Tuesday, 13 May 2008

Choked

Seven emergency calls and two running calls; one assisted-only, one taken by police, one sent by taxi, one conveyed in the car, one refused and the others by ambulance.

Morris dancers, seal-clubbing protestors, anti-this and anti-that groups – Trafalgar Square was a very busy place today. The sunshine helped to make it pleasant, even though some of the characters that came out of the woodwork to put themselves on display didn’t. Who is that sad man, who drapes himself in a Union Jack, dons a builder’s hard-hat and plays cricket with himself against the wall of the National Gallery? Is he some kind of representative of the great British sporting tradition? If not, he needs to go and get himself a job.


An eight year-old girl was fitting, so I was sent to help her but a crew were on scene and I was not required. I was required, however, for the usual time-wasting type of call when a 25 year-old man was reportedly found collapsed in a doorway. He was, in fact, asleep. He is a frequent-flyer of the highest calibre and crews continually pander to his demand to be taken to hospital for absolutely no reason at all.

‘Do you want to go to hospital?’ they asked as I stood there watching him go through his act.

He nods. No surprise there then.

Off he goes, a couple of hundred quid of our money; not a penny of which he’s earned himself and he will take up space reserved for more deserving cases today. Then he’ll leave of his own accord and play this game again when he feels like it. We are a stupid, self-destructing nation of fools with no backbone and no ability to refuse anything, lest we get sued!

The next one I got, a 50 year-old ‘unconscious’ in a doorway was, of course, just sleeping it off as well. This time, I cancelled the ambulance and moved him on to the nearest park...or anywhere less public than a street full of concerned tourists who don’t know what a sleeping alcoholic looks like.


A 40 year-old man ‘unconscious’ on a bus wasn’t...as if you didn’t know by now. He was taken by police because he kicked off as soon as he was awakened from his slumber – these guys are getting more and more dangerous. I had been sent on a call for a female having an allergic reaction who thought she might die (OTT, I think since most people who are dying don’t have the luxury of time to record it on the ‘phone with us) – it was still an emergency call but then, half way to the address, I was cancelled for the drunk on a bus call because, wait for it...it was a higher priority! This is absolutely crazy. Statistically, an ‘unconscious’ person on a bus will be nothing more than a sleeping drunk as opposed to the higher risk that a minor reaction could be a full blown anaphylactic event.
Somebody somewhere is going to die because of this computerized nonsense...and you know what? It’s not our fault and it’s not the Government’s fault – it’s EVERYONE’s fault. If it wasn’t for the fact that we simply cannot accept that mistakes are made and that life’s tough sometimes, we’d have a human-driven system that would make things a lot easier and probably cheaper for us. No more time-wasters – no more pandering to alcoholics and drug addicts. No more picking up the pieces for the bus companies, who are all privately owned and profit-making companies. Why the hell are we running around waking drunks up for them? Hire your own security people, I say. We don’t get calls from Burger King to wake up drunks – they have their own people chuck them out onto the street.

And while I’m ranting, what’s the deal with Murphy’s digging up just about every road in Central London on the same day? Traffic was a nightmare and getting to calls on time was almost impossible. Thanks guys – smart move.

PHEW!


A theatre in Soho was the setting for my next call. A member of staff, a 25 year-old woman with a possible cardiac history, had fainted. She told me she was waiting for the results of a recent ECG and that she was being booked in for a tilt test. I checked her blood pressure in the upright and supine positions and found that it dropped when she was supine (lying flat), increasing only when she sat up.

We waited for the ambulance outside in the fresh air because the inside of the theatre, two floors down, was very hot and noisy – not very conducive to a full recovery.


As I sat on Trafalgar Square absorbing the atmosphere, I was approached by a police officer and a couple with a baby. The officer told me that the woman, who’d been holding her child with one of those front-strapped harnesses, had fallen and the child had hit his head on the ground. The baby was only 12 weeks old and the mother was beside herself; panicking at the thought of what damage might have been done as her weight fell onto the child.

I felt the bump on the baby’s head – it was big but not huge and there was no bleeding. The child was alert and easily agitated, so all looked good and I told the parents that I wasn’t worried but that an ambulance would be a good idea, considering the baby’s age. I asked Control to send one and we waited for five or six minutes while I got all the details I needed.

When the ambulance arrived, the crew took the two worried adults and one not-so-bothered baby to hospital. Before the crew left, they were approached by another little family who were re-directed to me. It was another running call. A French family’s 6 year-old boy had fallen from a statue he’d climbed and couldn’t move his arm properly. It hung limply as he held it with his ‘good’ arm. He had fallen from about six feet onto the grass but it was enough for me to suspect that he might have broken his wrist.

He wasn’t in a lot of pain but his posture and the protective way he held it meant he should go to hospital for an x-ray. I asked the family to wait while I called for an ambulance but I was told that there were none around and, on a call like this I knew I was unlikely to get an immediate response. I told the family that there would be a bit of a delay.

I waited for fifteen minutes but no ambulance came and Control confirmed that nothing was yet available. We were busy.

As I explained the problem to the family and told them it may be best to get a taxi to A&E, I received a call from a MRU colleague. He told me that a patient – an 11 year-old girl who’d fainted earlier – had been waiting for an hour to be taken to hospital by ambulance. She was now on an IV drip because her BP had dropped so much. I was asked if I could go and transport her and her mother to hospital. Of course, she became the priority and I asked the French parents to take their son to hospital by cab, apologising as I left.

I got to Oxford Street, where the young girl was waiting, IV in situ. I drove her and her mum up to hospital in five minutes. The call had been categorised as a Green2. I simply don’t get this...I was being sent on Red calls for ‘unconscious’ people on buses and in doorways and yet an eleven year-old child faints and has low blood pressure is given a much lower priority. It’s all gone mad.


The one job of the day I could be proud of was this one; a 55 year-old man was choking at a hostel. At first, as with all ‘choking’ calls, I was sceptical about the accuracy of it...we get many calls like this and you rarely turn up to find someone actually choking.

As I made my way there, the call category changed from red to amber and back to red again, so something wasn’t quite right. I pulled up on scene and a couple of female members of staff were waiting outside for me – they waved and fluttered like panicking chickens.

I went into a dining room and a man was sitting at a table, a plate of food in front of him, making the most awful sounds. He wasn’t breathing and his chest was growling as it desperately attempted to move air around.

‘Have you done anything for him?’ I asked the gathered members of staff.

‘Yes, we tried hitting his back and thrusting his abdomen but it didn’t help much’.

The man was on his last legs, so I thumped his back...nothing. I got behind him as he sat in his chair and I carried out the Heimlich’s manoeuvre. A chunk of food flew from his mouth after my third attempt and he began to breathe but it was still very noisy. He had a glassy-eyed look about him and he wouldn’t respond to me at all, so I dragged him from his chair and prepared to carry out emergency procedures to keep him stable until the crew arrived to help me out but given my experience with the day so far, I thought it would be prudent to call Control and make sure an ambulance was coming for this one.

I tried to inspect his airway but his mouth was clenched shut and I couldn’t open it. I was sure there was more stuff to come out but I also suspected something else might have happened to him, prior to his choking trauma. He may have had a stroke.

As I supplied him with oxygen and listened to his chest for the free movement of air, the crew arrived and I explained what was going on. Just as we prepared to get him to the ambulance, he gave a long loud cough and a huge chunk of food flew onto his chest (see pic). This is the bit I’d pushed up from his trachea. It had been sitting in his pharynx (back of his throat) until now and that was why his breathing still sounded noisy. He couldn’t have inhaled it again because it was far too big.

When it came out, I lifted it up and there was a gasp of shock from the people around me. Ironically, one of his mates started tucking into his unfinished dinner as he lay on the floor, potentially dying of asphyxia. I found that sight remarkable but typical in a place like this. I looked down at him again...

‘Hello’, I said, ‘You’ve been choking but you’re alright now’.

He continued to improve and was talking a little when the crew took him away.

We don’t get many chances to treat choking, most are resolved (or dead) by the time we get to them. This was a rare opportunity for me to save a life using a technique that I teach an awful lot in first aid classes. I’ve only had to do this a couple of times in my career and it’s a very satisfying achievement. It made me feel good when I left the place.


I was just about back at station when I was asked to go and wake up a notorious drunken man who’d become ‘unconscious’ in the park at the London Eye. Two cops were on scene when I got there and they had been having no luck getting him to respond. We of the ambulance service are experts at waking the dead and it took me ten seconds to get him to sit bolt upright and stop being an idiot. I knew him and the cops decided to take him away themselves. I cancelled the ambulance and made my way home after a long, hot and traffic-filled day in which one life was saved and all the other calls seemed like routine duty stuff.

* At the time of posting, another fatal stabbing has taken place in London, on my ‘patch’. I wasn’t on duty but my colleagues would have struggled and done everything they could for this man. It’s a damned shame and it’s a sign of bad things to come. We already wear stab vests, what’s next - vests for ordinary people on the street? It’s high time we stopped pussy-footing around with these little killers. A mandatory prison sentence of ten years for anyone caught carrying a knife without good reason, on a three-strike basis. Go on Mr Brown, let’s see if you have the nerve...or are you, like the others, too scared to challenge the human rights of those who deprive innocents of theirs without compunction?


Be safe.

22 comments:

miss emma said...

these killers are getting more and more brave (not the right word to use i know) because now they are striking in broad day-light in a packed street! such a shame that so many innocent people are still losing their lives.

i hope the fact that you saved the choking man made up for all of the drunken bus calls you recieved in that shift!

emma x

Kate said...

I think it is time you had a holiday - you seem to get more annoyed in each blog. Hope the next day isn't as full of time wasting unconsciouss - ooops I mean Drunk people on a bus!!!

xxx

Martyn said...

You are so right, the politicians are too busy caring about the criminals' rights and forget about those of us trying to lead a quiet, productive life. Long overdue time for a change

Anonymous said...

Big man, good blogging as usual but do me a favour?
Get yourself down to a little house in a remote village in the south of France or something. Nothing around but the countryside, big fire at night, wine, bread and cheese. Lie and read some books or just zone out.
If not, i fear you may have an MI or something! Time for a stress-buster. You deserve it.

Yorkie

Xf said...

Hey guys

Thanks for your concern and the advice...I know I need a rest but don't fret; a good rant is as effective a way of relieving stress as any other I find - I'm just flexing a bit, that's all. I'm not mad yet.

Anonymous said...

Great writing as always - and a huge pat on the back (excuse the pun!) for your intervention with the choking man.

Sue said...

I wondered if you were on duty or not yesterday evening. Just a bit curious, why would they take the patient to Tommys and not UCLH? UCLH was nearer?

A holiday will do you good. I'm off to Switzerland in just under two weeks and cant wait!

Anonymous said...

Hello, i really enjoy reading your blog every day, i wish i could lower your stress levels. Always remember you are a very special person who makes a huge difference to a great many peoples well being. Not all Paramedics are as caring as you, if i was poorly sick i would want you to look after me.

Have just come out of hospital after massive asthma attack and was very grateful for the care i got from the Paramedics who whisked me in to Recuss, reassured me and saved me... i was going to go by car.

Remember you not only save lives but make a huge difference to people who are scared or ill. There are Paramedics and there are Paramedics and then there's the best.. you! Hang on in there bud, you will feel less frazzled soon, be safe, love Lois x

Ellie said...

Sorry you seem to be having a stressful time of it right now. You're right though, sometimes the blog is a good place to vent.
Nice job on the choking. Very rare indeed. Super gross pic! haha. It's odd to be proud of a half chewed piece of meat.

Andy C said...

When i did my training as a special constable, we were told we couldn't refer to the Heimlich maneuver since it was 'trademarked'. We have to call it abdominal thrusts

Fiz said...

It looks like a sausage roll to me!

Anonymous said...

Knives - trouble is when Hard Case A says to Acquaintance B "carry this or I'll use it on you". Terrified B then gets to follow A around all day in case he needs a weapon, but it's B that's off to jail if they get caught.
Also:
They don't think they'll get caught. When people were hanged (hung?) for theft, pick-pockets would work the crowd watching the execution.
Oh, and a shop near here does a good trade in stab-proof hoodies.

Kieran said...

Hey Xf, not had a computer for a longtime. Gotta say it's still as good as i can remember! Looks like you had a busy shift eh?

As for the last paragraph, really powerful stuff- i completely agree about on the spot sentences for those carrying knifes, or any other weapon for that matter.

I'm still pursuing the paramedic dream you'll be pleased to hear :)

- Kieran

Anonymous said...

Wow, great job on the choker. what a great feeling. I'm off to uni in september on one of the 'london' courses in paramedic science. I can't believe i have got in and am about to begin my life long ambition (35 year old mum with 2 kids!) i'm sooooo excited but also a little nervous of the reality of stab vests and 'little killers'. Who knows what the answer to all this crazy business is? I totally agree with you about mandatory prison sentences but can also see the point of 'anonymous' above. I just pray to God that neither of my two boys end up part of a bad crowd or on the receiving end in years to come. Unfortunately it's not even just london that this stuff is going on. we live in a seaside town in kent where we have had a recent fatal incident. in fact one of my own husbands friends was stabbed to death right here in one of the little cobbled streets some years ago. I fear for my childrens future. I really do.
keep up the good work
maz

Xf said...

Sue

I wasnt on duty the day of the stabbing but it was up to the crew to decide where to go. I don't know why they chose Tommies.

Xf said...

lois

Thank you...I feel less stressed already :-)

I will, as always, take your kind words and make them applicable to many of my colleagues.

Xf said...

andy c

I'm not sure that's true at all since it is named after the person who pioneered it! Go ahead and call it what it is and see if anyone tries to sue you for saving them using a 'trademarked' name :-)

It also suggests that you couldn't use the procedure unless you got permission...and that's just daft, don't you think?

Who told you that anyway?

Xf said...

fiz

It was a sausage roll - you win the prize (there is no prize actually) for spotting it!

Xf said...

fiz

Oh, wait a minute...there is a prize after all....you get the other half of the sausage roll :-)

Xf said...

anonymous

You are right about the influence to carry knives...and I have to admit that after I learned about the guy who'd been stabbed, shamefully or not, I felt less sympathy for him. Not that I condone the action but, let's be honest, who suffered most, the guy who died fairly quickly or the sixteen year old girl who was raped and burned and now has to live the rest of her life with it?

Xf said...

kieran

Welcome back! Glad to hear you're not put off by my blog!

Xf said...

maz

Great news on your new career! don't be worried, you'll get plenty of help from your colleagues and will eventually find your strengths and weaknesses.