Tuesday, 20 November 2007

Nothing too serious

Seven calls – one false alarm, one assisted-only and one conveyed. The others went to hospital by ambulance.

An 80 year-old Swedish woman fainted in a restaurant in Soho. The staff called an ambulance for her and I arrived to find her sitting outside (for fresh air) with her four daughters. She had no cardiac history but had fainted a few times in the past. At her age, it’s worth investigating before making assumptions, so she was taken to hospital. I saw her later on in the A&E department and she seemed to be recovering well.

An RTC involving a van and a pedestrian turned out to be a waste of time because the ‘victim’ walked off in a drunken rage after being clipped by the van (the driver of which stayed on scene for the police). I was about to leave when a police officer asked me to go and check the man out. He was around the corner and had been stopped and asked to wait for us. The ambulance had been and gone, so I obliged.

He was an obnoxious drunken fool of a man and he insisted on smoking and belching his way through an abusive volley of requests to be ‘left alone’. I left him alone and so did the police, who were none too happy with his behaviour but he just wasn’t worth the paperwork. He wandered off and we watched him go. He staggered a lot.

Into Theatreland for a 10 year-old girl who had fallen awkwardly when she tried to climb over the seats with a handful of ice-cream. She lost her balance and fell backward, cracking her head hard on the back of a narrow chair at the end of an aisle. She also had a sore arm (her ice cream holding arm).

When I arrived her mother and a member of staff were sitting on the fire exit stairs just outside the seating area. I could hear the show in full swing behind us. She was weepy and in a little pain but otherwise fine. She had no obvious breaks or bleeds and her sense of humour was intact (I tested it with my crap jokes).

I decided to take her and her mum to hospital in the car, rather than have her go through the ordeal of sitting in a big ambulance with even more strangers standing over her. Children can become quite unsettled when we arrive in droves.

Mum agreed and we went to hospital, chatting all the way about how much they loved London and how sorry they were to have missed the rest of the show. The staff member had given the little girl a signed photo from the star of that show.

‘When he heard you had been in accident, he came off stage to sign this just for you’, he told her.

Of course he did. It was a nice gesture though.

I have met a few boxers in my career but my call to a 46 year-old diabetic man, '?hypo', was my first introduction to a heavyweight champion. He is retired now and works as a doorman but he is a BIG fella.

His problem wasn’t related to his diabetes; he had a badly swollen eye and arm. It looked as though he had reacted to something, although he denied any allergies. He moved slowly as he lumbered to the ambulance and he was as gentle as a lamb. There are some large men out there with quiet voices; it’s a paradox to me.

I have only given penicillin twice for suspected meningitis. Many of the calls we get for this turn out to be nothing more than a ‘hot child’ or someone with the flu. I was sent to a 14 year-old boy who was suddenly unwell. The call description included the words ‘? meningitis’.

I found him lying on his bed; his mother and brother were in the room with him. There was no ambulance immediately available and I had just gone through a long tailback of traffic caused, ironically, by the police as they rounded up gangs of teenagers who had been fighting earlier. I knew I was going to be with this patient for some time without backup.

He had a high temperature, a widespread, non-blanching rash, photophobia and a throbbing headache. I carried out little tests for Kernig’s sign and Brudzinski’s sign and got some positive reaction, although they weren’t definitive. But the most important piece of information came from this mother.

‘His brother was in hospital with meningitis last year’, she told me.

A familial history of meningitis increases the likelihood of a genuine case, so I prepared to administer benzylpenicillin. I couldn’t go beyond IV access, however – his mother told me he had a positive allergy to penicillin. This was a problem because the earlier the antibiotic is administered, the greater the chance of success. I had to wait twenty minutes for the ambulance crew to arrive before I could get him to hospital. It was an uncomfortable wait but the boy remained stable and in good spirits.

It was a few hours before I went out on my next life-saving mission. This time it was for an 18 year-old male ‘unconscious after drinking’. I found him, surrounded by his mates, lying on the pavement.

‘Do you want to go to hospital?’ I shouted in his ear.

‘No, I need to sleep!’ He responded with a start.

So much for being unconscious then.

I got him to sit up, then stand up, then walk away to find a taxi to take him home, friends in tow. Another couple of hundred quid of tax-payer’s money saved, I thought.

My last call of the night was to a 50 year-old with reported DIB. He didn’t have anything of the sort – he was having a panic attack. He was in his hotel room with a friend and had collapsed in an emotional heap after a ‘phone call. He didn’t tell me any of this, I asked him. I use the same question whenever I see an obviously emotional patient: ‘Have you had bad news or are you upset about something?’

He had and he was. The crew took him to hospital anyway. I went home and left humanity to itself while I slept.

Be safe.


Anonymous said...

The West End Show must have been JOSEPH - Gosh I love LEE - do u think u could get me an autograph as well? Or do I have to fall over holding ice cream for that? *hystericallyscream*

Xf said...


Yeah, well, maybe.