Patient reminders

Six calls; All went by ambulance.

My first call of the night taught me a lesson in how not to assume a conclusion. She was a 35 year-old Chinese woman who’d ‘fainted and had a rash on her face’ at a hairdressing salon. A crew were on scene just ahead of me and I went into the small building with them expecting, as in the majority of such calls, to find a fully conscious person slumped on the floor in a dramatic way.

Sure enough, there she was – sprawled across the tiles with someone talking to her and all of us made the same assumption that she would be taken down on foot (the stairway was very narrow, winding and treacherous) or by chair if absolutely necessary.

She wasn’t communicating with us and, as far as we knew from her relatives on scene, she didn’t speak English, so it may have been for that reason that she chose not to speak at all. Neither did she make any voluntary movement and, from the smell I had picked up in the room, it was possible she had lost bowel control – now, that was unusual for a simple faint.

In a short five minute period during which we asked pertinent questions of those around us and carried out observations on the patient, it became clear that something was badly amiss. There was a packet of paracetamol on the counter and I asked if she’d taken them as a couple were missing. Her relatives confirmed that she’d had two earlier for a headache.

The rash, which appeared to be just on the left side of her face couldn’t be explained but it looked more reddening skin, as if pressure was being applied from beneath the surface. She was posturing decorticately now and that meant only one thing – she was in serious neurological trouble and had to be moved fast. A quick look at her pupils confirmed our suspicions; one was much larger than the other.

As we began to lift her onto the chair she vomited violently and repeatedly and we hurried her downstairs and out to the waiting ambulance as fast as we safely could, whilst maintaining her airway.

She was quickly cannulated and we could see that she was becoming more and more bradycardic by the minute, so all the other work was done on the way to hospital. I followed the crew in the car, in case the paramedic needed me further en route but we got the patient to Resus and I left shortly after the handover.


A minor injury for a 27 year-old man who fell into the side of a bus as it pulled in to the bus stop. He was a little tipsy and lost his balance too close to the vehicle. His face made contact with it at low speed and he was thumped to the ground. He had a cut lip and damaged nose and was picked up by a passing first aider who called us and handed him over when we arrived. The crew were just ahead of me on scene but I stuck around to see if I was needed. The bus driver was keen to leave and had to be reminded of the law and asked to stay there until the police arrived and took statements.


My second reminder tonight was that I should exercise patience, even when I’m tired and have seen enough stupid drunks for one tour. A 19 year-old student was reportedly unconscious after vomiting blood. He was found slumped in the lift lobby of a University campus building by a gang of fellow students. The ‘blood’ they had distressed themselves about was red cabbage that had been vomited up at the front door, probably as the young man staggered in on his way to his accommodation.

I was annoyed with this because my break – the only break I would get in the entire twelve hour shift – had been interrupted by Control for this call. I wouldn’t get another chance to rest and I really don’t mind that if I’m being asked to go to a suspended or a similarly serious call – but this was ridiculous and the fact that a bunch of higher education students couldn’t differentiate between vomited cabbage and blood made the whole thing surreal.

I woke him up (he was of course just drunk) and waited with him until the ambulance crew arrived. The crew paramedic was much more patient with him (I had been telling him that he should control himself when he drinks) and spoke with an even, soft voice. It made me feel like a bully and reminded me to try and calm down when these jobs come up, even if it cost you the only rest you’ll get. Human nature is a hard thing to control when the pressure’s on.

It was a relatively quiet night but I still felt cheated about not getting a break because it’s the only time you feel secure enough to relax and eat something – you don’t expect to get called out but that security has been taken away, so now I’ll never know when I’m going to be called and that isn’t good for my health as far as I’m concerned. I'm sure many of my colleagues feel the same.

A tall 26 year-old Chinese man was found ‘unconscious’ in the street and I went to see what I could do. He was drunk and freezing and I had no idea how long he’d been on the ground but he wasn’t interested in my help and told me nothing about himself or how he came to be there.

When the crew arrived, they had that fed up look about them; the same one I sometimes get and was trying to rid myself of tonight. They picked the man up and took him into the ambulance, where he promptly spat onto the EMT’s trousers. There was no 'excuse me' or 'sorry', just a pool of sputum as thanks for the crew’s efforts. If this sort of thing happens often enough during a shift, or even a tour of duty, then it's easy to see why a professional veneer can begin to tarnish.


At a club in the West End, a 20 year-old girl had collapsed and the staff first aider was taking care of her as she lay on the stairs unconscious. She wasn’t just drunk, she’d been drugged and it was obvious from her behaviour when I arrived that she wasn’t reacting well to whatever had she’d taken.

The security men were detaining a man they’d seen touching her ‘inappropriately’ earlier and they believed, although they couldn’t prove it, that he’d supplied her with drugs. The crew arrived and the paramedic advised the security guys to call the police if they believed she’d been abused in any way. If I’d been able to speak to them I’d have insisted they call the police because this didn’t look right at all.

We carried her to the ambulance and she continued to wander in and out of consciousness; her eyes were rolling around and her pupils were constricting and dilating every now and then. She managed to speak to the female EMT and told her, load enough so we could all hear, that the man she’d met had given her a pill to take. That was really enough to get the police involved, so I left the vehicle and let the crew get going while I went back to the club to ask that they hold on to the man while the police were activated.

Unfortunately, they had decided to let him go and that meant he’d probably never be caught, especially as they hadn’t even bothered to get ID from him – so no name or address, just a vague description. The police would have to go to the hospital and get a statement from the girl when she recovered but that wouldn't be enough and the guy will probably do it again to someone else.

I know the young girl was stupid to take the pill in the first place but that doesn’t excuse this creep’s behaviour with her when she was drunk and God only knows what his intentions were once he got her out of the club in a drugged state.

If you go out alone, or your friends leave you, don’t get involved with strangers; it’s not worth it – even for sex. Friends should never ever leave you alone if they truly give a damn.

I went to this call thinking I would be treating yet another young drunken woman but, again, I was reminded that not all of the calls we get are as routine as we think.


Finally, a 65 year-old man with chest pain that he’d suffered all day, called us from his hotel room in the early hours of the morning. He was a Russian musician who spoke little English but managed to explain that he had angina, so off he went to hospital.


Later on, I was told that the ‘fainting’ patient had a massive intracranial bleed and, although surgery was carried out immediately, her prognosis was not good and she was unlikely to survive.

Be safe.