Saturday, 14 November 2009

Cats and dogs

Night shift: Nine calls; one treated on scene; two assisted-only; two by car and four by ambulance.

Stats: 1 Palpitations; 1 Lacerated ear; 1 Drug o/d; 1 Head injury; 3 eTOH; 1 Hypoglycaemic; 1 Assault.


I wish the rain would stop for a minute. It's relentless and could fill a fireman’s helmet in seconds (I know L and S will appreciate that one) :-)

The first call was given as ‘chest pain’ but the 59 year-old man in the hostel for whom I’d been called denied this when I arrived. A crew was on scene and one of them knew the man well enough to tell me that he is a regular caller. Tonight he said he had palpitations and that he was diagnosed as having AF. In fact his ECG disputed this and all I could see was an irregular heart beat with deep Q waves, generally where they’d be expected to appear. I’d see this man later on in the shift, at hospital after having been thrown out several times by the staff because he is wasting their time. At the end of my shift I saw him sitting at a bus shelter, in the pouring rain, alone and miles away from the hostel.


The lacerated ear belonged to a 6 year-old boy who was ‘play wrestling’ with an older neighbour (a 12 year old). Things got rough and the little one ended up with a snip removed from the top of his ear, like someone had taken a pair of scissors to it. It would heal and he’d be fine but he needed to go to hospital and get it cleaned and closed. His not-too-impressed dad travelled with him in the car.


A 22 year-old woman who claimed that she had been drugged and robbed wasn’t keen to have anyone of the male gender near her, so I asked a female member of the crew and a WPC to help. Turns out she was drugged but hadn’t been robbed, unless she thought the price she’d paid for her fix was too high.


Another woman who seemed shy of men was the 35 year-old Latvian woman who stumbled in the street and smacked her head. The cut was deep enough to warrant a trip in the car to hospital but it wasn’t, as the doorman who’d picked he up had described when I arrived; a ‘serious head injury’. The lady was adamant that she didn’t want treatment – her English was poor and she spoke only Russian so I used our interpreting service to help me get to the bottom of her problem because I was convinced there was more going on with her than just a fall.

Eventually she opened up a bit and told me that she had problems settling into London life, describing the city as too big and noisy for her and her family. Her child had been having trouble at school too, so her pressures were considerable. A single mum in a foreign land, trying to earn a living to make a decent life for herself and her kids has a mountain to climb in this modern day. Nobody cares enough, so she was struggling. She’d had a drink and got caught out, so I got her to sign the paperwork and let her get the bus home.


Off to Soho next to test the blood glucose of a 30 year-old Glaswegian man who had been out on the tiles with his mates and whose behaviour had caused them concern. He’s a diabetic but his reluctance to have his BM done was nothing to do with him being hypo; he was just annoyed that nobody would leave him alone in his drunken stupor. I tested him on the pavement and declared him fit and drunk, nothing more.


A less than fit drunk lay on the pavement by a bus stop, vomiting pools of rancid red wine around him like he was promoting an art exhibition. He was over 6 feet tall and I called Control several times to get an ambulance crew to take him away but I got nothing; comms were, once again, down and out... like my new friend. So he and I agreed that he could be taken in the car if he behaved. He didn’t behave. He wailed, moaned, flopped around and generally made a nuisance of himself as I sped to hospital. He vomited in the back and it took more than a good scrub to clean the vehicle afterwards – particles were on the inside roof.

In A&E he threw himself from his wheelchair and onto the floor for a dramatic exercise that fooled nobody. He got a bed and zero tolerance. Puddling about in his vomit and being exposed to it so closely in the car was not the time to find out that he was HIV positive.


Far away in the south in a small flat I listened to a young woman tell me about her recent faint and how unconcerned she was about it, as her parents stood by with worried looks on their faces. They’d called an ambulance because she could have fallen down the stairs when she blanked out. Luckily, they had a stair gate at the top. She had a gastric band fitted and her appetite had decreased dramatically. Her BM was low but she wasn’t diabetic and there, I think, was the problem. I advised her to go to hospital and a crew was on scene to take her but, as far as I know, she refused and the crew spent more time with her after I’d gone, trying to convince her.


The rain began to fall with real enthusiasm again and twice I had to run up north for an assault involving a few people. When I got on scene the first time, the police were there and they’d found no-one. The next time, after the 999 call had been made again, I went thinking it was a hoax but two men presented themselves (well I had to find them) and told me they’d been set upon by a gang of other men earlier. They had minor cuts and bruises and I treated what I could on the spot and left them to worry over whether to bother reposting the incident to the police.


At the end of the shift I was sent to an address with no easy access and spent ten minutes trying to get close enough to the location to do any good before an ambulance arrived and we all piled into the street together. An elderly man had got himself drunk and fallen down stairs. I didn’t see him because the crew dealt with it. I went home instead. It was still raining.

Be safe.

3 comments:

Crystal Jigsaw said...

Going back to the HIV para, do you often come into contact with this or similar diseases where you need to be tested? Sorry for my ignorance, was just curious.

CJ xx

CrazyNewt said...

Regarding the 30 Year old Drunk Diabetic - I totally sympathize with the guy. I don't know the full details from your story, but if my friends called a paramedic because I was low blood sugaring, I'd be pretty ticked off.

Granted, he could have just tested himself and spared everyone the trouble. But I've been in far too many situations where people decide they know better about my Diabetes than I do. And because of that, I can understand his annoyance.

Lottie said...

CJ

We treat everyone as if they are high risk as, very often, the only way to tell whether someone has an infectious disease is for them to tell you, which patients are notoriously unreliable at doing.

You only need treatment/testing where you've had significant exposure (where you get high risk bodily fluids in your mouth/eyes/open wounds or where you get a needle stick injury) so testing isn't required after an exposure like that.