Saturday 27 October 2007

Whistle while you work

Eight emergencies; one assisted-only and seven required an ambulance.

Sometimes the radio is on in the car when I start my shift. More often than not it's been left on one of the commercial stations and eventually, after hearing a thousand ads and two songs, I switch it off.

Tonight, however, the radio was set to the ‘Classics’ station. Normally I wouldn’t bother with it, even though I do enjoy classical music but tonight I left the volume alone and the music seeped into the car’s environment like a warm friend. The music was playing even when I was running on my calls and I discovered that there’s a wonderfully relaxing quality to the mixture of sounds that I was being enveloped by as I rushed to my first call – I call it Vivaldi and sirens.

The call described this 24 year-old woman as ‘turning blue’ with DIB. Of course, when I got there nothing could be further from the truth – she had a kidney infection and her antibiotics weren’t working. She had a bit of a temperature and a low BP but her respiratory system wasn’t affected and so there was no DIB and she wasn't blue - she wasn't any particular colour.

A call that fit the bill for a 33 year-old female ‘drunk, dizzy and vomiting’. Why do we even bother? Surely the call-taker can see it’s not an emergency. This is an obviously drunk person. When I got on scene a crew were already dealing with her. I wasn’t required. She was taken to hospital, where she remained drunk and dizzy but probably showed no remorse or gratitude.

Thespians, I mean true honest-to-God actor types, are a quirky breed; they assimilate scripts into the fabric of their lives and eventually absorb the dialogue of numerous plays so that their everyday speech reeks of drama. I was called to a basement flat in an expensive part of town for a 70 year-old woman who was feeling weak and had been described by the caller, a friend and fellow artiste, as ‘drifting in and out of consciousness’.

I went to the wrong part of the house and stood at the wrong door, ringing on the wrong bell. A groups of people came from the basement area up onto the street. They were chatting, hugging each other, saying 'Ciao!' a lot and one of them mentioned success with ‘the script’. Not one of them, even though they had seen me, chose to point me in the right direction. I didn’t know that they knew where I was supposed to be but they knew an ambulance had been called and could clearly see that I wasn’t selling cleaning products door-to-door.

‘Oh, there’s an ambulance car’, one of them even remarked.

‘Oh, yes’, another said, ‘there’s the chappie at the door’.

I don’t like being called chappie, it’s the closest to ‘boy’ anyone will ever dare to venture when using it in the context of public servant.

‘Did you call an ambulance for this address?’ I asked them.

‘Oh, yes but she’s down there’, one of them pointed out. The young man who had bothered to enlighten me spoke like Oscar Wilde – well, in the fashion of. He had a flare about him and every move he made seemed to be choreographed. I stood on the wrong step and wondered what kind of emergency this was. None of them seemed concerned about the person I was supposed to be attending to downstairs – there was no sense of urgency.

I was directed to the basement flat and guided through a maze of posters, costumes and the paraphernalia of Theatreland. At the end of a hallway I was sent into a bedroom where a woman lay on the bed like a dying swan. She was fully conscious and displayed no sign of illness. Her obs were normal and all she could tell me was that she was ‘incredibly run down’. She did look tired but that was about the extent of it. I would argue that the times when she was ‘in and out of consciousness’ were nothing more than episodes of sleep!

She spoke in over-the-top detail about her every emotion and physical feeling during her bouts of illness. She had seen numerous doctors and her condition had been deteriorating like this for many weeks. She had her hand held over her forehead, palm up wards, like they do in the movies and she spoke in hushed tones...for added effect I guessed.

The crew arrived as I gathered my handover information and I left them to help the woman make a decision. Meanwhile, I looked around the room at the various costumes, wigs, photographs and props that she had gathered during her career. I have been to a few households where retired artistes reside – a lot of them live in the W1 area – and I am always amazed at how good they look in those photographs; head shots of former youth and glory. When I visit them, they are shells of their former selves and it can be a bit depressing because it comes to us all in the end.

She was taken to hospital for further investigation – despite my cynicism there are genuine illnesses that can cause fatigue, so for her own benefit off she went.

Then I was sent miles out of my area for a 25 year-old female who was 'vomiting blood' and had ‘? food poisoning’. When I arrived at the address an ambulance was joining me. We both pulled and it was a pleasant surprise to see him.

I pressed the buzzer to the flat and a young woman answered the door.

‘Ambulance’, we said, kind of in unison.

‘No, I didn’t ask for one’, the woman replied. She looked very confused.

We confirmed the address and she stood there for a few seconds considering what might have happened. Then she had an epiphany – maybe her flatmate had called us. As she dashed off to investigate this possibility we were left standing in the doorway looking at each other in bewilderment.

She returned and confirmed that her friend had made the call. She was in her bedroom but hadn’t told her that she was ill, so she knew nothing about an ambulance being called.

‘Sorry’, she said. Then we were taken to the patient.

I left this one to my friend. I stood with his crew mate and listened to the unfolding story. The girl had been sick but hadn’t vomited blood, at least not proper blood. She had retched so hard a couple of blood vessels had burst in her throat and that had produced a red tinge to the vomit. It’s quite common and not the least life-threatening.

She was taken to the ambulance for further checks and I used this as an excuse to catch up with things and do my paperwork. The patient was lively and chatty – she probably had a touch of food poisoning after all but she didn’t want to go to hospital – she thought she could dial 999 and get an ambulance crew to give her a second opinion. Another waste of time but I got to see my mate and have a ten minute chat before heading back to my own area for more of the same.

Falling down escalators is a ‘festive season’ thing. It happens all year round but it becomes much more common the nearer to Christmas we get, I find. When you fall down these steps you will probably make contact with the metal grooves with your head. This will leave a prominent, but not permanent, mark. It looks like three scratches. Sometimes they are deep enough to bleed.

A 60 year-old Irish man fell down the escalator steps at a busy tube station but he was having none of this ‘going to hospital’ fuss. He was drunk (escalator-fallers invariably are) and he may or may not have been knocked out during his descent. That is why the crew and I were trying to persuade him to go and get checked out. He hadn’t bled from his wounds – they weren’t deep enough but his drunken condition meant we couldn’t really assess him properly. We couldn’t be sure that he didn’t have an underlying injury. It took us more than 30 minutes to persuade him to go to hospital.

Fortress council estates are an obstruction to the emergency services – some of these places are quite impossible to access unless you have keys, know a code or have the navigating ability of a pigeon...or you live there. I was called to a 78 year-old man with chest pain. The call came during the early hours and I got on scene very quickly but was immediately slowed down by the inaccessible design of the estate he lived in. The numbering system was confusing and I tried four doors before finding the one that led to his floor. Then I had to work out which floor his flat number was on – they weren’t listed anywhere.

When I got to the correct floor, I found the flat numbering wasn’t logical. It wasn’t even consecutive. I wandered from one end of the dark concrete corridor to the other until, eventually, I found the man’s flat tucked in a corner. My two minute response time had been stretched to seven by the time I found him.

The patient had vomited a decent amount of ‘coffee ground’ blood, indicating that it had come from his stomach. He had chest pain and was very pale and sweaty. He told me he felt faint and when I checked his BP it was low. I carried out my obs and decided to cannulate him on scene, just in case he suspended on me before the crew arrived but as I completed this task, his door buzzer went – it was very loud and made both of us jump. His little jump pulled the cannula back out of the vein.

The crew took him straight to the ambulance. There was no time to spare with this man and I wondered just how close he was to going off as a result of where he lived.

Just before my shift ended I was sent to Regent Street for a 71 year-old male with chest pain. He was standing outside a shop waiting for me and even flagged me down as I pulled up. He looked more agitated than in pain but that was moot because the ambulance arrived seconds later and I didn’t get a chance to ask him anything more than his name. I handed him over to the crew and went back to my base station in preparation for my journey home.

Control had other ideas, however, and sent me to SW1 for a 78 year-old male with DIB. I sped over there and climbed the steep stairs to his flat. He met me at the door and told me he just felt unwell. He had no problems with his breathing and I decided to take him to the car – I may even take him to hospital myself, I thought.

He told me he couldn’t walk but when I pointed out that he had walked to the front door and was standing right in front of me, he said he would ‘give it a go’. I walked him down the stairs and out onto the street, where the ambulance crew were just pulling up. I handed him over and he was taken to the vehicle.

As I sat in the car (with my background music on) completing my paperwork a red-faced, panting woman tapped on my window. I wound it down and asked her if I could help.

‘I’m the key holder for the gentleman upstairs’, she explained, ‘do you want me to let you in?’

‘He’s already in the ambulance’, I told her.

‘How did you get to him?’

‘He let me in’.

‘But he can’t walk – he doesn’t ever leave the house and I always have to let ambulance people in’.

‘He walked down the stairs with me – there’s nothing wrong with his legs’, I told her.

I could see a mixture of anger and bitter disappointment on her face. It was early in the morning and she had been dragged out of bed for this call. She wasn’t a happy citizen and she stormed off to her car – probably to do a mile of paperwork and report in to her boss.

As for me, I was chilled. I had Mozart in my ears and I was going home. I felt sorry for her but I also thought she might need to be firmer with Mr. ‘I can’t walk so carry me’. She might also benefit from a bit of classical music in the background.

Be safe.

11 comments:

Anonymous said...

your blog is so interesting. you do such a rewarding job. im surprised at how much people seem to take the ambulance/paramedic service for granted. great writing btw. be safe.

Anonymous said...

I was on a ward with a woman much like Mr 'I can't walk so carry me'. She was so rude to the nurses, and was constantly banging on about how bad her back was. On the last day she was there she asked the nurse to take her to the shower and help her. When it came to being discharged she put her suitcase on the wheelchair and said she could manage fine to walk to the discharge lounge - on the ground floor - and flounced off in her high heeled boots!!!

Anonymous said...

As I sit here at the beginning of my shift, it's great to read your blog and realize that things really aren't that different "across the pond" from our service.

Have a good day, be safe.

Anonymous said...

I'm getting hints of 'Lou and Andy' with that last patient, good one!

Anonymous said...

"A call that fit the bill for a 33 year-old female ‘drunk, dizzy and vomiting’. Why do we even bother? Surely the call-taker can see it’s not an emergency"

The call taker (or Emergency Medical Dispatcher to you) can't actually "see" anything. They're not at the scene, it's not up to them to judge the caller. A call taker can not berate a caller for making a non emergency call. Do you expect ambulance control staff to turn away the call? The patient not worthy enough for you because it's alcohol related? What happens if the patient suddenly collapses unconscious whilst vomiting and chokes. It wouldn't be your fault would it?

Xf said...

anonymous

First of all, I refer to EMD's as call-takers because its easier for the reading public to understand. No offence intended.

Have you been out on the road with one of us yet? Have you actually seen how many drunks turn out to be just that - drunk. How many do you know have actually died choking on their own vomit when quite clearly the call was made by someone else with them?

I am writing from a realistic perspective, not one in which I fear litigation around every corner and YES, if you want my honest and professional opinion - she is NOT good enough to be taken to hospital because she is drunk. I am a tax payer just like you - consider the evidence.

I realise you can't see the patient and I guess the last line I wrote was less thought out than it should be but only its only been a few years since we decided, at a management level, to refuse ambulances to drunks - remember? Where were everyone's concerns about people choking on vomit then?

For the record, it is extremely frustrating to go to an obvious drunk while hearing other, more important calls being GB'd, so I tend to exorcise my annoyance through my blog. Free speech and all that.

I have many friends in Control, so I wouldn't deliberately offend anyone but you have taken it personally I think.

You don't see the patient, that's right but try to bear in mind that you are sending a human being to one time waster after another and at some point in his or her shift, a real tragedy will occur and s/he will be expected to become a different person altogether. You aren't doing it deliberately of course but the cycle causes real frustration. I have just aired that. Nothing more.

Anonymous said...

Have I been out on the road - yes I have. You obviously haven't spent any time in control, apart from the shift you obviously have to do for your Uni course. How ignorant to blame control staff for the type of "patient" you're being sent to. People phone for an ambulance, we ask questions, AMPDS grades the call, you get sent on it - which is your job by the way. Could be a drunk, a maternataxi, a 3 week old belly ache. Surely you've been in the job long enough to accept they're part of what you do and they're not going to go away. How pointless to get worked up over it.

Xf said...

anon

I won't be spending time going over and over this. Why don't you chat to the many other crews who are angry at this situation? Or the general public who know their4 money is being wasted and you think it's not a big deal. Don't lecture me about it and don't call what I say or feel pointless when it is nothing more than my opinion.

The very mention of AMPDS shows how little you think of what is happening. You would prefer a computer to decide who spends your money? This situation is going to get much much worse simply because there are people who say things like 'it's part of the job and isn't going to go away'. How ignorant of you. Read some of the old job logs from years ago then tell me its 'part of what I do'.

EMD's and all those in EOC do an important and necessary job but I have sensed a 'them and us' attitude over the years and it is all brought about by stress and low morale. This has been caused by the very nature of the job we all do. It's becoming thankless and I will be considering my options because I don't think it is my job actually!

You have had your say and you are the one getting wound up about it, not me. I do my job and get no complaints, I'm happy with that but I didn't go through years of study and hard graft to baby-sit people who couldn't care less, thus my outlet for expressing myself. So, don't read the blog. Go away and be content that all is well in your world. Nothing personal and no offence intended.

Helen said...

Hear Hear SG!! Well said. I have no idea why people feel the neeed to get wound up and have a rant.

I would recommend that anon clicks on the little red "x" on his/her top right hand corner of the screen if someone's opinion winds them up so much!

Take care and keep up the good work, love to scruffs!

Helen

Anonymous said...

What I'd just like to add here:
you are still quite lucky here with your system because at least they ASK the caller questions.
Ever called 112 in Germany??
They will answer the call: "Feuerwehr Notruf", you tell them what and where and they'll be like: "Alright we'll send someone" - THAT'S IT and I'm not kidding! Takes not even a minute and NO assesment what so ever takes place.........
Yet they have fewer "time-wasters" so now I start asking the one never-ending question: "WHY - IS - THAT??"

Xf said...

anon

Not sure what point you are making. You say we are lucky with our system but then state that in Germany they have less time wasters when such a system isn't used.

It's not the system really...it's the quality of the people. We rarely get time-wasting calls from responsible, intelligent people and at least they apologise when they think they are wasting our time. We get abused by those who belive that a FREE service is actually costing nobody anything or who don't care who it's costing as long as its not them.

A lot of these people pay no taxes whatsoever and live solely on the incomes of others. A lot of them are immigrants who are taking advantage of one of the many freebies we give in the name of human rights (notwithstanding our own rights).

A minority of them have no choice because they don't know where else to turn because our out of hours GP services are in decline.

I could go on for hours but nothing will be solved because, until the pot boils over, politicians are happy to let us all stew - it keeps us in line.