Friday 30 November 2007

Wet and wild

Nine emergencies – one cancelled on scene, one refused, one no trace and six went to hospital (one of them after a swim).

During the process of writing, editing and re-editing the book (which should be out now) I didn’t find the time to write regular postings and now I have a backlog of material, all of which is emerging here in retrospect. None of these postings are current and generally represent shifts from the beginning of the month (just in case any of you are trying to track them in real time). I’m sure I’ll catch up and get back into my normal time-zone. Apologies.

This shift started off with a call to a rail station for an 11 year-old female, ‘not feeling well’. I was cancelled on scene because I waited for a member of staff to come and guide me to her but they had already taken the crew, who had arrived after me but at the other side of the station (the correct side, I guess).

At another station later on, I met the crew on scene as they talked to a Scottish girl who had been described as ‘not alert’ when the call came through. She wasn’t drunk but she was acting strangely; giving us the impression that she was mysteriously ill but still managing to smile warmly when a kilted Scotsman (not me) wished her well. He had been her knight in tartan armour (and no, we don’t wear anything underneath, except in England or at parties where women are going to get drunk and therefore inquisitive).

We took her to the ambulance and she feigned a faint inside as we were talking to her. She held my hand a little too tightly I thought and she seemed intense at times. Still, what do I know? Off she went for more attention.

A call to W1 for a 69 year-old man who had collapsed in the street and I was dragged into one of the slowest transfers I’ve ever done. He was from the hostel (he is an alcoholic) at the end of the street he had chosen to collapse on. It was a mere hundred yards away but he was feeble and walked at a snail's pace – an old and very drunk snail. With a heavy shell and arthritis.

He had refused to go to hospital and quite frankly, he didn’t need to, he was just very drunk. The crew had been and gone and I was left to take him home. At first I thought about walking him there but I decided to drive him. It still took us fifteen minutes to get from the pavement to the car.

He was a well-spoken man, obviously of some breeding but he was dishevelled and dirty and smelled badly. Alcohol is a fearsome companion to dignity.

‘Have you had a drink today?’ I asked stupidly.

‘I may have had a few’, he replied.

When I got him to his hostel I walked him to the door and handed him over to the staff. They were not happy and wanted him to go to hospital but I explained that he had refused and was quite adamant about it. They still weren’t happy. I don’t know what they expected me to do. He signed my PRF and I went on my way, happy in the knowledge that yet another hospital bed was free for a genuinely ill person or a drunk with the opposite attitude to this one.

A Chinese restaurant in Chinatown (not surprisingly) next for a 61 year-old woman described as ‘nauseated’. I could see how unwell she was from a distance. As soon as I walked into the place I recognised my patient – the palest woman in the room. She had vomited into a plastic bag on the table. She was with six or seven friends and they were out for a meal together and now she was quite ill, with no apparent cause. I think the restaurant Manager was concerned about the PR this little event was giving his establishment. Diners went about their business all around us, not daring to look up from their plates, lest they see a vomiting woman. I have to say the sick looked just like the meals they were eating - no offence intended, just an observation.

She began to feel faint and I knew she would go if I didn’t move her, so I laid her on the floor and my obs continued while she recovered a little. The crew arrived and after a few minutes and lots of oxygen, she was carefully moved out of the place and into the ambulance. I took the vomit with me and disposed of it. I can sympathise with those diners. It wasn’t the poor woman’s fault, of course but you really don’t want to be eating a nice meal and hearing/seeing someone being ill right next to you.

I have said before that drunken people should be banned from entering railway and tube stations because they pose a danger to themselves and others. My next call was for a ‘male, fallen onto tracks ?electrocution’ at a BR station. He was stupidly drunk and his wailing girlfriend kept pawing at him and crying all over him, like he was a war hero. He had stumbled onto the tracks but hadn’t been electrocuted, luckily. Neither had he been hit by a train. He did, however, have a significant head injury and it was clear he needed to go to hospital urgently.

HEMS were on scene and just ahead of me when I arrived and there was an ambulance crew and a MRU paramedic there too, so he had a full complement of medical professionals on hand. More than the average old lady who has worked hard all her life gets for her chest pain, that’s for sure.

He was in and out of consciousness and was difficult to handle (when awake) because he didn’t understand what was going on or what had happened. His clinging girlfriend was becoming a bore as she continually got in the way of the team as they tried to do their job (I was bag-carrying on this one). He was a very large man; heavy and probably extremely strong and the task of wheeling him to the waiting ambulance proved tiring - I helped for a bit then my colleague carried on alone.

He was put on a trolley bed on the station concourse and taken into the ambulance so that the HEMS team could put him to sleep. He was too difficult to work with otherwise and it’s pretty standard practice in these cases.

His profane, fag-smoking partner had to be told again and again to keep back and eventually the police restrained her until she behaved. He was ‘packaged’ and sent off on blue lights.

I found myself surrounded by a mob of drunken idiots as I tried to treat a 40 year-old man who had been hit by one of those rickshaw type taxis (pedi-cabs they call them) and sustained a head injury and cuts to his face. He was slipping in and out of consciousness and I had an unruly bunch of people jostling me and making stupid nee-naw noises in my ear. What fun the drunken mob has.

The police arrived and bailed me out, thankfully and a crew turned up shortly after them to take the man, who was badly but not seriously injured, to hospital. The jeering adolescents dispersed and I got on with my shift.

A call for a male with a head injury, post assault, turned out to be a no-trace. I sat on stand-by for ages waiting for news of the police arriving but nothing happened. The crew arrived and we decided to do an area search. Nothing. Nobody to be seen with a head injury.

Just as I was leaving the scene, I spotted a young girl standing in the middle of the road. Traffic was swerving to avoid her and she didn’t seem to care. I swung the car around and headed over to her. She was sitting on the pavement with her legs sticking into the road now. I got out and asked her if she was ok.

‘What do you care?’ she said.

‘Well, if you need help I’ll do my best’, I said, not really knowing what I meant.

She stopped bothering with me and threw her bag across the pavement. The contents spilled out and she stood up and stormed off, mouthing something I couldn’t hear. A passing couple asked if they could help and started to pick up her belongings. I ignored them because I was watching her now. I didn’t know her personally but I knew that temperament. We were on the Embankment and she was walking at a fast pace along the wall, looking over into the river. I knew she was going to do something stupid.

I got on the radio and asked for the police, then I drove along the road and tried to locate her but I couldn’t see her and there was no way she could disappear from view if she had stuck to the pavement. A PCSO came running up to me as I cruised along slowly.

‘Did you see her?’ he asked.

‘Yes, she’s run off and I think she’s going to jump in the river’, I told him.

‘She had some sort of big argument with a man down the road earlier and we’ve been looking for her’, he said.

Just then, we were flagged towards a point of access to the river, down steps and directly into the water. She had been found but she was in trouble. The couple who had stopped to pick up her stuff had followed her when I went to call the police and now they were with her. I ran to help and found her in the river about waist deep. The couple were dangerously close to the water trying to coax her back in. I joined them and asked them to step back, which they did. We managed to persuade her that suicide wasn’t painless after all and she clambered out, slipping all the way. We pulled her to the top of the stairs and sat her down.

The river police arrived seconds later and she had an audience for her woes, whatever they were.

Apparently she had waded in and started to swim out to the middle of the river but something (probably common sense) made her turn back. She had been flagging towards the end and had only just made it back onto dry(ish) land. The couple had done a great deal for her and she didn’t even look at them, or anyone else for that matter. Now my boots and trousers were wet.

I ended this shift with an 18 year-old with DIB and I didn’t have to do anything. The crew were already on scene and I was not required. It’s nice to be wanted.

Be safe.

9 comments:

Anonymous said...

Hello, not read in a long time- Still makes a great read!

Just wanted to ask you whether the "Fitness Test" pre-paramedic science, is as gruesome as it's made out to be.
Apparently i need to be some advanced form of body builder- I walk upto 50 minutes a day to and from college, but that's about it.

Any advice ?

Cheers

Anonymous said...

I'd be wearing something under a hire kilt (which is all I can afford) purely because I have no idea where it's been before.

Nice post, looking forward to the book!

Anonymous said...

Hello there,

Big fan of your blog and read it daily to keep up with whats happening in your side of the world with regards to paramedics and the pre-hospital emergency field.

I was born in the UK and studied to be a paramedic at university in South Africa (in my opinion the best place in the world to study to be a paramedic)I have worked in over 10 countries including the United Kingdom alongside the London Ambulance Service and I must say that I throughly enjoyed working with such an organization, but reading your blog I can relate to some of the problems you encounter and suffer, such as the lack of communication regarding FRED and the time wasters that feel the ambulance service should bow to them and be at their service as a taxi. But with all due respect I found that as a paramedic in London you do not get much experience and exposed to much trauma or genuine emergency medical emergencies, things like a sore knee or fainting patient do not require an ambulance,paramedic and a MRU to arrive on scene for one patient who does not necessarily require ALS treatment, try having a normal shift with Gunshot heads, abdomen, thorax, Stabbings, RTC's, Rapes, Burns, Maternity cases, Medical cases, drownings in all one shift with you being the only ALS paramedic on shift, if you are thrown in the deep end, you learn to swim very quickly and get the expereince. Although Having said that I admire your work with regards to the decrease in cardiac arrests and the use of community lifesavers.But still think that the hospitals and emergency services are not used to the heavy cases as such as in other parts of the world such as South Africa,Iraq,Israel etc.A clear example of this can be seen on the British Royal Trauma website with Trauma pics showing a injured patient with a laceration after being stubbed in the foot during a football match, No offence but thats not trauma, Our First Aiders deal with that stuff this side, you should take a look at some South African websites for images.

Keep up the good blog.
Tyler

debbie said...

So glad I've got some time on my hands to catch up with you!! I've broke my foot lol! And no, I didn't call an ambulance and I wasn't drunk!! Will read you more often, a brilliant journal and you do a fantastic job. Totally fascinates me. Take care, love Debbie x (The Essex Girl, remember me?)

Xf said...

Kieran

The fitness test invloves lifting and carrying weights. Running and general fitness is also assessed but I wouldn't worry too much about this if you are already in good shape.

Xf said...

Tyler

I see your point but I'm sure we cope well with our differing situations and London is not far away from becoming the battle ground you are describing in your own land. We get our fair share of shootings and stabbings here but we also have a terrorist problem and our experience with bombs and large scale casualty situations is comparible with other 'in the deep end' models I'm sure. Treating hundreds of people deep underground after a couple of bombs have gone off gives us a fairly unique edge I think.

Xf said...

Debbie

Hi there!!

Sergeant Simon said...

someone faking illness in custody? surely not.

Anonymous said...

Cheers for the reply Xf!

Well i'm in decent shape, i'm told drumming is beneficial to the cardiovascular system also.
I'll keep up the exercise and see where i am in 2 years!
Cheers again, and i look forward to reading your book.

- Kieran