The first cut...

Twelve emergency calls and one running call; three assisted-only, one no trace and the rest went to hospital by ambulance.

A thirty year-old woman who ‘feels like she may have a fit’ was my first call of this long night shift. She was in a public place and it took me more than ten minutes to locate her because, even though I walked right past her, she failed to signal her whereabouts. By the time I did get to her, she was feeling better. The cycle responder had also arrived and he waited with me in case the lady decided she was unwell again.

She has a history of epilepsy and she suddenly felt dizzy.

‘My feet go strange when I know I’m going to have a fit’, she told me.

‘Ok’, I said, ‘just let me know if they start to feel strange and we’ll deal with it’.

Luckily for all concerned her feet decided not to misbehave and she was given ten minutes in the back of an ambulance to recover. By this time her boyfriend, with the two-tone hair (I think I mentioned a split personality) turned up and rescued her.

Straight after that I was winging my way to Soho for a 30 year-old female ‘choking on chewing gum’. These calls are almost always not as given. Choking to many people means they are having trouble swallowing, or they have a lump in their throat or they can’t get enough food in and it’s stuck in their mouths - that sort of thing. I’ve only ever been to a couple of genuine choking calls where I’ve had to intervene to save a life.

I stopped outside the alley leading to the address and as I got out of the car I bumped into one of our frequent flyers – our suspected hoax caller and general time waster.

‘I didn’t call you this time, boss’, he shouted.

I was reassured.

The flat was one of three in a tiny building in the middle of the alley and the minute I stepped inside I realised I was in a brothel. There were an awful lot of ‘beautiful and glamorous models’ being advertised. I was led up to the third floor just as one of the employees of the establishment brought in a customer. They went to the second floor.

In the front room there were a couple of women, one of whom was sitting on the sofa. They all looked tired and worn. Haggard is the word I’m fishing for. There was nothing beautiful or glamorous about any of them. Someone should point out the Trade’s Description Act or Advertising Standards or something.

‘I’m alright now. I don’t need to go to hospital’, said the sitting prostitute with a hoarse voice.

‘What happened?’ I asked.

‘I was chewing gum and it got stuck at the back of my throat. I’ve managed to cough it out, so I’m alright’.

‘I’ll have a look at your throat before I go then, if that’s okay with you’.

See? Gentleman to the end, that’s me.

I asked her to open her mouth and I had a look down her throat with my little torch (please, no crude puns or jokes at this juncture). It was red and painful looking, as I would expect but there was an additional medical problem that I didn’t mention because I thought it would be bad mannered of me and would probably result in my rapid and violent expulsion from the place. She had the worst case of thrush I had seen for years.

As I left I saw that a bedroom had been prepared for the next client. A grotty sheet and blanket with an incontinence pad laid out on it. My mind shuddered at the thought of it. Out I went, back into the Soho night.

A fall down concrete steps outside a church took me to the west. A 62 year-old man had tripped and toppled over on the top step as he left with his congregational friends. When I arrived a crew were on scene and they were working over him while a crowd of around thirty people mingled and jostled around them. He was lying conscious on the ground, with a head injury that was producing a lot of blood. The crew had quickly dealt with this and I assisted them with the immobilisation and lifting of the patient.

In the ambulance and on close examination, I could see that he also had a bad knee injury – it looked dislocated. I popped a needle in and asked him if he wanted pain relief. He refused at that point but my cannula left the option open if he changed his mind.

Then a 49 year-old diabetic with chest pain. When I checked his BM, it read 37.2 – that’s a wee bit high. His meter ‘wasn’t working’, according to the patient but when I checked it the machine was fine. I think he had been testing his blood glucose, saw the word ‘Hi’ on the screen and decide it was a fault of some kind. He went to hospital for his own good.

A serious RTC next, involving a 30 year-old motorcyclist and a car. I arrived to find the police just getting on scene, so I went straight to the first (and only) casualty I could see – the motorcyclist, who was lying on the road. I got the police to assist me while I kept him still because he was wriggling a bit and complaining loudly about pain.

I had been asked to report and I told my Control that I only needed one ambulance and that no further resources were required but when the crew arrived and I was telling them about my patient on the ground, a police officer walked another seemingly injured person from the car. I had completely missed that possibility because the cops had told me nothing about another person; I had assumed the driver was fine.

‘Is he alright?’ I shouted.

‘He’s got a bit of a sore neck’, the officer shouted back as he walked the man to the pavement.

‘Keep him still. Don’t move him at all until another crew gets here’, I told him.

I asked one of the crew with me to get on the radio and request another ambulance. The man on the ground had a chest injury and was having difficulty breathing properly, so he was our priority. A collar was made available for the other man; although he told the police that he didn’t need one.

The other crew arrived and took care of patient number two as I completed immobilising the motorcyclist with the first crew. His complaints about one side of his chest and the breathing problems he was experiencing became more urgent and we suspected he may have a pneumothorax, so he had to get to hospital fast.

While the crew were getting ready to take him to hospital, I asked the police officers how the accident had happened. They told me that an eye witness, himself a motorcyclist, said the injured biker had shot through the red lights at about 70mph, colliding with the side of the car, which then dragged him underneath at the back. The patient’s punctured lung could have been caused when he held his breath as he hit the car or the car itself had crushed his chest momentarily when he was dragged under. Either way, the mechanisms were significant.

I escorted the ambulance to hospital and as we made progress through the city, found the way blocked completely by one of those damned ‘road closed’ signs that have been popping up without warning as they dig up more and more roads to repair and replace water pipes. It wasn’t funny at the time and luckily we weren’t conveying a patient whose chest had just been decompressed because the delay could have killed him. Members of the public saw the dilemma and moved the cones away for us. The road had been prepared for digging but hadn’t yet been demolished, so we weaved our way through to the other side on an uneven, bumpy surface. The alternative was a long diversion.

The patient arrived in a stable condition and was taken straight into Resus.

A call for a 30 year-old female ‘drunk, dropped on head’ had me cruelly finishing the sentence ‘as a baby' as I made my way to the scene. She turned out to be a vomiting female who had fallen from her friend’s shoulders as they mucked about. She was fine but she was taken to hospital because she had initially been unconscious, according to her mates. More than likely fast asleep.

Another drunk, this one 21 years old, was said to be ‘fitting’ outside a pub. He was slumped in the corner, surrounded by the door staff who were obviously annoyed at his presence. He was drunk and looked younger than his age. No ambulances were available for me and I had waited with him for more than fifteen minutes before I decided to take him to hospital myself but he refused. He hadn’t fitted and wasn’t epileptic; he was just very drunk.

The door staff said they would get him a taxi to take him home and the young man agreed. I said I would stick around until they got him into a cab but as I sat in the car and watched them I saw that they were trying to get one of the local (and illegal) mini-cab drivers to take him. That wouldn’t be good. These guys would rip him off.

I got out of the car and stopped them, telling them that I would take him to hospital where it was safer for him. I reminded them and myself about my duty of care. The young man, despite his protestations about going to hospital, was vulnerable.

As I set off with him in the back, I was asked to help someone just around the corner who had a badly cut hand. Apparently he had been waiting for an ambulance for 30 minutes. I called it in and went round to have a look – my drunken friend was in the back moaning about his life.

I stopped outside a pub and a man was brought out with a large kitchen towel over his hand. He had fallen onto a glass, which had shattered and cut into his hand, across the fleshy part of the palm under the thumb. I unwrapped the crimson-soaked rag and a jet of blood shot passed me. He had a serious arterial bleed. He looked quite pale. I applied two dressings, one on the other because the first wasn’t stemming the flow. I put pressure on his radial artery for a minute and that seemed to help bring things under control. I was standing with him in the middle of a crowd of drinkers in Soho. There were no ambulances free to deal with this, so I called it in and told Control that I was going to take both patients to hospital. It would take me no more than three minutes to get there, as opposed to waiting another ten minutes or more for an ambulance.

I rushed him to hospital and my drunken friend continued to moan about his life. My bleeding patient’s wound was under control and his arm was elevated in a sling. He was stable and less ‘shocked’ looking than before. I got both of them to A &E in a few minutes. The bleeding man was taken into Resus and the drunken boy was taken to the waiting room, where he promptly fell asleep.

I had no break tonight and my next call was for a female ‘unconscious ? cause’. The location was a police station and I walked into the custody area expecting to be taken through to the cells but they knew nothing about the call. I called my Control and they said that it had come from someone who had seen the woman collapse outside the police station, so an officer came out with me to investigate. I certainly hadn’t seen anyone on the ground when I came in and nobody tried to attract my attention.

There was a small group of people milling about just up the road from the station and I suggested that they might have something to do with it. One of them was holding a girl who looked emotional. When we approached and asked them if they had called, the woman who was holding the girl said she had and that she was a nurse. This was a strange situation. She knew I was there but she ignored me completely, even though she had made the call for an ambulance in the first place. I went to check on the girl who had supposedly collapsed while the police officer spoke to the nurse, who was being very obnoxious.

‘Are you alright?’ I asked.

‘Yeah. I don’t need you’, she replied but she was a bit defensive, almost as if my presence offended her in some way. She wouldn’t make proper eye contact and I thought her behaviour was suspicious.

‘Did you collapse on the road?’ I asked.

‘No. That wasn’t me. That was someone else’.

‘Who?’

‘My friend but she got a taxi home. She’s alright.’

She was lying to me and I knew it. She didn’t want to tell me or the police officer anything. The nurse (if indeed she was a nurse) was still being a pain in the rear and the others turned out to be innocent passers-by who had helped. One of the men in the group took me aside and told me that the girl had been punched and knocked down by her boyfriend. This had been witnessed by the nurse who then called an ambulance. The young girl didn’t want the police involved but that had happened coincidentally because the location had been given as inside the police station.

The story made me very angry. This stupid little girl was wasting everyone’s time and had no apology or excuse to offer. To her, we were simply working and getting paid and were nothing more than an interruption to her life. If she wanted to let her boyfriend punch her lights out, fine, but women like her give the abuse a free licence I think.

I left them to it and the police officer went back to work just as fed up as me.

Another police station call, this time inside, for a 24 year-old male with a head injury who was ‘in and out of consciousness’. He had a small cut to his head but the police didn’t want to take a chance because he wasn’t responding to them. I gave him oxygen and played along with him until he decided to end the game and wake up. The crew arrived and he woke up even more when they lifted him to his feet and made him walk out to the ambulance. The guy just wanted a more comfortable bed to sleep in for the night.

A young man with a minor cut to his chin approached my car as I stopped to do my paperwork at The Haymarket. He had been assaulted and was waiting for an ambulance but on a night like this, he had little hope of getting one soon. I examined his injury, assured him that it was very minor and cancelled the ambulance. He was happy to go home with his mate after that.

A huge Russian, found asleep (drunk) under the seats in a bus next. He was firmly wedged between two rows of seats. I have no idea how he got there. He must have slid off like melting ice cream and slithered underneath as he dozed. I shook his shoulder, pinched it, thumped his back and did everything in my book of tricks for awakening the dead but he refused to budge. He shouted at me, threw his fists at me and was generally unpleasant, so I asked the police to assist.

They dragged him off the bus and stood him against a wall. He continued to sleep – standing up. I cancelled the ambulance and waited until I knew I could go. I asked him if he needed an ambulance but he didn’t reply. I pointed to the street and said ‘go home’. He seemed to understand and toddled off but he got no further than a few steps before he stopped and went back to sleep. He was still standing up. With the help of the police, I sat him down on a step and left him to sleep it off.

My last call was to a vomiting female who was slumped in the seat of a bus. I woke her up and spoke to her. During the conversation I found out that she had learning difficulties. She was also drunk and miles away from home. She had taken the wring bus.

‘Do you have psychiatric problems?’ I asked

She lifted her hand up and waved it in a ‘so-so’ fashion.

‘Are you a diabetic?’

‘I think I might be.’ She said as she dribbled saliva from her mouth as if she had no control.

Her BM was normal, as were her other signs. The crew arrived and as we took her to the ambulance I tried to persuade her to use her own two feet, rather than us lifting her from the bus.

‘You’re a grown up. You can walk for yourself’ I suggested.

She gave me an odd look and said ‘I’m only 22’. Then she grinned and said ‘How did I get all the way down here?’

‘The wrong bus’ I said.

Then with an even cheekier smile, she said ‘Do you have a cigarette?’

Be safe.