Tuesday, 12 August 2008

Lifeless


What goes up...this wonderful piece of grafitti art was pasted onto the wall of the building across from my station but in less than a month, vandals had torn a lot of it away at the bottom and so, down it all came again. I think this photo says a lot about society.

Day shift: Nine calls; four assisted-only, one false alarm, one conveyed in the car and the others went by ambulance.

Stats: 2 ETOH; 1 EP fit; 1 Fall with no injuries; 1 RTC with no injuries; 1 Unwell adult; 1 Muscular chest pain and 1 Suspended.

The day started routinely and ended badly.


My first call was to a 25 year-old male ‘unconscious on a bus’ and we all know what that means. He was drunk and asleep and at 7am when I hadn’t even had breakfast yet, he told me to ‘f**k off’. Still, mustn’t grumble, I had annoyed him into submission and he promptly left the bus. The bus driver looked in with admiration and then said:

‘I couldn’t have done that. You guys are trained for this sort of thing’

I knew what he meant to say but I was crushed at the thought that I’d become nothing more than a specialist drunk waker-upper. I thought I’d achieved a higher goal. I was to find out later on that not everything I do will go according to plan.


Then a 51 year-old epileptic man decided to have a fit in his police cell. He was found lying on the floor by the police officer charged with checking in on him every so often, as they do. ‘Are you alright?’ she’d shouted to him. ‘Yes, I’m just having a fit, don’t worry’, he’d respectfully replied.

His obs were normal and he wasn’t post ictal but he did have a history and I couldn’t ignore the giant, softly-spoken man when he confirmed that he had indeed suffered a small seizure. Who was I to judge? At over six feet tall and just as wide, I wasn’t going to argue with him. My MRU colleague was with me on this call and the crew showed up to take him away.


A call to a 49 year-old epileptic man whose Careline alarm had gone off explained to me that he was absolutely fine and that his power had gone down, thus the alarm was triggered and we were called out automatically. We stood on his doorstep; me fully clothed in uniform – him almost naked and not too fussed about the daylight or the neighbours…or me.


I didn’t do anything at all for the 85 year-old lady who’d fallen and got herself trapped between a wardrobe and her bed. The crew was on scene and they didn’t need a third pair of hands.


A report of a ‘bus vs ped’ meant I was racing towards Charing Cross Road thinking that I may do some good today after all. The bus had clipped a man as he walked across its path (yeah, they tend to do that) but he wasn’t badly hurt and just needed checked out by the crew who arrived before me. The additional MRU wasn’t required either. The man had lost all his beer, however because his plastic bag of booze had been hit, rather than him. You’d think he’d be grateful for small mercies. Still, what a waste.


Off to an hotel (got to say 'an', otherwise the pedants will have a go about the grammar) for a 75 year-old male with DIB ‘? Heart attack’. The staff probably felt it necessary to put that last bit in but when I arrived he didn’t have any chest pain, although he was as white as a sheet. He was with his wife and he denied ever having any DIB but his face was off-colour and sweaty, so he was going through some kind of crisis. He told me he had dizziness and visual disturbances when he exerted himself (this started when he lifted his case from the car to the room). I’ve seen something very similar to this and it rang a little alarm bell. The last case of this kind was a few years ago and I posted on it; the guy had lost some vision in one eye and was very off-colour but had nothing much else to report. He was later found to have suffered a neurological insult.

The man and his wife were quickly packed off to hospital, while the hotel staff helped by carrying one of my bags – it’s like instinct. No tip was offered; I was busy.


The call that ruined my day came next. After initial reports that a 15 year-old was fitting in a playing field, I was sent running on a Red1 ‘CPR being carried out’. I had to call in to confirm this because the call description was confusing – apparently he was still fitting…but that couldn’t be. Either one thing or the other applied and I had a gut feeling that it was the other.

I arrived to find another FRU colleague on scene (by seconds). There was a crowd of about a hundred people gathered around the perimeter of a playing area and I was ushered inside through the chain fence gate. I could see someone compressing a young man’s chest. The closer I got the more I could see that the young man was actually a boy.

I can’t go into specific detail on this call but before long there were three cars and two ambulances on scene and I had taken the reins of the job, so I was trying to co-ordinate airway management, CPR, defibrillation and drugs in an environment filled with people. Obviously, it’s not the first time I’ve done this but when it comes to young people the effort just seems that much more important…much more charged.

He was shocked three times during the attempt and he converted from VF to an agonal rhythm with a very weak pulse – but that didn’t last and try as we could, he slipped back into a pulseless non-shockable rhythm, which lasted all the way to hospital.

I had gone with him and had another paramedic and an EMT with me in the back of the ambulance. Together we struggled to keep him stable but he wasn’t responding to the drugs given or the continual CPR. We had already established that he had no medical history, didn’t take illicit substances and was normally fit and well – he was playing football when he suddenly collapsed, looked like he was fitting, then went into cardiac arrest. After that the story is vague and confusing because I wasn’t listening after the main facts were given by the police officers on scene.

At some point a medical student began CPR with the help of a police officer and a pocket mask. This continued until the first FRU arrived and then we all descended within minutes. None of it made any difference. He was pronounced at hospital after an extended attempt to recover him.

The call knocked the stuffing out of my day because the patient was so young (he was actually 18 years old) and because there looked like a chance in hell at one point but it slipped away.


After that I had to persuade an unconscious drunken Pole to get to his feet and wander off to a less public place than the middle of the pavement to sleep. This was followed swiftly by a 37 year-old French man who said he had chest pain but it soon became clear that he had nothing more than a muscular problem, so I took him to hospital myself. I loathed the idea of an ambulance being tied up on this one while another teenager possibly lay lifeless on a playing field.




Be safe.

2 comments:

Louise said...

Tough job. I've not been faced with this yet but dread when I will.

Anonymous said...

Having seen the same happen with my nine month old i appreciate how frightening it can be without having the responsibility/knowledge that i have to deal with these situations.

im sure the family really appreciate everything that was done for this young man.

Makes me wonder if it was an undiagnosed cardiac condition?