Friday, 2 May 2008

Things that drive you mad

Ten emergency calls; one false alarm, two assisted-only and seven by ambulance.

Drunks on buses are becoming increasingly common, as is the way in which they are being dealt with by bus drivers. An ambulance is called, whether it’s obvious the person is simply asleep or not and the report is almost always the same; ‘unconscious’.

So my first call of the shift was to an unknown male ‘unconscious’ on a bus. By the time I arrived, he was staggering off the vehicle, much to the embarrassment and annoyance of the driver and his manager. My blue light arrival was witnessed by a long queue of rush hour travellers as they waited to board the bus in question. They must have thought it was all a bit over the top – I certainly did.

A 60 year-old man was fitting in a park and on off-duty nurse called us. She gave me a thorough handover when I arrived and the man seemed to be recovering well. I thanked her for her help and the ambulance crew took him away.

Another recovering patient, a 30 year-old female who’d fainted at an underground station (on the deepest platform, as usual), was taken to hospital because she had been generally unwell the night before and her collapse was probably a by-product of something else going on.

A call to the Bond Street area next, for a 35 year-old woman who was ‘? About to fit’. Passers-by were attending to her when I arrived and they told me that she had epilepsy and they were worried that she might have a seizure. I watched her vomiting into a flower pot outside a trendy cafe and wondered what the owner would think. She hadn’t taken her usual medication this morning and had doubled up on another drug, Lamotrigine, instead – she always had reactions to this drug and she wasn’t surprised by her condition now. I guess the simplest advice to have given her was not to take too much of that drug but I thought it best to leave petty lectures to someone else – hospital staff, for instance.

As the rain continued to annoy everyone, another RTC came my way. A 35 year-old man was knocked off his motorcycle as he tried to sneak up the inside of a lorry (not the wisest thing to do). He had a ‘leg injury’, according to my MDT, so I knew I wasn’t going to be saving a life here.

He was sitting on the ground, chatting on his mobile phone when I arrived. The lorry driver was very angry and I had to keep him away from the patient in case a punch-up developed. When I examined him, I found he had a large lumpy mass on the top of his foot – he’d probably fractured it on the way down but he had no other injury and, by all accounts, the impact had been at low speed, saving me the need to worry about his spine and other life-threatening injuries. He still got a secondary survey and the crew, when they arrived soon after, completed it in the ambulance. He’d stopped using his phone by that time.

I visited the world’s cleanest first aid room when I was sent to a 50 year-old man with chest pain at his office building in the City. The place was plush, to say the least – leather chairs, a proper examination couch and well stocked, tidy equipment storage. I was impressed, as was the CRU responder who’d arrived after me.

He had been suffering chest pain for an hour but had no cardiac history, although high blood pressure ran in his family and had also affected him. He was sweaty and pale and he was rather large, so the chair was going to creak a bit when he was moved. The crew carried out an ECG and it looked normal but his BP was high and he didn’t look 100%, even after the GTN I gave him reduced his pain to a more bearable level.

Some calls are over-resourced because of a lack of communication or confusion over their exact nature and so my next call, to a 76 year-old female who was described as ‘unconscious’ but actually wasn’t, was also given to a MRU, who’d arrived way ahead of me, and an ambulance crew, who drew up soon after me. I’d been dragged all the way across town and I thought it must be a cardiac arrest if they needed all of us on scene. The lady was in bed, unwell with a UTI but not in any immediate danger. I left after a quick check that I wasn’t required – the little flat was filling up with uniformed medics and it was a little cramped.

I’ve never gone to a dialysis centre before and I got my first call to one, in support of a crew who had already been despatched for a 62 year-old man who had developed DIB during his treatment. The little clinic was in an alley off a main road and it comprised a single ‘ward’, lined with beds, every one of which was occupied by a patient connected to a dialysis machine – a LOT of blood was being cleaned today.

The patient didn’t have DIB as such – he had a fever and this had triggered a 999 call, which, considering his condition, was fair enough. The crew didn’t really need me there, so I bid them farewell and went on my way.

The rain fell heavily towards the end of my day and I went north to deal with a 35 year-old man, described by a caller as ‘very drunk and passed out in the street’. The police joined me for this one and I was glad of them because the drunken man had a very protective dog with him and it barked and snapped at us whenever we tried to get near. The man was sitting up and was quite conscious when we arrived – he didn’t need or want to go to hospital, so the police persuaded him to move on, which he did after two attempts at standing up and walking in a straight line failed. His dog wasn’t going to let us handle his master anyway, so we all hoped he’d disappear around a corner so that nobody else called an ambulance for him. If they did, it would be prudent to mention the mean dog next time.

I was just about half-way to my destination (base station and home) when I got a call ten minutes from the end of my twelve hour stint. They wanted me to go back up north, in the opposite direction, for a 40 year-old with DIB at a train station. There were no other vehicles available, I was told. I wasn’t happy but I knew I’d quickly be reminded of the fact that I was still on duty, regardless of the enforced overtime I was about to do. Such is the nature of the job.

I got there to find the police standing around a man who wasn’t having any difficulty with his breathing at all. He was dizzy. He didn’t want to go to hospital and had no interest in being checked out by an ambulance crew. I carried out my own obs and asked him three times if he wanted to go to hospital. He didn’t – thrice.

I had another twelve hours to do the next day; I’d be getting up at 4.45am and it would take me an hour to get home, so my mood changed with the weather as I sat in the heavy rush-hour traffic on the way back to the station.

Be safe.


Anonymous said...

On every Crew, is there at least one paramedic or do you get crews with two EMT's ?

Fiz said...

Take care and be safe this weekend, xf and the same to all the other emergency services and nurses and doctors out there.

miss emma said...

aw 12-hour shifts must be the worst!hope it stays sunny for you during the bank holiday!

and what are your thougths on boris johnson winning the election?
emma x