Night shift: Six calls; five by car; one left at home.
Stats: 2 eTOH; 1 Faint ? EP fit; 1? Food poisoning; 1 Allergic reaction; 1 Abdo pain.
The first call was for a drunken 49 year-old female but she had a story and her vulnerability made the call all the more poignant. She was found slumped on the pavement – quite drunk – by a MOP who called an ambulance after it was allegedly said that the woman’s husband had abandoned her there after a fight. A motorcycle colleague was with her when we arrived to convey her in the car and during the trip she cried and made several allegations of violence against her by her husband. True or not, the fact that she had said it made it imperative that I take note of it and make sure it went to the right place. This poor woman blamed herself for the physical abuse she was apparently receiving regularly.
A 25 year-old man was sitting with his friends when he had an ‘aura’ that he was about to pass out. This has happened to him before and it is triggered by something he sees or experiences. Then he fell and smashed his face on the floor, cutting his eye on glass that followed him from the table as he fell. His mates thought he had been joking.
He then had a short seizure, which may have been nothing more than the consequence of a brief lack of oxygen to his brain or it could be that he is epileptic and doesn’t know it. Whatever the reason for his collapse, he was taken in the car to hospital. His eye would need minor treatment and an investigation into why he has these ‘faints’ should be carried out. He was completely lucid when we arrived and his two friends joined him for the trip.
At a theatre, in an empty post-show auditorium, a 40 year-old woman suddenly felt ill and vomited violently onto the carpeted floor. Theatre staff and her husband were on scene and she was shaking like the proverbial leaf when we arrived. She had no medical condition significant enough to have provoked such an acute bout of sickness, so after a few questions and a look at her obs, I could only assume that something she’d eaten had done this to her. She had abdominal pain and a bloated feeling and this often accompanies food poisoning. Maybe a lack of basic hygiene in the restaurant they’d both had dinner at four hours earlier could account for this.
There were no ambulances immediately available and she was stable enough, with a clinical waste bag for vomit management, to take to hospital in the car.
Metoclopramide would have been useful and I could certainly have given her some to reduce the vomiting but it would cost her ten minutes of feeling rubbish in a public place and I had a five minute journey to hospital in mind. So she got me, Sarah and her husband by her side to help her into a less fragile state of mind.
Later on, as the locals tanked themselves up on cheap booze (regardless of the recent budget hikes), we were sent to check out a 32 year-old female with a history of anaphylaxis who was having an allergic reaction. Luckily for her the problem she was experiencing was very mild – facial swelling that was insignificant and went no further than her gums and cheeks. She had no rash or breathing problems but she was worried because she’d been given no education about her condition and has had to endure these low-level reactions on a regular basis without knowing the cause or the remedy. She’d taken an antihistamine and her condition was stable.
She sat in the front room of her perfectly decorated Muslim household with her father, who insisted we sit down and in such households I feel obliged to do as I’m asked in case I offend the host. Also, without bias, I wasn’t keen on trundling a decent, law-abiding, non-drinking woman up to a crowded A&E packed with the debris of a Saturday night, just so she could sit for four hours waiting to be told another Piriton was all she needed.
She listened to my candid advice and I filled her in on how Histamine affects her and what was going on in her body – this seemed to calm her and help her decide to stay at home, with advice to call us right back if she felt worse.
Continuing with the great ‘my drink was spiked’ spectacular, we were sent to a club where we found a 19 year-old German girl sitting with her two friends on the steps inside. She was only responsive to painful stimulus and, when bothered, would answer questions (in German and translated via her mates). One of them stated that she’d accepted a drink from a stranger (this is not wise) and that it may have been drugged. Okay, it’s not impossible but it’s not likely either – as I said in my last post, using drugs to entice a woman to your place for sex is only going to be the choice of a seedy, sad few men with a plan. It won’t work on a 6-foot German teenager with two heavy-set friends in tow. So there’s no point. Also, when asked how many drinks she’d had, the answer, as is stock and predictable, was ‘only two glasses of wine’.
‘Large glasses?’ I asked.
‘Oh no, just small ones’.
She was either out clubbing on a budget and hoping to have a free drink or ten from passing strangers or she was so drunk she’d actually forgotten the last five or six that followed the first two. Alcoholic amnesia I call it.
However, before you criticise my criticism, she may well have been offered and accepted something nasty and for that reason I gave her the benefit of the doubt and added ‘possible drugs’ to my report.
There were no ambulances and the Booze Bus was unloading a tribe of drunks at the local hospital, so we got her to her feet and walked her to the car. Then she and her two friends travelled with us to hospital where she joined the living dead of Saturday night (the Booze Bus remnants) in the waiting area.
The abdo pain call started out as a chest pain call and so a crew was being dragged for miles to get to it and I was on the doorstep so went to check it out. She was a Ketamine user who said she had Cystitis and was prone to panic attacks. I cancelled the ambulance and we took her in the car to hospital where she promptly changed her story to ‘found collapsed’. Sometimes patients will do this and you can look pretty foolish as a result.