Sunday, 19 October 2008

Fragile

Night shift: Nine calls; one declined; one assisted-only; the rest went by ambulance.

Stats: 1 Assault with head injury; 1 ?Fit; 1 Unwell baby; 2 eTOH; 1 eTOH with Head injury; 1 eTOH with Facial injury; 1 DIB.

I took my first call without knowing what I was going to. This happens when a call is still in progress and FRED gets a bit over-eager to stop the clock. We get despatched with the address only and we are expected to run until further details are available. Unfortunately, on a number of occasions, I’ve arrived on scene before being updated with said details, so getting outside a dodgy housing estate and then seeing the words ‘do not enter premises – murderer inside’ can be the closest of calls. Okay, I’m only kidding about the example – there was no murderer and I’m sure my colleagues in the bunker would call me and give me the heads up, wouldn’t they? Still, my point is made.

So, I arrive and it’s an assault – a 40 year-old man has been hit over the head with a bottle. He’s very agitated, as you’d expect from a decent head injury but his shoulder is injured too and he complains loudly when it’s touched...or even looked at. The crew take him away, gingerly persuading him to do the walking because he won’t allow any sort of assistance.


Another call for a warm bed I think on the next job. A 35 year-old man claimed to have had two fits outside a bus station but he’s not epileptic and shows no sign whatsoever of having had a very recent seizure.

‘Did anyone witness your fit?’ I asked.

‘Yes, my friend did.’

‘And where’s your friend.’

‘He got on the train and went home. He said he’d send some money through the bank for me tomorrow, ‘cos I’ve got nothing.’

So, not a very close friend then, I thought.

The man was clearly on the street and needed a place to lay his head. It’s cold tonight and I don’t blame him. I just wish he’d be truthful with me.


On to a premature baby that’s being fed via a gastric tube and has been vomiting. Mum is worried and there’s a crew on scene when I arrive. I hear the story of this little mite’s problem birth and the host of medical issues that are currently cramping her life and I feel like crying. I do the BM and her little foot keeps bleeding, regardless of the pressure I put on it. I feel guilty about this and eventually, after five minutes of pressing and re-pressing, she stops leaking. Now I can go without feeling that I’ve added to her misery.


A 61 year-old woman who was ‘shaking badly’ had nothing wrong with her and her family gathered around the bed as she jerked about for no reason. It cost an ambulance before she declined any aid because she’d been exposed. I will never understand why people do this to us.


If you call us don’t expect to be taken to the hospital of your choice. Like the 54 year-old alcoholic who’d had a ‘disagreement’ at the local hospital and now wanted to be taken to another one, miles away. He complained of vomiting blood but there was no evidence of this and he’d been waiting in a callbox for me to arrive. I left him and his insistence with the crew. I'd been a target for the local louts in this estate before and I thought better of sitting around while they armed themselves again.


Another drunken person, a 22 year-old woman, fell off her bike and ended up being collared and boarded by us when we arrived. She had fallen hard enough to do damage to herself – now she had neck pain. She was also drunkenly agitated, which makes things a lot worse to manage.


Still on the drunken scene, a 68 year-old man was found collapsed after falling and hitting his head on a wall by passers-by, one of whom was a ‘qualified first aider’ and who insisted that he had ‘a right to be there’ even though I hadn’t actually spoken to him - nor had I challenged his rights to do anything. The man on the ground was very, very drunk and was miles from home but he refused to go to hospital and gave the crew a hard time. He stormed off and became my next call when he was found lying in the middle of a busy road with fresh injuries to his face, after repeating his previous performance. This time, however, he was lucky not to be killed.

Again, I got abuse from a person in the know, when I proceeded to get the patient off the road and into the ambulance without collaring him. I knew he’d just fallen because I was told he’d just fallen – he hadn’t been hit by a car and hadn’t crashed down from a height but that didn’t stop another bystander from shouting at me and describing to all and sundry how I was doing it all wrong. They'd never do it that way on the telly.

Next time, I’ll wait in the middle of the road, struggling with a drunken, combative patient as I put a collar on for no reason and get me and the patient killed by a passing car/truck/bus/bicycle. That’ll teach them!



In the early hours I was called to an emphysema patient who had DIB. He was standing outside his flat, leaning against the railings. He’d been asked politely not to move but he’d insisted. I had to shoo him back inside and carry out my obs while he recovered from the distress of moving when he had very little oxygen to keep him going. His flat smelled strongly of fresh paint but he denied he was doing any decorating – the doors were off their hinges and the place had paint lying around (big clue). Fresh paint fumes are never good for those of a clinically fragile pulmonary disposition. His sats were dreadful but as soon as he went back on his home O2, they improved. The crew took him away to hospital and out of the danger zone. He was, all in all, a thoroughly nice chap.

Be safe.

3 comments:

the black papillon said...

oh dear me... a little knowledge is a dangerous thing. if you got your 3 cross award at school or your first aider badge at brownies suddenly you're a brain surgen *shudder*

one of my friends has a couple of mental health problems which, to her eternal credit, she has battled through succesfully for a number of years. her (now estranged) mother took a psychology course with the soul purpose of proving that my friend was making it all up and that all the doctors who had seen her and helped her were wrong and a waste of time. nice.

ho hum.
take care
sarah

Hugh said...

at last the media has caught up with what you've been reporting for a while

http://www.guardian.co.uk/society/2008/oct/21/nhs-health-mrsa-superbug

Tabitha said...

It still shocks me every time I read this how much of your work is dealing with the drunk.

And is it just me, or is London traffic rather stubborn when it comes to moving out of the way for an emergency vehicle? I was at the Chelsea Embankment/Battersea Bridge junction a few days ago. The lights were about to turn green, an ambulance was speeding down the road from the left, lights and sirens going. The green light came, and everyone started driving off, despite the fact there was clearly a need for them to stay put until the ambulance had passed.