Night shift: Six calls; six by ambulance.
Stats: 1 Faint; 1 Dislocated knee; 3 eTOH; 1? Fit.
The start of those magnificent night shifts I love so much but the compensation is that I have Sarah as my observer. Sarah works in Control and is ambitious about going frontline in the near future, so she is tagging along for experience and crap jokes. It’s always nice to have good-natured company on these shifts.
A 73 year-old lady collapsed and fainted in a theatre and we walked in to find her on the floor, legs raised and a small crowd of concerned people around her. She had family with her but she also had the efficient and very kind theatre staff on hand.
She was recovering from a faint brought on by abdominal pain and she told me she’d had this event before but did nothing about it. She was very pale and hyperventilating, so her recovery wasn’t swift and this concerned me more than the faint. I suggested, regardless of the lack of any distinct medical history, that she should go to the ambulance for an ECG and when the crew arrived, that’s what she did.
Her ECG was not quite right; she seemed to be ‘dropping’ P waves on a regular basis, suggesting an AV block – this could mean something significant was developing and her two faints made the necessity for her to go to hospital much more relevant.
Then a 24 year-old woman twisted her knee so badly that she dislocated the patella laterally. This is an easy fix but caution is required if the knee isn’t to be damaged, so careful gentle examination is needed. Oh, and lots of entonox, which she seemed to thrive on. Her two bemused friends stood by as she occasionally swore and more than occasionally shouted ‘don’t bang it back in!’ Obviously, with or without her tacit consent this wasn’t going to happen – the patella would just slip back into place itself if she would just move her leg the right way... but she wasn’t keen and so I acknowledged her pain and her absolute refusal to have anything drastic done to help. There was, however, the problem of getting her out of a tube station corridor and all the way up stairs to an ambulance and that would need planning.
My initial idea was to have her leg splinted – this alone would probably repair the knee instantly but the crew arrived and the leg was straightened with the effect that was desired by all – an instant reduction of that naughty knee-cap. She still hogged the entonox though and it ran out before she reached the top of the stairs, tied into a chair.
She went to hospital because the knee would require further examination. This joint is a particular troublesome one to effectively repair if it has been damaged – ligaments and other structures within can give life-long problems once they have been insulted by an injury.
A 35 year-old Lithuanian man, known to me from a saga a few months ago in which the police had to accompany me whilst he sat in my car attempting to smoke a cigarette, called for an ambulance outside a club and said he was ‘unwell’. We arrived to be told he’d walked off after waiting impatiently for a rapid response. He called again for an update on how long we were going to be, and then secreted himself around a corner until he saw the lights of the car flashing. Then he walked towards us and promptly collapsed and acted out a seizure for the benefit of the worried public. He’s done this before and it’s his M.O. – all he would say to me initially was ‘epilepsy, epilepsy’ but he soon became fully aware when I told him I knew who he was. Still, he demanded an ambulance and that’s what he got. The crew knew him too – he’d just come out of hospital (well, he was thrown out by security) and he will, no doubt, be leaving that place again soon after arriving. It could go on all night.
Multiple calls came in for the next patient – a 25 year-old female who was seen fitting on the pavement before a man picked her up and attempted to drag her away. This caused panic among the MOPs and more than a few of them made frantic 999 calls with conflicting details. This brought the police and two ambulances (and us) onto the scene. It certainly was confusing as the woman hugged the man, staggered and behaved very strangely. Not epileptic post-ictal strange but drug-induced strange.
The man with her didn’t seem to know much about her and the police were very wary of what might be going on between them. Certainly, they knew each other but exactly what their relationship was became cloudy and disjointed as each was asked about the other.
One of the crews took over and she remained agitated and whispery in verbal communication. I left them to it and the police followed the ambulance to hospital.
It would seem that the semi-torrential rain, which began to fall at 2.30am, is not a deterrent to the hard-core drinking public who imbibe too much and then blame the Gods or whatever else they can think of for their new status on the pavement. This call was for a ‘faint’ but he was slumped in the doorway of a McDonald’s restaurant, vomiting on the doorstep (I’m not amused because I go for breakfast there sometimes) and stating merely that he was ‘unwell’.
The 25 year-old told us he had a history of HepA, so drinking was probably not a good idea – thus his current state and by rebound, I would venture, an evening of alcohol culminating in a trip to A&E on the ‘Booze Bus’, courtesy of the NHS.
Another customer who needed the help of the emergency services for alcohol-induced ‘illness’ was a 20 year-old female whose friend claimed she had been ‘spiked’ by someone who bought her a drink. There’s little mileage in this excuse because if someone wanted to drug a female, his plan is probably to use that to his advantage – it is therefore unlikely that he’d top-up a drink with drugs just to watch her collapse outside and become wildly emotional about what has happened. Especially if she’s had enough to drink so that this effect is almost certainly going to be initiated without the need for drug enhancement.
She was out of harm’s way on the pavement – club staff and friend on hand with the addition of a perfect stranger who sidled up to us, looked at her sadly, tutted and then proceeded to offer her a lollipop so she can ‘get sugar’ for her drunkenness. Someone's been listening to Granny's remedies and taking them far too seriously.