Day shift: Numerous calls; four worth mentioning.
Stats: 1 RTC with neck injury; 1 fitting; 1 fracture; 1 petrol burn.
A shift on the ambulance today and therefore all of my patients went to hospital in the back. As usual with my ambulance stints, I prefer not to mention all of the jobs, so here are four worthy calls.
A 40 year-old woman, who turned out to be a lawyer, insisted that she had neck pain after a RTC in which her vehicle was side-swiped at about three miles-an-hour (if that) by a large truck. The poor truck driver sat in his cab, worrying about how much damage he’d caused to the car driver, as she winced and moaned in pain every time she moved. Allegedly she’d been on her phone shortly after the accident and didn’t complain about anything until she’d had a conversation with someone on the other end of the line (why do we still say that when clearly there are no 'lines' involved with mobile phones?).
Every opportunity was given for her to tell us she could get out of the vehicle but she was adamant and, as a result, the LFB were called and within the space of twenty minutes she lost the roof of her brand new £40k Mercedes. It was a birthday present. The pavements quickly filled up with people - mostly car-loving men - who watched in horror as this beautiful machine was peeled open like an orange. The fact that there was a potentially injured person inside failed to register with them I think.
Ironically, the damage caused by the truck would probably have cost no more than a few thousand to repair. Still, one can’t refuse a patient’s wishes.
Then there’s the repeat offender in North London who has fits after smoking dope and then gets all annoyed and aggressive when we try to help him. We were called to him twice today and on the first job he wasn’t answering his door at the hostel where he lives. We shouted his name, banged with our fists and did everything possible to get his attention.
His Careline alarm had gone off (he wears a sensor which detects if he’s having a fit) and we were called to assist. He may have been dying inside his room but we just couldn’t get to him.
I tried a window outside and managed to slide it open (one of those sash type things). I could see him lying face down on the bed and I shouted in at him until his feet moved. I couldn’t lean too far in because I would have fallen into the basement below and that would have made my heroic climbing act look dumb. The FRU paramedic, who’d arrived just before us, had an idea though. She brought an old broom over from the garden and used the handle to get the man’s attention by prodding him through the open window. It was funny and practical at the same time.
He got up and opened the door for us and we spent the next thirty minutes arguing with him about going to hospital. He’d clearly had a fit and was still post ictal but he frustrated us with his attitude, which had nothing to do with his epilepsy.
The smell of freshly smoked cannabis permeated the room and it was still strong enough to give us all a buzz if we breathed too deeply, so we worked quickly to get him to agree to go to hospital.
After a good while, he relented and came with us but he didn’t stay long and we found ourselves back at his place later on for some more fun and games.
Children tolerate fractures very well, generally speaking; their bones heal quickly and they can suffer a serious break with very little or no pain. This was the case when I attended a 5 year-old Polish girl on a bus, who’d fallen whilst going down the stairs. She’d landed hard on her arm and broken it mid-shaft at the Humerus (the not-so-funny bone). She sat on the bus waiting patiently for us to come and showed no discomfort or distress, even though she told her mum that it hurt.
I carried her out and into the ambulance, where she took some entonox during the journey to hospital. She didn’t whimper once.
I learned later on that she’d need an operation to bring the bone back into alignment and while I spoke to her non-English speaking mum through her translating sister, I discovered an anomaly with the Polish language. Apparently, to say ‘ta-ta’, you say ‘papa’ and to say ‘papa’ you say ‘tata’. What’s that all about?
If you have a problem with your car and you are feeding petrol into it over the engine it’s probably best not to have someone turning the ignition at the same time. My next patient got burned when his wife clicked the key while he was pouring petrol directly into the engine because his fuel pump was bust. Crazy, really. The spilled stuff ignited and he was flash-burned for his trouble.
‘Yeah, turn it over now….’
‘Oh, wait no, DON’T!’
I think that’s how he said it went before he saw the light. It took 10mg of morphine to stop him screaming.
And back at the hostel with our epileptic drug-smoking friend, we argued again. Another FRU had been called and we arrived to find the patient slumped on the floor. His friends said he had another fit after a smoking session with them. He’d only just been discharged from hospital. This time he was rude, aggressive and very loud about his protestations. If I’d been able to accept that he had capacity to refuse I would have left him at home quite frankly.
In the end the police had to forcibly remove him to the ambulance, for his own good. That shook him up a bit and I felt guilty about it to be honest. It wasn’t my call and I wouldn’t have done that myself but sometimes the good of the patient has to be decided for them and if they are going to be violent (in the absence of capacity) then the police can be very helpful.
I know that he has since played the same game a number of times with other crews. One day he’ll be in real trouble with his condition and nobody will believe him.