Wednesday, 30 June 2010

Combat medic

Night shift: Eight calls; one declined; two left at scene; one false alarm; five by ambulance; one by car.

Stats: 1 faint; 1 RTC bus v sped; 1 head injury; 2 cut feet; 2 eTOH; 1 assault with head injury.


A 26 year-old gave blood earlier in the day and then fainted when she was queuing with her friends at a restaurant. She was recovering well when I arrived and her obs were all normal. She didn’t want to go to hospital and she didn’t need to, so I asked the restaurant people if they could put her and her friends at the front of the queue (she needed to eat) and then got her to sign my paperwork, leaving her in the care of her mates.


No sooner had I finished this call when another came in – a 22 year-old man had been hit by a bus on Oxford Street. When I arrived, there were a few PCSO’s on scene and a grey car parked in front of a bus. The windscreen of the bus had a large bulls-eye on it – two in fact and I was shown inside to where the patient was sitting, chatting merrily away with one of the PCSOs.

He’d been walking across the road and got hit by the bus at around 20mph; his head and shoulder hit the windscreen, thus the two bulls-eyes. All he complained about was a sore shoulder. His head was marked but there was no bleeding and no other visible injury of any significance. His neurological signs were good and he generally looked okay. I spent a long time with him because there were no ambulances available and in all that time (30 minutes) he showed no sign of deterioration.

I had explained to him that he would be ‘boarded’ when the crew arrived. I’d already put a collar on him but he needed to know that it was all precautionary. I got another FRU colleague to assist me while I waited for an ambulance and while he held the man’s head still, I asked about the grey car that was still in front of the bus. Police had arrived by then and Oxford Street traffic was being controlled. I was told that the man was hit by the bus, flew across the road a few feet and then hit this car. I looked at the side of it and there was a huge dent in the back door. If this young man escaped injury he was very lucky indeed.

When he finally got to hospital, boarded and immobilised, the doctor gt a little excited about the impact speed and the fact that he'd been thrown across the road and into a car, so he was rushed into Resus, looking bemused. Later on he was walking out of the hospital and thanking me as I entered with another patient - just goes to show you, doesn't it?


The second trauma call of the night was to a 33 year-old man who was hit by a chunk of brick that apparently flew off some covered scaffolding as he walked innocently underneath – and not directly underneath either; the only way that bit of masonry could have reached him was if it had been lobbed or kicked. He had a head injury and I found him sitting at a tube station entrance near the scaffolding. Two witnesses told me what happened and the works manager, who came out after the incident, was also hanging around, although he was very quiet about it all.

I asked for police to come and check it out because I had concerns about how this brick had flown off the scaffolding and what possibility there might be that another would follow. From three or four floors up, one of these missiles could kill someone. The site Manager was very cagey, to say the least and the police found him a little fidgety about the whole incident.

I asked for an ambulance and got the patient on a board; I wasn't prepared to take any chances with him. The same doctor took delivery of him at the hospital and he must have thought I was deliberately bringing in walking-talking serious stuff.


Later on a 27 year-old woman cut her foot on glass – she was walking barefoot in an underground station and thought she may have stepped on a broken beer bottle. The undergrounds staff called an ambulance (even though there was a first aider on scene) and all I had to do was listen to the woman, who was a soldier apparently, and her three mates, laugh about the fact that I would take her to hospital if she wanted me to.

I put a dressing on it and she said she’d either just leave it or go and see her doctor. I think they’d all had a drink but her underlying point was made – a 999 call for a cut foot? Crazy, surely? In what other country on Earth (apart from the obvious few) would that be considered an emergency to life?


So, another cut foot made me look silly again but this time, the 25 year-old woman hadn’t called and neither had the train station staff. The first aiders were dealing with a very minor laceration to the bottom of her foot but some strange person, who wouldn’t stop pestering them apparently, went off to the nearest payphone and dialled 999 – thus I arrived ready for the emergency. This type of behaviour is akin to taking money out of our pockets and chucking it down a drain – it’s so easy to do.


Another easy thing to do is get drunk while on antidepressants, fall to the floor of the toilet, retch, foam at the mouth and struggle to vomit on an empty stomach... apparently. The rescue mission took me to a bar where an off-duty nurse (yes nurse) was carrying out vital research for the NHS. The crew was on scene just ahead of me (‘cos I went the wrong way and got there late), so I helped them get her onto the chair and up the stairs to sanctuary. ‘Why am I like this?’ she asked as she lolled around trying to throw up. It would have been easy to say ‘because you have had too much alcohol’ and that would probably have been true but factor in the drugs and she may just have been having a good old fashioned reaction to them - either way, she should have known better but she didn’t get a leaflet or a lecture; she got Metoclopramide and a free ride to the nearest A&E.


As Soho racked up another couple of drunks, fighters and arrested wasters, I was asked to go up north to visit a man who’d been introduced to a bottle – in the face. I was told to ‘stand by’ for police. I have no idea what this means any more – do I travel towards the call and then wait somewhere? Do I wait where I am and then go? It all used to be so simple but now it’s all got a bit stupid. So, I waited, pressed my ‘please talk to me’ button and waited some more. Then I waited a bit more... and more until a driver pulled up alongside my car and told me a man was lying in the road, so I called in a running call and went to check on him.

The young lad was half-in, half-out , body on the pavement, legs in the road. Any vehicle coming along and cutting up the corner would also have cut his limbs off. A lady had stopped to help him but she couldn’t wake him up (everybody knows only the LAS can wake people up, right?). She put his keys and his wallet into his rucksack and zipped them away. Then she left when I arrived and after she’d told me this.

I woke the man up and told him where he was. He seemed surprised. ‘I’m very tired’, he said, eyes half shut. ‘Well, go and find somewhere safe to sleep... not the road’, I replied, eyes wide open. He shook my hand and staggered off into the early morning. My God, it’s July already – where’s my life gone?


Assaults involving gangs that pounce on individuals and stamp on their heads are among the worst calls to go to because there is always an element of anger and shock at the brutality of it. My next patient, a 34 year-old gay man, was sitting on a step with his boyfriend and two police officers. He’d been set upon by four people, punched, kicked and thrown to the ground. Then they’d stamped on his head so hard that the boot print could clearly be seen on his cranium. He had other cuts and bruises but it was the mark on his head that concerned me most.

I couldn’t get an ambulance and he was stable, so I took him and his partner in the car. They swore a lot but I guess this was all anger and frustration.


Two for one next when I went to a call on which police were standing guard over two semi-conscious drunken males, both from the same group of friends, who’d collapsed in the street and had been there so long they’d both become hypothermic. No ambulances were available and there’s no Booze Bus running (this is exactly what it exists for), so with the prospect of waiting a while, I covered them both to keep them warm and plumbed them both in to keep them hydrated and to dilute the alcohol in their blood. The Summer has arrived and this is what we are all up against for the next few months. It will get much, much worse when the schools break up. It can be like treating in a war zone.

I got two ambulances after a while and my patients were carted off one by one to the great drying-out centres we call hospitals.

Be safe.

5 comments:

Julia said...

"Assaults involving gangs that pounce on individuals and stamp on their heads are among the worst calls to go to because there is always an element of anger and shock at the brutality of it."

You got that right! I saw it for the first time recently and it was scary as hell. :(

Minty said...

How on earth does one become hypothermic in this weather???

the_dark_angel said...

Well hello there :)

I'm Sebastian, I work as a Paramedic in Poland. Down here it's all roughly the same, with some exceptions.

We are a fledgling profession in this country still. First released on the streets in 2004 we've been setting new standards for the whole country and the, still very chaotic, polish EMS system.
Still, many people treat us like stretcher-bearers or orderlys and become very disgruntled or even aggressive when they discover that no doctor came to their sore foot.

The topic of inappropriate calls is very wide here. We totally lack qualified dispatchers and those that are filling that place are mostly just simple telephonists that "swallow" every call and send ambulances to everything that comes in. Sometimes those are nurses on a second job aside from the hospital. Yet among all of them there is only a small percentage that would take it upon themselves to "bounce" a call, telling them to use their available transportation to the hospital or take care of it themselves if it's no real emergency.

Believe me, if you would work in my enviroment you'd consider a foot wound to be something quite interesting. We get calls to "lonely grandma's" who have their tiny apartments all in devotional iconography, radio set for Radio Mary (local christianic-Jihad radio) and nobody to talk to... Drunks of all sorts and no Booze-bus cause the city does not recognize the problem (it's better to leave it to us and pretend it doesn't exist, right?).
Recently we were almost beaten cause the foot wound had some drunk buddies.
All in all it's all fun and games ;)
Sometimes thigs are serious though. I had to call in HEMS three times in eight days a week ago. First there was a gas explosion. A badly burned 60 yo woman (90%, 2 deg burns), second was a spectacular MVA - Four men nicked a car, a brand new slate grey Ford Mustang GT and went for a ride. The ride stopped on a tree in the countryside. The driver had a cranial trauma, broken femur and a open broken knee and third was a epileptic 2-year old child that didn't respond to Diazepam.
So yeah, we do have our share of adventures.

I'll be commenting some more in the future.
Good luck.

the_dark_angel said...

Well hello there :)

I'm Sebastian, I work as a Paramedic in Poland. Down here it's all roughly the same, with some exceptions.

We are a fledgling profession in this country still. First released on the streets in 2004 we've been setting new standards for the whole country and the, still very chaotic, polish EMS system.
Still, many people treat us like stretcher-bearers or orderlys and become very disgruntled or even aggressive when they discover that no doctor came to their sore foot.

The topic of inappropriate calls is very wide here. We totally lack qualified dispatchers and those that are filling that place are mostly just simple telephonists that "swallow" every call and send ambulances to everything that comes in. Sometimes those are nurses on a second job aside from the hospital. Yet among all of them there is only a small percentage that would take it upon themselves to "bounce" a call, telling them to use their available transportation to the hospital or take care of it themselves if it's no real emergency.

Believe me, if you would work in my enviroment you'd consider a foot wound to be something quite interesting. We get calls to "lonely grandma's" who have their tiny apartments all in devotional iconography, radio set for Radio Mary (local christianic-Jihad radio) and nobody to talk to... Drunks of all sorts and no Booze-bus cause the city does not recognize the problem (it's better to leave it to us and pretend it doesn't exist, right?).
Recently we were almost beaten cause the foot wound had some drunk buddies.
All in all it's all fun and games ;)
Sometimes thigs are serious though. I had to call in HEMS three times in eight days a week ago. First there was a gas explosion. A badly burned 60 yo woman (90%, 2 deg burns), second was a spectacular MVA - Four men nicked a car, a brand new slate grey Ford Mustang GT and went for a ride. The ride stopped on a tree in the countryside. The driver had a cranial trauma, broken femur and a open broken knee and third was a epileptic 2-year old child that didn't respond to Diazepam.
So yeah, we do have our share of adventures.

I'll be commenting some more in the future.
Good luck.

the_dark_angel said...

Well hello there :)

I'm Sebastian, I work as a Paramedic in Poland. Down here it's all roughly the same, with some exceptions.

We are a fledgling profession in this country still. First released on the streets in 2004 we've been setting new standards for the whole country and the, still very chaotic, polish EMS system.
Still, many people treat us like stretcher-bearers or orderlys and become very disgruntled or even aggressive when they discover that no doctor came to their sore foot.

The topic of inappropriate calls is very wide here. We totally lack qualified dispatchers and those that are filling that place are mostly just simple telephonists that "swallow" every call and send ambulances to everything that comes in. Sometimes those are nurses on a second job aside from the hospital. Yet among all of them there is only a small percentage that would take it upon themselves to "bounce" a call, telling them to use their available transportation to the hospital or take care of it themselves if it's no real emergency.

Believe me, if you would work in my enviroment you'd consider a foot wound to be something quite interesting. We get calls to "lonely grandma's" who have their tiny apartments all in devotional iconography, radio set for Radio Mary (local christianic-Jihad radio) and nobody to talk to... Drunks of all sorts and no Booze-bus cause the city does not recognize the problem (it's better to leave it to us and pretend it doesn't exist, right?).
Recently we were almost beaten cause the foot wound had some drunk buddies.
All in all it's all fun and games ;)
Sometimes thigs are serious though. I had to call in HEMS three times in eight days a week ago.

I'll be commenting some more in the future.
Good luck.