Bad behaviour

Eleven emergencies – two assisted-only, one no trace and everyone else got an ambulance.

The ‘booze bus’ is back on the road, ready for the Christmas and New Year onslaught. The Patient Transport Vehicle comes out and picks up as many drunks as possible, carting them all off to hospital under an agreement put in place a few years ago. This frees us up on the frontline to deal with genuine emergency calls. Personally, I think the guys who volunteer to do the job are heroes. At this time of year it would be more of a nightmare than ever to work; the booze bus crew, often made up of a non-frontline team with blue light driving skills and a frontline EMT or Paramedic, can ‘clean up’ the streets for us. All we have to do is call for them and if they aren’t currently working elsewhere, they will appear, as if by magic and remove the offending item.

If you see the booze bus around, give the crew a wave. Thank them whenever you can. Later on, they might be standing in a pool of your vomit, rescuing you from the gutter.

The Evening Standard recently reported that alcohol related incidents were up 70% in almost every major city in the UK – only in the City of London has the figure risen comparatively moderately – by 25% - but then most places in the City are shut after working hours, so there’s little scope for drunken idiocy among the sleek, shiny towers of commerce.

If our workload has increased in line with this statistic, we are in a lot of trouble.

My first call of the shift was to a 35 year-old man whose motorcycle was hit by a car just outside the LAS headquarters in Waterloo. I was literally seconds from the call but didn’t hear anything going on just up the road. When I arrived, traffic was slowing down and a queue had formed along the road. Staff from HQ had spilled out to help the poor bloke who had been hit. His body had travelled some way through the air and he had landed with a clearly fractured ankle in the middle of the road.

I was the only uniformed person on scene and I wasn’t sure who else I was working with, they all had suits on.

‘Can I establish skill levels here please?’ I asked before I allowed anyone else to mess around with the man on the ground.

‘Paramedic’, said one of the suited guys. ‘Paramedic’, nodded the other.

Well, I had to be sure but I don’t think they were too pleased about the challenge.

By the time I had completed my initial checks and the man’s ankle was being examined (he was obviously hobbled) there were more uniformed members of staff on scene. Too many probably.

The crew arrived and I handed the patient over. I had given him morphine for his pain and he was sucking on entonox to supplement it. He was taken away quickly and the road was cleared and opened for traffic. We had caused a bit of chaos for a time.

I couldn’t find the address for my next call to a 75 year-old man with chest pain. The crew drove up and looked confused too. Then they headed further down the road and located the place where I was supposed to be – it’s a lot easier when you have another pair of eyes looking out for you. I left them to it and greened up.

I got called to a 45 year-old female having an epileptic fit at an underground station within two minutes of declaring myself available and off I went. Again, a crew had arrived and I wasn’t required but as I completed my paperwork another ambulance arrived. They had been given the same location and call description but a different age for the patient. Two calls had been made and the difference in age generated two CAD references, thus two ambulances. I clarified the confusion and they left the scene. The woman hadn’t been fitting anyway; I had popped down to check.

Green Park tube station next and a 25 year-old male, ‘lying in street’. When I got there I couldn’t see anyone lying anywhere. The crew arrived two minutes after me and they couldn’t find him either. He had probably woken up and wandered off. A small group of people giggled and pointed at the silly paramedics with their blue flashing lights and noisy sirens...and nobody to help.

A panicky 81 year old man with chest pain and dizziness at a housing estate later on. He had taken his own GTN for his angina. This had brought relief and he seemed to be settling down again. He had a problem with vertigo and this had triggered his panic and chest pain. I left him with the crew – he would still go to hospital just in case his pain decided to return without warning.

Another RTC. This time a man on a bicycle managed to get himself knocked down by a car. He had been creeping over a very busy junction, against the red traffic light and a car had clipped his front wheel, lifting him up onto the bonnet and carrying him 20 or 30 feet before depositing him with a thud on the ground. He had a badly broken nose, burst lips, which were bleeding badly and broken teeth.

Bystanders had tried to make the scene safe by slowing traffic down but it was still very dangerous for him when I arrived. The car that hit him was way too close to his head and moving vehicles were coming through the lights and swerving to avoid his feet. I got another cyclist to direct the traffic (he had a hi-vis vest on) and had the offending car moved away.

The man was conscious and alert but his face was a mess (it had hit the car’s windscreen with the full force of the impact) and, although he asked me to find his missing teeth, they were never going to be put back. At least six of his best teeth had been smashed and were ragged, shark-like protuberances which would need a lot of dental work.

The crew arrived and helped me collar and board the poor bloke. The police were nowhere to be seen, despite several calls to Control to get them there. A couple of patrol cars even went by but didn’t stop. I couldn’t believe it. When a siren-wailing, light-flashing police vehicle did show up and stop to help, I discovered they were on a different job but decided to make this a running call. I wondered how long we would have waited for them.

The driver of the car that had hit the cyclist was standing on the pavement in a state of shock. I felt sorry for him, it hadn’t been his fault and cyclists continue to make themselves vulnerable to this kind of accident. How many spare a thought for the car driver who will have to live with the injuries or death caused by their actions when they cross a red light and attempt to weave through moving traffic?

I was called to a night club in the city next for a 25 year-old female ‘not alert’. That probably meant drunk. I raced to the scene and found the police already there and an ambulance crew getting out of their vehicle. Another FRU paramedic was already inside talking to the fully alert woman and a second ambulance arrived within a minute or so outside. I wasn’t required and this call was over-resourced, so I asked Control what was going on. Apparently two separate calls were generated for this lady because someone else had dialled 999 and said she was in cardiac arrest! How can that mistake have been made?

A bizarre call to a very large Asian lady next. I had been on scene only a few minutes with her and her family when the crew arrived and joined me in what was rapidly becoming a joke call. She had called an ambulance because she had back pain and couldn’t move – at all. She was lying in a most dramatic way on the little bed in her front room and she made a point of crying out and wailing about her discomfort every time I asked a simple question. She had been suffering back problems for months and her doctors didn’t have a diagnosis. She had been given tablets but that wasn’t enough and now she wanted attention.

She may have been in pain but I wasn’t convinced. Neither were the crew and we planned a way of getting her to go to the ambulance because up until now (20 minutes after I had arrived) all she wanted to do was be rude to us and demand pain relief, whilst at the same time refusing entonox. She adamantly refused to move herself and insisted that we bring a chair in for her and carry her out. She was a large lady and there was no way, without a valid clinical need, that she was going to be carried. It was unnecessary.

She took the entonox but didn’t use it properly – pretending to inhale the gas with little whimpers instead of deep breaths. Then she flung the tube and mouthpiece away like it was a bit of rubbish. I wasn’t happy with that and I asked her not to throw expensive ambulance equipment on the floor. I reminded her that other patients would need to use it. She didn’t care and now she hated me. I didn’t care.

Through long negotiation and almost an hour of stupidity, she was ‘walked’ out by one of her sons. Her arms were high in the air and he literally lifted her feet off the ground and ‘skipped’ her along to the ambulance. It was the most unlikely and demeaning thing I have seen in a while. She wailed at the top of her voice. It was 2am and her neighbours must have heard her. She was embarrassing herself and her family.

She sat down on the ambulance step, refusing to go further. We were all getting fed up of her behaviour now. We managed to get her to crawl the next few feet and then she saw the stretcher – she threw herself onto it, despite being asked to sit on the chair. She simply didn’t care what the crew wanted. I suggested that maybe it would be easier to transfer her out of the ambulance if she was on the bed and the crew agreed. I think they were too tired to fight with her any longer.

Incredibly, as soon as she was away from her family (who had been openly worrying about her), she stopped complaining about her pain and stayed completely quiet all the way to hospital.

Next – a 22 year-old male ‘drunk and vomiting’. I still don’t understand why this description generates an emergency call, regardless of the tiny little statistic that says a couple of people choke on their vomit. Most drunks who vomit are just drunk...and sick. As it happened, I arrived to find a young Italian man on the ground, drunk. He had also vomited. His friends were embarrassed and didn’t know where to look.

‘Why do you think he needs an ambulance?’ I asked them.

‘We don’t. We want a taxi to take him home’.

The crew arrived and together we persuaded them to do just that.

My first elderly ‘drunk on a bus’ next. Usually, they are young and a lot of them are East European (sorry but they are). This one was English and a pensioner. The crew and I helped him off the bus and he wandered around trying to find a route home.

My last job of the night was a 35 year-old man who insisted his name was Mr. fuk-hugh. He had taken an overdose of Ketamine and was in a bit of a state when I arrived. The crew met me a few seconds later and the police joined in the fun. We all stood in the ambulance with the man, who was recovering a little on oxygen, and tried to keep the grins from our faces whenever he repeated his name or was referred to by it. I still think he was having us on but the police were convinced and they had checked out his ID. Or it was a lie and they wanted to keep us amused.

I’m not very good at keeping a straight face when something is cracking me up so I had to turn my back on him several times when he was being asked questions.

‘Sir, what’s your name?’

‘Fuk-hugh’

My colleague had to resort to pretending that he had forgotten it so that he didn’t have to say it. I think he used the name ‘thingummyjig’ instead at one point. This made me cry.

Be safe.