know this part of London well because it is my patrol route and if the idiot hadn’t crashed the car into bins and made a spectacle of himself by running off, he might have got away with this. The car would have sat there undetected until it was finally detonated and the rush hour became carnage. The LAS crew that reported the vehicle were on the ball and deserve a bit more credit than the press has given them.


I went to Park Lane to deal with a 22 year-old male who had come off his motorcycle. His bike had lost traction on a drain cover that was slick with rain (and there has been a LOT of that) causing him to lose control and slam into the back of a slow moving van. He was lucky because the only injury he appeared to have was a badly dislocated shoulder. It took 10mg of morphine just to settle him in the ambulance but his pain hadn’t diminished by much and the crew decided to blue him in to save time in the rush hour traffic.

I went with them and stuck around to hear the opinion of the doctor. He decided an x-ray would be a good idea.

Then on to a 77 year-old female with SOB. She is emphysemic and so this is not a surprising complication for her. Her home Oxygen was providing no relief and neither did her inhaler, so I put her on a higher concentration and the crew, who arrived minutes after me, took her to hospital. She had improved within a few minutes of breathing a decent amount of Oxygen.

On my way back from this job a white van man wound down his window, stuck his head out and shouted across to me that another bomb had been found in Park Lane. I had just been there an hour earlier. I went back to my base station and asked if they had heard anything about this second device but nothing had been reported. All I could hear outside were sirens – it reminded me of 7/7.

I’ve said before how satisfying it can be to deal with a potentially life-threatening condition swiftly and efficiently. Hypoglycaemia is one of those serious conditions that we all get loads of practice with. I was called to a 37 year-old diabetic who had become ‘confused’ at his place of work. His concerned colleagues called an ambulance but had no idea what else to do for him. This is quite common.

When I got to him, he was slumped in a chair at his desk, a freshly opened carton of orange juice next to him. He didn’t respond much and his speech was slurred and confused. I could tell he was hypo even before I did his BM, which was too low at 1.6 – he needed glucose. I tried giving him the orange drink but he refused to take it. He wasn’t aggressive (many of them are) so I had no trouble treating him.

I gave him an injection of Glucagon to release his Liver’s stored glucose (this is the life-saving stuff and it’s so easy to do; the result is rapid). I knew that he would recover quickly and would be right as rain in less than 20 minutes. Of course, I mustn’t become complacent because there is no guarantee that Glucagon will work – if he has no stored glucose then none will be released. I have a back-up plan for that – I can put him up on glucose fluids if necessary. If that doesn’t work, he should be in hospital by the time I have discovered the problem.

It worked though – it usually does. He began to communicate with some clarity after a few minutes and he was willing to drink his juice. I asked his colleagues to get him a sandwich (he will need some ‘slow burning’ carbs) whilst he sipped on his drink.

When the crew arrived he was well on the way to a full recovery. His BM had risen to a decent 4.6 and would continue to rise until it was reasonably normal. He was lucid again within 20 minutes of my arrival and he didn’t want to go to hospital. I left him with the crew and did my paperwork with a sense of satisfaction. There’s nothing wrong with that on a day like this.

I went back to my home station, poured some cereal into a bowl, added the milk, stirred it up, munched on two spoonfuls and got called out again. I put my breakfast in the fridge, bowl and all, for later.

A 50 year-old female thought she was having a heart attack as she sat down to her own breakfast in a local café. I was there in two minutes, so was the motorcycle responder and an ambulance crew. She was having a panic attack, that’s all. I wasn’t needed, so I left the scene soon after I had arrived.

I greened up and got called to a 49 year-old male who had fallen 20 feet from a ladder. He was lying on the ground in the back yard of a small house that he and his colleagues were renovating. He was covered in what looked like blood but turned out (to everyone’s relief and amusement) to be red paint. He had been painting the upstairs bedroom window when he slipped, tumbling all the way down the ladder. Luckily he was able to keep his body upright and close to the ladder as he fell, resulting in abrasions, bruising and a possible fractured arm. His neck and head had survived the flight intact, which is always good news.

It’s good to know that, amidst the cacophony and confusion surrounding the bomb alerts and suspect vehicles being uncovered all over Central London, there will always be time to take care of the usual suspects – individuals too drunk to care about the real world and its woes. I was asked to attend an ‘unconscious’ male at a bus stop on London Bridge. I got there to find the HEMS car crawling along – the team were looking for the patient. I told the driver I would go to the other end of the bridge and check it out. When I reached the south end I saw my MC solo colleague standing over a collapsed male at the bus stop on the other side of the road. I swung around and went over to see if she needed help. I told her that the HEMS team were at the other end of the bridge and she asked me to send them down (just to say hello, they weren’t really required; the patient was drunk and incapable…and Russian).

I obliged and now we had more resources for one drunken Russian than you would expect at a car crash. One MC paramedic, one HEMS doctor, one HEMS paramedic, one observer (HEMS), myself…and the ambulance crew that showed up a minute later.

The Russian was abusive and aggressive and the poor by-standing public didn’t know what to do as they waited for their respective buses (some bendy, some not). Obviously, it was a lot easier to have their hard-earned taxes spent on this massive response to a single foreign alcoholic with attitude. He had a mini medical army at his disposal and of course we can all afford this.

After a long drawn out attempt to get this drunken man to comply, the police were called and the ambulance crew left the scene, followed shortly afterwards by the HEMS team. I waited with the MC para until the police had confirmed they would deal with the man, fully expecting them to remove him from the scene to a place of safety – a police cell for example. Today was not the day to be filling up any A&E with time-wasters.

After this job, I was sent south of the river for a 45 year-old male having an EP fit in a pub. I was being sent a long way and I asked Control if there were no closer vehicles. They told me that I was the nearest paramedic to the call, so off I went. The call details changed en-route to ‘unconscious, ? cause’ with information that read ‘caller happy to manage patient’. This sounded encouraging.

When I arrived, there were people standing around outside the pub drinking their pints. I went inside and saw a crew on the floor working on a suspended patient. The patient had gone into cardiac arrest and they had already delivered one shock. Now the paramedic was intubating him and the EMT was compressing his chest. I looked around and realised the audience of punters were obstructing the exit. Some of them were even attempting to buy more booze as the resus took place below them near the bar! It took a few attempts to finally get them to move away from the potential shock they would get from the defib if it was used again. It would have been easier to herd cattle away from their field.

The crew had done a stunning job and before I had completed cannulating and readied my drugs, the patient had a pulse and was breathing, with support. We now had a solid chance of saving this guy’s life. It was time to get going; the quicker the better. We deputised a few of the blokes in the bar and they helped us transfer the patient on to a trolley bed and out to the ambulance.

I took the man’s brother in the car with me and we sped off to the nearest hospital. He was taken straight into resus where the good work continued. When I left to green up, he was still breathing for himself, albeit with support and he had fairly stable vital signs. I hope to find out what the outcome is in the next week or so.

This was the fifth suspended patient I have helped work on where ROSC and ROSR have been established as a result of good CPR - five survivors in just over a year. Before the new guidelines were introduced, you would be lucky to see one. Of course, this is a personal perspective and I’m sure there are medics out there who have seen more or less but I think the change in the way we carry out CPR has had a positive effect on survivor statistics.

After this job, I went on standby in the West End. Roads were being shut left, right and centre as nervous cops investigated suspect cars highlighted by the even more nervous public.

Then I got a call for an unconscious male on London Bridge. I looked at the description again and called Control, telling them that I suspected this was the same drunk Russian from earlier. I asked them to hold off on an ambulance until I checked it out.

I arrived to find the Russian man slumped against the same wall I had left him at. The police hadn’t taken him away. Did they think he would just walk home? Two new police officers were on scene with him and I explained about our earlier call. They agreed to take him to the station and had to cuff him before the three of us tackled with him in an attempt to get him into the back of their van. It was a struggle and at one point we were lifting him off the ground like a giant baby. A giant, drunken, Russian baby.

I got my day’s exercise and the police carted him off, this time for the last time...today at least.

As I made my way back to my standby point, I was diverted to Whitehall for an unconscious male on a bus. This usually meant ‘asleep’ on the bus. I was directed to the correct vehicle by two young girls on the upper deck of the bus in question (it can be confusing when you are given a bus number – there are lots of buses with the same number). As I got out of the car, I was shown to the top deck by the driver who explained that he couldn’t get the man to move.

The two young girls were sitting upstairs (all the other passengers, mainly tourists, had alighted for safety reasons) eating fish and chips together. They seemed completely unphazed by the large man lying on the floor at the back of the bus. I said hello and they said hello. Got to be polite at all times.

I went over to the large man and looked down at him (which I don’t often get a chance to do with tall people). He was asleep and drunk (educated guess). I shouted at him once and he woke up.

“Do you need an ambulance?”, I asked

He shook his head.

“Have you had a drink today?”

He nodded.

“Can you please get off the bus?”

He nodded again.

He then muttered in Russian (I didn’t even feign surprise) and made his way to the exit. When he stood up straight his head cracked off the roof of the bus. He was a big guy.

I left him to wander off but he must have gone the wrong way because he wandered back towards me as a police officer joined me to check that all was okay (on Whitehall they get especially nervous and this was all taking place outside Downing Street). He approached us and asked the way to Victoria Station. We both pointed in the right direction and off he went.

I cancelled the ambulance and five minutes later my MC solo colleague turned up. It’s all about communication.

My last job of the shift took me to the posh side of town where net curtains are forbidden. I was going to the aid of a 49 year-old man who had fallen and hit his head. The au pair steered me into the front room of a very neat semi. The man was on the floor, bleeding from a head wound. His wife was with him and there were two young children staring at me from the hallway stairs.

I knelt down next to the man and could smell the alcohol immediately. I had a flashback of London Bridge. He had gotten so drunk and out of his head during a liquid lunch that he had lost control of his balance and smashed his head on the furniture during a backward topple. The bleeding was under control and I applied a dressing to his wound for good measure. Then I set about trying to establish what had happened. He seemed concussed to me and he insisted that he was fine. His wife was not happy.

One of his kids popped her head round the door and asked if daddy was alright. Mummy said yes he was and she asked why daddy had red hands. Good point. Why has daddy got red hands? Oh, probably because he has had so much to drink that he can’t stop falling over and hitting his head on things. He seemed completely unfussed about his child’s concerns.

I spent twenty minutes with him and I liked him less and less as time went by. Here was a man with a decent home and family behaving like a street drunk. I checked his BM and it was low (he had type II diabetes), so I gave him some glucogel, which he ate with relish. That in itself is unusual, the stuff tastes awful and most diabetics throw it back in our faces.

I stood and listened as he argued with his wife. He wouldn’t go to hospital, she insisted that he did. She even threatened him with divorce if he didn’t go. I backed away from what was developing into a full blown domestic row. Meanwhile, his kids are downstairs in the living area, eating crisps and watching telly. Must be normal for them I thought.

The crew arrived and I let them attempt to persuade him to go. They tried a softly, softly approach and I stuck around to see if I could learn anything but I could see it all descending into no man’s land again, so I left to go home.

I got back to the station amid reports of road closures and further suspect devices being found, so I requested a couple of hours overtime and stayed on duty ‘til 9pm. I figured it would take at least that long to get home anyway, so why not?

In the extra time I worked I only got one call that didn’t get cancelled and it was for a DIB in a council estate. I was there for ten minutes and left the crew to deal as I made my way home for the second time. One of my cancelled calls was to a 'male who had sex two days ago and now has a black and swollen penis' - I smiled as I thought about this one. Could it be that he was just a very horny black man?

I heard about the Glasgow Airport bombing attempt (are these guys rank amateurs?) when I got home. I was born and grew up in a town near paisley, where the airport is located. I go to Glasgow Airport a lot. I never thought Scotland would be a target – this was a new development.

I have ended every posting the same way since starting this blog but never have the two words I use meant so much or been so relevant.

Be safe.