Wednesday, 25 June 2008

Naked cyclists

Eleven calls – one cancelled en-route (among the many others I don’t bother mentioning) and ten by ambulance.

An aggressive drunken 50 year-old slumped at a bus stop had my attention first thing in the morning. The crew was on scene with me and, although MOPs and an off-duty LAS EOC bod were helping him, he became a bit of a handful when the female crew member said something to him. He shot up and went for her but my hand was on his chest and pushing him back into the bus shelter seat before I’d planned it. He thumped back onto his behind and glared at me. ‘Don’t push me’, he said with slurred anger. It took us ten more minutes to calm him down enough to be taken to hospital, where absolutely no medical treatment was required.

On their way to work, two young men sat on the top deck of a bus heading down the Strand. One of the men suddenly collapsed and started fitting, much to the deep consternation and confusion his mate. When I arrived, the patient was in the recovery position on the floor – he was post ictal after having two seizures in quick succession.

‘Are you epileptic?’ I asked him. He nodded his head.

Sometimes even best friends keep their medical problems from each other as a way of protecting themselves and retaining their sense of capability. His mate was shocked to learn that he had this condition but he obviously knew the right thing to do and I applaud him for that.

The patient was very tall and the transfer from top deck to ambulance at ground level (obviously) was awkward and dangerous for the crew but we all get plenty of training on buses and trains to equip us for such lift and carries – not that our backs care much for this expertise.

A trip to the Great Ormond Street Hospital for Sick Children (GOSH) to attend a 55 year-old member of staff with chest pain next. The hospital isn’t equipped for emergencies like this and we are often called to deal with crises of this nature. In fact, the man had abdominal pain and right arm numbness, which I couldn’t connect to be honest but then I noticed a rash on his neck. The erythemic blush spread across his throat and down onto his chest; it seemed to be getting worse as we looked at it, so I figured all of his symptoms were associated, even though he denied having allergies. There’s a first time for everything and the older you get, the more likely you are to become sensitive to something. Having said that, he also had a high temperature so an internal infection may have triggered a reactive response.

Back into the West End to deal with a 40 year-old man who was ‘fitting’ inside a café. His seizure had stopped when I arrived and a customer was trying to help him as he lay completely confused on the floor. He didn’t know where he was or who he was so his BM was checked and it was low. The crew arrived and he was given Glucagon immediately. This would need to be followed up with a carbohydrate, so I begged a free croissant from the café ladies, who were only too happy to help. I should stress that the pastry was for the patient, not me, although I was very hungry. I did share a Mars Bar with a diabetic once after he’d had his bit and I didn’t feel too guilty about that.

After a short while, he became more aware and went to the ambulance for further obs and a trip to hospital (he had been fitting after all).

Now we don’t often get calls where professionalism is tested but my next job, for a 38 year-old man with chest pain at a posh hotel threw me off course for a few seconds. I was taken up to the room by the concierge and the door was opened by a beautiful tall Eastern European woman wearing a flimsy top and nothing but underwear below; not very much underwear I hasten to add. I walked in expecting her to blush and cover up rapidly but she didn’t – she walked around and talked me through her boyfriend’s problem as he lay on his back on the bed, half naked himself. The concierge was still at the open door and looked as though he wanted to come in but patient confidentiality forced me to smile at him and say ‘thanks, I can deal with this now’. I could see the smile melt from his face as he closed the door on himself and I chuckled inside.

My patient was having chest pain after taking cocaine earlier, by his own admission. I won’t go into more detail about the movements of the young woman around me as I tried to talk to him but I had to stop and refer to her directly after a few seconds.

‘Sorry miss, what’s your name?’

She told me her name.

‘Do you think you could get dressed for me or cover up a bit more please?’

I had a friendly smile on my face so I don’t think I caused her any embarrassment - not that she seemed capable of that anyway.

She spent the next few minutes struggling to find appropriate clothing and I continued to be professional with my patient. Cocaine can cause serious problems with the heart, so I wasn’t demoting his condition, although he did keep asking me if he was going to die, which was unlikely.

When the crew arrived the girl was respectable and the man was calmer. Downstairs, the concierge had informed his mates about the fuss in the room and told me that, as far as he knew, she wasn’t an ‘escort’. I hadn’t even asked him.

Another allergic reaction in the afternoon and my 42 year-old patient was waiting for me at the local fire station, where the boys in (black?) had put her on oxygen and readied themselves for a possible cardiac arrest. She was stable, although her throat had swollen and she was concerned about that. Her breathing was fine and she could still talk – always a good sign. She had no allergies that she knew of and had just finished a Chinese meal. The bad news for her was that she did have an allergy and it had caught up with her, so off she went to hospital.

I sped up to Camden on an assist when Control relayed a message that urgent police had been called for a crew who was being attacked (presumably by a patient). When I got there the police had arrived and at least two other FRU’s were on scene. Whatever had taken place was now over so I turned around and headed back.

A call to the Globe theatre for a 67 year-old man who’d fainted was a wasted journey too because the crew was arriving as I pulled up but I bumped into an old friend from years ago. She works there now and I managed to get ten minutes of catching up done before I went back to my own area.

A 25 year-old man with a history of fainting may need specialist examination because he had no other relevant problems. Repeated faints are always suspicious and should be carefully checked, so off he went to hospital.

On the way to my next call, which was cancelled before I got to it, I drove through a ‘parade’ of semi-naked cyclist on a rally through Central London. I went contra-flow and this upset some of them but I think I had the advantage because (a) I was in a car with blue lights on, (b) fully clothed and (c) might have looked better naked on a bike than most of those I saw.

Two children to treat next; a four year-old who was badly shaken after a mirror apparently fell onto her in a shop as her mother tried on clothes and another four year-old girl who fell off her dad’s bike on Park Lane – a notoriously fast and busy road. The former, as I said, was just shaken and the latter had a minor head injury, luckily. She too was distressed but the crew was on scene as I arrived and a passing medic had stopped to help. Both children were taken to hospital.

Be safe.


Emily T said...

This post really does show the huge variety of jobs you go to! Keep up the good work!

Oliver Smith said...

Busy day as ever then...

It really does confuse me as to why people don't tell people close to them that they suffer from epilepsy.

miss emma said...

I read about the naked bike rally in our local paper. It said their aim was to raise awareness to cyclist in the Capital. Well I think they certainly managed that!

But I thought the purpose of the event was to reduce the number of bike related accidents. Surely naked bike riders would cause more accidents?!

Great post Stuart! Keep it up!

Sian said...

i can totally understand why people dont tell friends that they are epilectic, they are ofen worried that poeple wont understand what the condition is and be put off by the condition, a close friend of mine is epilectic and she didnt tell me untill we had been friends for a good couple of years as she had had experiences in the past where ppl treated her like she was an invalid or had some kind of disability.