Saturday, 8 August 2009


Someone, somewhere is missing an evil feline :-) This poster was displayed in a shop window in Soho.

Day shift: Six calls; one treated on scene, three by car and two by ambulance.

Stats: 1 Back pain; 1 Sprained ankle; 1 EP Fit; 1 Head injury; 2 Unwell at same place.

Apparently I've got a nickname - well, it's better than some of the others I've heard.

This weekend I was host to a Welsh Student Paramedic (I shall call her N) who wanted to find out what all the fuss was about in London. She found out straight away when she realised that what I described as ‘quiet traffic’ at 7am was more like full-on rush-hour to her!

A 40 year-old hotel doorman went to work after trying to keep his back pain in check with painkillers. He’d lifted a heavy weight a few days before and felt a twinge. His back was further insulted when he fell on an underground train. Now he was in agony, stuck in a small space, where he had been attempting to get changed for work; his trousers were at his ankles and he was unable to do much more with them.

I gave him entonox and made him breathe it in while I sorted out his attire (I couldn’t have him limping through a twenty-star hotel looking like a pervert, could I?) and carefully prepared him for the walking trip to the car. He made it there in painful slow motion as I steadied him. He declined morphine because he had a needle phobia. They all say that. Wait ‘til a nurse gets hold of him with one.

Sprains are fairly easy to recognise and diagnose but they have several grades of seriousness, depending on whether the ligament is damaged, partially-torn or completely ripped away. In some cases you may as well call a sprain a fracture because it amounts to the same thing (ligament tears from bone, bone is therefore damaged and so you have a fracture).

So the 31 year-old woman who tripped on a kerb and twisted her ankle had one and I called it a grade 2 on recognition, although an x-ray would be needed for confirmation. A swollen, rounded ankle with pain and the inability to weight-bear after that kind of twisting-fall is enough for me. An off-duty MRU paramedic was on scene and called me in to take the lady to hospital. She didn’t need an emergency ambulance because this type of injury simply doesn’t require the fuss (I’m now about to be bombarded with stories of ankles hanging off to disprove that).

A strange call to a 22 year-old who had a fit in her office while her colleagues looked on had a little twist to it. The woman was post ictal when I arrived; completely confused and disorientated but she also complained about having painful, swollen cheeks and jaws. I could see that her jawline was very puffed up and I asked about allergies and the usual suspects but got no sensible answer. She hadn’t been bitten and this phenomenon had occurred when she collapsed and started to fit.

Her Parotid glands were up and her speech was affected by this, although her breathing was normal and there seemed to be no airway compromise. All her vital signs were good and within ten minutes of getting into the ambulance, she began to feel better. Her face became less swollen and her speech improved dramatically. It would appear that her post ictal state and this possibly trigeminal problem went hand-in-hand, although I had thought of Mumps too.

The Welsh God (whoever that is) was obviously grinning down at me because he sent me to a hotel room where a 21 year-old had fallen in the shower and cut her head. I found myself virtually surrounded by Welsh women – every one of them on a weekend Hen trip. Most of them were fully clothed but a few had towels wrapped around them and, I guess, not a lot else. Being the shy person that I am, my eyes had to be averted and so I distracted myself with chit-chat, introduced my Welsh student to them, so they could 'integrate' and checked the tiny little scratch on the woman’s head. She shouldn’t have called an ambulance for this but here I was and I knew that she wasn’t going anywhere but out tonight, so I cancelled everything, including the helicopter that might be sent for her ( head injury), stuck a strip on her cut and bid her a jolly good night out...and not to come anywhere near where I work until I had gone home.

Two patients fell ill at the same time in the same place and I was sent to investigate. Usually we ring our alarm bells when we get these coincidences but obviously the powers that were in Control decided I could catch whatever was being passed around. So, I went and I found an elderly man and a young man, both with their loved ones in hand, sitting looking quite ill in the lounge area of a gallery. The young man was actively vomiting and the older man was very pale; pasty-looking in fact. At first it looked like the same thing was affecting them both but neither knew the other and they had eaten different meals. Their histories were different, of course and they had slightly variable symptoms.

I checked one while N checked the other. I decided one had to wear a mask (the young, vomiting man) and the other didn’t – he was on Beta-blockers and had a slow heart rate, so his meds were probably making him feel ill.

I took the older man in the car and the young man, who became acutely more unwell, went by ambulance. It was a bizarre end to the day and one which N decided was very entertaining.

Be safe.

1 comment:

Toni said...

I bet N won't be forgetting her day trip with you any time soon!