Glass and sand

Eleven calls – two conveyed, one false alarm, one cancelled on scene, one refused and all the rest went by ambulance.

Early warning signs of migraine include visual disturbances and ‘paralysis’ or numbness of one limb or side of the body. After a short while, the headache begins and the other symptoms fade.

My first call, before I had even completed my VDI, was to a 25 year-old man who had distorted vision (he thought he was going blind) and ‘paralysis’ of his right side, although he could walk perfectly well. He had collapsed outside a posh hotel and the staff (whether through kindness or the need to quickly remove such a distraction from their threshold) had called an ambulance immediately.

When I arrived I wasn’t sure what I was dealing with and the possibility of a stroke, however unlikely in his age group, was hovering around. But his vitals were normal and he had no significant medical history...not even migraine. The ambulance was going to be a while, so I took him in the car – the hospital was literally across the bridge and it took me five minutes to get him there.

Only when I got to A&E and the nurse listened to what I had to say did the possibility of migraine enter the equation properly. The nurse had personal experience of such fore-warnings and confirmed that this was a likely diagnosis. The man had said this had happened to him when he was younger but was never diagnosed because by the time he got to hospital, it was better.

‘How is the numbness and visual problem now?’ asked the nurse.

‘It’s much better’, replied the patient, now sitting on a chair inside the Majors department.

‘Do you have a headache?’

‘Yes, it’s just started’, replied the man. I think he was surprised at the nurse’s predictive skills.

That clinched it of course. The migraine was kicking in and all the other symptoms would go away. I left him sitting in the triage area, awaiting a proper examination.

South of the river now for a 65 year-old man who had ‘cut his hand with a saw’. I got to the address, went in and found him sitting on his sofa with a deep cut to his thumb. He had done exactly what it said on the tin, so to speak. He had sliced through the bottom of his thumb with a rusty old saw while he was cutting wood for the new floor. His daughter was with him and she had placed a cloth over the wound to stem the bleeding.

I replaced the cloth with a sterile dressing and took them both to hospital; he’ll need stitches and a tetanus injection.

My next call, for a RTC involving a motorbike and a pedestrian, turned out to be a false alarm. A woman living in a flat on a busy road had heard a screech and a thud, looked out her window and seen a motorcyclist with a pedestrian who looked as if s/he was hurt. She dialled 999 but neglected to return the call and tell us that she had been mistaken. Nothing had happened and there was nobody on scene when I arrived. The ambulance appeared as I cruised around looking for a likely patient. In her defence, she bothered to come out to see me and apologise for wasting our time. Fair enough. It didn’t do her any harm that she was very pretty too :-)

Then a 24 year-old ‘passed out, been drinking’. Sure enough, she was drunk and barely able to open her eyes, even to painful stimulus. She had been vomiting heavily and her friends were doing their best to avoid standing in the pools she had left around herself. They were obviously embarrassed. One of them even asked me if calling us was the right thing to do – he seemed genuinely worried (maybe he reads this blog). I found myself reassuring him and telling him it was the right thing to do. She was in such a state that a taxi home was out of the question. I know the difference between a drunk who can get home and one that needs IV fluids and a long rest in hospital. She was the latter.

I was on stand-by in Soho and Control sent me south for a DIB at a police station (in custody). These calls are almost always fantasy acts by prisoners who want out of their cell and into a nice clean hospital bed. They invent fits, unconsciousness, self-harm claims and the all-time favourites DIB and chest pain to get them out of those stinking little rooms. If they want a nice warm bed they should stick to legal stuff.

Off I went and it took me over ORCON (I was late). I arrived to find an ambulance already on scene. Great. I went in and met the crew. They had come from 4 miles away and they were chatting to the ‘DIB’ at length about why he needed an ambulance. There was nothing short about this man’s breath. I decided I wasn’t needed and to add insult to injury another crew turned up for the same job. I spoke to the crew and explained what was going on. Then I watched as the first crew on scene, who had been trying to get back to their own area so that they could return a medical team and equipment, left the police station...empty chaired. No patient. Waste of everyone’s time.

Up north now for a 50 year-old male, ‘fallen over. Cut to head. Choking’. I was confused by the mixed description here. He was choking? I raced to the scene and pulled up outside a pub in a less than desirable part of town. I looked over to a small group of people who were waving frantically at me. One of them ran towards me. On the ground I could see a very large man being pinned down by three or four other men, one of which had a finger in the prostrate man’s mouth. Maybe he was choking, I thought.

I got out, ran over before I was accosted by the man coming to get me and knelt down next to the big man on the ground. His friend’s finger was stuck inside the man’s mouth because he was biting down on it. He wasn’t choking after all, I presumed. Was he fitting?

I asked them.

‘Is he epileptic?’

‘No, he aint got nuffink wrong wiv im’, one of the replying voices said. I’ve no idea what the others said - I could just barely decipher that one.

I looked at him and tried opening his mouth so that his friend, who was now screaming in pain, could get his finger back but the man’s huge jaw was keen to hold on. I was keener to have this problem resolved, so I persisted and angrily told the man to let go. It took another ten or twenty seconds but his jaw relaxed and his mouth opened. A bloody, half-chewed finger leapt out, thankfully still attached to the screaming friend. I had to assume they were friends for them to be that close.

Now the big man started throwing his weight around on the ground. His fist made contact with my body several times and I had to lie across him to keep him still. I asked two of his mates to pin down his arms while I worked out what the hell was going on. Then I got a punch to the head and that was it. I called control while the others held him to the ground.

‘Is there an ambulance coming?’

‘Not yet. Nothing available.’

‘Well can I have some police help here please. I’m on my own with a very strong guy who is thrashing on the ground. I keep getting thumped. I need some help to control him and his mates.’

The scene was getting disturbingly menacing. Two of the men had decided to fight with each other. The big man’s wife had lit up a fag and was nonchalantly puffing on it, six inches from my face as I struggled to cope with his wrestling antics. The others had wandered off to discuss something I couldn’t hear and his son was welling up in a corner. I thought I was part of a circus routine for a minute.

The man relaxed and I let my guard down. I really, really, didn’t believe him. His family told me he had been in a fight and had fallen down unconscious, then he had started thrashing about uncontrollably and yet I detected a lot of conscious effort in him. There is an easily recognisable difference between a true seizure and one that is being played out.

Before long he was off again. Violent flailing and rolling, pulling me with him. He was on oxygen now but the mask ripped off his face. My service mobile was punched out of my hand and I got a swift kick to the ribs from God knows where. This went on for another minute, then he settled again.

Sirens were wailing in the distance. It seemed like a LOT of sirens. I told the family that the police were coming but not to worry because they were coming to help me out. What I didn’t expect was an army, however. I think someone in Control thought I was being murdered; three police vans showed up. Another FRU paramedic pulled up just ahead of them (and he was all I needed to assist me to be honest) and then the crew arrived in the ambulance.

When he heard the sirens get close, the big man began thrashing about again. Two police officers held him down until he regained his composure. All the time I was trying to convince him to stop doing what he was doing. Then my colleague from the ambulance spoke to him after my hand over. She and her crew mate lifted him to his feet and walked him to the vehicle. He was as gentle as a lamb!

He had been faking all of it and now that he had a huge audience, he was too tired to carry on. He apologised to me and I was left with bruises and a limp for my trouble.

After a cleanup and a bit of a rest I headed out to Leicester Square for a 25 year-old who had been assaulted and was ‘?suspended’. I doubted it but I got there at an appropriate speed.

He was lying on the ground in a pool of blood. He had a head injury and his eye had been mashed, probably by a bottle. He wasn’t fully conscious and kept asking for a drink. The police were on scene and an ambulance had pulled up just after I got there, so he was taken away quickly. I don’t think he had life-threatening injuries and I had checked him thoroughly for weapon wounds. He had got himself beaten up and he probably wasn’t innocent – they rarely are in these situations.

I was finishing my paperwork and a lot of police vehicle flew past me, one after the other. They were stopping just up the road at the tube station, so I asked Control if there was anything going on I could help with.

‘We have a call coming in that a man has been stabbed. Can you deal?’ they asked.

I greened up and drove all of a hundred yards to get on scene. The whole of Charing Cross Road had been closed off by the sea of police vehicles that had parked there. Armed and unarmed cops roamed around. Buses were now queuing up and down the length of the road; instant congestion at 3am.

I made my way to the police officer I thought would know what was going on and found myself looking at the stabbing victim. He was standing talking to the cop in the middle of the road. He had been stabbed in the hand by a random person who he claimed was now grinning at him from the window of a cafeteria across the road. He couldn’t prove it but he was pretty sure it was him.

I examined his wound. It was no deeper than a scratch and a splinter would have trouble getting into it. I couldn’t believe the manpower that had turned out for this. Maybe my experience with the number of police that had appeared earlier for my little altercation was simply indicative of how edgy the cops were tonight.

In the end I cancelled the ambulance before we embarrassed ourselves further and the guy refused to go to hospital. In fact, after a long debate with the police, he decided he didn’t want to go any further with it and simply walked away. It took twenty minutes for the roads to get back to normal.

My next call was also an assault. The 25 year-old had been ‘glassed’ by a guy he had taken exception to and decided to challenge. He had a small, insignificant cut to his forehead. He was also drunk.

Finally, just as I was creeping back to my base station in the hope of an early night, a call to a 25 year-old female in a night club. She had fallen down a flight of steps and cracked her head open. She was conscious when I arrived (the ambulance crew were just behind me) but not very stable. There was blood coming from inside her ear and that isn’t a healthy sign.

The steps she had gone down were made of glass. They were also covered in sand for some bizarre reason. She was, of course, wearing heels and not-very-sensible shoes because she was on a night out. So the combination of alcohol, unsteady gait, high shoes, glass and sand made this kind of accident inevitable. I told the club Manager what I thought of his steps and amazingly, he agreed that they were unsafe. Incredible that he hadn't thought of it earlier.

We carefully (because all of us were slipping on these steps) lifted her up to the ground floor and onto the trolley bed. She had a head injury and this was causing her to behave erratically, so it was a bit of a struggle trying to get her to comply with our wishes. Luckily her drunk but sane friend kept things running smoothly by talking her down whenever she decided to try and fly.

I left the crew to get on with it and made my way back to civilian clothing.

Be safe.