Tuesday, 20 April 2010

ECG not-so-easy

Night shift: Six calls; one false alarm; one NPC; one by car; three by ambulance.

Stats: 1 Fire incident; 1 EP fit; 1 Head injury; 1 RTC; 1 Chest pain.

Fire calls are becoming more common and some of them involve multiple casualties – a few of which don’t make it. My fire call tonight mentioned ‘multiple victims’ but it turned out to be a small fire that had taken hold on the roof of the bin shed of a block of flats. Somebody up in the heights smokes and then drops his/her/its lit cigarette butts onto this roof. When enough of them accumulate, a small fire erupts, causing panic with the residents and the LFB to trundle out. I was on scene with a crew and we were effectively cancelled as soon as we arrived – no persons reported in fact.

As I completed the paperwork I was asked to go a mile further to a faint that in fact turned out to be an epileptic girl having a fit. She was post ictal when I arrived – recovering slowly but in danger of having another seizure, so when the crew got to us we took her down to the ambulance fairly quickly. She had a minor scalp wound which had been caused by the hard wooden floor she’d fallen onto. She was a diagnosed epileptic but her GP had weaned her off her medicine a few years earlier.

You’ll see a lot of head injuries in my stats but don’t be alarmed because most of them – around 95% of them (if you wish to trawl through every case and substantiate that statistic, feel free) are nothing more than little cuts that need closing with paper sutures or a dressing applied. This stuff could walk out of the house and walk itself to the nearest Minor Injuries Unit or A&E reception. Unless they’ve been knocked out or there is another significant complication, a 999 ambulance call is a dramatic and unnecessary thing to make. This includes children.

My next patient was a 20 year-old man who bumped his head on a wall and cut his forehead open. There was a good dressing in place but, for some reason, an emergency call was made and I travelled a long way south to deal with it. He went in the car and the nurse ‘tutted’ loudly in her head when I handed him over.

An RTC next and a 45 year-old cyclist was knocked off his bike and left in the road with a broken cheekbone by a lorry driver who either didn’t see him or didn’t want to because he continued to drive away from the scene. A doctor and nurse were coincidentally nearby so he had good company until I arrived. I made use of them obviously, for neck control and general stuff while I requested police and an ambulance. The man had been thrown over his handlebars and landed on his face. He had no memory of the incident but appeared to have that single injury and nothing else. Cyclists in London risk their lives every day and no amount of TV preaching about watching out for them is going to slow the rise of death and injury caused by blind drivers and/or stupid manoeuvres (by both parties).

A good few hours passed by and in that time I was called to attend a drunken women who was already being attended to by another FRU and then, at the very end of my shift when, just like my colleagues, I am tired and needing to recharge for yet another 12-hour night, I got called north to a ‘chest pain, back pain’. A crew arrived as I pulled up but I had to stick around because if this was a cardiac problem then a paramedic would be required to be there. To be honest I thought the 22 year-old man would have back pain and somehow that became chest pain but he told me he had a recent history of Pericarditis and he’d been suffering chest pain over the past few days.

His ECG was abnormal, with hypertrophic ‘R’ waves and concave ST elevation. He was a fit man who worked out, so his muscle bulk and his recent diagnosis may have been the cause of these anomalies but he told me he took cocaine regularly and that changed the colour of it. We blued him in to the most appropriate hospital, just in case he was having one of those sinister MI’s that always catch paramedic people out (sometimes to the cost of their careers). I felt it better to be cautious with him than blasé; you never know, right?

I was late home, with my sore throat, my stupid cough and my generally unwell personage. Sleep was going to be limited because Harry would be up and around with his mum and they had visitors, including another child – an older one – and that meant noise. Night shifts with late finishes are no fun.

Be safe.


Achelois said...

Pleased to hear from later posts you are feeling better.

Just had to comment on this one to say. I don't get it - do people that work out in an effort to keep fit somehow think that it negates the long term effects of cocaine abuse!

Anonymous said...

What a tool. Deserves to have heart probs if he takes illegal drugs making huge profits for criminal gangs and terrorists