Saturday, 8 May 2010

Searching for the elusive job

Night shift: Ten calls; one by car; one declined; four left at scene; four by ambulance.

Stats: 1 RTC; 1 purple; 1 abusive person; 1 chest pain; 1 faint; 1 eTOH; 1 eTOH head injury; 1 infection; 1 head injury; 1 assault.

My assigned student paramedic is with me tonight and tomorrow so I get to watch someone else doing all the work and so we stopped to assist at a RTC involving a cyclist and a car. The cyclist slammed into the parked vehicle and took out the back window (see pic). An elderly couple were just leaving it to go to the theatre and were made late by the incident, which was not their fault. The cyclist wasn’t wearing a helmet but only seemed to have cuts to his face, caused by the shattering screen, so he was incredibly lucky. Still, the biker on scene decided, quite rightly, that he needed to go in a collar and board to hospital and I made that an excuse for the student with me to get some practice.

A call to a large theatre for a 26 year-old man ‘not responding’ took us to an obtuse and verbally aggressive man who was sitting on a chair in the canteen area, ignoring the security men who were trying to help him. He seemed drunk but a tag around his wrist told us that he’d been out, probably all night, at a place where they sold alcohol and where drugs like GHB were probably available, so his attitude and demeanour could be explained from that clue alone. When he started to get obnoxious with the student ('you're just a bloody jobsworth') I intervened and stopped the process. I asked the security guys to deal with it because the man had no medical problem and didn’t want us to help him even if he did. I wasn’t going to sit there and pander to his aggression as if we were just puppets in his little play. So, we left and the security men took matters into their own hands.

For the sake of practice, Control are sending me wherever necessary so that the student paramedic can get valuable skills in, so I was sent more than 3 miles to a ‘not breathing’ call for a 32 year-old woman who hadn’t been seen for a couple of days, only to find a confusing situation. There were two calls in the same street; a RTC with a child in the car and the one I was tasked to. The street soon had four or five yellow LAS vehicles and a police car in it.

The patient we were going to deal with had been dead for a long time and so all my student had to do was go through a few checks (rigor, staining, temp) and leave the EMT on scene to complete the paperwork. He had arrived earlier and there was no need for us to hang around. The student paramedic needs to get tubes and needles, drugs and fluids practice, so we are searching for the right calls.

Then onto a chest pain in the City and a 56 year-old Asian lady had nothing more than an anxiety attack in a club. She’d found a mouse at home earlier and had chased it around until finally capturing it and this, she told us, was the cause of her stress. She’d had chest pain, radiating to her neck and then began to lose her vision. All the signs of a faint after stress in fact. A crew arrived and we went through the routines required of us; ECG, BP etc and this lady was as fit as a fiddle (why do they say that?).

An Italian man with a history of PE fainted in a restaurant and I had to control the little mob of family and friends that gathered around him, including, strangely, their family GP who just happened to be joining them on their London holiday. Only one person could speak English and the student paramedic was using her as a translator. The GP was difficult to keep back because he was interested, obviously, but the patient’s stress level was being affected by the constant pawing and staring, so I asked for everyone but the translator to clear a space – not an unreasonable request. There were so many of them; I think they’d taken over the entire Italian restaurant.

He was left with his family after thorough checks and a normal ECG. He’d fainted and nothing more. His GP could keep an eye on him.

The next patient punched me in the jaw as I tried to take his pulse, so I suddenly became less interested in those around me who were claiming he was ‘ill’ and ‘can’t breathe’. The 39 year-old was drunk among many other drunks at a family party in which small children and babies were witness to his thrashing on the floor antics, coughing and general abuse, which he threw at myself and the crew on scene. His trousers were around his thighs and I asked that the kids be taken away, especially the one being held by its mum as she stood close by to get a better view of what was going on in the little community hall.

The police were called because, despite our gentle attempts to calm him, he was only interested in throwing his fists at us. I won’t tolerate this and so he was tied onto a trolley bed and escorted out by cops and the crew. He was completely unmanageable and seemed to be suffering nothing more than hysterical intoxication. After the incident I took myself and the student back to the station where I inspected the state of my molars. I'd lost a bit of filling, so I'll live.

The 23 year-old girl who fell down six steps at a night club, smashed her face and head and then walked out to be met by her (equally drunken) boyfriend was taken away by cab because neither of them were interested in her health and welfare. In fact, the crew that arrived with us were left standing on the pavement without acknowledgement. It’s going to be a night of ignorance.

Off to the East for a 66 year-old man with a leg infection who was feeling very ill. He had a high temperature and shook continuously; he also had leg pain higher up than the infection itself, so my guess is that the problem is spreading. The crew arrived with us and he was taken to hospital.

Now, it’s all very good getting dressed up in school uniform and prancing around a disco when you’re all grown up and want a bit of fun but to start fighting in the street and end up getting arrested is just stupidity - especially when dressed like that. Alcohol and testosterone has a lot to answer for.

An 18 year-old lad tried to fend off the lecherous advances of several thuggish ‘schoolies’ towards his mum, who he had brought along, dressed appropriately in short school skirt, shirt and tie of course, and got beaten up for his trouble. He suffered minor head injuries and was knocked out for a few seconds. Meanwhile another fight kicked off as we arrived and another young man got his nose busted out of that one. In the middle of it all, with twenty or so drunken, uniform-clad teenagers and men behaving badly, a single police officer tried to keep the peace but was forced to draw his baton to defend himself against what looked like an angry mob that was about to turn on him.

Broken nose man walked away for some reason and I called an ambulance because it just felt like more trouble was coming. Sure enough, with the head injured man in the back of the car and the broken nosed one in the ambulance, further little scuffles ensued and more police arrived to sort it out. One or two of the less intelligent among the mob got arrested because they just wouldn’t or couldn’t control their aggression. I have a bad feeling that this lot, as they disperse into separate groups, are going to create problems later and elsewhere. I'm guessing they behaved like that in school for real.

And fights broke out here and there in the West End as expected, so we were sent to an assault in which a 25 year-old Latvian man was allegedly robbed of all his hard-earned cash as he made his way to the coach station for the trip home. He had superficial facial injuries but complained of C-Spine tenderness and that meant an ambulance, collar, board and a trip to hospital. When the crew arrived we were all pretty cold; the night got progressively bitter temperature-wise and the cops and CID on scene huddled around as we secured the injured man. He began to fit, however, making life difficult for us – then he recovered for a short while and repeated the seizure again, just as we thought the worst was over.

At last he was taken into the ambulance where he began to talk again and the crew decided to move away in case he had another fit. I took my freezing fingers back to the car and the student paramedic followed with her paperwork and obs.

Drunken idiots decided to knock down a barrier set up to channel traffic into one lane because work was being done on the road and I didn’t notice that they were flat on the ground until I saw how close I had come to falling into the deep, five foot square hole that was now exposed and ready to injure or kill a driver or pedestrian if they just happened not to be concentrating. I roped in a PCSO, my student paramedic and a couple of volunteering road sweepers to help me get the barrier back up. The last thing I needed was a late job back there for a ‘car down hole’ or ‘person impaled on spike down hole’.
And the fight with the schoolies meant we didn't get called on the near-fatal stabbing in Piccadilly Circus that would have given the student some real practice.

Be safe.


Anonymous said...

"Fit as a Fiddle"

'Fit' was originally used to mean 'suitable', in the sense 'fit for purpose', 'perfect for a use'; not healthy or energetic as is more often meant nowadays.

Also ‘fiddle’ earlier had two meanings –
a) the colloquial name for violin or
b) on a ship the guardrail used on a table to prevent things from slipping off during rough weather and storms (see DVDs, reruns of The Onedin Line).

So the phrase originally meant well designed for its purpose – as in the 'fiddle' stopping plates & cutlery etc sliding off the table whilst eating during rough weather at sea; or a violin which is the best shape, construction and design for the playing of European derived music.

It has continued in use as a phrase, as its meaning has changed and drifted over the last 4 centuries or thereabouts to its current meaning, because it is an extremely good piece of alliteration, fit for its purpose.


Kieran said...

Glad to see student is back with you! We students are pretty good at carrying the response bag as well as paperwork eh!!

As for the fit as a fiddle comment- I was thinking about the exact same thing the other day, fit as a fiddle-r maybe?! It still makes no sense and I too wonder why we say it.


Uncle J said...

Social events with "GP on scene" seem to happen quite a lot, but sometimes more hindrance than help? - discuss.

Xf said...


Thank you for that. Yes, it makes sense. A lot of our sayings come from naval terms, such as the brass monkey term, you know 'cold enough to freeze the balls off a brass monkey'. The brass monkey was the instrument used to keep canon-balls in place and when it got too cold the metal would contract, causing the balls to 'come off' it.

This is what I know of it anyway, so it coud be accurate to believe 'fit as a fiddle' came from the navy.

Xf said...

Uncle J

Hmmm. Not sure I'd want a discussion about it; GP's can be useful and they can be annoying, depending on their skill level pre-hospital and whether they have any respect whatsoever for what we do.

I had to tell the GP in this story to sit down several times because he thought he was in charge.

Anonymous said...

Xf - I think that was just about the sort of 'discussion' I had in mind (Chortle)