Saturday, 26 December 2009

Goodwill to all men (unlikely)

Shoppers prepare for the Boxing Day Sales.

Day shift: Eight calls: three assisted-only; one false alarm; one by car and three by ambulance.

Stats: 2 Abdo pain; 1 Fitting; 1 Unwell adult; 1 Broken nose; 2 falls.

Another year and the Boxing Day sales are on. Oxford Street, and in particular, Selfridges, was hosting the biggest crowds in London for the day, or at least until they’d spent themselves into debt. Fortunately the Starbucks across the road was serving coffee and Panninis in a smooth and efficient manner, even if they weren’t having a sale – something that would have eased the pain of their horrific prices - £8 for a latte and a hot piece of bread!

The fairly sedate start was quickly run over by a call to the north for a chest pain that was an abdo pain in disguise. The 45 year-old Somalian man had a very strange ECG but his tall, thin figure and genetic predisposition called for anomalies that were normal for him. He also had a missing lung – the result of an earlier fight with pneumonia.

A cardiac arrest call came in as I left that job to the crew and I ran on it in good faith, knowing that it was probably nothing of the sort. A biker was on his way and as I approached he called in an all too familiar report, ‘not as given’. I stood myself down before the excitement overwhelmed me. I had the madness of sales fever to deal with later on anyway.

A call that went from red to green in quick succession turned out to be for a 50 year-old street dwelling alcoholic who had fitted in a doorway. I was only a minute from the location, so stayed put when the call changed priority and watched as he had another seizure in front of me. He was unresponsive but conscious and I’m sure that his habit had a lot to do with this event, although his friend told me he’d never seen him have a fit before. The man has been on the streets for eleven years and now his time was coming – the seizures, loss of bladder control, inability to breathe properly without oxygen and the fairly new hospital tag around his wrist were all testament to that.

To the south next for a 74 year-old Bangladeshi lady with a nosebleed that stopped before I got there. She was lying on the sofa and had been shaking with stress before I arrived. Her family was around her and they explained that she was a worrier and that, although healthy as a horse, she made herself ill by thinking she was ill. I spent a good 30 minutes with them and enjoyed chatting and learning about them, as a family and their culture. I convinced their mum to settle down and stay at home with her family and won the day – PRF signed obviously. Oh, and a crew showed up after I’d asked for them to be cancelled, so our comms were working top notch as usual.

Acute severe abdominal pain next and a 41 year-old woman with a 20 year history of unsolved agony called us, so I went to give her morphine because it works ‘instantly’ she said, in between long screams and moans. She was doubled up on her sofa, trying to vomit into a small bowl that may or may not be used later on for cooking and such. Her BP was consistently high and so the crew ‘blued’ her in. She was very adamant that she wanted to be taken to a particular hospital and I wasn’t too happy that she wouldn’t let us take her to the nearest but the issue was logged and she went where she wanted to go.

They knew her there and she has a little history of going in by ambulance, staying for a while until they give her pain relief and then leaving without a diagnosis. So, the facts of the matter are yet to become the light of her problem – nobody knows what is wrong with her. Her dangerous hypertension and obvious pain made it impossible for us to be passive about it, so she will present again and again I should think, with the same problem and never get to the bottom of it.

Outside a theatre, as the crowds swelled the streets, a 50 year-old woman tripped and fell onto the pavement as she and her boyfriend (it seems strange to use that title at that age, doesn't it?) were about to go inside to see the show. The manager told me that she didn’t really need an ambulance and I accepted that but her boyfriend came out and I thought better of leaving the scene too hastily when he explained that she probably needed ‘butterflies’ in her lip.

She appeared with him a few minutes later and it was obvious that she’d busted her nose. It was leaning over to the right and this, I was told with confidence, was not how it had been created. Her lip had a little puncture in it but she went in the car for the nose. I made a point of telling everyone who would listen that she’d been in a fight. It brought a cheery smile to those waiting outside Resus, which may or may not have been appropriate.

A Red1 that became a Red2 became a farce when I arrived in the crowds of Oxford Street for a 28 year-old woman who’d fallen. A gangsta type offered his medical opinion ‘she’s diabetic’ when I asked the woman what had happened. He was nothing to do with her; his little gang stood around just being nosey and I’m sorry to say (and this is not a slight on young people) that I worried that my car may not be locked. There’s helpful and there’s dodgy.

Anyway, the woman had absolutely nothing wrong with her except an emotional problem that nobody would be able to solve except her husband. She flopped around and I did my obs. She was in normal health and they agreed to take her to their nearest hospital after I cancelled the ambulance and informed them that I would drive her to a four or five hour wait at one of ours. The ambulance I had cancelled, as per the whole point of having me there, arrived anyway, so the crew were informed of the decision and they left empty-trolleyed.

And just as the day ended for me I was asked to assist an Urgent Care crew who wanted to leave an elderly person at home after helping him back up after a fall. He had no injuries but his BM was high, so I went there to double check him and carry out a thorough examination, including an ECG.

There were the usual anomalies but they were expected for a 93 year-old. He declined hospital before I’d even started to check him and his wife added her own refusal on his behalf. He had wet himself and his urine smelled familiarly off, so I suspect he had a UTI and I advised his wife to contact their GP as soon as possible to have it treated. Apart from that he was fine, so I left him in the care of his wife and the crew, who completed their paperwork on scene.

During the day, as per last year and the year before, a gang of youths went on the rampage and a fight broke out in Oxford Street. Someone was stabbed apparently and this is now normal on sales day up there. The atmosphere is seldom friendly and people become selfish and aggressive, driven by their overwhelming desire to cash in on the best bling at the cheapest prices, regardless of the health and welfare of others. Welcome to the new society.

Be safe.


CrazyNewt said...

Well, I don't really know much, but from how you describe it, it sounds like that woman with the abdo pain just wants morphine. Which is why she goes to a particular hospital (she'll get her fix fast), and why she leaves without a diagnosis.

James said...

Someone was also stabbed outside the Ed Hardy shop in Westfield.