Day shift: Three calls; two by car and one by ambulance.
Stats: 1 Near faint; 1 Dizzy person; 1 Heart attack.
A 39 year-old doctor who travelled a long way on the tube suddenly felt faint but didn’t quite go the distance and pass out. Initially he wanted to go home after all his obs showed how healthy he was but for some reason he changed his mind and began to worry about possible cardiac problems he may have developed (in the hour or so on the train I guess), so I took him to hospital and he lay on the back seat of the car, chatting nervously to his wife about his possible dramatic conditions. Differential diagnoses by proxy.
All the obs were normal again for my next patient, a 58 year-old man who felt dizzy at work. He had a bit of nausea too, so this prompted him to take the rest of the day off and keep me company as he travelled in the back to hospital. His history of hypertension must have given him cause for concern, despite his normal reading and the fact that he was looking very well as he entered A&E. The Swine-flu ridden 'panademic emergency area' (or, as we simply call it - the waiting room) was stuffed full but this didn't put my patient off at all.
The only real emergency call I took today was my last. An 88 year-old man lay in the street having a heart attack. He had a previous history of two MI’s and so he was being taken very seriously. A couple of very kind MOPs, a police officer and an off-duty nurse were on hand to help as I worked to keep him stable but his condition was deteriorating fast and there were no ambulances available (probably because they were tied up dealing with dizzy people and faints).
The busy crossing in which he lay provided endless entertainment and local drama for those wanting to move from one side of the street to the other and so I asked the MOPS, two young men who wouldn't leave him and wanted to help as much as possible, to give him a blanket screen for privacy. He grew paler and less alert and I had time, given that I was on scene with him for almost 40 minutes, to do a 12-lead ECG in the street. The result was pretty bad and there was no doubt that if he didn’t get to hospital soon, he’d become a work-in-progress for CPR.
Just as time was running out on us all, the crew arrived and he was taken to hospital for specialist treatment. One day soon, all my moans and groans about silly calls and time-wasting do-gooders who think we are simply a taxi service will be highlighted with the demise of a patient on the street like this. A lack of resources, caused primarily by the type of call that dominates our system will be to blame. In the meantime, I have to rely on luck and as much of my own judgment and skill as possible. Thank goodness for nick and time.