Monday, 25 August 2008

When pavements attack

Day shift: Two calls; both by ambulance.

Stats: 1 burn injury caused by an explosion; 1 Mental health transfer.

Well, there were more than two calls on this shift but I was on an ambulance and I wasn’t attending today, so I cherry-picked the calls worth writing about.

The explosion on Oxford Street wasn’t a dramatic terrorist attack but it could have been and when the call first came in we were certainly gearing up for the worst because this is how 7/7 unfolded. At first the location was vague and an underground station was named; a MOP had heard a loud explosion coming from the underground, according to the early report but we were diverted into Oxford Street itself and nowhere near the station. A few police cars had parked up and a small crowd had gathered around an area where an alley was congested with Fire-fighters and one engine. A woman stood with her family on the corner and we were told she was the only injured party, so we went over to find out what was going on.

A piece of the pavement (see pic) had suddenly blown up, fragments of it showering passers-by. The cause of the explosion was a mystery, although gas or electricity seemed to be the culprit. Molten tar hit the woman as she passed with her son and husband – it burned her shoulder and stuck in her hair. She was shaken and, apart from the burns, physically sound. Her family didn’t get hurt and nobody else around caught the debris from the blast. The bang had been heard all the way down the street, so it’s possible someone mistook it for an explosion on the underground but this didn’t stop the LFB from showing up in force to check the station anyway.


The area was cordoned off and we took the family to hospital. It was a small, insignificant event but it made us aware of how quickly things can go from normal to dangerous in this city.


It took over an hour to wait for, collect and transport a perfectly physically well man with psychiatric problems, who’d volunteered to go for assessment, to a Mental Health Unit in south London. No blue lights, plenty of traffic and a waste of emergency resources in my opinion. We are struggling to meet demand at times and yet we still have to do transfer jobs that could be managed by a private taxi firm. It’s small wonder we fight for our targets sometimes.


Be safe.

5 comments:

Anonymous said...

I hear you on the transfer jobs. We have to deal with the same crap here in the US.

Aussiepara said...

Transfers are a funny beast in rural practice. We often get "oh he can sit" or you need to know the full history they are just going for an xray" from the nurses. We often end up initiating treatment or providing pain control. Recently an abdo pain ruprured a gastric ulcer, bled out and arrested enroute. Beware the "lazy transfer", they are generally in hospital for a reason.

Regional Para

Aussiepara said...

Transfers are a funny beast in rural practice. We often get "oh he can sit" or you need to know the full history they are just going for an xray" from the nurses. We often end up initiating treatment or providing pain control. Recently an abdo pain ruprured a gastric ulcer, bled out and arrested enroute. Beware the "lazy transfer", they are generally in hospital for a reason.

Regional Para

La G said...

I'm a Psychiatric Liaison Nurse at a South London A&E.Maybe it was me! We don't like using your time if we can help it, and if the patient is physically and mentally safe to travel by hospital transport or taxi then that's what we use. On a purely selfish level, we prefer the latter, they are quicker and take us back to work, unlike LAS (yes, I know the pressure you're under, it's not a criticism). We try to only call you when warranted. The vast majority of our informal admissions are done by taxi. Sometimes we have informal patients whose mood is too variable, or have significant risk issues, or although medically 'cleared' are still experiencing significant effects following overdose so for everyone's sake, it's safer to have trained colleagues with us to do the transfer. Normally these go without incident, but that's not a reason not to do them.

Xf said...

La G

I understand what you are saying and I appreciate your honesty but frontline A&E ambulances should not be used for transfers unless they involve a threat to life.

Any ambulance can transfer a stable psychiatric patient surely? What would a paramedic crew have, in terms of psychiatric treatment, to contribute to the welfare of a mentally ill patient?