Tuesday, 3 March 2009

Kat's night

Does anyone know why these bikes are showing up chained to railings around London?

Night shift: Eleven calls; one assisted-only and the rest by ambulance.

Stats: 1 Allergic reaction; 4 eTOH; 1 Abdo pain; 1 Chest pain; 2 Vomiting. Four of these are no patient contact (NPC).

Kat is a fellow professional from the sticks (sorta) and she was out on obs with me tonight. Even though she didn’t really experience anything different from her home territory (apart from my driving and good conversation), she was taken aback by the volume of stuff we get thrown at us here in London town.

Starting with the 35 year-old female who complained that her skin felt like something was crawling underneath it. She had been using new cream for her general skin condition and it’s possible she was reacting to it. We were right down in the bowels of an underground station and I felt it was safe enough to walk the patient to street level rather than wait forever for a crew to make their way to us. There was no need for emergency drugs – the woman was perfectly stable.

The first drunk of the night was a 50 year-old Polish man who had apparently fitted twice, according to his two very vociferous friends. This was a NPC job because the crew was on scene and all I did was stick my head in the door (not literally of course).

A long and fruitless search of the Embankment led us to our second NPC, a 25 year-old female who’d collapsed and was drunk. The crew found her before we did but that was sheer random luck because the Embankment is miles long and just telling us there is a drunk person on it somewhere doesn't really help.

Abdominal pain, especially low-level pain, can be associated with many things, including exertion, if the muscles of the groin are involved. I think the 30 year-old man who’d had an ambulance called for his acute pain just after he’d visited the toilet might have been overdoing something in there. His flushed, sweaty appearance and rapid heart rate disappeared quickly (as did his abdo pain) when I got there and spent ten minutes on his obs. Obviously, he declined to be taken to hospital.

Drunken middle-aged women are a nightmare. I can only compare them to drunken teenagers in that they become extremely emotional, highly irrational and stupidly paranoid. In a place where learning is God, we found a group of staff members who’d stayed late at the University office for a drink...or ten. One of them, a 50 year-old who should have known better, was lying on the floor with a minor head injury after falling down because she failed to stay upright. Her wailing mate was no help at all and the other one just scattered her intelligence about the room by flitting in and out with no purpose whatsoever. Behind every one of these calls, there are serious life issues.

A NPC for a 46 year-old man who’d ‘just had a fit’ but was obviously able to make the call to let us know. He came out of a callbox on two crutches, for balance or effect – who knows?

Calls from police stations for people in custody are always a bit suspicious. That’s not to say that people don’t get ill inside these little rooms so I’m always wary of supposition. Like this guy – he is suffering chest pain and has his own GTN but it hasn’t been effective. He doesn’t look like he’s having a heart attack but he gets aspirin and a trip to A&E anyway because you can never be too sure about these things.

A French drunk next. He and his mates had been out all day and now he was paying the price – vomiting in the street as the others looked on. He was scooped into an ambulance – his vomit stayed where it lay.

Immediately after the French vomiter, we were sent to an English one. A 20 year-old man lay in a narrow street with six or seven noisy friends around him. He had thrown up quite a large pool of salmon-coloured puke and one of his mates had decided that was a serious sign, until I pointed out that it was food. They had also claimed the man had been unconscious for ‘ages’. He wasn’t when I got there. Kat stayed a few feet back in case the stuff on the pavement meandered to her feet (not a fan of vomit she tells me).

When the crew had taken the young man away I was asked to check on the health of a girl (part of the same gang) who was slumped in a corner, throwing up over her knees. I looked at her, decided she was drunk and told them to keep an eye on her. She giggled and came out with one of the most stupid statements I’ve heard in a while.

‘Oh my God, I’ve had so much Ketomine’, she chuckled.

I think she wanted me to be impressed but I wasn’t and I told her so. I also added that she looked like an intelligent girl and that she should know better than this.

‘It’s so difficult when your best friend is dealer’, she whimpered as if that was an excuse.

I told her that dealers were nobody’s best friends and that the people around her, noisy or not, probably were. That made her cry, so I left her with her friends as she summed up her young life so far.

We watched her as she threw up some more, laughed, moaned and cried her way through drunkenness and when I was satisfied that we were not required there, I got out of the area as quickly as possible.

We get a number of calls with the description ‘having a heart attack’ stuck on there because that’s what the caller said. We invariably find that the patient is not having one and that their English isn’t good enough to describe what they are having and so it’s easier to say the most dramatic thing when calling 999. The trouble is, someone else is probably having a genuine MI somewhere else and you are tied up with a drama queen (or king). And so, when we went into the flat in the early hours of the morning, we were faced with a woman who looked too healthy to be dying. She was in a pose we all know well; it says ‘I’m very, very ill’. I hold it in the same not-so-high regard as avoiding eye contact with me or not opening them at all when we get on scene. Really ill people don’t do these things – they are far too sick to play-act.

‘Her heart is stopping’, the husband says in Arabic as the neighbour kindly translates.

‘No, it’s not’, I said. I’d just felt her pulse and looked at her obs...there was nothing to see here but the woman continued to arch back in the pose of someone in extreme pain, minus the actual pain.

She was waiting for a scan on her kidney and had already been given pain killers for it. As much as I sympathised with her discomfort, tonight, when over 4,500 calls would be taken, was not the night to be dialling 999 when you could wait for the doctor to see you.

The crew arrived and took her away with the same look of disbelief on their faces that I’d been wearing.

On the way back from this call I noticed that one of the back doors had been left wide open on a car parked in the street. On closer inspection it looked like someone had either broken in or dragged someone out of the vehicle – women’s clothes and a hair straightener were lying on the pavement a short distance away. In the early hours of the morning, we found ourselves looking for a possible victim down one of the basement areas along the trail of strewn belongings.

I asked Control to get the police on scene because I wasn’t sure what we were looking at yet – it all seemed very surreal. The small hours, an eerily quiet street and a car with an open door. There was a bag of potatoes on the front seat, personal items in the back seat and, the strangest thing of all, a cassette tape (who uses them anymore?) bearing the title ‘The Twilight Zone’.

When the cops arrived, they confirmed that the vehicle had been broken into, so we left them to it, safe in the knowledge that some girl’s lacy underwear will, at some point, be removed from the street and not left for everyone to see.

One of the most frustrating aspects of the job is being forced to continue to calls that are not going to be emergencies (you just know they aren’t) when, on the way, you have come across one that is. We were halfway to a 32 year-old woman who was ‘unconscious and vomiting’ when we almost ran into a man in the middle of the road who was helping a motorcyclist who’d just come off his bike at speed. His machine lay further up the road in pieces and traffic threatened to turn the incident into something much more serious (not that it wasn’t already) so I stopped the car and got on the radio just as another FRU pulled up beside me. Neither of us had been called to this.

I was ordered to continue to the vomiting lady, despite the fact that a single FRU paramedic was going to be vulnerable and pretty useless in this scenario. I asked again whether or not I was to continue – I gave them more information about the seriousness of the accident and the risk that was present for everyone in the road but I was still told to continue.

Luckily an ambulance and the police showed up just as I left and it’s entirely possible that this had been noticed by Control at the time but it still made me feel pointless in the great scheme of things, especially when I arrived on scene for vomiting lady and a crew was arriving at the same time, rendering me useless as well. Useless and pointless in the same shift - all I'd managed to save tonight was the reputation of a woman, her car and her knickers. Never mind...it's the thought that counts.

Be safe.


Sarah Heacox said...

That's a ghost bike.

It means a cyclist died in an accident there.

Rich said...

They are ghost bikes.

harri carter said...

The white bikes are 'ghost bikes' these are left when someone has been killed after being knocked off them - they are left in tribute and a reminder to all of us to be more careful

hope this helps x

Anonymous said...

The white bike is a ghost bike and marks where a cyclist was killed. There is more at http://www.ghostbikes.org/london and http://www.ghostcycle.org.uk/ amongst other places.

Lucie said...

They are ususally memorials for cyclists that have died there.

ceri said...

The bikes are ~ cyclist gravestones. We leave them on the site of the death of a cyclist.

Little Miss Ileostomy said...

I think the white bikes are to mark the spot where a cyclist has been killed.

Anonymous said...

I think that friends and family of people killed on bikes leave them near the scene.

Kat said...

Heya! Thanks for a good night, it was fun. I was so amazed at the amount of calls you get a day, in total we get approx 450 on a busy day meaning we do about 6 jobs and feel like we havent stopped.You also forgot to mention the ketamine girl's friends singing 'try to make me go to rehab but i say no no no...' as we were leaving. That amused me! :) Bring on the next one!

Dan said...

I was going to explain the ghost bikes, but I've been beaten to it. 8 times already.

rosiero said...

I recently found your interesting blog and have revisited several times. Could you just enlighten me what a eTOH and NPC is, please. I do not envy your job and have witnessed at first hand how difficult it is. I am full of admiration.

Anonymous said...

Alchohol and no patient contact respectively.

lightsandsirens said...

eTOH is an abbreviation for ethanol- the alcohol we drink. NPC is No Patient Contact, as in he wasn't required at the scene

Dan said...

EtOH= Ethyl Hydroxide, aka Alcohol. Refers to calls to patients that are simply drunk.

NPC= No Patient Contact. Refers to calls where because a crew was already on scene, he did not talk to nor treat the patient.

Ethans Mummy said...

Hi Ive linked your blog on mine, will you put mine on yours ?


cheers xxx sam

nb u might like my most recent one..

If u ever have to ask yourself do I NEED an ambulance u NEED an ambulance !

rosiero said...

Lights/ Dan. Thanks for enlightening me!