Things that slow us down

Six emergencies - one hoax and the others went by ambulance.

It was a busy night for retired professionals and there were dinners and functions going on all over the place, so when an 84 year-old man collapsed at the table during one of these soirées, the crew and I found it difficult to get to him. The location was packed with people and the patient was at the top of the building. We waited for the lift to take us to the 5th floor. You know how it is, you stand there and look at the stairs and consider whether it would be easier just to walk up. Then you think ‘What if the stairs are long and steep?’ and ‘What if the lift arrives just as I’m dying for oxygen on the third floor?’ – not that I am unfit, although I do need to get to the gym again regularly – but with all the bags we have to carry around, a handy lift is a huge incentive to avoid lugging them up a load of steps.

There was a long queue of elderly chaps, all smartly dressed in suits and shiny shoes, waiting for the one lift the building had to take them to their relevant floor. As I stood there I thought (and I can be forgiven for thinking like this, considering the company) about how easy it would be for one or two of them to have a heart attack as they mounted the stairs in frustration. Then again, these guys may well have had lots of practice, since this was their ‘club’ and they came here regularly, so they were probably fit enough to tackle them. Then I pondered the contrast to the men and women I see every day who are as old as these men and how different they are when stuck in a council flat with no prospects and a shabby state system looking after them.

The lift arrived and I snapped out of my day (night) dream. It had taken five minutes to finally get to its landing point and we were prepared to fight these old men to get in if necessary but it wasn’t necessary, of course. They stood aside and let us in. A few of them joined us. Then we wasted another three minutes as the lift visited every floor on the way up. It would have been quicker to walk up the stairs after all.

Luckily for all concerned, the patient was sitting in a chair in a side lounge when we got to him. He was conscious and alert, although a little off-colour. The crew began their chat and obs and I had little more to do than stand and watch. It was clear the gentleman wasn’t in serious trouble; he had probably fainted and, although it merited some investigation, considering his age, he looked as though he was recovering well. I asked the crew if they needed me and when I was told ‘no’ I made my way back to the lift – and waited – eventually, I relented and took the stairs.

As the rain began to fall I made my way to a small estate in the Holborn area for an 87 year-old lady who was ‘vomiting blood’, according to the call description. When I arrived I found the gate to the little community required a code. Obviously, I didn’t know the code, so I parked in front of it and pressed the buzzer but there was no reply. A young couple who lived on the estate approached me, told me the code and I let myself in. Now all I had to do was remember the number; the ambulance crew would need it. I have a rubbish memory at times, so I called my Control and told them the code – that way if the crew didn’t receive it, I wasn’t to blame.

I struggled to find the lady’s house – there was scaffolding up and none of the door numbers were visible. Detours were marked in such a haphazard way it was impossible to know what the number logic was unless you actually lived there. I despair at these places sometimes – someone will die as a result of the access and location difficulties we frequently encounter.

I found the flat after a few minutes of searching and was met by the patient at the door. She had been looking out for me. I walked her back into the flat, sat her down and asked her my usual questions (after an introduction of course). She had back pain and was vomiting blood. I couldn’t see evidence of the latter but if it was true then she may have a serious problem, although the sign and symptom may be unconnected. What was evident, however, was that she was in pain.

The crew arrived as I completed my obs and she was quickly taken to the ambulance. Unfortunately, the gate code had not been passed to them and the patient had to be wheeled all the way across the road in the rain to the waiting vehicle.

I got back to my station and managed a cup of coffee before my next call to an underground station for a 60 year-old female who was ‘in pain and unable to walk’. When I got on scene I was taken to the staff office and introduced to the lady. She was sitting on a chair where she had been deposited after being rescued by two British Transport Police (BTP) officers.

I learned that she had a history of hip problems, including a replacement and previous fracture. I also learned that she was sozzled. I don’t know how much she had been drinking but her speech was unintelligible at times and her eyes had that lazy, wandering look about them. I find the wandering eye thing is more distinct in women than men – I have no idea why.

She hadn’t fallen (or she couldn’t remember) and the pain had started suddenly. She had a low BP and looked a little pale. I think she had fallen over, drunk as she was and damaged her femur. She may even be bleeding internally, which would explain her blood pressure. I gave her entonox for the pain and when the crew arrived she was carefully moved to the ambulance. Alcohol and brittle bone disease is a dangerous combination.

During the night there were no less than four hoax calls, made by our usual suspect from phone boxes in and around his stamping ground. I was called out to the first and the others were cancelled but I made a point of finding the man I think is responsible. I saw him talking to some of his cronies on the street around the corner from where the last call had originated a few minutes before. He saw me and approached the car – he knows me well and we have not always seen eye to eye in the past. I’ll call him ‘M’ here.

‘Awrite boss’, he said as he slouched towards the vehicle.

‘Hello M’, I replied, ‘have you called us tonight at all?’

‘Not me boss, I haven’t been making calls. Ask my mate, he knows. I’ve been here for an hour.’

His spiky-haired, tattooed and pierced punk mate looked at me and nodded but M is shifty and he is a damned good liar. His behaviour was suspicious and he said more than he should have considering I hadn’t mentioned hoax calls yet. Why would he feel he needed an alibi? As far as I am concerned he is making good on his promise to ‘wind up’ the emergency services with every opportunity. He made that vow over a year ago when he attacked me in an alley way. The guy is going to cost someone their life if he continues to do this.

‘Last week someone’s mum almost died because of these hoax calls M’, I lied.

I was hoping that a threat would lead to the end of this game. These calls, all with the same request for all of the emergency services, have been going on for months and are received every week. As many as six calls are made in a single night, all from the same area.

‘Well, it weren’t me. I was here and my mate can vouch for it’.

Yeah, his mate looked like a stand-up guy.

Not once had I actually accused him of making the calls but he was very defensive. I can’t prove he does this but I hope that I am close enough to one of these calls and get to scene whilst it’s still in progress. We can identify the callbox from its number, so if I am a minute or less away from it, he won’t have time to get away before I see him.

An hour after I spoke to him another call was received.

I had an hour or so of quiet before I went to my next patient, a 75 year-old asthmatic female with DIB. She lived in one of those posh flats that are deceptively spacious on the inside – the Tardis effect I like to call it. She was in bed and her family were around her. The home nebuliser she had used didn’t help and she had a terrible sporadic cough, although she could still speak in full sentences, which is always a positive sign with asthmatics.

She had a recent history of chest infection and her G.P. had changed her antibiotics a few times because they weren’t working. Her current problem was certainly just an exacerbation of that infection – she was wheezy and her peak flow (PEFR) was lower than normal. There really wasn’t much I could do and when the crew arrived they felt just as redundant. Nebulising her again would relieve the problem slightly but the patient had already tried it four times that day without success.

I handed her over to the crew paramedic, who would make a decision about hospital or a G.P. referral, which was more likely. I went back to my station and waited for my next call. It would prove to be my last call of the shift.

‘Man on fire’ the call descriptor read. It was out of my area but I ran on it and arrived to find the Fire Brigade, two ambulances and the police on scene already. There were two women with smoke inhalation being treated by the one of the crews and one other patient, the burning man, was in the back of the other ambulance. I had nothing to do really except assist one of the crews and hook up with the officer on scene but I stuck around long enough to find out what had taken place.

A young Asian man had walked into his home with a bottle of flammable liquid. He threatened to kill the women (his family I believe) inside and threw the bottle into the lit fire. It ignited and he was engulfed in flames – he made it to the hallway but burned for a while as he tried to escape through the front door. His family were lucky to escape the fire but were overcome by smoke as they fled the house.

By the time we arrived, the man had received burns to more than 60% of his body. His chances of survival are less than 50%. He was conscious and in extreme pain in the back of the ambulance - he would need a whole lot of morphine to relieve it.

Before I left, a fire officer told us that when they entered the house they found a row of knives laid out on the floor, as if ready for use. I think the man intended one way or another, to kill himself and his family – nobody seemed to know why.