Monday, 18 August 2008

Injured queens

Day shift: Six calls; one false alarm; five by ambulance.

Stats: 2 Head injury; 1 Angina; 1 Allergic reaction; 1 Emergency transfer; 1 Cut chin.

This was my second shift on an ambulance and it started early on with a ‘one under’ at a busy train station. We were almost on top of it and could see the fire engines, police cars and other ambulance vehicles ahead when we were cancelled. Since we were passing the scene, we stopped and asked a crew what had happened – there was certainly enough fuss.

Apparently a man had jumped but the train had just gone passed him, so he fell into the pit on the track. He had minor injuries and a crew were dealing with him. He hadn’t tripped; he’d allegedly leaped with the intention of going under the train – strangely the entire length of the train had already passed him by before he acted on his impulse. He literally missed his train.

Later on we were standing over an unconscious 24 year-old Colombian man who’d collapsed in front of his friends after a night out drinking. He wasn’t drunk, they suggested and he definitely hadn’t taken any drugs...they suggested. Nobody’s is ever really sure about the drink and drugs habits of their close friends. He had a head injury – the result of falling and meeting the ground, so his condition may have been caused by this, although I had to bear in mind that he fell first, so he was probably losing consciousness before his head hit the ground...bringing me back to the possibility of drink, drugs or both.

His vital signs were abnormal - his pulse rate was slow (35 bpm) and irregular and his blood pressure was consequently low. He didn’t respond at all throughout our time with him and we were on scene long enough for him to have woken up if he’d wanted to. I’d given him narcan and that hadn’t helped, so now he was on fluids and I’d lifted his pulse rate with atropine. His vitals were stable enough after twenty minutes on scene and it should have taken us less than ten minutes to sort him out and get going except for a bus driver who clipped the ambulance as we worked on the patient inside. He’d tried to take a turn around our vehicle and misjudged it badly. Then he spent the next ten minutes shouting at me and my crew mate because I’d stopped him from driving off after the accident!

We got the young man to hospital and he was poked and prodded by even more people in an attempt to find the solution to his state.

A 68 year-old man had an angina attack at a police station, where he was being held on suspicion of alleged fraud. He was the perfect Essex type bloke from the old days...a gentleman. He’d sorted his pain out with his own spray and the police doctor had attended to him but because the police get a bit paranoid when it comes to people potentially dying in their custody, he went to hospital for checks.

It’s been a long time since I gave an injection to a small child but my next call, for a 2 year-old girl who was having an allergic reaction, forced me to make a quick decision about whether to leave it to the hospital staff or to do it myself. At first she’d been fine – swollen lips, rash...the usual stuff but she quickly became more lethargic and floppy and her airway was becoming swollen. I gave her a shot of adrenaline on the way to hospital and by the time she arrived (literally two minutes), she was beginning to look much better. The medical team worked around her for a short time and I watched her bounce out of the hospital with her parents fifteen minutes later. A miracle.

Some of the saddest jobs I do involve children and our next call was an emergency transfer. We had to take a 4 year-old boy from one hospital to another for specialist treatment. It was a long trip on blue lights and took up a lot of our afternoon.

The child had complained of earache, which his G.P. diagnosed as an infection but it got worse over the course of a few days and his face began to swell on one side. He was taken back to his doctor, who repeated the diagnosis of infection. The parents weren’t convinced and when he complained of great pain and his face became even more swollen a few days later, he was taken to hospital, where a scan revealed a massive, intrusive tumour.

He sat on the trolley bed with a smile on his face and a large family gathered around him as we left the hospital. On the way he began to feel pain again and was crying his eyes out by the time we got there. I could do nothing to relieve his discomfort because the doctor had already dealt with his meds before he left. We took him up to his new bed and left him with his doting mother and weeping father. My crewmate and I stood in the corridor and discussed the non-existence of God.

The shift ended with a farcical call in a park. A gang of gay men were playing rounders when two of them collided head-on at speed. One had a head injury and had been knocked out and the other had a deep cut to his chin. The MRU was on scene and had attended the man on the ground (the head injury) as it started to rain. From the very start, this man was a bit obstructive. He didn’t want his head and neck held still – he didn’t like the collar and he refused the continuance of his care twice before we were able to talk any sense into him. The other guy – the one with the cut chin – behaved like an adult.

We took them both to hospital at the same time and on the way, our chin-injury patient said ‘I’ll bet you didn’t think you’d be coming to the aid of forty queens playing rounders’. Funnily enough, it hadn’t crossed my mind.

Be safe.


Fiz said...

That little boy has me in tears. I'm a Christian, but sometimes, reading this blog and a couple of others, I do wonder. Can they do anything to help him?

Smithy27 said...

Do the Dr's of patients who are seriously unwell and the fob off with 'an infection' ever get investigated. I'm sure there are some examplery GP's out there but is more than often that patients just aren't happy about the way they are treated by their GP's I work in Paramedic Emergency Control and hear time and time again 'we've been to the Dr's and they said it was an infection. It's more than an infection'

Who knows, maybe just me as a newby getting overly emotionally involved in cases.

Anonymous said...

Does anyone else find the decision to allow the 2 yr old home after fifteen minutes, considering the anaphylaxis and the adrenaline it was treated with a little 'unusual'?