Tuesday, 27 January 2009

Coughing, not choking

Day shift: Eight calls; all by ambulance.

Stats: 1 DIB; 2 Faints; 1 ?TIA; 1 Cough; 1 RTC with multiple injuries; 1 RTC with minor injuries; 1 Suicidal person.

Plenty of cancelled on the way calls for me today and a few ‘not required’, including an 84 year-old man with DIB. The crew was on scene for that.

My first faint was at an underground station, where a 35 year-old man was slowly recovering on the platform as staff helped him. He’d passed out once before, so this wasn’t new to him but he’d never been checked out properly, so the crew took him for an ECG and on to hospital.

One of my MRU colleagues was with me and when we went back to our vehicles a security guard from one of those cash-collecting trucks had a go at us for parking in the bay that he and his crew mate needed in that location. He shouted at us and I noticed that his van was parked quite dangerously at an angle in the road, almost nose to rear with the motorcycle.

‘We are on an emergency call’, said my colleague but it fell on deaf and ignorant ears. Once again, someone who’s relative was not the focus of our arrival was hell bent on making our morning miserable by giving us verbal abuse just for doing our job. Nice.

I travelled a log way out for the next call, to a 74 year-old man who’d collapsed outside a tube station and had been taken inside by the staff. He was sitting on the toilet in their office when I arrived and he wasn’t very responsive at all. Then he began to lose consciousness, so I pulled him to the floor with the help of an underground bod.

He’d lost bladder control and the tell-tale stain on his trousers made me think that this probably wasn’t because he hadn’t made the loo in time. I did all my checks and came up with a low BP and pulse rate. He was very pale.

I asked for a first aider just in case he suspended on me before the crew arrived; I’d need the extra help, and a lady materialised within seconds, gloves on and ready, if a bit pale herself. Luckily she wouldn’t be needed because when the man’s head reached the floor, he suddenly became alert, almost as if he’d been faking it all.

He was lucid enough to answer my questions and I found that he had no medical problems.

When the crew arrived we took him to the ambulance and he began to repeat the same thing over and over again. ‘I need a crap’, he said. He seemed genuinely desperate to go to the toilet and purge his bowels but we insisted that he should either hold on or just go where he was and we’d clean him up afterwards (its all part of the service but don’t try it deliberately because we know the difference).

During the second set of obs he kept asking to empty himself and it became very odd. I didn’t think his behaviour was normal, regardless of his need to go to the loo. I suspected he’d had some kind of neurological event, possibly a stroke, so he was taken to hospital quickly.

I was asked to call the doctor in charge of this patient later on and he asked me questions about what had happened to him and how long it had gone on. He too felt that the man had suffered a stroke.

A two year-old boy who was supposedly choking required my assistance at a doctor’s surgery miles away but his mum walked him out to the door when I arrived. The doc had ordered a blue light response for this and it was given a Red3. The little boy had a week-old cough but the medic felt he might have a partial obstruction, so needed an x-ray. Even the mother thought I was there to trundle them to hospital and no more. Instead a crew did it. This, in my opinion, was a routine transfer and not an emergency. Sometimes abuse of the service comes from professional sources.

A motorcycle was hit by a taxi and the bike rider ended up on the ground with C-spine tenderness and pain in his ribcage and hip, so he was collared and scooped from the ground, as was necessary. He lost his leather jacket and trousers to our shears but no visible injury could be found.

He was given pain relief and taken to hospital on blue lights in case we’d missed something but I honestly don’t think he had anything more wrong with him than bruises (which were invisible). The speed of impact was low and he had flung himself to the ground when the cab hit. I'd be visiting this exact spot again within a week to scoop another RTC victim from the road.

My second faint took place at a bus stop. The 22 year-old man had a low BP and the crew was already taking care of him when I showed up, so I just took note of the numbers and left the scene.

Up in Oxford Street, where the traffic crawls almost permanently, a cyclist clipped a pedestrian as she crossed the road. She had minor facial injuries and was badly shaken by her experience but she’ll definitely survive.

Just as I made my way back to go home, I got a call and turned around to head for a pub, outside which the police had taken a man into the back of their car for his own safety. He had threatened suicide in the pub and people had taken him seriously enough to call 999. I didn’t make contact with him because I felt the police officer already had his trust and if he was fragile, I could upset the balance, so I waited until the cop told me what was what.

‘I’ll try to convince him to go to hospital of his own accord and if he doesn’t want to, I’ll section him for his own safety’, the police officer told me.

Fair enough, so I waited for the crew and when they arrived I advised them of the plan but it looked like he was going to comply and the fuss wouldn’t be needed. I left the crew to it and headed back on overtime.

Be safe.

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