Day shift: Five calls; three by car; two by ambulance.
Stats: 3 Head injuries; 1 Drug o/d; 1 DIB.
The first head injury of the morning was a 23 year-old blonde cyclist whose saddle had come off as she rode her bike, causing her to lose control and go over the handlebars. She sat on a step with a kindly passer-by, mopping the blood on her scalp with a tissue. Her blonde hair had a red streak in it and I told her that it looked fashionable – anything for a cheap smile. She seemed to take that on board, so it’s possible I will see her riding around in the future with a dyed line in her mop.
I took her to hospital by car because her injuries were very minor and a kind man from across the road, who’d witnessed the accident and was at work, offered to secure her bike until she could return to claim it. His name and number were taken and passed on to the patient, of course. Then I drove her to hospital and deposited her on a seat in the waiting area, where all minor problems listen for the call of their names.
I thought I had another fall from a bike job as a running call a little later as I wandered through Soho towards coffee and cake. A woman was lying on the ground quite still and people were gathered around her, looking concerned, so I stopped and called it in.
A bicycle was leaning against a post next to the supine woman and I assumed, like everyone else, that she had fallen off it and knocked herself out… or that she’d had a seizure because she did not respond at all initially.
I requested an ambulance and by the time I had returned to check on her (I had left my student with her to start obs), she was conscious and the police were telling us that she was a drug addict that they’d just turfed off another street for violent behavior. Now, at least I knew what we were dealing with.
A crew drove past on their way to the same assignment that I’d been carrying out and I asked them to help out, which they did. They got the necessary bits and pieces out of the ambulance, including the stretcher, and the patient became annoyingly agitated when we tried to support her neck (on the theory that she’d fallen from the bike remember) and attempted to tear away the collar we’d placed for her protection. Now we could see what state she was in; her pupils were pinpoint and there was a fresh injection mark on her already punctured and tracked veins. I decided we’d give her some Narcan because she kept slipping in and out of annoyingness.
The police stood by in support and an attempt to give her the opiate-reversing drug failed when she, once again, became combative. She was lucid though and that meant she had the right to refuse, so I accepted her refusal to be treated and asked the crew to let her go if she wanted to. We all knew that she wouldn’t make it more than a few feet before collapsing again.
Her drug support worker appeared (she resided in the local hostel) and he tried to persuade her to co-operate but she was having none of it. ‘You are trying to experiment on me’, she moaned. She was free to go of course but when the decision to allow this was made she promptly became unconscious again, so she was given Narcan IM, which worked almost immediately, and taken to hospital on a blue call. By the time we got to hospital with her, she was back in the land of the living and giving the hospital staff all sorts of grief.
She hadn't fallen from the bike. She didn't even own a bike. She'd stumbled over a bicycle on her way to wherever she goes and people had assumed she'd taken a tumble from two wheels. We figured all this out when we saw that the bike was chained to the post.
Having an accident that requires hospital treatment can be inconvenient, so the 70 year-old man who tripped and fell, bashing his head, in a coffee shop wasn’t too pleased when I took over from the CRU paramedic who’d handed him over to me. Giving someone with an appointment at the House of Commons (an appointment that he’d been arranging for months apparently) advice to go to hospital and run the risk of being late, didn't go down well but he accepted my advice and went along with it. He had a minor head injury but at his age and given that he needed the wound closed it was in his best interests.
A pleasant 52 year-old man fell outside his place of work at a posh club in the West End and sustained a head injury. He’d collapsed for an unknown reason so I dressed his head and took him to hospital in the car. The only medical problem he had was high blood pressure and maybe there was a connection, although all of his vital signs were normal. Still, he was concerned about himself and so were his work colleagues, who gathered around him before we left.
Continuing with the theme of wealth, I was called with an ambulance crew to a very plush flat with a view of the Houses of Parliament to deal with a 65 year-old woman who had DIB and possibly pneumonia, which had been given a cursory look over by her GP earlier and diagnosed as a chest infection. She was given antibiotics and told to go home and rest. Now she couldn’t breathe without pain in her lungs.
Both she and a male colleague who resided in the marble-floored flat were employees of the people who owned it. Apparently it is the rich owners’ ‘London pad’ and they seldom visit it, so the two members of staff; my patient and the man, who acted as bodyguard and chauffeur, were allowed to live in it while it was empty, which was pretty much most of the year. Alright for some I thought as I made my way back to base for the end of the shift. I need to write a bestseller and get myself a London pad, then I can sleep more when I am between night shifts.