Monday, 25 February 2008

Advertising space

Seven emergencies – one running call, one conveyed by me, one time waster and four by ambulance.

There’s something distinctly cheeky about standing in front of a busy McDonald’s restaurant (forgive the gross misuse of that term) with an advertising board that declares ‘Burger King – 200 seats’ and a big arrow pointing away from the competition. Cheeky and amusing. Still, I’m sure those 200 hundred seats would have been filled as a result. We need a similar competitive edge in the NHS, I think. A big sign saying ‘REAL emergencies, this way’.

A 30 year-old carpenter from Iraq cut through his finger with a power saw on a building site and when I got there, he was being jostled out to me before I had a chance to properly assess him. His finger will survive but the cut was reasonably deep, although I doubt the toilet tissue sticking to it would benefit the laceration much. Its one thing to stop bleeding and quite another to introduce infection.

The site had no first aider and the first aid kit (which nobody would have been qualified to use anyway) was hidden away somewhere…or so the boss man told me. I smelled a rat and the whole thing smacked of a lack of care for the mainly foreign workers the company were employing. The patient had been wearing gloves, although they were flimsy and offered no real protection, and there were hard hats in use but the basic principles of first aid at work were obviously of no real concern to the firm.

As I packed him into the car for the trip to hospital, dressing and elevation sling in place, I warned the site foreman that he had a duty of care and that he needed to get it sorted before a more serious incident took place. I hope I embarrassed him into some kind of action but I doubt it.

Then a 48 year-old man with pancreatic cancer and diabetic problems became my next patient. He was at a work conference and had suddenly felt ill. I found him sitting on a settee, shaking like a leaf. His BM was high, as was his temperature and I discovered that, because his cancer had been quite widespread, his spleen had been removed. People without spleens can catch infections easily and are usually on antibiotics for life.

I spent five minutes with him before a crew took him to hospital, still shaking.

A call for a 58 year-old male ‘feeling dizzy’ had me searching for a patient. The call had come from a public phone box but there was nobody around – well, nobody who admitted calling us. The crew duly arrived and together we scoured the local area, only to find our man sitting on a bench at a bus shelter 100 metres from the given location. As soon as I approached I recognised him. He is a very regular timewaster. He has no genuine illness but he calls us a LOT. He recognised me too and his face dropped.

A concerned woman told me that he was unwell and he plonked himself down beside her, giving her full details of his need for an ambulance. She believed his story, so I went over to him for a chat. There was a very brief exchange and he walked off because he knew he wasn’t going to get anywhere this time. He was offered the chance to be checked out in the ambulance but he sensed the game was up.

I don’t mean to sound harsh or cruel and I’m sure a few of you will be thinking ‘but what if he really was ill this time?’ Trust me, he wasn’t and I can assure you that he had every intention of wasting time in hospital; he knew how to get the best attention – call an ambulance. I know this because he was sitting at a bus stop directly across from the hospital A&E department. He could have walked there as easily as he had walked to where he now sat. Ka-ching.

Another dizzy person, this time a 77 year-old woman, wasn’t wasting our time, however. She had been discovered on the floor by the meals-on-wheels people. She was wedged in between her bed and a chair. She had been incontinent and the smell of urine was quite overpowering. She was also very confused and seemed to think everything was fine. I learned from a carer (her neighbour) that she suffered from Alzheimer’s, so her state of mind was always questionable. Even though she refused help, she was gently lifted onto her old sofa (with the help of the crew who had just arrived) and checked out thoroughly. She would need to go to hospital, for her own safety if nothing else.

Not many 80 year-olds are out riding bikes these days but my next call was to an active Octogenarian who had allegedly been knocked off her wheels by a taxi in a narrow one way street. I found her lying on the ground with a head injury and a possible broken wrist. There were no eye witnesses and the taxi driver adamantly refused to believe he had made contact with her. ‘She just fell off in front of me’, he said

The woman was just as adamant that he had hit her, describing her fall as ‘flying off suddenly’. She seemed mentally able to make that judgment and didn’t appear to be confused at all, so the police had to reconstruct the incident and as I like a bit of detective work, I helped them look at the scuff marks on the taxi and compared them to the damage on the bike. The rear wheel was completely bent and I couldn’t see how a frail five footer could have caused such damage, even if she landed on it from a height, so I had to assume (and the cops agreed) that she was probably knocked off her bike and that the taxi’s front wheel had gone over her rear wheel…and her wrist, since her head injury had been caused by the landing and was on the opposite side to her wrist injury.

I left them on scene to work it out and the crew took the old lady to hospital. She had been lucky not to be crushed to death under that cab.

I went over to Traffy Square and sat on stand-by watching a group of young homeless alcoholics kick a ball into a makeshift goal (the wall of the National Gallery), which sounds like fun but I don’t think they were too concerned about the people walking around or the fact that this is also where toddlers toddle and a ball in the face is no fun for a two year-old. They were stopped by the Gallery security people who thought it was bad publicity.

On my way back to the station I waited at a red traffic light and when it turned green I cautiously moved forward. I have no idea why I felt the need to keep it slow for a moment but as I crossed the busy junction a cyclist sped straight through the opposing red light. If I had been travelling at a normal speed I would definitely have had him for company through the window of my car. How then would I have explained the rest of my day? Thanks, you selfish misery-bringer.

A 17 year-old pregnant girl with a polycystic ovary and no boyfriend (since he left her alone when he found out about the baby) was sitting crying at a tube station because she had abdominal pain. She hadn’t been told about her ovary but it was in her notes…I’m not sure if that meant she couldn’t read but I read what the doctors had written so that she was at least aware of why she might feel pain. The medics weren’t negligent; the fact is she is too lonely and despondent about her situation to bother with details. She was a frightened child carrying another child and she just needed help, so she got it – from the tube staff, me and the sympathetic crew.

As soon as I finished with that call and just as I packed up to leave the scene, I was asked to help out with a diabetic who had become ill on a train. He was being brought up for me, so he couldn’t have been that sick, I thought.

When he arrived at the station office, he was drinking coke, courtesy of the Transport Police (a nicer bunch of people I’ve yet to meet). He was already recovering well and his blood glucose level was improving, although I hadn’t tested it originally, it was climbing above 4.0 when I did, so that was encouraging.

He didn’t want to go to hospital but I had to wait with him to ensure that he fully recovered.

‘You don’t drink alcohol, do you?’ I asked.

Of course he didn’t; he was a good Muslim man and he insisted on walking over to the station shop and buying everyone a bottle of coke. The police followed to steady him and I watched as he piled bottles into a plastic bag before returning, with a much steadier gait and placing them on the floor.

‘These are for you all. Thank you all very much’.

‘Thank you’, I said.

‘No’, he replied, ‘thank you for being you’.

I don’t know why I bitch about getting no thanks when one like that is worth ten days of being invisible.

Be safe.

6 comments:

Anonymous said...

Hiya,

What a heartwarming story about the Muslim boy.

~ C

Anonymous said...

Hi,
I remember a whole Timeout issue which was asking how much money and time the emergency services would save if London (or any major city) became Islamic.
It was incredible, I can't remember all the facts and figures but can you imagine your job without alcohol and drug abuse, and can you imagine how many Police there would be on the streets on Friday and Saturday nights with not much to do!
x

Anonymous said...

What is wrong with using toilet paper if nothing else is to hand, first aid taught me to use whatever was available, recently I used kitchen towel to stem heavy bleeding from the back of a friends hand was I wrong?

Xf said...

anon

Nothing wrong per se but in the context of a company where the law requires a wee bit more care than that for injuries, I think I'm right in questioning their choice of wound dressing, don't you?

If you are going to make do, use something clean if possible...and something that won't stick to the wound too much.

Anonymous said...

Just building off what "xf" said about using TP for an open cut. It was probably obtained from a nearby Port-O-Let (as most construction sites offer for workers), that sits in the sun day after day. Imagine the bacterial buildup; I cringe thinking about it!

SJAV said...

Kitchen Roll won't usually stick unless its bleeding REALLY heavily.

Tissues, and toilet roll both break incredibly easily when damp, and bits stick to the wound.