Early shift: Nine calls; one assisted-only, eight by ambulance.
Stats: 2 asthma; 1 assault; 1 fit; 1 chest pain; 1 trauma; 2 fainted and 1 ETOH (I might drop these stats...they seem a bit superfluous).
Regular callers are part of the job and my first call, to a 61 year-old man having an asthma attack was someone I recognised immediately, although I haven’t seen him around for a while. He’d told underground staff that he was having DIB and had forgotten his inhaler but when I saw him his breathing was fine and he perked up even more when the crew arrived to take him away. Funny that.
A 29 year-old woman was crouched in the hallway of an expensive building of flats, hyperventilating after allegedly being assaulted by the man who’d taken her and a friend in for the night. The call had stated she’d had an epileptic fit and she confirmed she suffered from this but I’m not sure a seizure had taken place at all. The man had punched her out of a stool in the kitchen after an argument and she’d collapsed to the floor (thus the ‘fit’ I guess).
Police were on scene when the crew and I arrived simultaneously but they’d left her on the ground floor landing whilst they attended to the assailant, who was upstairs in the flat. It took us almost 30 minutes to calm the woman down and by the time I left she was smiling and hugging her friend.
My second asthma attack was a non-starter. The crew was attending to the 36 year-old woman and I wasn’t required.
A 2 year-old boy had reportedly had a fit at home and his mother called an ambulance because it had happened before and nothing had been properly diagnosed. I found the child lying in the doorway of the flat as his mother looked down at him – she didn’t seem too worried. He responded immediately to my voice and the crew, who’d arrived with me, gave him oxygen. As with all cases in which children have had a seizure, my first job was to get a BM, which read low. I gave him Glucogel and he absorbed enough over a short period to bring his BM back up to normal but that wasn’t the end of the story.
I’d asked about the circumstances of the ‘fit’ and the mother described a kind of drop attack rather than a seizure. This wasn’t his first collapse and I was suspicious about other factors. Two other kids sat like robots in front of the television and they didn’t smile when I spoke to them (I’m obviously not that charming) but I noticed they were sitting rigidly, not relaxed. It seemed unnatural.
As we got the boy ready to go to the ambulance the mother screamed at her other daughter, her eldest, when she appeared at the front door. She left the teenager to take care of the two robotic children and accompanied us to the vehicle. I asked the crew to do an ECG, which isn’t normally done with kids but I felt these drop attacks might have a cardiac origin. As soon as the strip printed off we could see a problem; there was an irregular rate and a complex dropped every five beats or so. This could possibly mean an AV conduction problem but I’d have to wait until we got him into hospital to find out.
He remained irritable and lethargic all the way to hospital and I wondered if he had been born with a problem or it had developed because of other reasons which I’d better not speculate on here.
In Resus he was thoroughly checked out and his ECG there confirmed what we’d found – he had a sinus arrhythmia of, as yet, unknown aetiology. Whatever else was going on in his little life, I was never going to know.
A long drive to a place way outside my area for a 61 year-old man with chest pain who walked to meet me when I pulled up. He had that ‘regular caller’ look about him and after I’d finished my obs the local crew confirmed just how regular he was when they arrived. He’d given me a pain score of eight and a half out of ten, which was kind of a clue.
Mixing alcohol with drugs is never wise. My next patient, a 55 year-old man, fell into the road and smashed his head after washing down his anticonvulsants with vodka. His wife and daughter, who were on scene, weren’t happy with him and remonstrated with him as he was loaded onto the ambulance. Alcohol, drugs and an unhappy family - nice combo.
I wasn’t required for the 22 year-old who’d fainted with ‘breathing problems’. The crew was with her.
Next, a 55 year-old woman who passed out in a restaurant after a near-choking event. Her BM was high and her ECG was anomalous, so there were other reasons to take her to hospital, even though the food she had choked on had cleared and she was fully recovered when I arrived.
I watched a pedibike (it’s a kind of taxi bicycle) brake hard as it careered towards a car at traffic lights. These guys drive them around like idiots sometimes. This time there was a man and two children on board and the braking pitched the whole passenger area forward as the bike tipped over, spilling one of the little girls onto the road. The man wasn’t happy at all and shouted at the ‘driver’. Then he took his kids and himself off the contraption and onto the pavement, where he waited for a proper taxi. Pedibike man didn’t seem fussed at all.
Finally, a 50 year-old man ‘unconscious with head injury’ turned out to be an alcoholic with a skin infection (which was bleeding) who was trying to sleep in a public place (they never learn). The cops were with him when I arrived and they moved him on after a quick check of his condition. He staggered off like a drunken shadow and found a better, more private place to sleep.