Friday, 31 July 2009

Glassed

Trafalgar Square attracts all kinds of people! (Lottiecam)




Night shift: Nine calls; one false alarm, one treated on scene, one declined and the rest by ambulance.

Stats: 1 Faint; 1 Hyperventilation; 1 Cut throat; 2 eTOH; 1 Chest pain; 1 Coughing blood.


A 65 year-old Northern Irish woman fainted in a restaurant as her family looked on but was recovering well when I arrived. This is a common occurrence; the stomach requires more blood when a large meal has been consumed, so there tends to be a drop in blood pressure in some people – this causes light-headedness or fainting.

The patient was a type II diabetic but her BM was normal. She was taken to hospital for further checks just in case.


The false alarm was for a 20 year-old Chinese man who fell asleep (drunk) in Leicester Square’s park, prompting a Red1 ‘cardiac arrest’ call for some reason (well, the usual reason – nobody bothered to check if he was breathing). I sped to scene as if it could be genuine (you never know) but it wasn’t. I arrived to find a stressed out park security man puffing his way through an explanation that the man on the grass ‘was not responding to anything’. Well, he responded to me immediately and the bemused and embarrassed tourists around him (who had also thought he was dead) slunk off to a safe distance.

‘Do you need an ambulance?’ I asked the sluggish little man.

‘Yes I do’, he slurred.

‘Why?’

‘Because I can’t move. I can’t stand up.’

You also can’t tell the truth, I thought. It crossed my mind that he might recognise it if he crouched and it ran in like a rabid dog and bit him on the arse but luckily that wasn’t necessary. As the sirens of two approaching ambulances (yep, two – ‘cos he’s dead remember) reached my ears, he stood up (not bad for someone who is paralysed) and walked off to find the toilet. And just to prove that he was more sober than drunk, he walked into the Ladies’ loo, corrected himself, u-turned and found the Gents. I remained in place, arms folded, as if I’d been stood up on a date. ‘Tsk!’ said I. ‘Tsk’ said the embarrassed tourists, some of whom were also lying on the grass but weren’t dead.


I overheard a funny little exchange on the radio after this job. A crew requested police to scene for a call they were running on; the call descriptor had stated ‘violent’ and so the dispatcher obliged and said the police would be sent. A few minutes later and I heard this...

Despatch: ‘Oh, sorry, police aren’t needed on this call. It actually states that he has diarrhoea. And that it is violent. He has violent diarrhoea. Sorry!’

Who the hell describes their runny number two’s as violent? Hilarious.


A stupid 21 year-old betrayed his youth and masculinity by refusing to stand up or walk properly because he was panicky. The call had been given as DIB but it was just another hyperventilating person who wouldn’t listen to the advice he was being given about breathing slowly. His work colleagues were around and so he continued to parody the dying swan for their benefit and although I understand the struggle of a first-time panic attack, his performance was not in tune with his condition at all.

I sat and chatted to a very good friend of mine who was leading a training crew. They sat in the back with the man until he pulled himself together and we jawed about life and the pursuit of happiness. As you do.


The serious call of the night was next up and I got lost in the traffic and roadworks (including several blocked off roads and diversions). It was for a 22 year-old woman who’d ‘cut her throat on glass’. These calls tend be something or nothing, so I went as if it was something, to be safe. I should have been there two minutes earlier than I actually was and it’s frustrating that the need for new water pipes is a potential for loss of life as a result of emergency vehicle delays. A crew arrived on scene before me and by the time I pulled up, they were bringing the girl upstairs from a club.

She had fallen onto a wine glass which had shattered, slicing deep into her neck and severing several main veins. Blood was gushing from her throat and it took enormous, persistent pressure to keep it under control. I went through four or five large, thick dressings trying to stem it but the wound was so serious that she began to slip away in front of us.

As soon as fluids were put up and everyone knew their place, we rushed to Resus with her. Her blood pressure had started to fall and she was perilously close to death. Blood stained every part of her clothing, even through to her underwear and pools of it gathered on her chest.

In Resus, she was given blood infusions and the frantic efforts to stop the bleeding continued. They were still ongoing when I left. I wouldn’t know until the next night what had become of this young woman.


A drunken 35 year-old woman demanded to know where her shoes were as the crew took her aboard the good ship NHS. At first she’d been uncooperative but had relented and allowed herself to be ‘treated’ for her excess. She’s probably a mum with two proud kids somewhere.


This call was followed another of the same ilk; a 40 year-old woman lay on the pavement, surrounded by police and PCSO’s... and a man she just met tonight, declaring that she was ‘hypo’. At first I believed her and checked her BM but it was normal at 5.7. ‘That’s low for me’, she said. ‘I’m not diabetic, I’m hypoglycaemic’, she then informs me, as if that’s a diagnosis of anything.

I decided she was drunk and being silly, so I left it to the ‘booze bus’ crew, who’d just arrived, to help her make her mind up. She didn’t like being told that she was a grown up, so she stormed off with her new boyfriend and took a taxi home (I guess).


Burping associated with chest pain and/or shortness of breath may be indicative of a heart attack. Unfortunately, there appears to be little material out there to confirm this but there are many, many personal reports. In fact, we are taught that burping is a significant sign and my next patient, a 54 year-old man who told me that he’d started burping ‘out of the blue’ after experiencing bouts of SOB for the past 24 hours and who now had chest pain, was a classic example.

Following the rule of ‘it’s only gas’ would have been potentially fatal for him but luckily myself and the crew that attended with me are switched on about this sign and his ECG confirmed an ongoing anterior MI. His heart attack was progressing so we quickly took him to hospital and straight to the Cardiac Cath Lab, where he got immediate life-saving treatment. He’d live to walk his dog again.


At a hostel in north London, a 34 year-old man walked down stairs and out to the ambulance, passing me and the crew as we made our way up to him after a call for ‘coughing up blood’. The alcoholic was even carrying a glass of beer and began sipping at it as he sat in the chair awaiting treatment. I absolutely hate the way people like this, who have ruined their lives through excess and stupidity, make us look like professional servants – they pay no taxes and generally give nothing back to society. They cost us dearly and often abuse their rights and privileges. Only those that have returned to society after having made a mistake with their lives get any respect from me because we can all end up where they were but those who choose that path and stay on it, while they get pampered and provided for, are nonsense to us all. This is your opportunity to tell me how bad that reasoning is and how we should all be glad to chip in to help them, even when they drink booze in the back of an ambulance, vomit and spit on us for the love of it.


The drink was taken away and poured out into the gutter. He wasn’t coughing up blood, he was just coughing.


An ashamed 21 year-old, caught drunk in a club and who was now too out of it to keep her eyes open, lay on a sofa as her boyfriend explained that she was ‘always like this when drinking’. The police arrived because a call had been made to them about drug use (she’d taken something with her booze) and she suddenly woke up and became semi-sensible. The cops weren’t interested and they left soon after, so I walked her to the ambulance when the crew arrived as she held on to my arm and told me how bad she felt. ‘I’m so, sorry. I’m so ashamed of myself’, she repeated.

Her boyfriend chipped in several more times about her state (for my benefit) and she showed him how much she loved him. ‘F**k off, George!’ she spat. How could such a nasty phrase come out of such a pretty mouth?

Be safe.

7 comments:

Anonymous said...

Did the cut throat lady make it?

brokenangel said...

Haha the disadvantage of skim reading made me laugh

Fee said...

Actually, I agree with your reasoning. As someone who has worked full time since age 16, and only used the NHS when I needed to - I get a bit annoyed (actually, read "foaming at the mouth" there) with people like this.

You can't help them unless they want to change their lifestyle for themselves, and how many really do? Unless they're complete imbeciles, they know they're killing themselves slowly, but they still do it. Yes, it's a disease (alcoholism) but it's not one you catch on the Tube!

So no, I'm not glad that my hard earned taxes are paying for people like this to abuse both the system and the people who work in that system (and who are also paying a chunk of their hard-earned for its upkeep!).

Rant over. Think I'll go and lie down, now.

KH said...

Re belching in MIs, a couple of papers here: http://www.bestbets.org/bets/bet.php?id=72

Fiz said...

Did the young woman make it, Stuart? Just the idea of cut throats make me practically pass out. I do hope she was OK.

brokenangel said...

Haha thats why skim reading is bad tho it did make me laugh

Tom said...

Once again your readers are treated to a beautifully woven mixture of humour, pathos, and social observation.

Dead Asian gentleman rising from their tombs in a sexual funk, to people suffering serious assaults from their colon did, I have to admit, cause me such mirth and merriment my wife told me to "shut up."

It was good to see resources deployed to those in serious need, and I hope that the glassed victim survived because of your sterling efforts, and the Irish lady enjoyed her family time without any further mishap.

Once again however, there is the drug fuelled and alcohol related incidence that leaves very sad.

Entertaining as ever. Thank you Stuart.alist