Night shift: Seven calls; one left on scene; two by car; four by ambulance.
Stats: 1 Cold homeless person; 2 eTOH; 1 EP fit; 1 Tachycardic; 1 AF.
I have plastic bags over my socks inside my boots. Once again, after only a year or so of wear and tear, my work boots are cracked on the sole and are leaking water and whatever else I step in into my socks. I endured the damp, squidgy feeling last night for the entire shift but today, as I inspected my footwear and realised both boots were soaking inside and that I was about to put my nice new, freshly-showered and warmly dried besocked feet into them, I took the radical decision to cover both using the small freezer food bags that we keep at home.
So, first job with dry feet was a false alarm for an angina attack on board an incoming train. The crew was with me and we stood by on the wrong platform until we were moved and then informed that the BTP had decided to have the train stopped at an earlier station. There was no ambulance deployed there, however, so more advice, for the train to be allowed to continue, was given.
We changed location and I got myself and my bag a lift on the little noisy kart (it would have been quicker to walk but it was fun and convenient) but it was all in vain because a crew were despatched to the nearer station and all we got was a ghost train.
Then a 37 year-old man claimed he had a fractured shoulder and demanded to be taken to hospital. A posteriorly photogenic police officer (this is a private joke so don’t worry) was on scene at the time and he informed me that the man was homeless and showing no obvious signs of distress. This was a typical cold homeless person wanting off the streets and I have sympathy for them but his ‘injury’, which was never diagnosed, was two years old and so I felt kind of abused. If he’d told me the truth and levelled with me about getting a free warm, dry place to put his cold feet, then I’d have more respect for him but he preferred to lie.
I drove him to hospital anyway and he valiantly carried most of his fairly heavy bags, despite his painful shoulder. He’d be carrying them back out the exit door of A&E in a few hours I imagine.
Outside a University campus building, lying in the gutter is a 19 year-old girl with thick, smelly vomit in her hair (the shampoo of the new generation). She’s been found by a bunch of students and a security man and they put her into the recovery position and call an ambulance because she’s ‘possibly drunk’. Correct diagnosis but I'd like to expand on it with my extended medical knowledge. She is very drunk. So much so that after telling me she’d just had ‘three drinks’ that night, she commences vomiting again until her face is covered in the stuff and her warbling voice tells me that she is feeling guilty but unrepentant at the same time. They used to say 'never again' but now they just say 'I'm really sorry' or 'I'm disgusting'.
She gets scraped off the road and into an ambulance where fluids help her falling BP to recover, although her dignity never will.
South of the river and a 25 year-old doctor is fitting in a wine bar where a piano-playing jazz singer bellows out a tune as she shakes on the floor for almost five minutes. I struggle to communicate with her as she recovers and the manager finally puts a stop to the cacophony ( sorry, I'm not a great jazz fan), just in time for me to hear that she’s recently been diagnosed after a short history of ‘absences’ and a full-blown seizure weeks ago. The crew persuade her to go to hospital because her BP is high and she has yet to completely get over it. Trying to convince a doctor to go to hospital is almost like trying to prise a live whelk out of its shell.
The Saturday night morons began their onslaught just before 2am when a call came in for a 30 year-old man who was ‘unconscious’ and vomiting outside a gay club. The police were on scene and they made it clear before I got started that the man had been ‘playing dead’ all night. He was flopped dramatically on his back with a large crowd of cat-calling transsexuals around him. They were clearly enjoying the sport and you don't see that very often. Not unless you are a fan of The Rocky Horror Picture Show.
I woke him up with the necessary pain and made him sit upright before establishing certain facts. I discovered that – 1. He was Lithuanian and 2. He was drunk. He was left on scene with no promise of an ambulance.
It is not unusual for young men to have fast heart rates every now and then when Adrenaline rushes through their bodies for no reason whatsoever but when you have high blood pressure and have been through a vivid sex dream, the risks associated with a tachycardia are greater, so I took the Russian patient to hospital in the car after ensuring that his ECG was normalish for his current heart rate (180bpm dropping to 111 after a few careful exercises in reducing it) and that he had no pertinent chest pain.
Interestingly, he seemed keen to stress that he had managed to complete his sexual antics before waking up with what he thought was his first heart attack. I'm not entirely sure which tale he was trying to impress me with.
I don’t get to meet many true ladies in my job (foul mouthed drunken women don’t count) so it was refreshing to be sent to the aid of an Urgent Care crew who needed help in deciding whether or not to leave their patient at home after she’d fallen out of bed. The patient, a titled Lady, had COPD and, at 89 years-old, wasn’t doing very well in the breathing department. Her ECG also showed AF and it was necessary to take her into hospital on the basis of a lack of information from her live-in carer and the confused state of the patient herself. Whether she coped normally with her rasping, heavy breathing and erratically irregular heart beat wasn’t clear and I wasn’t about to take the risk.