Day shift: Four calls; one declined; three by ambulance.
Stats: 1 COPD with SOB; 1 Unwell adult; 1 Abdo pain; 1 Hyperactive person.
There’s no frost on the ground but it’s very cold and an unkind wind makes life miserable outside of a warm stab vest. Oxford Street and Regent Street have been closed to traffic all day, so that's going to cause chaos. Plus, just to amuse me, they are digging up bits of road all over the place, coning them off and going home for tea...what's that all about?
As usual with a Saturday morning, the first call is early on in the shift and it’s a 64 year-old Glaswegian man with COPD and SOB. He’s rude initially but that’s because he’s having a lot of problems breathing, so his abrupt attitude is forgivable.
‘Come in!’ he yells when we knock at the door (the crew is with me on this one). We’re already half way in and at least we know where he is. ‘I’ll answer your questions when I get oxygen’ he complains between wheezy breaths.
A quick neb and some patient care and he’s able to pull himself onto the chair for the two-flight trip to the ambulance. I leave the crew and get on with the rest of my day.
Three vehicles arrived up for a ‘chest pain’ that turned out to be an 80 year-old Italian lady who was generally unwell. The MRU, ambulance and myself arrived one after the other and we ganged up on her in the little bedroom where she lay. She wasn’t in trouble and there was no need for all of us to be present but it was nice to see and catch up with old friends from my previous life in Islington.
When my MRU colleague and I went back down to our vehicles we were greeted by an almost-spitting mad woman whose car had been inadvertently blocked in by us when we arrived. Our blue lights were on, so we were advertising an emergency but she didn’t care and ranted about how selfish we’d been…only thinking of our patient instead of others. I found that comment quite incredible.
The fact is, we couldn’t have parked anywhere else because the road did not allow for it – we had no choice in the matter and we never deliberately set out to ruin your day when we arrive on scene. We’d rather not be there quite frankly.
I asked the lady how she’d feel if it was her mother we were attending to. I got no answer and a dirty look. If there’s a letter coming, it won’t be a thank you note.
To help out, my colleague jumped in the ambulance and drove it down the other end of the road, where he assumed the crew and patient would exit the building (and I suppose to defuse any other angry driver nonsense we may be risking). The crew, however, were on top of the steps just behind me and now they and their vehicle were parting company fast. It was quite funny to watch.
I managed to catch the attention of my colleague all the way down the end of the road as he began to helpfully lower the rear ramp. He realised his mistake and u-turned to get back to us. The patient was fine about all of this as she waited for the return of the vehicle. I told her it had been stolen and a replacement was coming and that seemed to make her smile long enough to cover our tracks. It was very amusing.
Abdominal pain is one of the most common types of call we receive on a regular basis. For some it’s nonsense…for others its agony. My next patient, a 23 year-old woman with IBS lay on a sofa in the basement of a restaurant, writhing about in pain. She was on the first day of her period and had just gone to the toilet when the pain struck. I spent more than half an hour with her, her friend and a member of the restaurant’s staff, as we waited for an ambulance. The closed roads and thoughtless road-works were slowing down the response to calls in this area and my patient’s pain wasn’t getting any better.
She vomited violently a few times and I gave her morphine to help her cope. It had to be done in almost total darkness because the cellar’s lights didn’t glow any more than above 10 watts (it’s a night club). Cannulating in those conditions is problematic, so my little pen-torch was deployed and I had the manager hold it over the girl’s arm. This time, I was accurate.
When at last the crew arrived, she was much more comfortable. I usually employ a simple test to confirm that the morphine is working (with females only I should add). I ask if the pain score has gone down and if I look more handsome. Obviously a positive answer will verify that the patient is delirious and thus the drug is working.
On the way out to the ambulance (she was now able to walk with support), she wrapped herself around me to keep warm and I found myself supporting her in a hug as we slowly made our way to the vehicle. She wasn’t shy, that’s for sure. I felt a bit awkward but then I shrugged it off; this was my job and she clearly trusted me, so her proximity for heat and comfort was part of the care package.
I was just around the corner when a call came through for a 40 year-old woman who was ‘feeling faint’. A quick trip to the underground station and I was briefed by a staff member before I’d set eyes on the patient. She was in the little office and told me she had ‘felt strange’ all day. She was wobbly on her feet and very jumpy when I touched her. She was definitely wired.
‘I don’t suffer from anything but I feel weird – it might be all the Red Bull I’ve been drinking recently’, she said, calm as you like,
‘How much have you been drinking?’ I enquired.
‘At least five cans a day’.
‘With or without vodka?’ I cheekily ventured.
Some nuts don’t need to be cracked; their shells just fall off during interrogation. She went on to tell me that she had been under stress recently and that the Red Bull (sometimes with vodka) had been her coping mechanism. Fair enough – better Red Bull than cocaine or Heroin, right?
Once the mystery had been figured out and the crew had checked her over thoroughly (all my obs were normal), she was allowed to go on her way with advice to cut down on all stimulants until she’d flushed them out of her system. She hadn’t wanted to go with the crew to hospital anyway…and she didn’t need to, clinically. She’d probably fly home now...