Saturday, 12 November 2011
Naomi the Welsh
So, a fainting rough sleeper in a train station, whose medical history included five heart bypasses, started us off but we were joined by the ambulance crew at the same time, so neither of us laid a hand on the patient.
This was quickly followed by a police call to a young woman who was fitting in a shop. Armed cops had come across her and had rendered some basic aid whilst waiting for our arrival. Again, the crew was on scene very quickly too, so it was a minimal challenge for us. I spoke to the patient's mother on the 'phone, because her daughter was post ictal and very confused, so couldn't tell us anything about herself. The cops had taken her mobile phone and called mum to explain what had happened, and to glean more information. I was passed the phone, so that I could get the medical info I needed.
'She has these all the time. She'll be okay soon. She doesn't need to go to hospital', mum told me.
'But she took her anti-epileptic medicine and she still had a fit', I explained.
'Yes, but she'll be fine. She always recovers', mum replied.
'Well, she fell onto a cafe floor this time. If we let her go now, she may have another fit and fall in front of a car.'
I think I persuaded her mum not to pursue the 'she'll be okay' route. The crew took the patient to hospital.
In Oxford Street, a 19 year-old Red Bull drinking girl was hyperventilation and having palpitations. I told the crew we'd deal with it without the need to take her to hospital. She'd declined that anyway and just wanted not to be at work I think. Her colleagues were around and they were very sympathetic, so, after calming her down and reminding her what Red Bull and the likes can do, we left her in the gentle care of her boss.
And a fainting 21 year-old hotel cleaner, who'd been unconscious for a brief time, was taken away for checks by the crew after we'd spent a few minutes finding out that she was doing three jobs a day and not eating well enough to remain standing up. Low-paid foreign workers are suffering in the Capital as they try to make ends meet. They earn enough in reality, thanks to the minimum wage (which you might argue is never enough... but at least it's a start), however, living in or around London is very expensive, and so anything they work hard to earn simply disappears in rent and other costs. No wonder the poor woman was running from one job to another and neglecting herself.
During the weekend of shifts, we had two anaphylactic calls. The first was serious; the man was collapsed at the bottom of the stairs inside a shop. His wife was with him and she explained that he'd come in to buy antihistamine because he'd felt he was reacting to something he'd touched earlier. He'd fallen down and couldn't get back up.
He was covered in a rash and, although his breathing hadn't become compromised, it was clear he was going into Anaphylactic shock. His systems were shutting down. He looked like a man deteriorating there and then. He'd lost bowel control and his vital signs - pulse and blood pressure especially - were out of control.
Naomi is a registered paramedic, so there was no need for her to stand and do nothing. She helped me get started on saving this man's life. A crew had arrived, with another paramedic, so we had more than enough hands and resources to deal with this. If only the shoppers would stop climbing the stairs by walking over us!
We got oxygen on, an anti-histamine and some adrenlanine into him, and very quickly moved him to the ambulance, where we'd stabilise him even more before setting off to hospital. He'd need urgent intervention to bring his BP up. He was still very conscious and quite able to talk to us, but he was clearly frightened.
Naomi has had little experience in giving IM injections, by her own admission, I should add. So I asked her to administer an injection to the patient. She did so and I've never seen anyone jump so much in my life. The patient lurched as if being lanced by a ten-foot pole. Poor Naomi's face... bless.
It was, nevertheless, a job well done by all; a good team effort. A combined Anglo-Welsh effort you could say. The patient arrived at hospital in much better shape than we'd found him and (just so you know) has no objection to this being written.
Our second anaphylactic call was less dramatic. A 17 year-old French visitor began to suffer shortness of breath after eating something she disagreed with. She injected herself with her Anapen auto-injector and her family called an ambulance.
I was a little concerned that they'd chucked the Anapen, with exposed needle, into a litter bin. I asked the family members to go and retrieve it. If someone had pricked their skin with it whilst rummaging around (there are people who do rubbish-rummaging), they'd have been given a nasty little puncture, which may have carried a little Adrenaline into the tissue. Epinephrine causes local tissue necrosis; it's not friendly.
She was fine though. Her Anapen had worked and her breathing was normal, but she still had to go to hospital because Adrenaline doesn't last very long... Histamine does.
There's a sinister looking Santa-type wandering around Trafalgar Square. He has the red suit and the white beard... but he wears orange wellies and he has the complexion of a 1990's Michael Jackson. He is utterly weird to behold and I wouldn't want my little boy seeing him and believing him to be the bringer of presents. I have no doubt his reindeer are parked somewhere but I don't want to see them. Look out for him and send me a pic if you can.
Naomi's comical adventures didn't end with the jumping patient, so I'll share them with you, because they are a lot more entertaining than a list of no-patient-contacts.
A visit to a 52 year-old hostel-dwelling man with abdominal pain, caused by liver damage and Hepatitis, meant she had to ask a simple question or two....
"Do you take pain killers?" She asked.
"Yes, I do", he answered.
"What for?" She continues.
"Pain!" He says, with the exasperated look of a man who is speaking to the Village Idiot.
I had to grin, as did she. We both knew what she meant, but it was funny to hear how it was received.
Then we went to see an 88 year-old man who'd collapsed in a department store. He was very unwell looking; diaphoretic and with suspicious periods of apnoea. We'd already started treatment, wrapped him up and taken him out to the ambulance. The vehicle was parked at a risky angle because the road had been narrowed due to works going on, so we'd asked the workmen to keep an eye on traffic flow and our bags as we continued treatment inside the vehicle.
Just as I was about to get on the ambulance, I saw Naomi trip over the bags and fall, like a lumbering sack of wood, to the ground. It was as though she'd seen them but still wanted to fly over them. This was also witnessed by about five grinning workmen. The poor woman didn't know where to look. Obviously balance and grace aren't taught out in Wales... in London we are all practically Ballerinas!
Maybe I should retract that last comment :-)
Anyway, she recovered, but without the benefit of video evidence (and I wish I'd filmed it), there is no way you can know just how comical it was. She's tough as nails, so she won't mind how I've described it.
The rest of the weekend consisted of more no-show patients and no-contact calls, including the one to Park Lane underpass for an 'unconscious' man. When we got there and went underground to find him, we saw a slumbering street-dweller... inside a sleeping bag. Now, if someone inside a sleeping bag in an underpass in the middle of the day isn't the biggest clue you'll ever get to NOT being dead, then I despair.
He even had a little pool of change lying next to him. Evidently, other, less frantic members of the public who'd passed by had seen it for what it was and thrown a little money at him. Now he has effectively cost you and I hundreds of pounds, just so we can see that he is, in fact..asleep. Oh, and not too happy to be woken up by me.
We ended the tour of duty with a very unwell man with chest pain and a soaring blood pressure. He needed to go to hospital quickly and we made sure that he did.
I've been invited by Naomi's boss to do a few shifts out that way, so that I can experience another way of working. I'm looking forward to it and will report back of course, with all the details. Well, the ones I'm allowed to write about.
All in all, Naomi gave me and my colleagues a laugh at her own expense but she was very well liked and respected. Cheeky banter and humiliating situations often combine in this job to make us what we are. This is a human profession and, regardless of the perspectives of a narrow minority, we really care about what we do. I now know that the Welsh produce paramedics that are just as caring and professionally minded... even if a little brutal with their needles and a little confusing with their questions... and a bit clumsy and blind.
We love you Naomi, you're the best.