Day shift: Six calls; one cancelled on scene; one treated on scene; three by car and one by ambulance.
Stats: 1 Unwell person; 2 Abdo pain; 1 ? Swine flu; 1 Foot injury.
A 47 year-old vomiting woman with a headache and abdo pain worried me a bit when she called after presenting with sudden onset symptoms after a few days trying to beat back her head pain. I’ve seen SAH develop like this, especially in females of her age, so I wasn’t about to rule out anything significant immediately. She had no past medical history and was normally well. She may have had a simple viral infection or she may be in trouble, so as soon as she got to hospital they took her to Resus but I saw her later on in a cubicle and she seemed over the worst. The morphine I’d given her for the pain and the metoclopramide to stop her being sick seemed to have done the trick. I hope she’s fine now.
A call from a 33 year-old woman who had ‘menstrual dizziness’ seemed nonsense to me but I trundled over to where she worked and found her to be well enough to travel in the car (of course she was). The Portuguese woman held her head, moaned to herself and kept up a long telephone conversation at the same time as I drove her to hospital. She could have taken a cab or walked there – she had waited quite a while with a CRU paramedic tending to her before I arrived. I was only assigned because it wasn’t deemed serious enough for an immediate ambulance. That at least was accurate.
Then, miracle of miracles, she seemed right as rain when she arrived in A&E.
Abdo pain can cause a lot of discomfort; sometimes so much so that a person loses consciousness, depending on upbringing, DNA profile and pain threshold I guess. Of course, there are physical reasons for passing out but most of the abdo pain calls we attend are not serious at all and require no further treatment than obs and time to recover. So, the 23 year-old woman who called an ambulance (or had it called for her) from work and was now laying on the office floor ‘fainting’ apparently, was ‘tagged and bagged’ with normal obs and no hint of a life-threatening illness as she went to hospital with me in the car.
My first possible Swine Flu case next and it happened to be a Traffic Warden. He was on duty and had probably ticketed many victims before folding up with back ache...in fact he was ‘aching all over’. His supervisors were with him and they’d insisted on a 999 call, even though this guy was fit looking and had no previous history of illness. He wouldn’t even stand up for me when I got there; preferring instead to keep the drama going while being watched by his superiors. I know this game well, I’m afraid – you have to be really ill before you can get a day off work, so even if you are a bit under the weather, or perhaps taking on a few symptoms of Flu, it is important that you act out the agony of a recently shot soldier in order to get the necessary nods of approval as you are wheeled off in an emergency vehicle.
The agony didn’t stop him getting into my car, mask firmly stuck on his viral face, and seemingly improving when he got to hospital. The nurses took one look at his uniform and their eyes rolled to heaven. He may well have contracted Piggy Flu but he should have gone home or been taken in by car – they could have ‘impounded’ a naughty motorist’s vehicle, you know, one that was parked deviously outside a shop on a single yellow line, then transported their friend and colleague to A&E reception, where all the masks are worn with pride.
A call that was cancelled for me as I approached the scene made me smile a little. A 30 year-old female who’d complained of neck pain and had spent some time with a CRU before I turned up (and went to the wrong entrance), walked herself onto the back of the ambulance before the crew had even got a chance to pull on the handbrake. Priceless.
There is a particular type of shoe worn by children that is a potentially serious hazard for their feet and I have to warn you about them here and now. My last call, to a 5 year-old girl whose foot had become caught in an escalator at an underground station, rang a bell because I have been called to several such incidents over the past two years, only in summer, where children’s feet have been caught, pulled in and mangled by the teeth of the steps as they close off. The problem isn’t the escalator, or the children...or their parents – it’s the shoe they are wearing. It’s always the same type of footwear; those plastic sandal style things with holes in them (I believe the holes are for little colourful bits to be stuck in).
This little girl had a minor graze on her foot but her shoe was torn apart and had been dragged right inside the gnashing mechanism of the step as it slid down inside itself. Her foot would have been ripped apart too, if it wasn’t for the quick-thinking of her mum and a lot of luck. The last patient I dealt with had severely damaged toes as a result of this kind of accident.
The shoe is made of a material that gets pulled easily by anything touching it – the plastic seems to have an easy-to-grip surface, so the metal teeth of the escalator only need to make light contact with the toe area and the whole shoe will be pulled in, foot included.
Luckily, the girl was fine. ‘I don’t need to go!’ she said as I arrived on scene in the little control room. She and her mum were in good spirits about it but I asked mum to write to the manufacturer and point out the problem. A warning should be sent out; otherwise a child is going to lose his or her foot.
I laughed and chatted with this cheeky little Irish girl as her mum reassured her and I dressed the wound. She didn’t need to go to hospital and I didn’t want to upset her more, so she was left with mum to go shopping – for new shoes. Any excuse.