HEMS has a new recruit!
Day shift: Six calls; all by ambulance.
Stats: 1 Stabbing; 1 unresponsive person; 1 Broken hip; 1 Cardiac arrest; 1 anaphylactic reaction; 1 Non-cardiac chest pain.
The weather is turning cold now and the week has been busy with ‘proper’ calls – the kind of jobs you get when the winter depression sets in.
Police arrived after the ambulance and me to a 21 year-old man who’d been stabbed in the hand during a robbery at his hostel. The injury wasn’t serious but the assault was and the cops started looking for the assailant as soon as they had a description. It was very early in the morning and I wondered at the mentality of someone who goes around stealing people’s stuff then stabbing them before breakfast.
Lying on the ground in a park was a 30 year-old man who’d been found by the police. The crew was on scene just ahead of me and the man on the ground was conscious, although he couldn’t or wouldn’t open his eyes. It was clear he was keeping them shut deliberately – you can tell by the way the eyelids tense. Nobody knew how long he’d been there or what his problem was but we managed to establish that he was Romanian and probably homeless. He may have been using the system to get a warm bed for the day. To be honest, moan as I do about the abuse of our ‘sponger-friendly’ system, I can’t blame someone for trying to get out of this freezing weather.
I was asked to support a crew on scene with a 92 year-old woman who’d fallen at home and broken her hip. The attendant is a paramedic but is not yet registered, so can’t give drugs or perform invasive procedures without supervision, so I took myself up to the estate where they were and simply showed my face so that the paramedic could get on with her job. It can take weeks or even months for a newly qualified paramedic to get registered and during that time they cannot practice, even though they are perfectly capable.
I had just been cancelled on a Red1, ‘Cardiac arrest’ call because a nearer vehicle had become available when I received a Red2, ‘ineffective breathing’. These calls usually convert to Red1 cardiac arrest and this one followed that pattern a few seconds before I arrived on scene. The ambulance was pulling up with me but the crew hadn’t received the update, so I let them know that it was now a suspended.
Upstairs in the building, a 66 year-old man lay on his back where he’d fallen six or seven minutes earlier after struggling to breathe. Nobody had carried out CPR but there were at least half a dozen people around in the room, which was some kind of office.
I worked with this crew on the hotel cardiac arrest – the one we saved – and I have worked with one of the crew on at least three of these in the past, so we knew the routine and settled into it very quickly. Shocks were delivered, drugs were given and his airway was sorted out when it became difficult to manage, although nowadays my brief is to concentrate on the defib, drugs and fluids. The airway is not as important as it used to be.
A second crew was requested early on but nobody appeared until we were preparing to move the man and he was strapped into the chair. A hysterical relative suddenly appeared and had to be gently moved away and no matter how many times the people around us were told to leave the room, they persisted and hung around the doorway, causing obstruction for us when we wanted to get the patient out quickly.
The second crew helped us to get the man down to the ambulance and we continued CPR all the way to hospital, at one point with me on the floor after I’d been thrown there by the movement of the vehicle.
The patient arrived at hospital in the same condition in which we’d found him and after a few more minutes of CPR, the doctors called it.
If you come across a cardiac arrest and you have any idea about CPR (you don’t have to be trained formally) – please try. If you leave someone lying on the ground for six minutes before anything is done, then don’t expect a survivor. Any CPR is better than none and mouth-to-mouth isn’t necessarily that important (recent research has shown), so start pumping the chest until we get there. I would never forgive you if you let my mother lie there without help for so long.
A car pulled into the pavement just outside the Houses of Parliament and the security people got nervous. Inside was a 51 year-old cancer patient who was having a severe allergic reaction to something she’d eaten. She had a history of anaphylaxis and now she was scratching so much that her arms and neck were grazed and gouged. Her throat was closing and she was panicking when I got to her.
I started her on a nebuliser and was about to give her an injection of adrenaline when the ambulance pulled up alongside. The drug was given a few minutes later when she’d been moved to the trolley bed. Then off she went on blue lights to hospital.
I ended my shift at a restaurant in Leicester Square, where a 25 year-old member of staff was complaining of chest pain. A couple of questions about the nature of the pain and a few basic checks convinced me that the discomfort was probably not cardiac-related. His age and demeanour helped confirm that but once the crew was on scene an ECG was carried out, just in case.
This job was behind my usual stand-by location in this area. I only had to move the car from one corner to another – another ORCON buster. I expect my medal’s in the post.