Day shift: Five calls; three by car and two by ambulance.
Stats: 1 Cardiac arrest; 1 Abdo pain; 1 Back pain; 1 Head injury; 1 EP Fit.
First call of the day and it’s for a 29 year-old man who is lying on the floor of his male partner’s flat. He was found like this a few minutes ago – he’s in cardiac arrest as the result of alcohol and drugs (GHB and Crystal Meths). For some in the gay community this is a lifestyle and it’s simply not worth it.
My MRU colleague is on scene with me and we begin resuscitative efforts; the patient is still warm and pink but he’s a fit, young man, so there’s no reason to believe this is an indication of potential for recovery. His jaw is almost locked and it takes a lot of strength for me to get a Laryngeal Mask Airway in there. Intubation is not an option – it’s been tried by the MRU medic and it’s failed because of the stiff jaw.
A crew arrives after five or so minutes and we continue with CPR, drugs and no shocks – he’s been asystolic from the start and there is little hope of that changing, so we do what we can and look at the bleakest future for our attempt.
We take him to hospital, continuing his care all the way but they call it after a further ten minutes in Resus. So, before breakfast, I watched another young life disappear for no good reason; it’s depressing and makes me wonder what kind of day this is shaping up to be.
Abdo pain and groin pain next. A 43 year-old man, working as a labourer at a building site has collapsed and there is a protrusion in his lower abdomen. He may have a hernia.
The pain is only relieved with morphine – he refuses entonox and I find this to be quite common in people with abdo pain – just sucking on the mouthpiece causes further discomfort, so they tend to abandon it. I take him in the car because he is walking and talking and there isn’t an ambulance handy at the moment.
A 52 year-old woman is complaining of lumbar back pain at work. She walks to the car with me and tries entonox en route as her friend sits in the back with her. After a minute of travelling, she complains even more loudly about her pain and tells me that the entonox is ‘no use at all’, so I stop and give her IV morphine in the street. As I pack up ready to leave, a street sweeper happens by and delicately removes my debris (packaging and syringes) for me. Then we continue to A&E, where my patient’s condition continues to aggravate her despite the drug. She waits a long time before being booked in and clings to her friend as the pain beats her down relentlessly.
My MRU colleague was already on scene with a 68 year-old female who’d fallen down steps and banged her head. She had minor head and facial injuries; nothing life-threatening but enough to warrant a check up at hospital, so I obliged with transport and continued care. Her friend was with her – they were out on a jolly in London and I helped to create friction by remarking that she had spoiled it for everyone. It was all taken in good humour. Thankfully, I don’t come across too many dour patients and when I do, I don’t bother with quips to lighten the situation. I won’t waste energy.
Finally, an epileptic patient who had a 5 minute fit was recovering and post ictal when I arrived. She, like most of my patients during the day, was at work when she collapsed. She was very confused and had a bruised cheek for her troubles.
A crew arrived after I’d managed to get no sense out of her during my ten minute chat and by the time she was walked to the ambulance her memory was returning.
I start my nights soon... four of them to contend with. I apologise in advance if my posts become a little depressed as they progress.