Friday, 22 May 2009

In excess

Night shift: Eleven calls; one treated on scene; two assisted-only; two conveyed and six by ambulance..

Stats: 1 RTC; 1 Asthma; 6 eTOH (most with head injuries); 1 Cut lip; 1 ? Drug overdose.

It’s Friday night, the weather’s warm and it’s a Bank Holiday weekend – obviously a recipe for disaster and upward of 4,500 calls says it all. Happy holidays and alcohol mix to give us a subtle blend of work, work, work. Hey ho – it’s a living.

But I started with a short-lived VDI check when a call came in for a RTC in which a motorcycle had collided with a bicycle. I requested a delay because I had barely sat in the car and wasn’t quite ready but the call was upgraded to a Red1 – apparently a 12 year-old boy was in cardiac arrest on scene. So, I set off half-checked and made my way to the place where this dead boy was supposed to be.

I got there and a crew was on scene. They were dealing with a very alive young boy of about eight or nine. He was lying flat in the road and a few women were milling around anxiously; one of them was his mm.

He had been hit at 30mph by the motorcyclist when he and his friend had allegedly darted out on their cycles, straight into a busy road, from their estate. The motorcyclist managed to swerve away from boy-rider number one, but hit boy-rider number two. Both of them (cyclist and motorcyclist) went flying. I was asked to attend to the 49 year-old man who sat against a wall looking worried (he still thought the boy had been killed).

I examined him, reassured him and went back and forth doing errands wherever I could. He had an injured scapula, so I put a sling on him and waited for a second ambulance to convey him to hospital. I waited and waited.

After a delay and by this time the boy was ‘packaged’ and ready to go, I decide to take the injured motorcyclist in the car. He was in pain but stable; he had no neck injury and complained of nothing else. He agreed to get into the back seat and I sped behind the ambulance as we headed for the hospital on blue lights.

There had been a bit of a crowd of people around the scene and I don’t think the motorcyclist was popular, so it was best to get him clear of it sooner rather than later.

Next on the menu, a 68 year-old man having an asthma attack at his hostel. He’d recently been diagnosed with a chest infection and his inhalers had brought some relief but not enough, so I nebulised him until the crew arrived to take him away.

The first drunk I encountered was described as ‘incontinent of urine’ outside a pub, which kind of says it all. The 52 year-old man was with people he had befriended earlier in the evening when he started his drinking binge. He told me he had bowel cancer and was trying to forget through booze. Fair enough. He became tearful at times and his mates were very sympathetic and helpful. One of them, a tall woman in her fifties decided she wanted to marry me and landed a kiss on me as I stood in the road signalling the ambulance in. The crew were highly amused and as the man was taken into the ambulance, my new girlfriend pawed at me some more for attention. I bid my farewell as hastily as I could because it was all getting embarrassing and I’m quite shy really…ask anyone.

A call to a 25 year-old woman who lay on the pavement until I arrived then miraculously became conscious, left me standing with the security men as she walked off in a huff with her equally drunk father. ‘Nobody cares about me!’ she shouted over and over again. Dad seemed unfussed. I wondered why on earth she’d think that.

No patient contact (NPC) for the 30 year-old pregnant woman who fainted. The crew was on scene and I wasn’t required.

A Green call to a 26 year-old woman who’d cut her lip and it ‘won’t stop bleeding’ led me to a no-trace because she was nowhere to be seen. Then she approached me with her friends (all drunk) and her boyfriend insisted that I take her to hospital. She had the world’s smallest incision on her lip and it had stopped bleeding long ago. The only way it would seep again was if she smiled too much, so I stuck a strip across it to close it off and she was happy to continue homeward. Her boyfriend wasn’t pleased because, as he eloquently put it, ‘I won’t get a shag now’. No, I thought… you probably won’t.

Sometimes only a few drinks can cause problems with your body and you end up wobbly-legged and in and out of consciousness. I explained this to my latest friend, a 30 year-old woman who definitely looked much younger, as she lay in her hospital bed recovering from her little adventure in a club toilet a few hours earlier.

She had been knocked over by a guy in the club and fallen onto a table, where she was knocked out for a minute. He didn’t bother to check on her or offer to pick her up. He didn’t even apologise apparently, so her friends took care of her and I found her in the loo with a very small cut to her head. She was groggy but that could have been the booze, although she will hate me for saying that.

At first she was fine with me and when I was told there was no ambulance for her, I opted to take her and one of her mates in the car but she quickly fell asleep on me, again and again, refusing to lift her head to acknowledge me, let alone her body off the floor to walk. So I struggled with her until I could no more and she got what every alcohol-unconscious person gets – a needle and fluids, which temporarily woke her up. I say temporary because she was with me for no more than a minute at a time before flaking out again.

I had to have the biggest security guy and a couple of her friends help me drag/walk her toward the exit – it became a saga and I told her off more than once (but I’m sure she’ll understand). She wasn’t heavy in mass, she was just dead weight. At one point the big man pulled her up in a most undignified manner, which she strongly objected to – I couldn’t blame her but there was no way she was staying on the floor for the night. ‘Just give me two minutes’, she’d say after each stagger-collapse attempt. It was like the Great War, we were gaining ground but by God it was slow going and we were losing men along the way, so to speak.

‘Just another two minutes’


Eventually one of her more dominant mates talked her into behaving and she managed to get herself, with a lot of support, to the car. I sped to hospital and deposited her there as quickly as I could. I was concerned about that head injury, even though my instinct told me it was minor. It was convey or wait for a long time, so I conveyed.

Now, she was chatting away to me in hospital some hours later. Fully recovered and quite sure, without reservation, that the drink had nothing to do with it. ‘I’m never going to drink again’, she says. Hmm, I’d like to believe that but I don’t smiler.

I seemed to be battling my way through this shift and my next call, to a 33 year-old man who had cut his hand attempting to break into his home through the closed window, quickly deteriorated from a solo attempt to get information from him as he lay in the doorway, with his mum and a very large dog in the background. I asked him about booze and drugs, as you do but he was unwilling or unable to tell me anything – he just lay half-in and half-out of his home. Mum was useless – ‘come on son, tell the man what’s wrong’, she’d say quietly and gently, like she was coaxing a song from him.

The way this man was behaving and his pin-point pupils had me suspicious about his night-time habits and whether drugs were involved. ‘Does your son take drugs?’ I asked his doting mother. ‘Well, yes he does’, she replied. At last, I thought direct honesty – something I could work with.

‘What does he take?’


I tutted very loudly in my head. Or possibly out loud. I can’t remember.

Just as the crew pulled up, the man began to get feisty and I found myself being grabbed at. ‘F**k you!’, he spat. His aggression was unprovoked and without warning. He scratched my arms as he clawed at me again and again. Then he tried to wrap himself around my legs – I absolutely hate it when they do that. I managed to break free but my unfortunate colleague, who was in the process of getting mummy to lock the dog away, got a superhuman hug around his ankles as he stepped over the wild man.

The level of aggression rose sharply and the three of us were having a hard time controlling him. Meanwhile, in the background, mum’s soothing voice was having no effect whatsoever. We were getting assaulted and she was trying to give him love.

I had Narcan at the ready and my colleagues held the man down as I approached to inject it but he saw the needle and flew into a rage, throwing off the strong hands that were on him. This little guy was enormously powerful when he got mad. Mum almost walked into the needle as I held it away and out of the man’s reach – I nearly stabbed his mother. That would have got me dead I think.

We’d had enough, so I called for police backup and they joined us within a few minutes. We managed to get a BM from this man but not without a mammoth struggle in which my fingers were almost fused to his hand by his unrelenting grip. I thought he was going to dislocate them; it took the combined force of both my colleagues to prise his stupid hand open so that I could feel them again.

The cops looked fed up – they’d had a night like this too and they attempted to calm the man but he was unwilling to behave. There was definitely a drug at work here but we didn’t know which one, so he was going to get Narcan as soon as we were able to give it.

His hand was cut but it was a minor wound and, considering the trouble he was giving us, not worth the worry. He was physically hauled to the ambulance, kicking and flailing all the way. Then he collapsed into a heap on the floor like a rag doll.

‘Madam, can’t you speak to your son with more authority than that?’ I asked after getting very annoyed by her continued mild manner in the face of the abuse we were all being served by her baby.

‘Mamma’, the man would say every now and then during his violent outbursts.

‘I’m here. Please don’t embarrass me. They are trying to help you’, she’d almost whisper. This woman seemed to have only one volume level for her voice and at 33 years of age, he should have been living somewhere else or at least doing as he was told.

When he quietened and went to sleep, I jabbed him in the arm and he got 400mcg of Narcan – just in case.

The journey to hospital was uneventful and he arrived awake and compliant. I didn’t know whether to feel sorry for his mum or angry with her softly-softly attitude. Maybe its me and the way I was brought up but my mother would have murdered me if I’d behaved like that – at any age.

Another NPC for a drunken 20 year-old with a minor head injury at a club, the crew was on scene just ahead of me.

People who abandon their drunken friends in the street are a disgrace to the whole ‘mates’ ideology. A 25 year-old man was found lying on the pavement with a head injury (caused when he fell) and a complete lack of interested buddies. Apparently, according to the MOPs who stopped to help him, they buggered off and left him to dry out in the street. Nice.

He remained unconscious while I waited for an ambulance. The MOPs had left the scene and I was alone with him in this quiet little street at 4am, so I crouched down next to him, monitored him and caught up with my paperwork. There was nothing else for me to do. He had a blanket on him because his temperature was low but, apart from that, his obs were normal and he was breathing.

I’d spoken to his father on the phone because one of the MOPs had used the man’s mobile to call him and explain what was going on. The other had rolled him into the recovery position and I was very grateful for their help.

When the ambulance arrived and the crew started to check him out, he suddenly went from not there to wide awake. Typical.

My last call of the night was a reassurance job really. A 30 year-old French man staggered back to his hostel with a crowd of mates after a night out and collapsed in the hallway. Even though he was patently drunk and nothing else, they called an ambulance because ‘he hadn’t drunk much and maybe his drink had been spiked’, as one of them said.

See? You have to understand that alcohol is a poison in excess and the body decides what excess is, not you. Sometimes you can tolerate a lot and sometimes you can’t. It’s got little to do with eating prior to consuming it (although that does slow down absorption); it’s about the state your body’s in at that precise moment. You could swallow a single glass of wine and it could knock you down. That’s when you and your friends chorus ‘he/she/it is never usually this bad. He/she/it has only had a few’.

I left the man in the care of his friends after confirming their worst fears. ‘He’s drunk’, I said.

Be safe.

1 comment:

Music Medic said...

I was just cruising online looking for stories, I can tell that THIS is going to be a blog that I will enjoy checking in on. I'm currently a Medic student in California. I can't wait to begin sharing my stories on my blog.