Thursday 2 August 2007

Melting snowballs

Nine emergency calls and one running call. One assisted only, one refused and one conveyed (the running call). Seven went to hospital by ambulance.

The shift kicked off with a call to an unconscious male. The call had come from someone who could see the man lying on the road but would not go out to see if he was okay. We get a lot of calls like that.

When I arrived I found him lying in a car park space. He was sleeping; just another homeless person trying to get a kip but unable to because everyone who sees him thinks he's dead...or worse, undesirable.

I woke the poor bloke up and asked him to find another bed. I felt sorry for him because he looked so tired. He is a Big Issue seller (I saw his ID) and it must be hard work to stand around all day trying to sell a copy or two to make ends meet. Most of these people are dead on their feet by evening time. Next time you see someone selling the Big Issue, buy one. Then leave him/her alone when you see him/her sleeping in a doorway (or parking space).

As I left the scene, I saw a woman's head pop back inside a window just above me. She had been watching all the time and had probably been the person who rang in. Show yourself.

A 28 year-old who felt faint at an underground station next. The crew had arrived at the same time as I did so I wasn't really needed but I went down for a nosey anyway. It was extremely hot down there.

She was okay, just weak. The poor crew had to carry her all the way up to the top because she claimed she couldn't walk. I have to say I think she was being a bit unfair on those two guys. She could have walked if she'd tried. Oh and I did offer to help.

Another tube station call - this one immediately after the first and I was only a few metres away from it when I got it (makes Orcon look good) - on scene within one minute :-)

This lady was drunk. She was so drunk in fact that no amount of induced pain would make her react. It wasn't until her gag reflex was tested with an oropharyngeal airway that she responded...and even that took some time. Getting so drunk you lose your gag reflex is a very stupid thing to do.

Her Portuguese friend was translating from Italian, spoken by the station staff member (he couldn't speak Portuguese but the girl spoke Italian). Oh, it’s all too confusing these days.

Anyway, we managed to get her to stand up and walk with support until we got her to the last escalator where, at the very top, she decided to pass out again. We almost fell into a heap on the floor. Her landing was clumsy and undignified and she was told in no uncertain terms to behave and keep her eyes open. Alcohol makes you selfish - she didn't care about the possible injuries she could have caused if that fall had happened half way up the escalator. Obrigado indeed.

As I was returning to my standby point I was sent back to Regent Street, where I had been earlier, to deal with a RTC involving a motorcyclist and a taxi. As I pulled up on scene I had a bit of a flashback. This is almost exactly where the hit and run had taken place earlier this year and more ironically the same FRU colleague was attending to the patient who was lying on the ground, his bike smashed and leaking petrol and oil on the road.

There was a group of noisy and boisterous individuals, mainly kids, milling around my colleague as he tried to render aid to the injured man. I shooed them away but they didn’t go far and were all standing in the middle of this busy London Street. The traffic had halted on one side but not the other. This was a dangerous scene and the crowd were a little hostile - a couple of them were arguing viciously with each other. One young lad was taking photographs as we tried to deal with the patient. I moved him away and he got abusive - he must have been 14 years old. It was all getting stupid.

I called for the police and the Fire Service (we would need to make the petrol and oil safe) and I could hear LAS sirens approaching, so I knew the ambulance was on its way too.

Eventually we had control of the scene and the police turned up to deal with trouble-makers and the traffic. The injured man had slammed into a taxi and was now complaining of pain in his leg. He didn't seem to have any life-threatening injuries but he was collared, immobilised and given pain relief nevertheless. He had hit the taxi at speed, with no braking so there was the possibility of hidden injuries which could manifest later on.

As I played my small part in this incident, I noticed the taxi driver (whose cab had been hit by the motorcyclist) standing at a distance, watching us. He had that familiar worried frown on his face; the one that portrays personal guilt (even though, from the story, it sounds like it wasn’t his fault at all). I asked him to talk to the police about what had happened but I realise now that I didn’t ask him if he was okay. I felt a bit guilty about that myself.

I spoke to my colleague later on about the Regent Street hit and run. I told him that I had been trying to get information about the young woman’s fate after we had rushed her to hospital that horrible morning a few months ago. I was surprised when he told me that he had followed it up directly and found out that the girl had survived. Not only that but she went home within five weeks of the incident. Considering the extent of her facial injuries that day, I was very happy to hear it.

I made my way back to the Wild West End and cut through Trafalgar Square to look in on the many people who choose to sleep on the grassy areas at night. I was just about to set off when one of the roller-bladers who frequent the Square approached the car. He asked me to look at one of his friends who had fallen badly and hurt her wrist. I went over to a tall (well her blades made her look tall) young Russian girl who was nursing her left arm. She was in some discomfort and I asked her what had happened. She told me she had fallen backward awkwardly and now she had a lot of pain in her arm.

Her wrist was swollen and very tender to touch. It looked a little deformed over the ulna and I suggested that she may have broken it but that I would take her to hospital to get it checked. She was very upset and began to cry. Although I sympathised, I found it ironic that she felt so emotional about it – she must have known the risks she took every time she put on her wheeled boots.

I called it in and took her and a friend to A&E as promised.

Somewhere in the next few hours I got a break and a well deserved cup of coffee...

Then I was sent to the north for a collapsed 35 year-old male. A gentleman with a private ambulance had been flagged down to help the man, who had been seen lying on the ground by several passers-by. He was in the recovery position and some obs were being taken.

The man looked agitated. He was conscious but he looked as if he had a neuro-physical problem – something that was causing myoclonus; possibly MS. He couldn’t communicate clearly either, his speech was badly slurred but he hadn’t suffered a stroke – he confirmed that he was normally like this. Although he gave me his date of birth, he wouldn’t tell me anything about what had happened and why he was on the pavement.

There were two police officers on scene with us and they had even less success getting information but he had said something earlier about being attacked and kicked around the head and body. He kept referring to his ribcage and guarded it with his hand. I had a look but could see nothing significant – no marks, no bruising. It was a strange call.

The ambulance arrived after twenty minutes and the crew took the man inside for further checks. All his obs were normal and he didn’t appear to have any injuries. He still wouldn’t tell anyone what had happened and we only got his name and address through an ID check with the police. I left the crew with that little mystery and headed back to my own area.

Calls to police station cells are never any fun. I found myself inside one of these small, smelly places in the early hours, asking a man to confirm whether or not he had swallowed a number of ‘wraps’ containing cocaine. He had told the police earlier that he had removed them from his storage place (his anus) and swallowed them in his cell. Considering how long it had been since he had allegedly done this, I found it incredible that he was still breathing, never mind making any sense when he spoke. He was a very angry man and refused all help from me (and my colleagues, who arrived as I stood there listening to him). We got his recent life story and the police got loads of abuse. A fairly balanced call, I thought.

When I went to deal with a 35 year-old male with DIB, I got a surprise. I opened the callbox in which the man stood waiting for me and saw that it was a frequent flyer that I’d not laid eyes on for some months now. He is an annoying and persistent problem. He claims chest pain when he has none and is verbally abusive if challenged about his behaviour. Most of the hospitals know him and few tolerate him. I handed him over to the crew as soon as they arrived. My colleague referred to him (as we all do) by one of his names – he uses up to three different names in an attempt to disguise who he is.

My next call was to a hostel in south London for a 23 year-old female who had overdosed on a heroin and cocaine mix (known as a snowball). She had paid £35 for this single hit and I was about to ruin her day by reversing it with one injection of Naloxone. She was too groggy and her breathing was depressed, so she needed it. We took her to hospital and she stormed out with her boyfriend as soon as she ‘recovered’. Not a happy bunny.

Finally, a 34 year-old with chest pain who walked to the car when I arrived. I got him to sit down on a bench while he explained that he had gastric problems and that the pain felt similar to past episodes. He had no cardiac problems and was usually healthy; his obs said the same. When the ambulance arrived, he was swiftly taken to hospital – you can never be too sure.

I was cancelled no fewer than ten times tonight as I set off on calls. The new version of FRED that has been rolled out is even more frustrating than the old one. If it was a real person, he’d be taken aside and beaten up by now. Some shifts are all about rapid response and very little to do with pre-hospital care. I did nothing important tonight – I didn’t save, or contribute to the saving of a life (unless you count the overdose girl) and I used few skills. It was a routine night and my ‘rapid response’ technique has sharpened to a point where I am highly tuned to one probable outcome for any call. Cancellation.

Be safe.

6 comments:

thinblueline said...

I say we issue you with tazers , sod us

Anonymous said...

Did the 28 year old woman who felt faint go to hospital? Why would someone who simply fainted require an ambulance anyway even though it gets hot down the tube? I sincerely hope this is not a regular occurrence.

Give Quiche A Chance said...

I'm really impressed with this blog, I've been reading it for a while but didn't want to leave an anonymous comment. Have finally figured out what I need to do hence the comment.

I never realised how much time you had to waste on bogus calls like drunks, I'm amazed hospitals are still being treated as hotels by some of the less fortunate.

You've really opened my eye's to the type of workyou have to deal with and I have a new found respect for all NHS staff and not just the nurses who seem to be the only ones the papers publicise.

Thank you for all your hard work, I think this blog is wonderful publicity for paramedics everywhere and a small insight as to what goes on when most of us are looking the other way

Xf said...

thinblueline

Tazers...Hmmm...now there's an idea

:-)

Xf said...

anonymous

Yep. It happens a lot. Every summer we will average one or two 'underground faints' each day, probably in every sector.

The days of 'getting over it' have long gone.

Xf said...

quiche

Thank you. Nice to have you reading.