Sunday, 7 October 2007

The future generation

Ten emergencies - three assist-only and seven required an ambulance.

The morning kicked off with a 28 year-old female with chest pain, which she had apparently endured for three days before deciding to call an ambulance. When I examined her it looked and sounded like a chest infection - she had pain on inspiration and a ‘tender’ chest - although there are other possibilities. There was no trauma involved and she had no cardiac history. Her DIB was real enough, so she went to hospital.

It’s mid-morning and I am starving because I haven’t eaten since starting my shift (I tend to get hungry in the first three hours of work), so I got a call to a hotel restaurant where the residents were tucking into their cooked breakfasts – it didn’t seem fair. Still, I maintained a professional distance between myself and the food.

I was there to deal with a 70 year-old retired doctor who had collapsed, fainted and vomited at her table. She was conscious when I arrived and looked very pale. I chatted to her, carried out my obs and discussed her medical history while all around there was the sound of sausages being chomped. The poor woman had vomited down the front of her blouse and was very embarrassed. She had low blood pressure when I checked it. She also had an irregular pulse and was diaphoretic. She had no cardiac history but she is a doctor and she knew, as well as I did, that something was amiss.

The crew arrived and take her to the ambulance and I waited for the results of her ECG. When I saw it I could see the problem immediately; the doc had a second degree heart block – a cardiac condition that can deteriorate and become life-threatening if not treated. She was taken to hospital after I discussed the ECG with her – she knew that she may need a pacemaker for the rest of her life now.

The next call required my ‘assisting’ skills as I helped a crew to lift a drunken 30 year-old man to his feet after he collapsed in a heap on the pavement. He smiled, adjusted the cap on his head and shuffled off into the horizon with a sheepish look on his face.

I was ten seconds away from my next call – a 26 year-old male having an epileptic fit in a park. He was initially very combative but his mates, who had witnessed him collapse, helped me to control him until the crew arrived. Oxygen helped him recover and by the time he was on his way to hospital his condition was a lot more stable.

An ‘unwell’ woman with DIB and a temperature of 40*c in north London next. She had a recent history of UTI and had received antibiotic treatment for it but it had not cleared, so now she was in a worse state than when she was first diagnosed. She lay in bed looking like she was on her last legs, which she would have been if her daughter hadn’t called us.

Another epileptic fit – this time in a small and extremely untidy flat. I pulled up outside the address and a young girl’s head appeared out of a second floor window.

‘Up here!’ She shouted.

I went up to the flat and walked in to find a bespectacled 20 year-old girl sitting on her bed, crying and shaking. The other girl – her sister, who was 14 years-old, told me that she had fitted on the floor just before I arrived and that she had epilepsy. Her fits were becoming more frequent and she now has one almost every day.

I looked around the room and as I looked into the hall from the doorway, two younger girls appeared – one was about twelve and the other eight. Then a young, possibly 11 year-old boy ran into the bedroom.

‘Where’s your mum or dad?’ I asked them.

‘Oh, mum’s gone to visit her friend’, one of the kids replied.

‘So, apart from your sister, who's in charge of you today?’

‘Nobody’, they chanted.

I called my Control and asked them to hurry the ambulance up and to arrange for the police to visit because I couldn’t leave a house full of minors alone when I left. I was also reluctant to become their unofficial babysitter.

I continued my obs on the fitting girl and she continued to wail and cry. She was quite immature and out of control – there was really no reason for her to be so upset.

I asked one of the other girls if they had been on their own before when their sister fitted. They had – apparently mum leaves them alone in the flat quite often. The young epileptic girl has two babies, and her sister told me she dropped one of them when having a fit in the past. Strangely, the babies aren’t in the house and the girl can’t remember where they are until her sister reminds her that they’re with a relative. Probably safer, I thought.

I found the whole situation bizarre and unsettling. These kids were not responsible enough to look after themselves. Even the 20 year-old had no grown up qualities and could arguably be said to have a distinct lack of responsibility.

One of the upstairs neighbours came down and offered to watch the children and that meant the police were no longer needed. The crew arrived and I explained the situation to them. They took the crying patient out to the ambulance and her 14 year-old sister screamed instructions out from the window.

‘Remember to wait until our mum gets back!’

They had contacted their mum who, reluctantly, agreed to come home and rescue her children (from Social Services if she’s not careful). As I was standing in the ambulance with the crew, mum appeared – a large, tattooed, skin-headed woman. She starting barking orders at her kids and didn’t look a bit concerned about our presence. We are, after all, merely servants of the underclass.

Before I left, another sister appeared on the scene. She looked about 21 or 22 years-old and seemed a lot more sensible. Where the hell was she when I needed her? I don’t know how many more off-spring existed in that family but I left the scene as soon as I could before any more of them decided to join in the fun.

A quick call to a 65 year-old male ‘choking’ in a restaurant in Convent Garden next. When I get there a crew are on scene and the patient is sitting talking to them. He had choked but cleared it himself – people often do.

After a short break, I get called to a shop for a 17 year –old male who is feeling faint. His girlfriend and their child are with him. Initially, it looks like he may have had a drop in blood pressure but I asked the crew to do an ECG and it didn’t look right at all. He was taken to hospital and the doctor there agreed that something else was going on. I think the patient was crying when I left - it was probably a shock to him.

A man with a cut thumb next. He was working at a hotel when he broke a glass, a piece of which sliced through his thumb – almost to the bone. He looked very pale and was shaking when I got to him. His wound was dressed and he was reminded of the fact that he would live – that seemed to help.

My last call was to a grotty block of flats where a 23 year-old diabetic had collapsed. When I got to the address I was led into the kitchen by a relative. He was sitting at the dining table with a couple of other relatives (his mum and a sister I think). He was recovering – his mum had given him a sweet drink – so I asked if I could check his blood sugar. He agreed but insisted on doing it himself. I wasn’t sure at first because I wanted to get an accurate result but he was insistent, so I gave him the lancet to jab himself with.

I prepared the test finger for him, however -I always clean the test finger with a non-alcohol wipe, to remove any trace of sugar that may skew the reading but when I started to do this he became obnoxious and pulled away.

‘Aw that’s bullshit man. You don’t need to do that’, he moaned, ‘my diabetic nurse says you never clean the finger before doing this – its bullshit!’

‘This is how I do it – this is how it’s done by the ambulance service’, I said but, to be honest, I had no more time for him. In his voice and on his face I recognised a stupid little upstart with more attitude than manners. I was trying to help him and he was sitting there giving me abuse. Rude that is, just rude.

I did what I had to do, including cleaning his finger before he lanced himself, then I left them to it. The only person who bothered to say thanks was the man who had shown me in – his uncle I think. I walked out of that place and thought about thecrew that would come here someday and probably save his life when he goes hypo. Not once will that guy ever thank them. He is the future of our country and that depresses me.

Be safe.

2 comments:

Anonymous said...

I don't understand why some people don't say thanks. It's bad enough when they don't say thanks when you let them out of a junction, but when you save their life? That really is bad.

Anonymous said...

Hi xf, plsd book finished will order it! just wanted 2 say, we have just spent 4 days in London, and can now relate to your blogs about trying 2 get thru London traffic! it must be a nightmare 4 u! We did c many ambulances struggling past vehicles, cyclists, ricksaws and predestrians!! pat on 2u all!
Take care
joan