Sunday, 5 October 2008

The glass woman

Day shift: Nine calls; one treated on scene; one arrested; one declined aid and the rest by ambulance.

Stats: 1 EP fit; 2 Falls - one with facial injuries, the other with multiple fractures; 1 Human collision with minor injuries; 1 Drug o/d; 1 Chest pain; 2 RTCs - one with minor injuries, one with no injuries; 1 Self-harmer with cuts.

A busy day then.

Morning rush hour and the cafes are full of people buying their first cup of over-priced coffee and perhaps a muffin. In one of these places a 30 year-old woman has had a fit and is now lying on the floor with a FRU colleague in attendance. I’ve been called because a ‘Hotel’ (our term for a paramedic) must also be on scene when someone has or is having a seizure, in case drugs are required. The lady was post ictal but recovering and I did nothing but watch and wait for the ambulance.

Then onto the cold streets for a 75 year-old woman who stumbled down a step and landed on her face, knocking two of her front teeth clean out and damaging her nose and mouth. A first aider had stopped to help and when I arrived, her ungloved hand was holding a dressing under the poor unfortunate lady’s nose as it dripped fresh blood.

I had a look at her injuries and checked that she hadn’t hit her head and that she didn’t have any medical conditions that could have either contributed to or been exacerbated by the fall. Her friends were milling around her and I think they had plans to enjoy the day in London (they were all from up north).

Once the bleeding had been controlled, I asked to see the lady’s teeth. They were long and intact. I wondered how such long teeth could come out of such a small person’s gum but I guess at that age nothing holds firm. I asked the first aider, who was keen to help, to get some milk and she went to the trouble of buying some from the local Tesco, which was nice. I transferred a little milk into an empty water bottle and plopped the fangs into it. Hopefully they will remain in good condition and a dentist may, or may not, be able to put them back into their sockets. In the meantime an ambulance arrived to take the lady to hospital.

‘You need to get your injuries checked out at hospital’, I said.

‘Oh, no thank you’, she replied.

There are people who would rather not ‘bother’ the NHS and there are those who, with no reason to, continually harass it. She didn’t want to make a fuss but off she went, after a little persuasion.

Two 6 year-old boys ran into each other at school and the crew and I decided they would live. One had a cut lip and the other had a tiny cut to his head, so I left the crew to it and made my way back to my own area after the long trek south. I teach first aid in a lot of schools each year and the staff are becoming less able to cope with the most minor incidents because they are worried about parents suing them or something. I advocate calling ambulances only where life, limb or skin is at risk, where there is great pain or doubt about a medical condition. Otherwise, if a child bumps his head or cuts his lip, deal with it. A 75 year-old with chest pain needs an ambulance more than a 7 year-old with a bruised leg.

I wasn’t required for the 30 year-old methadone user who’d overdosed. A crew and a MRU were already on scene.

As I travelled back I saw a couple having an argument in sign language. It was heated but you could only tell that from a certain angle. Strange and interesting at the same time.

I had to compete for road space with an Armed Response Unit on the way to the next call for a 40 year-old man with chest pain. Of course, the cops won and I found myself ten seconds behind the ambulance, so I wasn’t required. Cops with guns always win.

‘I thought I was going to go under’, said the cyclist who’d just been knocked off his bike by a bus. He was shaken but, apart from minor cuts and bruises, unhurt. The whole thing was witnessed by a loud and vociferous woman on the pavement. She insisted on relating the whole tragic tale of how the bus driver was entirely to blame and how he didn’t even look before cutting in on the poor unfortunate two-wheeled man. ‘Don’t listen to her, she’s drunk and she’s mad’, the bus driver told me. I didn’t know if he knew her personally or this was his bizarre way of getting out of trouble. Perhaps the International Bus Driver's Manual states that, 'should a person accuse you of bad driving, they are probably drunk, mad or both because there is no way that you can be to blame'.

However, that particluar road, on a very busy intersection, is notorious for cyclists who speed through the red lights, crossing moving traffic. Even as I stood there, with the bendy bus practically parked in the middle of the road and my vehicle positioned so that a block was created, cyclists and moped riders were attempting to scoot through the small gap left between our vehicles and the barrier. It was ludicrous.

Last week at this very same junction a cyclist was crushed to death under the wheels of a lorry. There are still signs up in the area notifying everyone of the ‘fatal collision’ that took place. I was working in the control room when I saw the call come in; ‘person lying on the ground. CCTV confirms he is not moving’. Multiple calls came in for it and one person, cycling to work, never made it.

Clearly, the danger for cyclists is extreme enough without some of them increasing the risk by riding around like lunatics.

My next call cost me an hour but it was needed. An 83 year-old lady had fallen on an underground train and she’d broken her leg apparently. A medical student was taking care of her when I arrived and the train had been kept waiting, full of passengers, on the platform until I got there.

The lady was in pain and, after clearing the carriage of people, I examined her leg, which was being kept still by another passenger who’d volunteered to help. The entire limb wobbled like jelly below the knee and it was clear she had broken both Tibia and Fibula at the joint. She also complained about arm pain and I found a fracture at the distal end of her Humerus too.

The train had pulled away from the platform, a movement that usually starts with a sharp jerk and the lady had lost her balance and gone over onto her left side, landing hard on the floor. She fractured like she was made of glass and only one disease fitted the bill for this scenario; osteoporosis. I managed to get her friend, who was travelling with her, to confirm that she had ‘brittle bones’ as the crew arrived, along with the British Transport Police and more tube staff.

As the crew helped with pain relief and splinting, I asked to have the next carriage cleared because people were still peering in at the poor woman as she lay on the floor. I had cut through her tights in order to examine her leg and her dignity was already at risk. The police completely cleared the train however and as we developed a plan for her removal (no escalators or lifts at this station), the entire station was shut down, causing chaos I would imagine, with mid-afternoon travellers.

Once the lady’s pain had been controlled and her leg and arm splinted, we carefully moved her onto the chair (her leg was supported by a police officer) and we carried her all the way to street level using the stairs. It was an awkward and clumsy lift but we reached the outside world and were greeted by the sight of dozens of people standing patiently behind the entrance barriers. I understand the frustration that many of them felt – we had probably upset a lot of timetables but I heard no complaints and saw no aggrieved faces. If you were one of the people waiting for us to take this lady out of the train, thank you for your tolerance. Thanks to the police officers who helped. All in all it was a good team effort and made my day worthwhile.

The lady’s injuries were confirmed later on.

An assault turned out to be a case of self-harm. A drunken 25 year-old man was seen staggering around Victoria with blood dripping from his hands, so I was sent to check it out and cautioned to wait for the arrival of the police. The area around Scotland Yard is very sensitive and its not hard to find a gun-toting cop, so I wasn’t surprised when more than a handful of uniforms appeared for this one man. He was surrounded by at least eight officers and had two restraining him in cuffs because he was more than a bit feisty. His hands had been cut open by a ragged, sharp lager can that he’d ripped open. He had walked along the street carving it into his mittens until they bled from lacerations on the fingers and palms.

A police officer had already bound one hand up and I looked at the wounds, determining that they weren’t serious. The crew was on scene with me and the attendant decided the injuries weren’t worth taking to hospital – the police had arrested the man and were happy to continue his journey to jail instead of hospital.

At a junction in Knightsbridge, a van flashed a motorcycle and vice versa. The confusion caused by both signals meant that each driver, thinking he was being given right of way, moved at the same time, colliding at the centre of the road. The biker was dragged underneath the van and the front wheel of his machine was crushed and bent by the force. He, however, survived and when I got on scene he was standing on the pavement, mobile phone in hand. He’d refused the help of the FRU pilot who had arrived before me and there were no other casualties.

I helped a police officer to move the motorcycle off the road but because its wheel was bent, the heavy vehicle was difficult to manoeuvre, so my FRU colleague helped. He forced the handle bar on one side down in order to straighten the wheel but this meant that the bar I had my hand on was forced up and into the broken visor section, crushing my hand and cutting it open. I had to yell twice before he realised what he was doing. It hurt, I can tell you. Thus, I finished my shift and went home injured in the line of duty. Not that this washed with my DSO when I jokingly tried to use it as an excuse to stop early.

Be safe.


Anonymous said...

I wish that ungloved didn't make me think of degloved, which makes me feel nauseous.

Alex said...

I'm a cyclist in London and agree, sometimes fellow cyclists are to blame for their injuries but at teh same time it is occasionally safer to jump the lights then it is to stay and have motorbikes and taxis racing off the lights behind you or swiping your as they turn left. Until the road laws change to accommodate the increasing number of cyclists in our cities sadly I think you'll be attending more accidents/fatalities involving cyclists.

MarkUK said...

The myth that adults, particularly teachers, can't put plasters on kids' cuts seems to persist. The Health & Safety Executive have even included it in its "Myth of the Month" series.

As a Safety Officer who lives in the real world, I'm getting to like the HSE and professional safety organisations more and more - they've come into the real world too.

Unfortunately, enough of the myth still exists to make teachers and other school staff feel reluctant to treat even the most minor injury or illness. Mind you, they should be perfectly capable to do so in the eyes of many parents. According to Frank Chalk teachers are now supposed to be able to diagnose appendicitis!

Anonymous said...

Can you explain why it was felt that the guy who had self harmed so dramtically was better off with the police and in jail rather than hospital to dress the wounds and get a psych assessment?

Little Miss Ileostomy said...

Typical that you were in my neck of the woods when I'm not at work! For a mainly office area we have our fair share of "odd balls" wandering up and down Vic Street.

Shame it wasn't Friday, you could have seen Mandy arrive!


Xf said...


Although I don't agree that breaking the law is excusable on the basis of your argument (otherwise we could all run red lights), I do agree that the roads are very dangerous for cyclists.

London will never become a two-wheeled Utopia, so something else has to be done to protect vulnerable vehicles and their riders.

Xf said...


Yep, I spend a LOT of time convincing teaching staff that some of what they hear is rubbish, like the 'you can't check a pulse with your thumb' fantasy.

These comments are often made by people who simply haven't thought out what they are saying.

Xf said...


The guy who had self-harmed would be seen almost immediately by the police's own doctor. He wasn't injured enough to justify the risk of taking him to hospital. His wounds were re-dressed by me and he was cleared by two paramedics on scene. That is enough for the police.