Sunday, 15 March 2009

Slippery customer

Night shift: Eight calls; one assisted-only; one no-trace; six by ambulance.
Stats: 1 Drug o/d with head injury; 1 Hypoglycaemic fit; 1 eTOH fall with head injury; 1 DOAB; 1 eTOH; 1 RTC with head and chest injuries; 1 Rash.


On a corner of a street near The Oval, four men were holding a tall, wiry man down on the ground as he struggled against them. I had arrived after a short delay during which I was completing my VDI and I fully expected an ambulance to be here, if not nearby. The man on the ground had staggered and fallen onto his head, cracking it open. He’d fallen earlier and further down the road, according to a witness, so he had multiple head wounds and blood was spattered here, there and everywhere. The men holding him down were doing it for his own good because he was clearly off his nut on drugs.

I spent twenty minutes struggling with him too – the men (and one woman) stayed with me donning gloves I had issued to each of them, so that I could maintain control of this very strong and seriously damaged patient. We all got a little bit of his blood on us as a reward – he spat and sprayed it all over us but I was very thankful for the help because I would have been no match for him on my own in this dark little street.

I had requested police help as soon as I knew he was going to be a handful and they arrived very quickly to take over from my helpful MOPS. ‘Shall I cuff him?’ one of them asked me. ‘No, not unless he becomes a real danger’, I suggested. He was difficult to handle at times but he didn’t deserve to be restrained with cuffs.

The crew arrived after a short time and we loaded him onto the trolley but he wouldn’t have it. He struggled and screamed and tried to get away and I was very uncomfortable with the process. I don’t like being forceful with an injured person but I knew it was the drugs (whatever he’d taken) that were affecting his mood – or the head injury, which could also cause this aggression.

I gave him Narcan in one of his quieter moments (he’d slip into unconsciousness every so often) but it had no affect and I stayed in the back of the ambulance as we ‘blued’ him into hospital.

He was taken into Resus, where he started to thrash and fight again until slipping back into unconsciousness. The medical staff took a small bottle of liquid from his pocket and handede it to me. I opened it and smelled it – it was GHB, so now we knew what he’d been taking all night.


In the fashionable Riverside area, I attended a 60 year-old man who was lying on the floor of a restaurant, recovering from a hypoglycaemic fit. His BM was normal but that was probably because he had eaten 15 sugar lumps and a couple of glucose sweets when he felt ‘low’, according to his friends on scene. He hadn’t been fast enough to save himself from a seizure but he had managed to get his own blood sugar level up enough to get through it without compromise or intervention from me.


The St. Patrick’s Day celebrations spawned a number of drunken people tonight, including a 75 year-old Irish man who collapsed in front of a rubbish bin and cracked his head. Police were on scene just ahead of me as I waited for an inconsiderate private taxi driver to unblock the road so that I could get near him. He was conscious and adamant that he was okay but his bloodied scalp was making contact with the filthy bin as he leant against it and he was in danger of contracting a nasty infection, if nothing else, from his fall, so he was persuaded to go to hospital when the crew arrived twenty minutes later.

During the time I waited with him and his now bandaged head, he ranted about the state of the country – much like I do – and set about putting the world to rights. It was an interesting one-way conversation.


A DOAB next and this one was quite aggressive to start with. The drunken Polish man refused to budge until I had actually requested police assistance, then he stormed off the bus.


There was no trace of the supposedly verbally aggressive 45 year-old man who had collapsed outside a pub. He had picked himself up and gone, which was a relief to be honest.


I have dealt with a number of ‘bleeding from penis after intercourse’ calls and was about to set off on another when I was cancelled for a nearer vehicle, probably crewed by two females.


Near the Meat Market, in the very early hours, I was directed to a man who had slumped in a doorway and then slid down onto his face. He was lying in a pool of his own vomit and I approached him with a view to getting him up and walking him off if possible. He ignored me to begin with and then smiled, blew a long raspberry and fell asleep again. The 30 year-old child had to be man-handled into the ambulance because he wouldn’t or couldn’t move. His wallet was lying next to him on the ground and I am surprised it stayed there all the time he’d been out – it might have taught him a lesson if someone had relieved him of it.


Near the end of my shift I was called to a RTC involving a car and a tree. The vehicle was a mess and smoke was billowing from the engine when I arrived but the female driver was out and standing nearby with other people, one of which was her friend who’d been driving in another car behind her. She’d watched as her jet-lagged mate (she’d just arrived on a flight from New York), swerved suddenly on the empty road and careered into a tree without braking. She’d obviously fallen asleep at the wheel. In fact, as she was being prepared for the board, she closed her eyes on more than one occasion in an attempt to continue her rest.

The pavement was littered with debris from the wreck; the impact had been ferocious. I had asked for LFB attendance and expected one truck to arrive but they must have been bored because four fire engines turned up for this. All that was needed was a safety check and an oil spillage to be cleared up.


Some places feel unsafe as soon as you step foot in them. A man who’d called an ambulance for a rash on his groin (he’d had this for 24 hours and it wasn’t itching or burning) opened his door to me and I instinctively felt unsure about going into his flat. His behaviour and mannerisms were suspicious – he was covered in what looked like oil, although he told me he’d had a shower and shampooed his body. A knife lay on the floor beneath the chair, where he sat and exposed his groin area for me to inspect (not a request I’d actually made). The floor of the place was also slippery as if grease had been put down and I found my footing a little less sure than normal.

The call descriptor had stated that he was ‘very quiet’ on the phone and he was whispering most of the time as I attempted to get details on why he needed an ambulance for what looked very like a sweat rash caused by his clothing. The hospital was literally two minutes walk from where he lived, so the whole 999 thing was unnecessary.

He didn’t pose a direct threat to me but there was just something about him that made me uneasy – loners in slippery flats with knives on the floor tend to do that when you work solo at night.

Be safe.

3 comments:

Benj said...

I understand your comment about the LFB turning up in force!

I was travelling home one day, and came across a window box fire. The box was part of a flat above a hairdresser's.
IThe fire was fairly but as the owner was obviously out I decided to call LFB as the flames were getting steadily more ferocious.
I distinctly said on the phone that it was just a small window box fire...
So imagine my surprise/delight/horror when 2 pumps turned up, closely followed by the Major Incident/Hazmat Unit.

Anonymous said...

Why so against Calpol? I give it for teething pain, so the baby and I can both get some sleep. Is paracetamol really so damaging that it is a bad thing to avoid a night of her crying with pain every hour or so?

Xf said...

Anonymous

I was talking about its routine use for ferverish children...not pain.

And to answer your question fully, read this article...

http://www.australianprescriber.com/magazine/23/3/60/1/

Paracetamol is okay for things like pain reduction BUT we are encouraging our kids from a very early age to use drugs routinely.

I am against it and have never used any drug for my child when he was growing up. He went through pain and fever and learned how to cope with life. But that's my way...you and millions of others have to decide, using good evidence and comon sense, what is good for your own child.