Night shift: Seven calls; one treated on scene, the rest by ambulance.
Stats: 1 ETOH; 1 Psychiatric problems; 2 Chest pain; 1 Abdo pain; 1 Drug overdose with head injury; 1 Asthma.
Early into the shift I am requested for an 18 year-old girl who has collapsed at a busy bar near Leicester Square. Her friend is convinced that her drink has been spiked because (and I’ve never heard this before) ‘she’s never been like this’.
Despite being told over and over again that she’s only had a couple of drinks (never heard that one either), she looks like a girl with plenty of booze on board. She’s unconscious and has vomited at the feet of customers who are trying to get on with the business of enjoying their night out, even though there are two paramedics (myself and the CRU) among them spoiling their fun.
After a few minutes the girl seems to be recovering a bit; she tells me she’s been drinking all day – then she slumps back to sleep and that’s the last time I hear from her while I’m attending. I put a line in and fluids go up to support her diminishing BP. Fluids are also very good at flushing alcohol through the system, so she should wake up soon.
The crew arrive and take her away. I’ve had to control the emotions of her screeching friend a couple of times with stern words and I regret being a little harsh with her at times but it’s hard to concentrate when you have crowds around you, a drunkenly unconscious patient and a banshee in the same periphery.
As I tidy up the debris from my labours and gather bits and piecesd from a table I’d used, I apologise to the two ladies who have been sitting at it and who, all the while, have patiently got on with their drinks a mere two feet from the disturbance. They smile, thank me back and ask for my phone number. Of course, I’m not shy and don’t mind the attention at all. ‘It’s 999’, I say.
My first encounter with another regular next. He’s been in the area for months but I have never come across him, until now and for the next few shifts. The 29 year-old man is small, quietly-spoken and vulnerable. He’s living rough and has psychiatric problems. He has called an ambulance for ‘chest pain’ and I believe him when he says he’s ill. He is in a callbox which is literally a hundred metres from the hospital. The clues were there but I chose to ignore them because I felt sorry for him and I believed (and still do) that he needs help.
His lip is cut and he offers no reason for this. He sits in my car until the ambulance arrives and I can see no reason not trust him, so he’s taken to hospital. Only after this am I told by another crew that he is a frequent flyer. I thought I knew them all.
A big 40 year-old Irishman with chest pain kept apologising as we helped him. He’d suffered for a week and thought it would go away but it’s now much worse and he has had to give in and call 999. He’s an alcoholic by his own admission but he’s not been drinking, he tells us. GTN helps him a little but the crew are taking him in because we don’t take chances with chest pain and this is genuine.
Many of our ‘chest pain’ calls are nothing of the sort. As I explained before, a lot of people cannot differentiate between chest and abdomen, so my next call didn’t surprise me. I walked into the shop, where late night workers were re-stocking shelves, to find a 26 year-old man laying flat on a table. He had abdominal pain, which he scored 10/10 and he was so uncomfortable that he couldn’t keep still. This is one of the signs of true pain.
I didn’t know how long I would wait for an ambulance and fifteen minutes had gone during my obs and questions, so I offered him pain relief and opted for morphine, rather than entonox because the former is much more effective and long-lasting than the latter. I was drawing it up when the crew got on scene and gave him a small amount to get him to hospital.
Another genuine chest pain and a yappy dog at the address of a 50 year-old woman who’d held out for 4 hours before her husband decided enough was enough and dialled 999. She looked unwell and the crew, who arrived behind me, took her swiftly away…I wasn’t going to slow this down by playing on scene. The dog was relentless and his bark rang in my head a few minutes after I left. They don’t need a smoke alarm at that house.
GHB again and a 20 year-old Spanish man stood in the doorway of a club, supported by the doormen on duty. It’s raining now and I’m getting soaked as translations fly between me, the patient and the intermediate on the door. He’s okay but kind of out of touch after taking the drug, so when the ambulance arrives I leave them to deal with him.
Last call; a 24 year-old bodybuilder suffering an asthma attack at home. He’d been woken up by chest tightness and he was wheezing a little but not at death’s door. I sound him out, give him a neb, wait while he recovers and take my leave with the crew when he confirms that he is much better and would rather stay at home. I remind him on the way out that he needs to put some muscle on because he’s looking weedy. You can have a laugh with blokes who look like the Hulk because they aren’t easily offended and you get one chance to duck if they are.