Night shift: Seven calls; all by ambulance.
Stats: 1 EP fit; 2 Head injury; 3 eTOH; 1 Chest pain.
On a pavement in the West End a 16 year-old boy had his first ever seizure after complaining of headache for a short time before collapsing. An off-duty doctor was on scene rendering aid when I arrived and he was post ictal and recovering. His parents were with him and he was understandably confused about what had happened, denying the episode – this is quite normal after a fit, especially the first one of your life. He was taken by ambulance to hospital for further checks.
A running call next, for a male who was allegedly assaulted by at least three people; he was punched and kicked to the ground, sustaining a cut to his head. He was quite aggressive verbally but posed no threat to us as we attempted to find out if he had been knocked out during the attack. Police were on scene and he too was taken to hospital.
Some drunks are ashamed of themselves when we appear; they usually don’t call ambulances for themselves – others do that and in this case, a 24 year-old man, who couldn’t even walk because he was so inebriated, displayed appropriate embarrassment that we’d been asked to see to him. He could have gone home if his legs were working but they refused to comply and alcohol ruled his balance and co-ordination, so it was up to the NHS to assume responsibility for his health and welfare… as usual.
I made friends with the father of my next patient, a 26 year-old alcoholic woman with major life issues, as I sat on the sofa with her, trying to reason out her problems. Lottie sat there too, absorbing the conversation and no doubt wondering why someone so young could end up so far away from reality. The patient’s father was clearly at his wit’s end and made several remarks about being fed up, causing a few outbursts from the woman – it was clear that they didn’t get along.
The father had cancer and was struggling with his own life crisis – the man had lived thus far without a blemish to his character, as far as I could tell. His fridge was adorned with magnets depicting every country he had visited over the years with his family. His wife was also very unwell and lay upstairs in bed, away from the problems unfolding in the living room.
The woman had called us because of a widespread erythemic rash that had appeared just after she’d downed yet another beer. She had no allergies as far as she knew and this, above all else, seemed to concern her, as if the appearance of red, blotchy skin was her main problem. There was no ambulance available and so I decided we’d take her in the car but on the way out, in full view of her father, who she’d kissed goodbye and told how much she loved, she began to stagger and falter on her legs before collapsing at the car and ‘fitting’ violently on the pavement. She went on to play out these seizures five times more as I struggled to keep her head from hitting the concrete. I knew I was dealing with a pseudo and that she wasn’t in any danger but assumption is one thing and getting caught out by arrogance is another, so I asked for an ambulance on the hurry up, just in case I had miscalculated it.
She settled down after a chat and lit up a cigarette as we waited for the ambulance to arrive. I wasn’t prepared, no matter how much I felt she was faking it, to take her in the car now. She’d go in the back of an ambulance and she could roll about on the bed if she wanted.
We went to the hospital where she was taken when I discovered she’d left her precious ciggies in the back of my car and when we walked into A&E, she was chatting and smiling, as bright as a pin, with the crew and nurses. A miraculous recovery had taken place. In fact, she had exactly what she craved – attention. If she spent more time thinking about the misery her parents were going through, maybe she could glean more love from them and perhaps, give a little back.
Everyone who comes out on observation shifts is warned to expect violence from our patients and those around at times and when we arrived at the scene of a fight, where a 21 year-old man had been kicked and punched unconscious, Lottie had to make use of me and the only police officer there, to protect her from potential aggression. There was a large crowd around the man and one of the protagonists was a tall (over six feet), strong looking man with no intention of allowing us to do our jobs peacefully and safely. He threatened everyone, including the cop and at one point was prodding the poor officer and shouting into his face.
This single cop did everything he could to keep us out of harm’s way but the tension in the air was palpable and as soon as the crew arrived I asked them to grab the head-injured patient and put him on a trolley bed. We’d be dealing with him in the relative safety of the ambulance – there was no time to risk a full assessment. He was conscious and talking, so I felt this was a sound decision, given the circumstances.
As we took him into the vehicle, I saw other cops arriving, just in time to rugby tackle the tall aggressive man to the ground – he landed with a thud. He was cuffed and held down. Prior to that he had been up close and personal with us as we moved his mate away. His fingers jabbed and his voice screamed but his eyes did not make contact with any of us, even when I asked him, as politely as possible, to back off.
That was one of the most hostile calls I’d gone into ‘alone’ and it reminded me of the possibility of future incidents where my safety could be compromised for the sake of alcohol-fuelled, testosterone-accelerated hysteria.
In Soho later on, an 18 year-old drunken girl lay near a pool of her own vomit in a doorway. Her friend was with her and she acknowledged the stupidity of the situation she was in. ‘I can’t feel my legs’, her mate moaned. ‘Yes you can’, I replied, sure that she wasn’t suddenly paralysed, unless temporarily by booze.
The call had been given as a Red1 because some idiot had dialled 999 on her behalf, stating that she wasn’t breathing and was blue around the lips. This person didn’t even know who the drunken girl and her friend were, so I assume the call was made for dramatic reasons. It was possibly a slow night for the caller.
The girl’s drink could have been spiked because she had accepted freebies from strangers and that is most unwise. Nevertheless, she was able to drag herself, with assistance, into the ambulance.
Our last call was to a callbox where a 69 year-old man suffering chest pain waited patiently after trying to walk to hospital himself. He shuffled towards me and I recognised him as one of our fairly regular customers. Perhaps he had tried to get to A&E on his own or perhaps he knew to soften the blow of repetitive calling by saying this. He may even have been suffering genuine chest pain…