What's in your wallet?

Ten Emergencies; one assist-only, two ran away(!); one refused and one false alarm. The others went by ambulance.

I've been doing a lot of thinking about the financial consequences of certain calls. For example, alcohol-related calls - collapses, unconscious individuals, violence. Every time we go to one of these, the person who goes to hospital (whether a tax payer or not) is responsible for the costs associated with it. If that cost is, say, £300, it means his or her drinking session, which might have cost £30, has resulted in ten times the expense, payable by you and me. We might as well just go and put a quid each from our hard-earned cash into his or her stupid pocket.

If the person is a tax payer then he or she has made a contribution towards being stupid, although that doesn't excuse it but if he or she is not paying taxes, then we are paying for his/her drinks...and the fall out.

My first call was to a ‘?fit, ?drugs’ but when I got on scene, I learned that the ‘patient’ had scarpered. He ran away when he saw the ambulance coming but this isn’t a problem because, deep down I’m sure he pays his taxes and is entitled to run the emergency services around like that. Stop me when I become sarcastic.

Then a call to a 24 year-old cyclist who was cycling at speed across a junction (I wonder if the lights were red?) and got himself run over by a van, which was turning right at the time. He had a fractured wrist and a sorry looking face.

After that, I was off to rescue a 49 year-old man who called us to say he was vomiting blood. When I got there, he was standing on the pavement waving at me. There was no blood. He told me he had chest pain now and that he had a history of cardiac problems. He had ventolin and GTN with him, so I had to believe his story, although he seemed perfectly ok to me. He also claimed DIB but was able to talk in good long sentences without a problem. After a conversation with him about his circumstances he came clean and admitted he just needed a place to stay. He had been made homeless. I handed him over to a sympathetic crew and he was taken to hospital

The crew were already on scene for my next call; a 49 year-old female with chest pain. I wasn’t required, so I did my paperwork and ‘greened up’. As soon as I hit the button, I was off to wake up a sleeping drunk on a bus. I am now practised at this and so I went aboard, shook him ‘til he got the message, explained his options (get off, be genuinely ill or get arrested) and he responded by choosing option number one.

Another cyclist in trouble. This time the guy was hit by a car. Unfortunately, he decided to leave the scene when he heard the police coming. He’ll go home with his injuries and have another explanation for them no doubt.

Anaphylaxis is a very real and potentially life-threatening problem, yet time and time again I come across patients whose G.P. has either been reluctant or has simply refused to give them an Epinephrine device (i.e. Epipen) so that they can save themselves when the reaction occurs. I hope a G.P. out there can explain this to me because my next call was to a 4 year-old with a known nut allergy who developed a sudden anaphylactic reaction. I found him with a widespread rash and a wheeze when I listened to his breathing. Although he wasn’t yet critical, the swelling had gone far enough to cause his throat to come up a little.

I gave him nebulised Salbutamol and this brought some relief. Then he was packed off with mum to hospital.

Immediately after this call, I received another anaphylaxis job. This time it was a 46 year-old male, again the reaction was caused by eating food containing traces of nuts. I arrived to find him sitting on the floor of his office, surrounded by colleagues. He had puffy eyes, red and swollen hands and was complaining of nausea. He had eaten a trifle at lunch time and it’s possible it contained nuts. He too had been denied an Epipen when he was first diagnosed.

I nebulised him to clear his wheezy breathing and got him off to hospital – I took him myself; he was stable and recovering well after the Salbutamol and there were no ambulances available for him.

A pleasant (not) call to a hostel that I haven’t had to visit since my days working as a relief in another sector. I knew it as a place full of reprobates and I was being asked to go and assist a 60 year-old who had collapsed. The usual cause of collapse in this place is alcohol, so I wasn’t surprised when I was met at the door and told...

‘He got up and went back to his room. He’s absolutely covered in faeces but I don’t think he wants any help’.

One of the hostel workers had greeted me on my arrival with this information and I was glad to know that he didn’t want my help but I still had to check before I left, so I asked him if he would take me to the guy’s room and I would have a word.

We walked along the cramped, smelly corridor and knocked on the relevant room door.

‘Hello. The ambulance man is here. Do you want to speak to him?’ the hostel worker shouted through the wood.

A shuffling sound from behind the door and a moaning, winging comment that I could barely hear (or decipher) heralded his imminent appearance. He opened the door a little, stuck his filthy head through it and looked at us with a fag in one hand and a beer can in the other.

‘Do you need an ambulance?’ I asked.

‘Naw pal!’, he spat in broad Glaswegian.

Then he slammed the door in our faces. The sudden draft created by the force made me blink.

The ambulance crew arrived, despite the fact that I had cancelled them over the radio and I explained what had gone on. They cheerfully left the scene and I completed yet another form for someone who couldn’t care less for the NHS.

My next call took me to an area of London that I’m not familiar with. It’s certainly not a nice area because as soon as I turned into the little street I was confronted by one of those yellow police notices asking for witnesses to the murder of a young woman. The murder had taken place in one of the houses – hopefully not the one I was about to enter.

The house I went to was inhabited by an 83 year-old man who sat on his sofa, shaking and breathing with some difficulty. His wife, who seemed like a long-suffering woman, wasn’t happy that he had ignored her previous requests to call an ambulance. He had been coughing up blood for the past four days and now had a high BP. He had a cardiac history and had also suffered a stroke in the past.

‘Why didn’t you call an ambulance when you started coughing up blood?’ I asked. I could sense his wife rolling her eyes to the ceiling behind me.

‘I thought it would go away on its own son’, he said. I like going to older patients – I can get called ‘son’ every now and again.

I made sure he was taken to hospital by ambulance and I warned him about ignoring things like this in the future. I hope he gets better.

My final call of the shift brought me back to reality. That is, I was sent to another complete waste of time and tax-payers money. Someone called an ambulance for a collapsed person, ‘probably fitting’ but I arrived, as did the motorcycle responder and the ambulance, to find a drunken female who had been sleeping. She hadn’t called us remember – a Good Samaritan had.

‘I’m sorry you were called out’, she cried after us as we departed to go home.

Not as sorry as this country is for allowing such a shambles to continue.

Be safe.