Tuesday, 9 February 2010

Adjustments

Night shift: Four calls; two declined; one by car; one by ambulance.

Stats: 2 Assaults; 1 eTOH; 1 Epistaxis.


I have a couple of nights with my student paramedic on board and before we’d even got a proper job, a man ran at the car in Soho and complained that he’d been assaulted and that we should treat him and call the police. He was a bit wild-eyed and edgy, so I called for police and watched as my student attempted to deal with his childishly minor injury, caused by a punch to the mouth. He got predictably annoying and aggressive and so I asked him to go and that the police would deal with it.

By the time the cops arrived on foot he’d long gone and the people he’d been talking with and who knew him instantly denied they had any knowledge of him, his assault or his whereabouts. I could tell what kind of night this was going to be...


A 55 year-old Scot fell down drunk on the pavement at a bus stop and the good people standing around called an ambulance. We arrived and he was shocked at the fuss being caused. You see, where he and I come from, calling an ambulance is almost unheard of unless your head is falling off – and his wasn’t; he had a minor bruise to the side of it. Nevertheless, as he sat in the back of the car protesting his detention, we found his pulse to be a little too slow for his age (and it was irregular) and his blood pressure a little too high for his own good. So, with a good deal of repetitive arguing to and fro, we took him to hospital for an ECG. My suspicion was heart block but he could easily just have fallen down as a result of his inebriated state – he certainly wasn’t steady on his feet at all but the risk was also high that he didn’t just happen to have a slow, irregular pulse and high blood pressure as part of his design.

He was pleasant enough, in-between the odd profanity, which he denied spitting out when I asked him to refrain and my Glaswegian helped break the ice when our accents and colloquialisms collided.


Later on we were asked to go to an assault scene to check the welfare of the crew that had been assigned, as they’re vehicle was still showing on scene but nobody had called in to update Control, so there was concern about what may have happened to them. When we got there, outside a closed pub, there was no sign of an ambulance. This was a good thing because it meant the system had gone awry and not the crew, who’d obviously cleared the area and either taken the patient to hospital or left her alone and gone home after their shift.


The second assault of the night had us running south to a dodgy estate where an even dodgier flat contained a dodgy drug-user/dealer. He had a minor head injury and the police had been called by a neighbour who’d heard a disturbance earlier and then ‘some men’ had been seen scuttling away from the premises. I had a quick look around the place while the student did the obs and chatted with the 60 year-old Liverpudlian about what had happened. He said he had no recollection of being hit but that somebody had stolen his stash of drugs.

His injury had been caused by a narrow, pointed weapon and I noticed that he was sitting on a nasty looking crow-bar. This was probably what did the damage. He’d had a disagreement with his lugubrious druggy mates and during the inevitable scuffle he’d probably been smacked in the face with his own weapon. He’d started to become aggressive and verbally abusive towards us all now anyway and me noticing the iron bar had at least made it possible for one of the officers to remove it and make him less of an immediate danger to us. ‘I want you people to leave’ he said. It took less than a second for me to agree with him and do as we were told. I am not going to get injured doing this job if I can help it and neither am I going to be responsible for any injury done to someone in my charge.


As the early hours became late early we were sent to an 84 year-old lady with a nose bleed. She had suffered a stroke a few years ago and was bed-bound with hemiplegia. Her partner in the cramped little flat suffered COPD and was on an oxygen lifeline and it was almost sadly comical to watch when he shuffled in to her bedroom as we checked her over; he gasped and wheezed his way to the chair and began to chat about how much he worried about his friend. I was worrying more about him now.

The patient seemed back to normal after her fright – she’d woken up with blood in her mouth and her nose was pouring blood out onto the sheets. A few heavy dark clots sat around her and we cleaned her up as best we could. Her top had to be changed but after a half hour of wiping away red stains from her chin, neck and face, she was fine again.

Both of them had a wicked sense of humour and I exploited that to help me adjust my decision making because I initially wanted to leave her at home, where she was happier, and get a doctor to come and see them both to ensure they were okay but as we chatted and laughed I noticed that her hand was clawed in and she was trying to open it up. Her arm was paralysed but she could usually open the hand – now she couldn’t, so there was a change in her that needed further investigating. I asked for an ambulance and a crew arrived within ten minutes to take her to hospital. Given her history and this recent change, notwithstanding that sudden nosebleed, it was no longer safe to leave her at home, even in the care of her friend. I also organised a doctor to visit her partner because his breathing needed to be stabilised.

This couple have been living like this for years; both of them are quite ill but both have reached a good age and have no bitterness or regrets. They laughed and joked their way through our visit with them and we spoke about ‘getting on with it’ even though things aren’t great. I have the greatest respect for them. We deal with many younger people, in better circumstances, who have no sense of fortune and who cannot see that their fate is ultimately designed by themselves.

Be safe.

1 comment:

CrazyNewt said...

You know, I think this is the first time you've referred to a drunk that uses occasional profanity as a "pleasant enough" fellow, and I can't help but wonder if it's because you're both from the same neck of the woods.

Of course, can't say I wouldn't do the same. Only reason I bring it up is because of a post written by Steve Whitehead last week on the topic. At least, I *think* it was Mr. Whitehead...

Anyways, what a fun first day for a student observer! And as usual, great post!