Thursday, 27 August 2009

Crumbs

Saw this in a local supermarket; kind of says it all.

Day shift: Six calls; two treated on scene and four by ambulance.

Stats: 2 Falls; 1 Panic attack; 1 Chest infection; 1 Faint with head injury; 1 Seizure with head injury.


My second ambulance shift and I am crewed up with someone who has as crazy a sense of humour as me, so we don face masks, look serious and form the LAS ‘Swine Flu Crew’ just for the hell of it and on our way to the first call, which may have been a non-runner anyway, I introduce my wing mirror to its cousin, belonging to a white van that attempted to get out my way by driving right into me at a junction. Oh well, these things happen. The damage was fairly superficial but we still had to stop and swap details, as the law demands. We were cancelled on the call, of course.


But the first actual call we attended was for a 14-month old baby boy who fell out of his buggy and cracked his head on the hard, unwashed floor of a bus station. Mum wasn’t happy at all, claiming that neither the staff nor the people sitting around waiting for their coaches attempted to help her as she struggled to hold on to her many bags and recover her broken child at the same time. I felt sorry for her; she’d travelled from over 100 miles already just to get here for the onward journey north. She had another 200 miles to go and was alone with her baby and her life’s belongings as she relocated back to her parent’s house.

The little boy’s head was bruised and there was a decent bump on it but this is normal for children – they have more water than brain inside their craniums, so parents and school staff need to calm down and reconsider reaching for the phone to dial 999 every time one appears on a post-fallen kid. Our remit was simple; we examine the child, assess the possibilities and decide, with mum’s involvement, whether or not the child should go to hospital and ruin their day. They’d already missed their coach and the next one was a two-hour wait away. The staff had agreed to get her safely on that one and promised her that she could wait in the quieter, more secluded lounge area, away from the mainstream general public.

We concluded that the boy’s head would survive the trauma – he was active; lively in fact, happy and smiley, so there was no immediate need to spoil his day or interrupt their journey. Mum accepted this and agreed, after arguing against it, to be led to the quiet waiting room – she was still angry about the staff’s initial lack of response and was reluctant to accept their kindly (and apologetic) offer to amend her hurt.

We left her there and made our way back to our own area but Control had other ideas and returned us to the same location for another faller. A 52 year-old lady had stumbled and two PCSO’s worried so much about it that an ambulance was requested. The lady, a lawyer on her way to work, had no injuries, no medical problems and no need for us. She’d just tripped over, as you do.


A 31 year-old woman had a panic attack at work (best place to have one) and we found her lying on the floor doing the classic starfish impression that is so indicative of someone who is not ill…or is dead. She was alive, however. She’d received some bad news, so started breathing rapidly to relieve the stress and now had numb fingers. She insisted on going to hospital, even though her entire treatment package stood in front of her (i.e. me, my colleague and anyone else who was willing to calm her down). Once again, the traumatic trip to hospital didn’t stop her making several phone calls in order to share her major medical condition with friends and relatives.


Outside a doctor’s surgery I found a 39 year-old man with a severe chest infection, a temperature of more than 38c, a rapid pulse, DIB and sats that were comparable to a wheezing asthmatic on his last legs. So, I found him outside the surgery. Outside. He’d been sent away by the medic, or psuedo-medic receptionist inside and told to call an ambulance because he had ‘Swine Flu’. He hadn’t been tested (cos they don’t), he hadn’t been assessed and no history, as far as he stated, had been taken. A cursory glance and a quick, somewhat panicky decision had been made, according to the man, whose friend was with him on the pavement.

A FRU was on scene and after some mutual eye-rolling at the apparent neglect of this patient; I was given a hand-over. The man looked very unwell; quite uncomfortable and should never have been left outside the very place that he’d entered for medical help. If he didn’t have piggy-flu, he had something much worse going on.


Later on, in the south, a 70 year-old woman who fainted and smacked her head on a wall as she dropped told us she ‘wasn’t going anywhere’ as we led her to the ambulance for checks. She was one of those stoical, ‘never been ill, never gonna be ill’, types and she was giving us our warning shot across the bow. I decided that, if she had nothing scary on the ECG (and other obs), then she could jolly well rejoin her friend and get on with her day trip to London.

Thankfully, she was a hard nut with no problems, except a little hypertension, and we all agreed that she’d be best off getting home after signing our ‘get out of jail free’ form. We also agreed to give her and her mate a lift to the coach station, where they’d get on board a bus for their journey back up north.


That’s how the day ended but me and my crew mate had discussed, debated and laughed our way through the entire shift. We chatted about crazy stuff that made no difference to anybody. Being on the FRU is a lonely existence and, although I do like to have time to myself and to work within my own boundaries, these ambulance shifts have reminded me of what a good crew mate can add to a long, hard working day.

Be safe.

4 comments:

stuart said...

Just going on your first point of not calling an ambulance for a head injury - I've just read the following post:
http://basicsdoc.blogspot.com/2009/09/fun-in-back-of-ambulance.html

OK, the mechanism of injury, age, and unconsciousness were different, but if you weren't sure, would you not rather be called to something like that than "My baby fell, seemed fine and is now unconscious and not breathing"?

Xf said...

Stuart

Every case of unconsciousness with a head injury is serious...every case where there is doubt about a child's condition requires a 999 call BUT not every bump to the head should be taken seriously, otherwise we will have school staff and mums up and down the country calling ambulances for the least little thing.

We need to keep it all in perspective. Not every vomiting child is in trouble but after a head injury, its worth checking.

I try to stay balanced about things and not panic with the population. Things DO go wrong in life. why cant we face that any more?

Fee said...

I spent half my childhood with "goose eggs" on my head - clumsy kid, you see - and seem to have survived okay. Maybe kids were tougher in the 70's? Or maybe my mum viewed anything less than major blood loss as something she could treat, either with Dettol or Milk of Magnesia, depending on the ailment. If you were really not well, you got a junior Disprin and a comic! I've never figured out how reading a childrens' magazine made you better, but it seemed to help.

katiesadventures said...

Blackcurrent calpol cured everything :)

I never visited A&E as a kid. I used to faint at the sight of blood (which happens quite alot if your a clumbsy child) so spent lots of time in first aid rooms in public places. I remember scaring the general public in national trust houses when I'd fall over in the gardens, cut my knee and faint en route to find my parents for some TLC.

I also remember being knocked out by a rounders ball when it hit me on the chin, and when I walked into a lampost and wacking my head after going over the handlebars.

My parents/teachers never took me to A&E...Paranoia of being sued seems to have taken over now!