Night shift: Ten calls; two refused, two no-trace and the rest by ambulance.
Stats: 1 ?CVA; 2 Head injuries; 1 ? Tetanus; 1 Anaphylaxis; 2 ETOH.
My first call of the evening, to a 72 year-old female ‘? CVA’ was to a familiar address. It was the patient who’d slipped under the bed a few days before. Now she was in real trouble. She wasn’t smiling – she was crying. Her face has changed and she couldn’t communicate vocally at all. I felt terribly sorry for her but I knew that with cancer of the brain, fitting and other neurological problems, including stroke, were bound to occur. It didn’t stop me feeling her pain though.
A girl walks into a Chinese restaurant in Chinatown, orders, eats and then attempts to leave without paying. When she is confronted by the small Chinese manageress, she refuses to pay and says ‘you can’t do anything about it because you can’t touch me’. Then she tries to leave. She is again obstructed by the feisty little owner and the customer attacks her, smashing her in the face and breaking her cheap wooden jewellery on it as a punch is landed on her head. A male colleague attempts to intervene and protect his boss but he too becomes a victim and gets a punch in the eye for his troubles. The girl then storms out but is caught and arrested by police, who are always nearer than you think in this part of town.
I sat with the lady as she nursed her head. She hadn’t been knocked out and her injuries were minor really but she was badly shaken and broke down in tears a few times as I carried out my obs and asked her questions. At first she didn’t want to go to hospital but then she relented (the crew persuaded her it was best).
Bad people who know their rights should be stripped of them when they abuse them to such an extent. I couldn’t imagine stealing food like that and then using my human rights to get away with it. The right not to be detained physically should never be used like a cloak of invisibility but there are always people out there who will defend such a person…until they harm them or their families.
A funny story from the annals of stag history next. I arrived on scene for a 33 year-old male with a head injury and the police officers on scene were grinning at me. ‘You’re going to love this one’ the lead cop said to me as I pulled up.
On the pavement, wearing a field dressing applied by the police medic, was a sheepish-looking man. He was on his stag night and had, for reasons only known to himself, smashed a champagne glass, full-force, into his own head ‘for a laugh’. It turns out the joke was on him because nobody could believe he’d done it and his head was now gashed and blood was pouring from the wound. He was, in his defence, very, very drunk.
‘I’ve been really stupid’, he told me. His mates took photographs of him as he sat with a new bandage on his head after I’d taken a look at the wound. He was a very likeable bloke and he had a sense of humour about the whole thing but I wondered what his wife-to-be was going to think of his new permanent scar and the life-size photo’s that were going to be shown at his wedding during the Best Man’s speech.
It’s been the year for multiple drunken females in single calls for me. Two drunken women were falling all over the place as I drove by after the last call. I pulled up and asked if they needed help and a MOP who’d tried to assist told me that they’d given him abuse. I decided I’d leave them and they pretty much ignored me anyway. The taller of the two dragged her sleepy friend off across the Euston Road and I watched until they were off my radar and out of my realm of responsibility.
A 24 year-old complaining of feeling ‘unwell’ with a ‘tight chest’ seemed very genuine to me when I examined him as he lay on his sofa. He had a temperature of 38.0c and his BP was low. He’d been abroad recently and had also been treated in the not-too-distant past for a cut finger that had become infected. His tetanus status was unclear because he couldn’t remember if he’d had a booster in the past ten years. The one aspect of his presentation that struck me as unusual was that his fingers were stiff and bent; tetany it’s called. This, his high temperature and the chest tightness and discomfort he was feeling made me think of one thing – Tetanus infection.
An anaphylactic 17 year-old male stood on Oxford Street waiting for me as his face and throat swelled after eating something he was obviously averse to. He hadn’t brought his Epipen with him and so he got on-the-spot treatment before being taken to hospital, where his IV care continued. If you are anaphylactic, carry your Epipen at all times.
Another of our famous frequent flyers has re-appeared on the scene after a stint of absence – I think they work in shifts. This one is notorious for calling us three or four times a day and he lugs cases around with him as if he’s on holiday. There’s never anything wrong with him and hospitals in the area simply chuck him out after a while. Sometimes he’ll call an ambulance the minute he’s been ejected, only to be returned to the A&E department that didn’t want him. Sometimes he demands to go to a different hospital. Most crews know him but some do not and every now and then he fools them into doing his bidding. Normally I wouldn’t care but he, like so many of the others, is going to contribute to the death of a genuine patient as he ties up crews all day long.
This time he was on a bus and had to be lifted out of his seat before going to the ambulance. He won’t move unless he is sure you are going to take him to hospital – that’s his M.O. He can also be aggressive and violent when he feels like it or he doesn’t get what he wants. I often wonder why his rights are more important than ours.
I was flagged down to assist a diabetic who was ‘unconscious’ but I could see that he wasn’t. He and his friends were boisterously crowding on the pavement as they tried to drunkenly manage each other. His brother insisted that he was ok but the Polish man who’d drawn my attention to him wasn’t satisfied and shouted at me for doing nothing to help. I told him I couldn’t because he’d refused and his brother was going to take him home but Mr. Angry was most insistent. So much so that he started an argument with the small crowd of drunks. A punch-up looked inevitable, so I stood myself in between them to calm them down. I shouldn’t really do this but I’m from Glasgow and it’s in my nature. The fight was avoided and I continued on my way.
Two no-traces for the end of my night. The first for an unconscious man lying in the street outside a McDonald’s was invisible. He’d probably walked off. My presence prompted the security man at the McD’s to ask for advice about whether he should go to hospital by ambulance or not after being assaulted. I looked at the large-framed man and I looked at the smallest cut in the world and I couldn’t believe he was serious.
The second no-trace was for a 21 year-old unconscious drunken male. He didn’t exist either. I wish all unconscious drunken people were figments of my imagination.