Tuesday, 14 April 2009

DIY throttling

Day shift: Seven calls; six by car; one by ambulance.

Stats: 2 Dislocations; 1 Unwell adult; 1 D&V; 1 Back pain; 1 BPV; 1 Vomiting.

Sorry again for being a little behind on the writing. I am trying to catch up now so expect a few posts in the next day or two. I've been teaching recently and the last school I visited (in Gloucester) was one of the nicest I've been to. A beautiful setting for it and the staff were so friendly and welcoming. That's not to say that other schools I've been to aren't great but there was something special about this little lot - they all got on and you could tell they loved their place of work. The kids must be happy. Oh, and thanks to fidgeting Gina for the coffee :-)

A 31 year-old rugby-playing banker-cyclist fell off his bike, dislocating his shoulder and one of his fingers. He sat on a small wall with a police officer until I arrived. He didn’t complain once, despite the fact that he was in pain. He told me he was used to this kind of injury and we chatted about the banking world (and how I hate it) and the current crisis as I drove him south of the river to hospital.

My handover to the nursing staff was semi-absorbed because the ladies couldn’t take their eyes off this six foot and extremely well toned man. He probably got special care and attention when I left. He also probably forgot to tell his bosses (he works for the bank I'm with) to get off my back.

I called an ambulance in for my next patient, a 94 year-old man with a high BP, low BM and hypothermia (the probe simply read ‘LO’). He didn’t want to go to hospital and his on-scene carer couldn’t persuade him, so I hoped the crew would have better luck because leaving him at home alone wouldn’t be an option; not that we could have forced him to go of course.

He’d been found in his armchair with everything strewn around the floor, as if he’d fallen and dragged himself back up. His ankles were very swollen and his breathing wasn’t too great. Even when he tried to convince us that he could move around he failed because he couldn’t get himself out of the chair.

Luckily the male-female crew managed to change his mind (I think the female had more to do with it).

Unlikely friendships develop between elderly and not-so-elderly people I find and my next call took me south to a small flat where an 86 year-old man had vomited. His much younger friend (by about 30 years) was on scene and told me that he thought a reaction to medicine was to blame but after looking at the patient and finding out a bit more than was given to me by the initial descriptor, I had to assume food poisoning was to blame (probably).

The man was lying on his living room floor; he was very pale and a large pool of vomit (more of a mound really) was freshly deposited next to him. As I sat the man up and lifted him onto his sofa I deliberated whether or not to call an ambulance or take him myself. I decided he was too sick to risk taking in the car but was told that no ambulance was available.

After further obs and an improvement in the man’s condition I thought the risk was now less and I could take him in the car, so I got him ready for the trip and cancelled the ambulance (there wasn’t one coming anyway).

Meanwhile his friend mopped up the thick vomit with toilet paper (and unprotected hands). ‘What’s this you’ve been eating – porridge?’ he quipped. I thought that was a sign of real friendship (the vomit mopping, not the quip).

The trip to hospital was uneventful and the man’s colour had returned to his face by the time we got there.

Lifting a heavy door when you already have a bad back is probably not a good idea. My 35 year-old South African patient was working on replacing doors in an office when he fell victim to his own self-confidence. The pain was severe enough for him to need Entonox for the whole (long) trip to hospital through rubbish traffic. He was nice to chat to though.

Off to a dance studio (where young females prance around in skimpy clothing, so a nightmare scenario for me obviously) to tend to the knee of an injured 24 year-old who had a history of dislocation during practise. Now she had the same problem again, only this time her naughty knee popped back in after insulting her mid-routine. She too needed Entonox and that sorted her out almost immediately; some people just love the stuff! I drove her to hospital while she and her friend sat in the back of the car discussing how flexible their friends were. Nothing to put me off driving then.

My next patient sat in the back of the car with her husband, accusing him of leading her into a life of drugs before attempting to strangle herself. They’d both been waiting for me in the street – the call had been made for a female bleeding PV, which she confirmed when I arrived, although the connection between that problem and her alleged use of Heroin for the first time eluded me. Basically the conversation switched between the BPV, her hostility towards her husband and a story about a man who gave her class A drugs. Somewhere in the middle of it was me, sitting at the wheel wondering what the Hell I’d got myself into.

I warned them both that any further misbehaviour (like the strangling routine) wouldn’t be tolerated and off we went – quickly. I was already committed to taking them so I wanted to get rid of them rapidly; they caused me a lot of concern. There's nothing more bizarre than watching someone attempting to strangle themselves in broad daylight after accusing a spouse of getting them hooked on dangerous drugs whilst simultaneously suffering from a potential miscarriage.

I was called to my first blind man today. The 29 year-old lives alone in a council flat and he called an ambulance because he’d developed a right-sided headache that just wouldn’t go. He was also vomiting. The call descriptor read ‘vomiting blind’, which initially had me thinking I was going to a seriously drunk person - someone who was so damned drunk and throwing up so much their eyesight was lost.

I walked in to his home and he was lying on the sofa. He was the saddest looking man I’ve seen in a while and my heart went out to him as he struggled to tell me what was wrong. His obs were normal but that doesn’t mean anything; the whole one-sided headache thing is worth looking into.

He walked down to the car with me, cane in hand, and we travelled less than a mile to hospital. He didn’t say a word. He just sat in the back with his headache and his worries. A young life shouldn’t have those burdens. A young life shouldn’t be blind - or suffering anything for that matter.

Be safe.


ShelaghG said...

It's probably shallow but I always feel a pang of envy for those you describe getting such happy relief from entonox. I tried it when I was having my son, took a couple of deep puffs as insturcted by the midwife and was promptly spectacularly sick! That was the end of that, I was so disappointed :(

MarkUK said...

You posted:

Off to a dance studio (where young females prance around in skimpy clothing, so a nightmare scenario for me obviously) to tend to the knee of an injured 24 year-old who had a history of dislocation during practise.

I'm H&S Officer at a school (and lead first aider). We had a similar incident with a 16yo girl giving her GCSE choreography a run through.

When I got to the theatre, she was sitting up with another first aider in attendance, and the RRV had just turned up. (Why?) She was in no great pain but woe betide anyone who got within 18" of her knee!

When the crew turned up she was put straight on to Entonox, which I told her she'd like.

No kidding! I don't think I've heard anyone get so giggly on the stuff. When she'd been vac splinted, time came for her to be helped on to the trolley, so she was told to take a few really deep breaths.

"Hey, this stuff is great - it's just like being drunk". "How do you know?" said the paramedic, "You're only 16"

Yeah, and at 16 he didn't know?

Luckily she's not wanting to take dance any further than GCSE, as I've advised she doesn't do any more - she had a similar problem last December.

Si said...

Hi mate.

Hope alls ok? Which school in Gloucester were you teaching at? I live in Gloucester but studying on the Paramedic Science course else where.

Keep up the good work!

Xf said...


Aww...you win some...


Xf said...


Woodside. A lovely little place in the hills.

Si said...

Ah, If it's where i think it is (out in the forest by Ruardean), it's a lovely area!

Would be beautiful to work out there!