Monday, 14 December 2009

Not so green and not much peace

This is the melting ice bear on Traffy Square - read all about it on the WWF website at This, in my mind, is how to make an effective point.

Day shift: Seven calls: One treated on scene; four by car; two by ambulance.

Stats: 1 Gammy leg; 1 ? Dislocation; 1 ?PE; 1 Faint; 1 RTC; 2 Head injuries.

Trafalgar Square is playing host to a number of things in the run up to Christmas. The tree is there, of course – and it’s been straightened up at last (probably as a direct result of this blog); there’s a melting Polar bear on show (which isn’t melting fast enough) and the main attraction but only because it’s littering the area below Nelson’s Column, is a scattering of coloured tents containing various bodies, all contending to save the world. They call themselves ‘The Climate Camp’ and they are okay but I prefer the bear.

The first call of the day was to attend a cantankerous 70 year-old man who had wandered in to the ‘camp’ and made himself at home. He was given a cup of tea and lots of sympathy by the people there. He lived rough and had a pair of disgustingly infected legs – the direct result of long term abuse of his health. The legs became the focus for the campers and so they called an ambulance and I was asked to check him out. For the entire twenty minutes or so that I was there, he subjected me to a rain of spittle, verbal abuse and reflected anger. His legs were so bad that it was entirely possible they’d fall off if he stood up but he wasn’t interested in my help, except to demand that I bandage them.

I put a couple of dressings on the worst areas – a completely ineffective treatment but it was all he would accept – and tried to persuade him to go to hospital. ‘I don’t want your medicine’, he shouted in my ear. ‘I don’t believe in Western medicine, I use Eastern medicine’.

The campers stood around looking concerned and neutral at the same time and one of them, a bearded fellow that, in my youth would have been labelled a ‘Hippie’, spoke to me about how worried they were about him but that they didn’t know him. ‘So, he just came in here but he has nothing to do with you?' I asked.

‘What do you mean? We are a collective’, came the reply and I found myself being looked upon as if I was the enemy of something or somebody. I had no idea why my question had aroused such suspicion or why such a large chip had been thrown onto his shoulder out of the blue, so I decided, as he began his lecture about ‘us’ and his collective, to walk away from him and seek out an adult. I went back to the lady who had originally spoken to me about the man with the dodgy legs – she was standing with a police officer.

‘I’ve put dressings on his legs but keep an eye on him and if you need us again, just call us back’, I said. Now, I thought this middle-aged lady was a sensible type but she said something that made me realise I might be standing in the middle of a mini-conspiracy.

‘We have a policy of not contacting the authorities if we can help it.’

‘Authorities?’ I replied, rather taken aback, ‘Madam, we are the NHS – not the police.’

I know we have to save this planet of ours and I am 100% behind the efforts to do so but protests that come in this form – where everyone is the enemy if they don’t share the same opinion with an aggressive passion and where every uniform is seen as authoritarian, puts me off the very cause being fought for. The best way to dissuade the majority of law-abiding people about any argument is to act and talk like that. I got abuse and arrogance and all I did was show up and try to help. I didn’t even get a cup of tea!

A 25 year-old building site worker fell from some steps and twisted his knee, repeating an injury that he’d suffered a few days earlier but this time it looked like he’d dislocated the joint. I gave him entonox, man-handled his leg so that the knee was more aligned and got him into the car for the short journey to hospital.

The next call sent me to a private GP surgery in Poshville, London, W1. A 77 year-old lady had chest pain and shortness of breath and her doctor decided she might be suffering the effects of a Pulmonary Embolism (PE), which can be life-threatening. I didn’t realise that the GP had called 999 and asked for an ambulance to take her to hospital then promptly left the poor woman standing in the corridor while he attended to another fee-paying patient.

The receptionists had no idea what was going on when I arrived, then I was taken upstairs to the doctor’s surgery, only to be told that the patient was downstairs and had been abandoned there. The doctor didn’t even have the courtesy to come and give me a hand-over. I was simply a taxi for the patient and to make matters even more infuriating, the patient thought I was going to take her to a specific hospital miles away!

I’ve said it before but some doctors are as abusive of the ambulance service as our ‘regular’ callers – especially in the private sector.

At a coach station an 84 year-old lady became unconscious and I was convinced I was running to a possible suspended but when I got there I found her sitting with her friends, smiling and chatting. She had been unconscious, according to her buddies and the station manager, for about ten minutes apparently, so I was concerned that something serious was going on but the lady didn’t realise it. She looked well enough, if a little pale and she was animated and aware. We shared a few jokes as I got on with the obs but I’d already decided that an ambulance was more appropriate than the car. Her medical history included a brain aneurysm so there was no way I would risk less than full monitoring.

She’d had a few ‘turns’ recently and, although she wasn’t worried, her friends were and when we did her ECG on the ambulance, it revealed a first degree heart block – something she could live with but that could also explain her recent faints and spells of unconsciousness, alhtough this is rare, so she was taken to hospital.

In the west a motorcyclist braked hard and skidded under the wheel of a taxi as it u-turned in the road. This is a relatively common type of RTC involving these two vehicles and I’m not sure if it’s the taxi drivers or the motorcyclists who are to blame but it won’t be long before I go to one of these and the biker is dead or dying after being crushed. This 45 year-old guy was lucky, however and got away with a leg injury after sliding along and breaking his visor on the road as he fell. The impact would have been moderate because it wasn’t a fast road he had been riding on. The cab was relatively undamaged and it looked like only the front wheel had taken the brunt of the force.

A crew was on scene, as well as another FRU, so I was just an extra pair of hands and it took us no more than twenty minutes to assess, collar, board and move him onto the back of the ambulance.

A cheeky little 6 year-old girl whose parents were abroad and who was being taken care of by her auntie, fell from a playground roundabout and got clunked on the head as it spun round. She had a small cut to her scalp, which had bled dramatically enough for an ambulance to be called. The bleeding was under control when I got there and she was bundled into the car with a carer (she was with a school group) for the trip to Children’s A&E.

Compared to the last call, the only difference here was the age of the female and the mechanism of injury – oh and the drama being played out as a result. Another fall and another scalp wound – this time, it was 21 year-old woman at a college who’d been sitting on a cantilever legged table with her friends. When her mates got off, the table became unbalanced and she was propelled backwards, slamming her head against another table as she fell to the ground. When I walked in the tables had been labelled by the staff of scene – ‘Do not sit on these tables’, the signs read. Horse, door, stable, I thought.

The cut to her head was minute; almost microscopic, and she hadn’t bled much, if at all but she was lolling around in her friend’s lap like a wounded animal. Clearly this young lady had never been exposed to injury beyond a broken nail before in her life. I had to ask her repeatedly to lift her head so that I could talk to her. If her girlfriend hadn’t been there I bet she would have been absolutely fine – she was getting a bit old to be milking sympathy.

This injury could have gone home and helped itself to recovery, or taken itself to A&E but no, in today’s enlightened intelligent society, it’s all about service, so she had to go by ambulance. She got the car though because I was not going to get a hard-working crew down here for this.

She continued to feed herself with the human kindness pouring from her friend all the way to hospital and when we got there and I was booking her in, her mate came over and interrupted me to let me know that she (the patient) had a headache and was in ‘real pain’. The hope being that I would drop everything and rush over with heavy-duty analgesics. Meanwhile, fifty other people sat waiting with their own ‘real pains’ and Resus was full of critical patients, some of which were actually in real pain.

Be safe.


Sue said...

I didn't realise until i read this that the bear was supposed to melt. I thought it was a technical fault when I saw it the other day!

Anonymous said...

Re: the motorcycle and the taxi accident.

I appreciate you trying to walk a line between whose fault it is when you weren't there to witness it, but let me tell you that it is always the taxis' fault. You simply shouldn't be making a U turn in situations where oncoming traffic has to brake hard to avoid you. Not only is it common sense and a matter of courtesy, it is also the law!