Wednesday, 14 November 2007

Keeping it real

Eleven emergency calls – two assisted-only, one treated on scene and eight taken by ambulance.

A 33 year-old who fainted at home was recovering on her sofa when I arrived. I carried out a few obs and the crew took over. She wouldn’t be going to hospital; she didn’t want to anyway.

Another fainting female, this time she was 65 years-old. A doctor was on scene attending to her when I arrived. She had fainted twice, according to witnesses and now seemed to be recovering well and she didn't seem to think a trip to hospital was necessary. The problem, however, was that her age and the fact that she had dropped more than once in quick succession merited further investigation. She was persuaded to go to hospital – it was probably nothing to worry about but better safe than sorry in this case.

A six foot tall drunken 21 year-old man required my attention as he lay in a pool of his own vomit on the platform of a busy tube station. He couldn’t be roused by the staff, so they called 999 and hoped for a swift end to this human obstruction. For some reason the tube staff asked a St. John Ambulance volunteer to help and he appeared at my side as if by magic. I don't mind a bit of assistance so I roped him in and started looking for a response from my dead-to-the-world drunk.

When I shook him hard enough and pinched his shoulder he woke up. He wasn’t pleased but neither was he aggressive – he was one of those smiling drunks who ‘understand the situation’. I managed to get him to sit up but he insisted on falling asleep at every opportunity, so I had to keep him company with a loud conversation until the crew arrived. He had already made it clear that he didn’t want to go to hospital, so we gave him the only choice he had left – leave the station or the police would remove him. He chose the former but we still had to assist him all the way up the escalators; he kept nodding off...even when standing up.

We got him to fresh air and he seemed a bit more alert. He was taken into the ambulance for a set of obs before he went on his merry way. As he approached the ambulance, he noticed the car parked with its lights flashing..

‘Aw, for f**k’s sake – is all that for me?’ he asked.

‘Yep, just for you’, I replied.

‘Aw, go and save someone who really needs it.’

Amen I thought. He was very embarrassed by this, so I think he may just have learned a lesson.

Our hoax caller made no less than six 999 calls tonight. I was sent to one in which he had asked for all three services but specifically wanted the London Fire Brigade to take him to Heathrow! I was still sent to deal with it. Apart from catching him red-handed, I had no idea what else I was supposed to do when I got on scene. Never mind the fact that I was being diverted from genuine calls, I was annoyed that, once again, the LAS had been despatched and not the police...or the LFB.

Immediately after my hike over to the hoax I received a call for a 4 month old baby with DIB. I was now three miles away from this one, all because of this timewasting madman. If the child was seriously ill, precious minutes would be lost and I rushed over there hoping that it was just another ‘hot baby’. Luckily, when I arrived a crew were on scene and they were happy to deal with it.

Back in my own area and a call to a club for a 26 year-old woman who was unconscious after allegedly popping a pill into her drink. Her cousin, who was distraught about this, denied the claim (which had been made by the doorman – apparently he witnessed her putting the pill in her own drink). I didn’t know what to believe and I didn’t really care because the girl was out of it, one way or the other, and my priority was her airway and breathing. The crew arrived and we took her to the ambulance on the trolley bed. She hadn’t responded throughout the entire drama. Her cousin joined her – he still looked shocked and kept apologising for the state of her.

If you are turning 18 soon, go out and enjoy yourself but don’t get so drunk that you can’t remember anything about it. Don’t wake up in hospital with vomit down your clothing and a gang of unknown faces looking at you and asking you questions. This is what happened to my next patient. She ended up unconscious on the floor of the ladies loos, while women were strolling in and out; practically walking over her to get to the cubicles (a bursting bladder negates good manners). It was all very undignified and not the kind of memory your friends should be taking home with them.

When I arrived her mates told me she had been this way once before. She had only turned 18 today, so that means she had drunk so much that she fell down when she was underage. I know parents should allow their kids to experiment and we all had a drink before we were ‘legal’ but getting this drunk in a public place when you are only 17 is not a good reflection on the mum and dad and here she was again...all legal and all unconscious. What a waste.

Outside this club, I notice a little group of teenagers; boys and girls. The boys were taking it in turns to fondle one of the girl’s breasts. I think it was a competition.

A diabetic with a BM of 2.1 was treated on scene with Glucagon and recovered in ten minutes. He was a 27 year-old who really didn’t want any help at first – his condition made him stubborn but not aggressive. His parents were with him and had found him in bed when he should have been at work. His father called us because he wasn’t sure how low his blood sugar level was.

Next, a call from the police for a 20 year-old man who had been assaulted and had a laceration to his head. It was a small wound and the bleeding was easily controlled, so I stuck a small dressing on it and waited for the ambulance to show up. Meanwhile the patient was strangely silent. He wouldn't talk to me; he wouldn't talk to the police. He wasn’t interested. The only reason he was allowing us to treat him at all was because the police were there and they insisted. I really didn’t mind if he wanted to sulk off, quite frankly.

When I greened up from the moody assault I was sent a few streets away to a 74 year-old male ‘collapsed in street, cold and shivering’. I arrived as the ambulance was pulling up and the crew and I went to see the patient together. He was homeless but he wasn’t drunk. He had been found in a doorway by a couple who were passing by. They had noticed how cold he seemed and became concerned about his condition. He certainly looked cold and was shivering violently.

We took him into the ambulance and he winced in pain a few times on the way. He complained about pain in his knee so I had a look at it when he was sitting down in the back. There was no obvious injury and he had no critical medical problems. His temperature was taken - it was 33.3c, so he was going to hospital for hypothermia anyway.

I was just about to leave the ambulance when one of the crew noticed something.

‘Your sleeve has blood on it’, she said, pointing to the right arm of my jacket.

I looked at it and saw a smear of blood. I had no idea where it had come from but it was wet, so it wasn’t from a previous call.

I looked at the old man and checked his hands. I found a deep cut to one of them. He couldn’t remember how he got it but it was likely as a result of falling. The bleeding was under control, so it was dressed and he was taken away to a warmer place.

Combining drugs with alcohol increases your chances of ending up in A&E. I went to an 18 year-old male who was vomiting uncontrollably after a night of cannabis and booze. His friends ‘didn’t know what to do’, so they passed the responsibility (and the cost) over to you, the taxpayer, via me and the NHS. There wasn’t much I could do for him to be honest and I waited for a crew to take him and his sorry mates away to hospital.

I ended this shift with a call that put all the others in perspective. It was for a 57 year-old man with severe chest pain. He has cancer of the liver, kidneys, spleen and spine and is so far down the line that his own morphine doesn’t ease the pain any more. His wife apologised for calling us out. He had been suffering for four hours before deciding to get an ambulance because he (and she) didn’t want to inconvenience us! I told him that he was precisely the reason we existed and that he should never allow himself to suffer for so long before calling us.

He was taken to hospital where, hopefully, they relieved his pain. I know the man is in his end days though. It’s frustrating to know that there are people like him out there, biting their lips and suffering instead of calling 999 while all around them the freeloaders and timewasters of society a racking up billions of pounds in wasted taxes to feed their addiction – the belief that a free service is available on tap just for them when they get a headache or fall down drunk.

Be safe.

10 comments:

kingmagic said...

I went to a chap at the weekend who also had Ca. He had collapsed at the dining table at home.

When we got there he was in a bad way. But he kept apologising to us for being an inconvenience!

If only the scumbags and scroats were as considerate!

Anonymous said...

Hi there Paramedic.

I am a big fan of your blog and regularly read it. I find it extremely informative and interesting and yes at times even entertaining. I am looking at becoming a paramedic in the near future

I am amazed at the type of calls you recieve and the amount of calls that actually do not require an ambulance or real medical attention. Its funny that you receive quite a few drunk calls and this is regarded as a medical emergency, I do feel for you and must admit I would not want to study to become a paramedic and just end up dealing with calls like that, which to be open are merely a waste of time, money and resources and well really boring for you guys.

I know it might be difficult to say but how often do you actually have a genuine medical emergency call such as a resus or Code red/category A call (sorry do not know what you call them) or a real genune RTA. Also I see that most of your calls are medically related how many Trauma calls do you receive ?

Thanks.Keep up the good work

Anonymous said...

How long do you have to study to be a paramedic and what is the best way to go about it ? Where would you say the best college/university is ?

Anonymous said...

im a amzazed on what you, and your team mates have to cope with day in, day out. im only 15 yeard old and hoping to work as an ambulance paramedic as soon as i finish my 2 year public service course i start in the summer. ivce read some of your other blogs and wondered if u Have u got a book out ???

keep up the good work
lewis

Pzycoman said...

I had an ambu called for me when I got hit by a car - I felt really bad because of all of the resources that went into me - 2 ambu's, and the air ambu was scrambled - all because I got hit by a car at speed. I could move, but I didnt think it was a good idea.

Xf said...

kingmagic

It's funny how genuine patients can make us feel guilty when they apologise for 'inconveniencing' us, isn't it?

Xf said...

anon

The answer to your question is: it depends on the day of the week.

Generally, at the weekends, medical emergencies are overtaken by alcohol-related stuff. On average I probably deal with two or three genuine medical cases a shift and possibly the same number of trauma cases each week but you only have to read my postings to work that out.

Having said that, the number is increased by alcohol-related trauma. In that case I deal with ten to twenty head injuries (for example) every week.

Xf said...

anon2

It takes four years of study to become a paramedic; three years if you do the foundation course, which is a lesser degree. You will need good maths and science before you can even get on to the courses, which tend to be over-subscribed.

I went to the University of Hertfordshire, which pioneered Paramedic Science. Of course I am biased towards that Uni but there are many others, including Sheffield Hallam, offering the course.

Xf said...

anon3

Yes, the book (which is a month late!) is out at the end of November. I believe it is with the printers now. I'll put a little Ad on the site for it nearer the time.

Ben Bowen said...

Hi xf,

Brilliant - I am looking to do a Paramedical Science degree, and Hertfordshire is my first choice - I like the idea of sandwich year over other unis...

Also looking forward to readying the book - will definitely be buying it!

Thanks for taking time to have this blog - it is a real insight into a Paramedic's life!