Friday, 28 March 2008


Five emergency calls – all by ambulance.

More snow today, the last of it I think. I’m looking forward to sunnier days ahead.

Only one of the calls I attended today required an ambulance and even that was for self-abuse.

I covered pregnancy in my book and it still amazes me that an emergency response is expected when a nine month process is coming to an end. I can understand it when there is no warning and the baby decides to start its descent with minutes to spare, or when there is a genuine emergency, or the mother is on her own and has no experience of childbirth. What I find annoying is that we are frequently used like a taxi service by women whose waters may or may not have broken, whose contractions are often miles apart and who have waited long enough to have made their own way to hospital.

A 31 year-old pregnant woman, in her 41st week, sat on her bed for hours after her waters broke. Her contractions were 3 minutes apart when I arrived but she had plenty of time to get a taxi or have someone drive her to hospital. Instead, she waited until almost the last possible minute and then got her husband to dial 999. Now she had the urge to push. So did I.

Pain is difficult to assess but it’s not difficult to see on someone’s face. That’s why I didn’t believe the 42 year-old man who claimed he had severe chest pain (and DIB of course) at a train station. Staff had taken him into the office and he was sitting waiting for us to turn up before continuing his charade. I didn’t recognise him but I could tell (as could the crew and the MRU paramedic, who was on scene first) that he was living rough. He may well have been suffering some kind of pain but his face showed absolutely no expression for it. Even the member of staff who led me to him said he suspected the man was play-acting.

Drug addiction is also draining us of money and resources and it’s about time we threatened sanctions and removed benefits from those who continually abuse the system. I know there’s a great argument about how they will fund their habit if they don’t get money (i.e. more crime) but why should hard working tax payers finance the cost of their drugs and the consequences of their abuse? A single drug addict can find himself in hospital dozens, perhaps even hundreds of times in his lifetime. Have we any idea of just how much that person is costing us?

A two-for-one call next to a street where all of the houses are hostels. The complex attracts a lot of police and ambulance visits and this time I was going to see another pregnant woman but I had been told to be cautious because there was a known violent person at the scene. I asked for police to attend and when I arrived I was greeted by the hostel workers.

‘Are you here for the pregnant lady or the unconscious drug addict?’ one of them asked as I pulled up.

‘What do you mean? I only know of the pregnant woman’, I replied.

Apparently there were two separate problems here but we only knew of one, so I called it in and requested another ambulance. The ambulance meant for my patient arrived as I explained that the pregnant woman would have to wait, so I asked the crew to attend to the unconscious man, whom I’d yet to see, whilst I dealt with the lady.

The 29 year-old was waiting for me, bags packed and ready to go. She had been having contractions since the night before and now she wanted to be taken by ambulance. Across the street, a real emergency was demanding our attention and this, I think, highlights my point in a very tidy way. Now she had to wait for another vehicle to arrive and when it did the crew were obliged to see if the first crew required assistance while I walked this healthy young woman down to the waiting ambulance. A colleague stayed with her while I went to see what could be done in the other building.

A man lay flat on his back, unconscious and overdosed on Heroin. The crews were working around him, trying to keep him breathing until he could be recovered using Narcan. I asked the second crew if they could take my pregnant lady to hospital and that left me with the first crew, the police (who’d arrived soon after the first crew) the hostel workers and the unconscious man. Ironically, he turned out to be the very person that I’d been warned about approaching; he is known to be violent to ambulance crews. I can see why he doesn’t favour us – his fix was about to be taken away from him.

When the Narcan finally took effect (after a long twenty minutes and several doses) the man became rousable, then noisy, then aggressive. He struggled so much that it took three of us to pin him down. He was fairly big and the prospect of carrying him down the narrow stairs while he did his large dying fish impression didn’t inspire any of us, so the police trussed him up; ankles, knees, arms. He was handcuffed behind his back too, so now he couldn’t struggle. We had to be careful not to hurt him, however, and no matter how over-the-top his containment might have seemed to the waiting onlookers outside, it was important to keep him still for his own good...and ours of course.

Off he went to hospital, where he ended up on the bare floor of a cubicle, still trussed like a suckling pig until he was calm enough to behave. So far, he was the only patient who needed to go to hospital by ambulance.

Frequent flyers are a cause for concern and our society tolerates them because we don’t know what else to do with them. There’s a real need for a back-to-basics approach with family structure and social cohesion so that people learn to fend for themselves but we live in a nanny state in which a blame culture exists, so weaker individuals use that to run up huge bills at our expense; it doesn’t matter to them because they aren’t having to go out and earn a penny of it.

Finally, just to salt my wound for the time we are wasting, a 41 year-old frequent flyer (the same guy that walked off on us after we found him across the road from the hospital, having dialled 999 for an ambulance to take him there a few months ago). Again, he was claiming chest pain and DIB and again he had no such thing...really, he didn’t. The man has deep social issues and I’ve known him for more than 3 years; he goes to hospital and they check him out before feeding him and letting him go again. The crew were as gentle as lambs with him and even I didn’t have the heart to chastise him this time round; on busier days I usually don’t have as much patience for him, although one day I know he will genuinely need us and that may be his downfall.

Be safe.

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