Thursday, 13 March 2008

Classical drunk

Ten calls; one cancelled by police, one false alarm and eight by ambulance.

A 3 year-old boy who choked on a crisp caused enough consternation with his parents that I was called to assist, even though it was unlikely he was in a life-threatening state. The crew and I searched for the address for a few minutes because the estate had badly numbered housing but in the end, when we finally got the right place, I left them to deal with it. I was surplus to requirements.

A 20 year-old female who collapsed at an underground station appeared to be suffering an allergic reaction, probably to the seafood she had eaten earlier, although she wasn’t aware of having a positive allergy to it. She had a widespread, non-itching, erythemic rash and had just recovered from a gum infection for which she had been given antibiotics, another possible cause of her current condition. Other than that, she was stable, so off she went to hospital for some antihistamine treatment.

Some heroin addicts are genuinely trying to go clean – they valiantly fight an often losing battle with the drug in the hope that they can find a better, safer way of life. Others don’t care and impinge upon the NHS to such a degree that they become an expensive pariah.

I found a 36 year-old user vomiting in the street when I arrived on the call. The crew was with him and the attendant stood by him as he threw up on the road from a standing position. The call had originated from a hostel where many of them reside at our expense – he had overdosed and was barely breathing it was claimed. Well, he was breathing just fine now, albeit through a mouth and nose full of sick.

‘I need to go to hospital in case I die’, he told us in the ambulance.

I offered him narcan to reverse the effects and told him it would benefit him if he really thought he had taken too much but he refused.

‘My mates have told me about that stuff – it makes you sick’, he said, ‘and I don’t want it reversed.’

I mulled over the irony with the crew as he continued to moan about how he might not make it. It was our duty to take him to hospital, he said. It was indeed, if he was really dying, but he had brought this on himself and all he wanted was a bed in which he could enjoy his hit and where help would be right at hand should he suffer the consequences of overdoing it. A real selfish motive for calling an ambulance I think.

I raced to a call in which a 19 year-old female had fainted and now had ‘ineffective breathing’. I’m continually amazed at the level of skill friends of drunk people have in recognising clinical problems with breathing. It’s one of the most common phrases they’ll come out with when I arrive to watch them hurl up on the pavement. ‘She can’t breathe properly’, they’ll say. Thus the increasing number of calls where an addendum for the inefficiency or total lack of breathing is present on the call log.

In fact, she was just drunk and her breathing was fine because the police on scene cancelled me when I drew up. ‘She got up and went home with her mates’, the officer told me. She probably got fed up waiting five minutes for me to buzz in with my sirens blaring and lights flashing, lending even more weight to her ‘condition’.

A call for a 20 year-old male who had passed out intoxicated in an alley in the West End produced no patient for me either. As I approached a group of young people, two of the girls fled when they saw me, legging it down the narrow street without looking back. The two young black lads that were left paid no heed to me at all until I asked if they had requested an ambulance. Both were on their mobile ‘phones and one of them looked worse for wear and was sitting on the pavement – he was probably the passed out male, I thought.

After being told I wasn’t needed in the curtest of tones, I headed back towards the car and saw the ambulance pull up. I explained what a waste of time the call was and the crew duly left…after doing the inevitable paperwork, of course.

For the first time in a while I got the back seat of the car covered in vomit. It was produced courtesy of a 20 year-old man who got so legless he collapsed outside a hotel just around the corner from my station. People had gathered round him with concerned looks. ‘He’s a bit of a mess’, one of them said. It was an understatement. He was plastered in fresh sick and there was a good sized puddle of the stuff on the pavement. The hotel wouldn’t like that.

He was amiable enough, once I had roused him from his drunken slumber, and he voiced disgust at his own condition, which I found refreshing.

‘I’m a disgrace, aren’t I?’

I had to agree with his declaration but it was too cold for him to lay there and an ambulance wasn’t coming soon, so I moved him to the car and sat him in the back seat, where his rancid puke made itself comfortable too. The smell was awful.

I managed to get a full set of obs and all his personal details, which included the fact that he played in a classical orchestra and was due to go to the television studios for a concert the next morning. He would be in a fine state for that.

As the ambulance took him away for his own good, I realised that this young man may well be one of the few to actually learn his lesson from tonight. He was embarrassed and far too clever to be stupid twice. I hope I’m right; I need the boost for my faith in human nature.

A call for a 45 year-old man with chest pain next and the ambulance and I cruised around looking for the correct address. The call-back from Control prompted him to come out of his house and wave us down when we got close. I knew someone was coming to get us but I didn’t realise it was the patient! Walking with chest pain is not advisable and when I drew up to him and said this, he thought I was telling him off and became a bit defensive.

‘Yes, I called an ambulance for chest pain. Is that a problem?’

Oops. I calmed him down and explained that I was just concerned and didn’t want him moving around any more, so I sat him down and the crew wheeled him into the ambulance, as it should be done.

A call to a bus outside Australia House in the Aldwych for an ‘unconscious male’ turned out to be nothing more, as usual, than a man asleep. Not drunk; asleep. The warmth of the vehicle had sent him off during his journey and now he was far, far away from home being rudely roused by a Scottish paramedic in a bright yellow jacket – the right combination for a bad dream I think.

I felt sorry for him as he stepped into the cold and made his way to another bus stop for another bus, if he was lucky. Unfortunately, I have my job to do and one of them is to ensure that buses are cleared of humans when they reach their terminal destinations – the bus drivers simply must have empty vehicles, even if that means calling 999 to achieve it.

Be safe.


John said...

Speaking as someone who seems to have had to call an alarming number of ambulances recently (thankfully for other people!), I think I know where this "ineffective breathing" thing comes from.

Every time I've made a 999 call, no matter what the presenting problem, you get asked repeatedly (and usually completely unnecessarily) if the person is breathing properly.

As a first aid trainer cum student nurse, I can quite happily detect life threateningly abnormal breathing as distinct from "abnormal but benign". People who need an ambulance tend to panic and may, for example, be breathing faster than usual, and to the lay member of the public who sees an emergency once in a blue moon, this may well fit their idea of breathing abnormally, even though me and you both know it's not a problem.

I dealt with a situation just a couple of months ago where a student fainted about 3 times in 20 minutes on a first aid course I was teaching. Of course, an ambulance was required (so many faints in a short time span tends to indicate a problem other than not liking a gory photo you've shown or something you've said!), and I asked one of the staff in the office who'd come to help me if they'd make the call while I stayed with the girl. They, not being quite as experienced as me, took the little gasp she made as she fainted the second time as being "abnormal breathing", and so mentioned it when asked. 3 minutes later, an ambulance came screeching to a halt outside, closely followed by a second ambulance, a motorbike and an FRU to see my clearly unwell, but in no way dying, patient (cue much fuss from them about the fact that the patient clearly was breathing pretty well!). This may have been the lady who called not quite understanding what was being asked, although she did explain in full what she meant when she answered the question, so I'm inclined to think that the call-taker was similarly clueless as to what constitutes "ineffective breathing" and thus overly sensitive to it.

Something to look into at the control room I think!

stuart said...

Are FRUs lights and sirens only calls?

I'm not asking this as a boy racer or anything - do you enjoy driving fast or does it scare the shit out of you? Because when an FRU ends up racing up behind me/towards me I instantly go "oh fuck where do I go should I go anywhere?"

Tabitha said...

Australia House is so pretty though. If I was a drunk with nowhere to go in London, I'd be sure to spend the night next to some fine architecture.

Do you have plastic covers for the car seats, or do you have to get them specially cleaned after vomit spillages?

Japh said...

Ha ha I forget all too often that you're Scottish and every time I try to imagine you talking all I hear is an ad for the "Angry Angus" at Hungry Jacks in Australia. Ahh silly little Australians and their thoughts of people from overseas.

Though I would love to see you on T.V! I'm sure you'd love to appear on Australian T.V too. hehe

Take Care