Four emergency calls, all of them requiring an ambulance.
You can probably tell it was a quiet day today. At first I wondered what was going on. Was it the rain? Was it yet another half term for the kids (but then it would be busier, wouldn't it)? Was it that Londoners had finally learned only to call ambulances out when they were dying or very close to dying? I had hours to ponder these questions during my shift.
The amber car is no more - they are sending ambulances to green calls instead of letting me suss them out. I am one of two cars working on all red calls, sometimes amber but mostly red. There are now at least two motorcycle responders, also dealing with red calls and the ambulances are answering these 'Category A' calls too, so it's little wonder that the combination of miserable weather, the drop in numbers of people around and the higher level of emergency cover had contributed to me sitting around doing nothing most of the day.
Not that a rest is as good as...a rest. I'm fine with it but I get bored if I'm not busy. My day goes much quicker when I am running from one call to another. Everything slows down when I sit and read or watch TV.
My first call this morning was to a hotel I didn't even know existed. A very posh entrance led to a very posh room. You can tell five star luxury when you can swing a fat cat on a bungee around the room and still not connect with the walls (not that I would advocate using a cat in such a way - not on a bungee anyway). I was attending a 91 year-old who had fallen and possibly broken a rib. We call this type of fall, where a simple trip is involved, mechanical.
When I went into the room, he was in bed and I asked his name. There were two women in the room with the man and one of them gave me his name and I recognised it immediately. I also looked more closely at the man and realised it was indeed who they said it was. He is a world famous and well respected American TV journalist and anchorman. I grew up knowing the name without knowing who he was and what he did but I know he is synonymous with honesty and truth in the USA. In fact, it is said that more Americans trust him than they do their own Government. I felt honoured to meet him.
Obviously I can't name him but some of you will probably guess. Keep it to yourselves.
He had fallen hard onto the corner of his bedside table and was battered and bruised around his abdomen and ribcage. Otherwise he was stable and in good spirits. I chatted to him until the crew arrived and we carefully moved him onto the chair and out of the hotel to the ambulance. He was still cracking jokes and asking about the possibility of there being pretty nurses at the hospital when I left him. A thoroughly nice man.
There was a lull in my proceedings and then a call for an epileptic at an office had me on my wheels again. An ambulance was already on scene and I went up to the second floor to find the crew attending a young female who was post ictal and recovering from a fit. Nobody in the office knew she was epileptic, it was a revelation for them. It's a good idea, if you are the duty first aider for your company, to find out who suffers from what so that you can report this to us if we are called and so that you know what you are dealing with initially.
I assisted the crew but had nothing to do otherwise - they had it all under control and the hospital was just around the corner. I left them to it and set off on my next call - a 91 year-old female (two 91 year-olds in one day?) with chest pain. When I arrived at the G.P. surgery where she had been attending a routine appointment, the crew were walking her out the door. She didn't have chest pain, she had abdominal pain and it was better now apparently. She seemed like a nice old lady and the EMT attending was getting along well with her.
I think you have done very well in life to reach the age of 91 and still be going to your G.P. for routine appointments! She walked there herself incidentally.
During the rest of my shift I got a large number of cancelled calls. The consequences of living with FRED are beginning to drain me and my colleagues on the other FRU's and bikes (and cycles). One call after another will get you running on blue lights and sirens then they will be cancelled by the system because there is a 'nearer vehicle' or it was 'sent in error'. whoever developed this system had no idea of how it was going to affect the people at the sharp end. It is extremely stressful to start and stop like that throughout the day and, for your information if you are reading this, it slows our response to calls. I have now become so used to being cancelled that I actually wait for a little longer before I set off on the job. Invariably, I will still get cancelled but it has become a stupid lottery. Other road users are being put at considerable inconvenience I think. It got to the point that I was radioing in to ask if they really wanted me to run on this. That's a good 30 seconds wasted if I am required.
Two calls that were cancelled had the additional element of illogical idiocy in the descriptions. One was for a 'sharp leg pain' and was given as a Red3 simply because the patient had answered YES to the question "Do you have difficulty in breathing?". The second call had an address that gave a street name and included, 'London, England'. No postcode. It should be hilarious but it isn't really. Rant over.
Half way through this shift my vehicle's electrical system failed and my MDT gave up on me. All morning I had been getting beeped whenever my speed went over the legal limit for the road I was on. For some reason, the built-in speed warning system had been switched on. Ironic when you consider how many times I was going to break the speed limit today. It became annoying after a few hours and I couldn't work out how to switch it off without a hammer. I took the car back to the station to be fixed - apparently it had the wrong type of battery in it!
I took another car out but it smelled badly of vomit. I scrubbed and scrubbed the inside but I just couldn't get rid of the pong. I kept the windows open for the rest of my shift, rain and all. Later on a colleague explained to me that he had tried for two hours to get rid of that smell after a patient had thrown up without warning.
My final call came in at the end of the day, so I was happy to run on it knowing that I would be back on time. It was for a male suffering chest pains at a petrol station. I sped right past the place. I just didn't see it. What I did see however, was an ambulance coming in the opposite direction. I figured they knew where they were going so I turned around and followed them. They were lost too. Our MDT's were sending us into the wrong street. Luckily, the petrol station was visible around a corner and we both arrived at the same time. Drama.
There was a City of London police officer on scene and he chatted to me as the patient walked himself (chest pain free) to the ambulance with the crew. City of London police carry defibrillators so they can start CPR and give the first set of shocks if required before we arrive on scene to take over. This young officer was telling me all about the new defibrillators that had been issued. He also let me know that he didn't know how to use it. I showed him and he was suitably grateful.
I'm not worried, are you?
Be safe.
Thursday, 17 May 2007
Wednesday, 16 May 2007
Nosey people
Ten emergency calls. One refused, one hoax and one conveyed.
My last night shift. Again, I am on a call before I have time to complete my VDI. I race off to a female having an asthma attack and find a woman in her thirties lying in bed, wheezing and struggling to breathe. Her boyfriend is with her and he tells me that she has been like this all day, on and off. She demands oxygen before I can ask her name and repeats her demand as I carry out my baseline obs. The clever people in management want me to carry out peak flow (PEFR) tests for every asthmatic before I start treatment, yet clinical common sense demands that I do something for the patient. I can only ever do a PEFR test if the patient is calm enough and stable enough to manage it so I decide to start the woman on nebulised Salbutamol, after detecting a wheeze in her chest. I skip the PEFR.
By the time the ambulance crew take her to hospital she is a lot better.
I complete my paperwork and try to do a bit of a VDI but it is all in vain. I get a call to a male with chest pain a couple of miles away in the other direction (of course). I arrive, get confused about which block of flats might be the correct location, reverse, look again and am prompted to re-locate by a pair of waving arms from a balcony - could have been washing flapping on a line for all I could see in the dark but luckily it wasn't.
I made my way up the stairs and into the small, cramped and full-of-people flat. The man, in his 60's, was lying in bed complaining of chest pain. He looked very pale and had been like this for hours apparently. I asked him my standard questions, which always start with "what's your name?" and I carried out my basic obs. He wasn't well and I prepared him for hospital.
The crew arrived and the chair was readied for the man to climb into but he refused to go. In fact, it took us (and his family) more than 30 minutes to persuade him to go to hospital. In the end, we had to carry out a full 12-lead ECG at his bedside, show him how badly damaged his heart was and explain to him what the consequences were of staying in bed before he accepted our offer to save his life. He was probably just scared or stubborn or both. Or stupid.
After that job, I got a chance to complete my vehicle checks and, luckily for me, the wheels of the car were properly attached and there was air in the tyres. Technically, you can refuse to start your shift until a proper VDI has been completed but it rarely happens.
A 16 year-old who was drunk and had fallen (almost into the river) was already being treated by the crew when I arrived on scene so I was not required. I turned around and headed back the way I came but was dragged the other way for a woman at a train station who was feeling sick and dizzy. I was comiserating with her in my head.
I arrived to find the British Transport Police on scene and attending. They explained that the young woman was about to travel and had suddenly collapsed, feeling ill. I spoke to her at length about her medical history and how she felt now. There was another woman there and she sat next to the patient and asked probing questions every time I said something relevant or pertinent. She was beginning to annoy me to be honest.
"So, you took these drugs and then you drank alcohol?" I said
"Is that bad then...should she not drink at all?" piped up other woman
"Erm, no" I said to patient via looking at other woman
A proxy conversation. Very strange.
The crew arrived and I explained the woman's problem. Then the police officer took me aside and commented on the other woman. He made a statement that shot a light through my feet which ended up as a glowing bulb above my head. I turned back to the women on the bench. My colleague was already discussing her personal details. I apologised to my colleague and interrupted.
"Is this lady actually with you?" I asked the patient.
"No" she replied, "she just stopped to help."
I turned my attention to the other woman.
"I'm sorry but you have to leave now." I said
"Really", she responded with a shocked look on her face, "can't I stay?"
"No, we have to consider this lady's confidentiality". I explained
"Couldn't I stay and help her some more?" she said desperately
"No."
"Can I just sit here then?"
"No. I insist".
Hilarious. This lady had absolutely nothing to do with the patient but she presented herself as if she was one of the family! She even asked questions and led the patient to reply to some! There was a lot of eye rolling going on during that exchange, let me tell you.
I spent a pleasant 20 minutes chatting to my colleagues (and completing my paperwork of course) before greening up for the next episode of the shift.
The next drama was a call to a male, fitting in the street. The area I was going to is a known haunt for foreign (mainly Polish) alcoholics, so it was fair bet that it would not be an epileptic seizure. I arrived to find a group of people gathered around a man who was jerking and flailing on the ground. A young girl was holding him down. This little group comprised two members of the public, who had stopped to help and three or four fellow Polish alcoholics.
Right from the start I could see the man was putting on a show. It was the most pathetic parody of epilepsy (or any other kind of seizure) I had seen in a while. It also made me a little angry because there would have been genuine epileptics out there waiting for an ambulance whilst I baby-sat this drunk until an ambulance arrived.
I tried reasoning with him, telling him that I knew what he was up to and that he may as well stop thrashing about and putting me at risk from his loose fists. I told him he would get his hospital bed, so he didn't need to carry on the pretence but he had an audience and he had to keep them convinced. He didn't respond because, apparently, he couldn't speak any English.
His friends weren't happy with my conduct and in between swigs of extra-strength lager they protested his innocence. Let me be clear. I was never rude. I was strict and stern. I was not about to be thumped by this man's stupidity in the street and I cannot tolerate time-wasting fools.
The crew arrived and we bundled him into the ambulance and that's where he recovered miraculously. He stopped flailing, he stopped moaning and, oh prize of prize, he suddenly discovered he could speak English. He still wanted to go to hospital...for a bed. The crew reluctantly obliged. I will try to remember this man's face. Next time, the police will be with me.
Then a 27 year-old female suffering an asthma attack at the bottom of the escalators in a tube station. It was pouring with rain outside so I was glad of the warm, dry environment. That, unfortunately, was the cause of this lady's discomfort. I nebulised her (after a failed PEFR attempt) and she felt a little better but she had a persistent cough and she probably needed steroid treatment for that, so off she went to hospital. I saw her later on and she had fully recovered. A pleasant woman who thanked me for my help, which was nice.
A quiet few hours followed and I went back to my station to recharge. I got my break during this lull and took advantage of the chance to eat some food...and chocolate.
A call in the early hours to an 18 year-old with a head injury after a heavy, stock-laden cage toppled over on a ramp, falling onto him. His nose was bleeding and he had a bump to his forehead. He felt dizzy but he had not been knocked out and he had no neck pain or other associated problems. I took him to hospital in the car.
The next call was to a 60 year-old man who had somehow twisted and ? dislocated his knee in bed. He may have moved awkwardly and pulled his knee cap out of place but it was an unusual job. Together with the crew, I helped keep his pain level down and he was gently moved onto the chair and out to the ambulance. He refused IV pain relief, so it was all achieved with Entonox, which seemed adequate for him.
My last call of the shift was to a 30 year-old male who had been shot at an underground station in South London. I was given an RVP (you know how I love those) and warned not to go near the station in which the shooting had occurred. Of course, I drove right up to it because I didn't have a clear RVP (which was changed half way there) and I didn't know the area well enough to circumnavigate an avoidance route! Luckily for me and all else concerned it was a hoax. No shooting, no victim and no real danger. Just one out-of-place paramedic and ten or so armed-to-the-teeth cops. They smiled at me in pity. I left with my car's tailpipe between its tyres.
Be safe.
My last night shift. Again, I am on a call before I have time to complete my VDI. I race off to a female having an asthma attack and find a woman in her thirties lying in bed, wheezing and struggling to breathe. Her boyfriend is with her and he tells me that she has been like this all day, on and off. She demands oxygen before I can ask her name and repeats her demand as I carry out my baseline obs. The clever people in management want me to carry out peak flow (PEFR) tests for every asthmatic before I start treatment, yet clinical common sense demands that I do something for the patient. I can only ever do a PEFR test if the patient is calm enough and stable enough to manage it so I decide to start the woman on nebulised Salbutamol, after detecting a wheeze in her chest. I skip the PEFR.
By the time the ambulance crew take her to hospital she is a lot better.
I complete my paperwork and try to do a bit of a VDI but it is all in vain. I get a call to a male with chest pain a couple of miles away in the other direction (of course). I arrive, get confused about which block of flats might be the correct location, reverse, look again and am prompted to re-locate by a pair of waving arms from a balcony - could have been washing flapping on a line for all I could see in the dark but luckily it wasn't.
I made my way up the stairs and into the small, cramped and full-of-people flat. The man, in his 60's, was lying in bed complaining of chest pain. He looked very pale and had been like this for hours apparently. I asked him my standard questions, which always start with "what's your name?" and I carried out my basic obs. He wasn't well and I prepared him for hospital.
The crew arrived and the chair was readied for the man to climb into but he refused to go. In fact, it took us (and his family) more than 30 minutes to persuade him to go to hospital. In the end, we had to carry out a full 12-lead ECG at his bedside, show him how badly damaged his heart was and explain to him what the consequences were of staying in bed before he accepted our offer to save his life. He was probably just scared or stubborn or both. Or stupid.
After that job, I got a chance to complete my vehicle checks and, luckily for me, the wheels of the car were properly attached and there was air in the tyres. Technically, you can refuse to start your shift until a proper VDI has been completed but it rarely happens.
A 16 year-old who was drunk and had fallen (almost into the river) was already being treated by the crew when I arrived on scene so I was not required. I turned around and headed back the way I came but was dragged the other way for a woman at a train station who was feeling sick and dizzy. I was comiserating with her in my head.
I arrived to find the British Transport Police on scene and attending. They explained that the young woman was about to travel and had suddenly collapsed, feeling ill. I spoke to her at length about her medical history and how she felt now. There was another woman there and she sat next to the patient and asked probing questions every time I said something relevant or pertinent. She was beginning to annoy me to be honest.
"So, you took these drugs and then you drank alcohol?" I said
"Is that bad then...should she not drink at all?" piped up other woman
"Erm, no" I said to patient via looking at other woman
A proxy conversation. Very strange.
The crew arrived and I explained the woman's problem. Then the police officer took me aside and commented on the other woman. He made a statement that shot a light through my feet which ended up as a glowing bulb above my head. I turned back to the women on the bench. My colleague was already discussing her personal details. I apologised to my colleague and interrupted.
"Is this lady actually with you?" I asked the patient.
"No" she replied, "she just stopped to help."
I turned my attention to the other woman.
"I'm sorry but you have to leave now." I said
"Really", she responded with a shocked look on her face, "can't I stay?"
"No, we have to consider this lady's confidentiality". I explained
"Couldn't I stay and help her some more?" she said desperately
"No."
"Can I just sit here then?"
"No. I insist".
Hilarious. This lady had absolutely nothing to do with the patient but she presented herself as if she was one of the family! She even asked questions and led the patient to reply to some! There was a lot of eye rolling going on during that exchange, let me tell you.
I spent a pleasant 20 minutes chatting to my colleagues (and completing my paperwork of course) before greening up for the next episode of the shift.
The next drama was a call to a male, fitting in the street. The area I was going to is a known haunt for foreign (mainly Polish) alcoholics, so it was fair bet that it would not be an epileptic seizure. I arrived to find a group of people gathered around a man who was jerking and flailing on the ground. A young girl was holding him down. This little group comprised two members of the public, who had stopped to help and three or four fellow Polish alcoholics.
Right from the start I could see the man was putting on a show. It was the most pathetic parody of epilepsy (or any other kind of seizure) I had seen in a while. It also made me a little angry because there would have been genuine epileptics out there waiting for an ambulance whilst I baby-sat this drunk until an ambulance arrived.
I tried reasoning with him, telling him that I knew what he was up to and that he may as well stop thrashing about and putting me at risk from his loose fists. I told him he would get his hospital bed, so he didn't need to carry on the pretence but he had an audience and he had to keep them convinced. He didn't respond because, apparently, he couldn't speak any English.
His friends weren't happy with my conduct and in between swigs of extra-strength lager they protested his innocence. Let me be clear. I was never rude. I was strict and stern. I was not about to be thumped by this man's stupidity in the street and I cannot tolerate time-wasting fools.
The crew arrived and we bundled him into the ambulance and that's where he recovered miraculously. He stopped flailing, he stopped moaning and, oh prize of prize, he suddenly discovered he could speak English. He still wanted to go to hospital...for a bed. The crew reluctantly obliged. I will try to remember this man's face. Next time, the police will be with me.
Then a 27 year-old female suffering an asthma attack at the bottom of the escalators in a tube station. It was pouring with rain outside so I was glad of the warm, dry environment. That, unfortunately, was the cause of this lady's discomfort. I nebulised her (after a failed PEFR attempt) and she felt a little better but she had a persistent cough and she probably needed steroid treatment for that, so off she went to hospital. I saw her later on and she had fully recovered. A pleasant woman who thanked me for my help, which was nice.
Each time I tried to replenish my bags (oxygen masks, nebs, etc) I got a job. I was running out of stock in the car. I made my plea to return to station and I got all of two minutes to re-stock before they called me again.
Another asthma attack, This time a 60 year-old at home. All she needed was a neb and she was happy. Her normal at-home treatment consisted of nebulisation and rest, so that's all she wanted from me. She was packed and ready to go on holiday and refused to go to hospital, despite my advice. She signed my form, chatted for a LONG time about stuff I couldn't keep my brain focused on and then, backing up to the door, I made my politest exit (escape). I was glad she didn't go to hospital - she talked a LOT.A quiet few hours followed and I went back to my station to recharge. I got my break during this lull and took advantage of the chance to eat some food...and chocolate.
A call in the early hours to an 18 year-old with a head injury after a heavy, stock-laden cage toppled over on a ramp, falling onto him. His nose was bleeding and he had a bump to his forehead. He felt dizzy but he had not been knocked out and he had no neck pain or other associated problems. I took him to hospital in the car.
The next call was to a 60 year-old man who had somehow twisted and ? dislocated his knee in bed. He may have moved awkwardly and pulled his knee cap out of place but it was an unusual job. Together with the crew, I helped keep his pain level down and he was gently moved onto the chair and out to the ambulance. He refused IV pain relief, so it was all achieved with Entonox, which seemed adequate for him.
My last call of the shift was to a 30 year-old male who had been shot at an underground station in South London. I was given an RVP (you know how I love those) and warned not to go near the station in which the shooting had occurred. Of course, I drove right up to it because I didn't have a clear RVP (which was changed half way there) and I didn't know the area well enough to circumnavigate an avoidance route! Luckily for me and all else concerned it was a hoax. No shooting, no victim and no real danger. Just one out-of-place paramedic and ten or so armed-to-the-teeth cops. They smiled at me in pity. I left with my car's tailpipe between its tyres.
Be safe.
Friday, 11 May 2007
A close call
There are some shifts that shake you out of your comfort zone and test your ability to remain calm and make the best decisions possible for the benefit of the patient. Tonight was one of those shifts.
I was just about to start my VDI when I got a call to a 6 year-old male, fitting. Control called me on my 'phone and apologised for the distance they were sending me but, at that moment I was the only paramedic available and near enough to deal. That's always an ominous statement.
I sped through rush hour traffic and got one scene, over four miles away, just outside the required Orcon time. In other words, I was late. I grabbed my bags and headed towards a door which was open and being guarded by a little girl. She had been sent to ensure I went to the correct address. She said nothing as I walked past her and into the flat.
Inside, a woman was kneeling on the floor, 'phone to her ear, looking down at a little boy who was on his side, writhing and shaking. He was clearly having difficulty breathing properly and his airway was very noisy. The woman handed me the 'phone as I put my bags down and assessed the situation. The call-taker from EOC was on the other end and, as I unpacked what I needed she confirmed my presence on scene and I asked her when I could expect an ambulance. I made it clear that I needed it quickly. She told me that one was on its way but I didn't get an ETA, nor did I remember to ask her not to have the call downgraded or over-ridden by a higher priority whilst the crew were en-route.
This call was originally given as a young male fitting but the updated information stated that he was no longer having a seizure and was simply 'hot'. As I rushed to get there, I instinctively thought that this would be another run-of-the-mill infection and temperature-related fit. In other words, non epileptic and likely to end with me assessing a conscious and lively (albeit hot) child. I knew the ambulance crew would be thinking the same way and I hoped that the tone of my voice held enough information for an experienced call-taker to recognise that I was dealing with something serious.
I immediately began my primary assessment; his airway was noisy, so I adjusted his head position manually and that improved things a little. His sats. were extremely low; 78% and so I put him on oxygen. His pulse was racing at 142 and he was hot to touch. He was in spasm, especially around the diaphragm and he was completely non-responsive. Given the initial call information and the history, which was related to me by his mum, there was a possibility of status epilepticus and I was not about to take the risk that it might be anything else at this stage, so I administered rectal Diazepam.
The boy's status did not change and his breathing was now causing me great concern. He was becoming flaccid, except for his Phrenic spasms and his sats. were only improving marginally to the mid 80's on oxygen. I knew I had to get him to hospital without delay. His mother told me that he had been like this for 20 minutes and that she had considered getting a taxi to hospital.
After what seemed a lifetime, the crew arrived and I wasted no time in getting him into the back of the ambulance. The two EMT's on the ambulance worked around me as I cannulated the little boy and considered another dose of Diazepam but something wasn't right with this. We set off on blue lights and I asked the attendant to put a nasal tube in. The child's breathing had now become much noisier and he was clenching his teeth - trismus. There was a problem with his brain.
His breathing began to deteriorate, despite his airway being improved by the nasal tube. He wasn't breathing adequately enough and so we 'bagged' him and prepared to resuscitate. All the time I was reaching over to the mother, who was travelling with her daughter, to comfort her and reassure her as best I could.
When we arrived at hospital, the boy's condition had deteriorated significantly. The attendant carried him him whilst the other EMT continually ventilated him. A colleague from my base station helped with the oxygen and that freed me up to begin the hand-over in resus. I stood and related the history and my findings, including drugs given and other treatment carried out, whilst the resus team and a paediatric registrar worked on the little boy. His mother and sister stood in isolation at the end of the room, distressed and overwhelmed.
Before I left, the team had intubated the boy and had him on a ventilator whilst they worked out what could be wrong with him. I spoke to his mother, gave her a little hug and reassured her daughter, who burst out crying from a state of staring silence. I sat with the crew who had been with me throughout this and had a cup of tea (I don't drink tea usually).
Then I got a lift back to my car, which had been left on scene. I said thanks and goodbye to the crew and off I went, back to base to reset my head and complete my VDI, not knowing whether we had saved the little boy or not.
A routine job in the West End after that. A doctor had fainted in a cafe and had a bump to her head. She was fine when I arrived and a little embarrassed I think but lucid enough to refuse the offer of hospital care. She had fallen down after feeling faint, probably as a result of lack of sleep - she was extremely tired and I sympathised with her. I sat with her for a few minutes and we chatted about clinical decisions. Then I gave her the honour of the golden signature and I left.
North London and my next call was to a 45 year-old with chest pains. He had no cardiac history and the pain was exacerbated when he breathed in. It sounded pleural to me; he had suffered a recent chest infection, so it wasn't a long shot. He was taken to hospital by ambulance just in case. I wouldn't risk leaving any chest pain at home.
A four mile trip on blue lights in the opposite direction and I found myself watching my colleagues attend to the needs of a woman who had fallen down the escalators in a tube station and sustained the all-too-familiar groove markings on her head. I wasn't really required, so I assisted the crew by carrying some equipment back up the escalators as they gingerly walked the lady to ground level and into the ambulance.
There were a lot of police officers in Whitehall tonight. At first I thought it was an anti-terror exercise but they were working in conjunction with Transport for London to arrest fare dodgers on the buses as they pulled up at the stands. A lot of money spent to save a few quid I think.
A few minutes rest and then I was on my way to a regular location - a police station. A prisoner was unconscious. It took me 10 seconds to establish that he was feigning unconsciousness and that his acting abilities were in dire need of improvement. Still, he persisted in playing the dead duck. His eyelashes flickered when they were touched, he moved when pain was induced...he even adjusted his head to a more comfortable position when I moved it into a slightly awkward angle! He wasn't funny though. When the crew arrived and the paramedic began to induce a little more pain, the prisoner became abusive and aggressive, lashing out and grabbing my colleague's leg. It took four police officers to hold him down and sort him out.
After that job I got a few routine drink-related calls. A young woman, lying in the rain, too drunk to understand she was alive. I waited with this lady, her friends and the police officer who had called it in until the crew arrived and we loaded her into the vehicle. She vomited a LOT on the way in and had completely dried up by the time she was in the back of the ambulance.
Then I was approached as I sat on stand-by. A young woman asked me to check her friend's condition. She was drunk and couldn't stand up. It sounded familiar. Sure enough when I went around the corner I found a teenager flopped on a ledge, vomiting and being assisted by her friends, some of whom were a little too loud and active for my comfort. I suggested they all calm down and let me do my job. Luckily for me, they obliged.
I called this one in and an ambulance plucked the young lady from obscurity to sobriety.
A little time to myself during which I saw nothing of interest, I'm afraid and then off to another sector for a female with abdo pain and a PV bleed. The ambulance arrived on scene at the same time as me, so I simply assisted them with the young woman. The crew looked very tired and the EMT attending told me that they had been thrown from one end of the town to the other, non-stop and with no break. That's not amusing when you're on nights.
My last job of the shift was for a male with chest pain. I thought the job was going to cost me sleep time, as it was creeping towards 7am but a crew were on scene and all I had to do was carry my bag back to the car with my false-alarm face on.
And now some good news. I posted this days after the shift and I got a call today from the mother of the little boy who was 'fitting'. He survived and is back home, awaiting future scans for a possible cranial bleed. The only reason I know this for sure is that I gave his mother my mobile number and asked her to let me know what happened. Otherwise, as with the other serious jobs I have written about, I would simply never find out.
Be safe.
I was just about to start my VDI when I got a call to a 6 year-old male, fitting. Control called me on my 'phone and apologised for the distance they were sending me but, at that moment I was the only paramedic available and near enough to deal. That's always an ominous statement.
I sped through rush hour traffic and got one scene, over four miles away, just outside the required Orcon time. In other words, I was late. I grabbed my bags and headed towards a door which was open and being guarded by a little girl. She had been sent to ensure I went to the correct address. She said nothing as I walked past her and into the flat.
Inside, a woman was kneeling on the floor, 'phone to her ear, looking down at a little boy who was on his side, writhing and shaking. He was clearly having difficulty breathing properly and his airway was very noisy. The woman handed me the 'phone as I put my bags down and assessed the situation. The call-taker from EOC was on the other end and, as I unpacked what I needed she confirmed my presence on scene and I asked her when I could expect an ambulance. I made it clear that I needed it quickly. She told me that one was on its way but I didn't get an ETA, nor did I remember to ask her not to have the call downgraded or over-ridden by a higher priority whilst the crew were en-route.
This call was originally given as a young male fitting but the updated information stated that he was no longer having a seizure and was simply 'hot'. As I rushed to get there, I instinctively thought that this would be another run-of-the-mill infection and temperature-related fit. In other words, non epileptic and likely to end with me assessing a conscious and lively (albeit hot) child. I knew the ambulance crew would be thinking the same way and I hoped that the tone of my voice held enough information for an experienced call-taker to recognise that I was dealing with something serious.
I immediately began my primary assessment; his airway was noisy, so I adjusted his head position manually and that improved things a little. His sats. were extremely low; 78% and so I put him on oxygen. His pulse was racing at 142 and he was hot to touch. He was in spasm, especially around the diaphragm and he was completely non-responsive. Given the initial call information and the history, which was related to me by his mum, there was a possibility of status epilepticus and I was not about to take the risk that it might be anything else at this stage, so I administered rectal Diazepam.
The boy's status did not change and his breathing was now causing me great concern. He was becoming flaccid, except for his Phrenic spasms and his sats. were only improving marginally to the mid 80's on oxygen. I knew I had to get him to hospital without delay. His mother told me that he had been like this for 20 minutes and that she had considered getting a taxi to hospital.
After what seemed a lifetime, the crew arrived and I wasted no time in getting him into the back of the ambulance. The two EMT's on the ambulance worked around me as I cannulated the little boy and considered another dose of Diazepam but something wasn't right with this. We set off on blue lights and I asked the attendant to put a nasal tube in. The child's breathing had now become much noisier and he was clenching his teeth - trismus. There was a problem with his brain.
His breathing began to deteriorate, despite his airway being improved by the nasal tube. He wasn't breathing adequately enough and so we 'bagged' him and prepared to resuscitate. All the time I was reaching over to the mother, who was travelling with her daughter, to comfort her and reassure her as best I could.
When we arrived at hospital, the boy's condition had deteriorated significantly. The attendant carried him him whilst the other EMT continually ventilated him. A colleague from my base station helped with the oxygen and that freed me up to begin the hand-over in resus. I stood and related the history and my findings, including drugs given and other treatment carried out, whilst the resus team and a paediatric registrar worked on the little boy. His mother and sister stood in isolation at the end of the room, distressed and overwhelmed.
Before I left, the team had intubated the boy and had him on a ventilator whilst they worked out what could be wrong with him. I spoke to his mother, gave her a little hug and reassured her daughter, who burst out crying from a state of staring silence. I sat with the crew who had been with me throughout this and had a cup of tea (I don't drink tea usually).
Then I got a lift back to my car, which had been left on scene. I said thanks and goodbye to the crew and off I went, back to base to reset my head and complete my VDI, not knowing whether we had saved the little boy or not.
A routine job in the West End after that. A doctor had fainted in a cafe and had a bump to her head. She was fine when I arrived and a little embarrassed I think but lucid enough to refuse the offer of hospital care. She had fallen down after feeling faint, probably as a result of lack of sleep - she was extremely tired and I sympathised with her. I sat with her for a few minutes and we chatted about clinical decisions. Then I gave her the honour of the golden signature and I left.
North London and my next call was to a 45 year-old with chest pains. He had no cardiac history and the pain was exacerbated when he breathed in. It sounded pleural to me; he had suffered a recent chest infection, so it wasn't a long shot. He was taken to hospital by ambulance just in case. I wouldn't risk leaving any chest pain at home.
A four mile trip on blue lights in the opposite direction and I found myself watching my colleagues attend to the needs of a woman who had fallen down the escalators in a tube station and sustained the all-too-familiar groove markings on her head. I wasn't really required, so I assisted the crew by carrying some equipment back up the escalators as they gingerly walked the lady to ground level and into the ambulance.
There were a lot of police officers in Whitehall tonight. At first I thought it was an anti-terror exercise but they were working in conjunction with Transport for London to arrest fare dodgers on the buses as they pulled up at the stands. A lot of money spent to save a few quid I think.
A few minutes rest and then I was on my way to a regular location - a police station. A prisoner was unconscious. It took me 10 seconds to establish that he was feigning unconsciousness and that his acting abilities were in dire need of improvement. Still, he persisted in playing the dead duck. His eyelashes flickered when they were touched, he moved when pain was induced...he even adjusted his head to a more comfortable position when I moved it into a slightly awkward angle! He wasn't funny though. When the crew arrived and the paramedic began to induce a little more pain, the prisoner became abusive and aggressive, lashing out and grabbing my colleague's leg. It took four police officers to hold him down and sort him out.
After that job I got a few routine drink-related calls. A young woman, lying in the rain, too drunk to understand she was alive. I waited with this lady, her friends and the police officer who had called it in until the crew arrived and we loaded her into the vehicle. She vomited a LOT on the way in and had completely dried up by the time she was in the back of the ambulance.
Then I was approached as I sat on stand-by. A young woman asked me to check her friend's condition. She was drunk and couldn't stand up. It sounded familiar. Sure enough when I went around the corner I found a teenager flopped on a ledge, vomiting and being assisted by her friends, some of whom were a little too loud and active for my comfort. I suggested they all calm down and let me do my job. Luckily for me, they obliged.
I called this one in and an ambulance plucked the young lady from obscurity to sobriety.
A little time to myself during which I saw nothing of interest, I'm afraid and then off to another sector for a female with abdo pain and a PV bleed. The ambulance arrived on scene at the same time as me, so I simply assisted them with the young woman. The crew looked very tired and the EMT attending told me that they had been thrown from one end of the town to the other, non-stop and with no break. That's not amusing when you're on nights.
My last job of the shift was for a male with chest pain. I thought the job was going to cost me sleep time, as it was creeping towards 7am but a crew were on scene and all I had to do was carry my bag back to the car with my false-alarm face on.
And now some good news. I posted this days after the shift and I got a call today from the mother of the little boy who was 'fitting'. He survived and is back home, awaiting future scans for a possible cranial bleed. The only reason I know this for sure is that I gave his mother my mobile number and asked her to let me know what happened. Otherwise, as with the other serious jobs I have written about, I would simply never find out.
Be safe.
Wednesday, 9 May 2007
Blinded for a mobile phone
Seven emergency calls. One non-convey, one false alarm, one no trace and four ambulances required.
Before I had time to start my VDI there was a call on the screen for a male who had been stabbed in the eye in South London. I raced to the scene and there was an ambulance crew attending. I hopped aboard and learned that the 30 year-old man had been mugged for his mobile 'phone. The assailants had allegedly hit him hard on the head with something and then proceeded to try and relieve him of his left eye by stabbing it. They did a good job because the weapon had penetrated the eyeball and the man couldn't see out of it anymore. Although he was fully conscious and seemed to be in no great pain, he sensed the seriousness of his injury and kept asking whether he would lose the eye. He was rushed to hospital and I hope that they can do something for him.
For some reason, only known to himself, a taxi driver slammed his vehicle into a post. I watched as he reversed from the impact point and carried on his journey as if nothing had happened. I couldn't see any passengers inside...or maybe they were all thrown to the floor. What is going on out there?
Another fainted female and another non-convey. She was 20 years-old and very nice to talk to. She had fainted before and knew the score. Even though she was offered the opportunity to go to hospital and be checked out she declined. She had recovered fully when I arrived and I saw no reason to push the subject further, so she got the famous signing honour and off I went.
I received a call from my Control desk about a job that was coming down to me and was told that there was possibly a child fitting at the address and to proceed with caution as there was a lot of commotion in the background. There was a crew there but the whole thing sounded very dodgy and when I got on scene I found myself walking cautiously up to the entry door of the flats. The buzzer was answered by a slow and very slurred female (Scottish) voice.
"Ambulance", I said
"No, we don't need an ambulance", came the reply
"But you have a crew in there, don't you?"
"Oh, ok then."
I pushed at the door but it didn't open. She hadn't pressed her door release and I was getting concerned now. I pressed the buzzer again. There was a delay and Mrs Slur came back on.
"Can you let me in please?", I asked politely
Eventually I got in and made my way to the floor where the flat was. When the lift door opened I walked into the corridor carefully. I had imagined her and whoever else harming the crew and then lying in wait for me!
I went into the flat and discovered that the crew were talking to a young man who didn't even want an ambulance. All the while this Glaswegian woman, who was extremely drunk, hung over my shoulder talking at me. I wasn't listening- I couldn't understand her to be honest.
It turns out there was no child in danger at this address, just three stupid drunk people who had nothing better to do than call an ambulance out. The woman claimed her boy had been fitting and it's quite possible he had but he was taking diazepam and alcohol at the same time, so I suppose he was heading that way. Nevertheless he declined to go to hospital and I left the crew to work it out with them. Anti-climax.
Later on I was called to a 53 year-old male with DIB. He did indeed have problems with his breathing and had been diagnosed with a chest infection. On top of that he was asthmatic, diabetic and suffered from angina, so he wasn't in good shape. I arrived to find him sitting in his cramped hallway with his family looking on anxiously. Once he was nebulised he began to recover but he went to hospital anyway, he needed a proper check up.
I rested for a bit at my base station and then I was off to another stabbing. This time it was a 16 year-old boy who had been stabbed in the chest and was on a stairwell in a block of flats, or at least that's what the call description stated. In fact, when I arrived at the RVP, along with another ambulance and a few police vehicles, there was nobody to be seen. A search of the location revealed nothing out of the ordinary; no blood, no signs of violence. My control updated me and said that the alleged victim had called again from another location but this time he refused to say where he was. This was typical of a hoax call but also likely to be a stabbing victim who didn't want the police involved. I never found out which because the search was called off and I went back to the station.
A few years back, I was told of a call just like this. It had come from a vague location and the caller had simply stopped talking and hung up after a while. Everyone searched but found nothing so it was assumed he was a prankster. The next day his body was found in a local graveyard. He had crawled his way there with multiple stab wounds and died in the night. Sad really.
A quick call to a train station for a man who claimed he was having palpitations. He had been seen by the hospital doctor two days previously and nothing was found wrong with him. He was a homeless Romanian man and all he wanted was a bed I think. He got his wish; the crew took him to hospital. The rail staff who had tended to him before I arrived were not impressed with him and they apologised for wasting our time. I told them not to bother, it's better for them to call us than to risk getting it wrong.
My last call of the night was to a 70 year-old female who was hypoglycaemic. She wasn't taking good care of herself at all and only had an elderly husband to help her. When I checked her BM it was extremely low - 1.5mMol.
The crew arrived soon after I did and we set about reversing her potentially life-threatening condition. She wouldn't take anything orally, so she got an injection of Glucagon and that was followed up by a little Glucose IV. This did the trick and within ten minutes she was wondering what all the fuss was about. Her blood sugar level returned to normal and she was taken to hospital for further checks.
All told, a good night's work I think.
Be safe.
Before I had time to start my VDI there was a call on the screen for a male who had been stabbed in the eye in South London. I raced to the scene and there was an ambulance crew attending. I hopped aboard and learned that the 30 year-old man had been mugged for his mobile 'phone. The assailants had allegedly hit him hard on the head with something and then proceeded to try and relieve him of his left eye by stabbing it. They did a good job because the weapon had penetrated the eyeball and the man couldn't see out of it anymore. Although he was fully conscious and seemed to be in no great pain, he sensed the seriousness of his injury and kept asking whether he would lose the eye. He was rushed to hospital and I hope that they can do something for him.
For some reason, only known to himself, a taxi driver slammed his vehicle into a post. I watched as he reversed from the impact point and carried on his journey as if nothing had happened. I couldn't see any passengers inside...or maybe they were all thrown to the floor. What is going on out there?
Another fainted female and another non-convey. She was 20 years-old and very nice to talk to. She had fainted before and knew the score. Even though she was offered the opportunity to go to hospital and be checked out she declined. She had recovered fully when I arrived and I saw no reason to push the subject further, so she got the famous signing honour and off I went.
I received a call from my Control desk about a job that was coming down to me and was told that there was possibly a child fitting at the address and to proceed with caution as there was a lot of commotion in the background. There was a crew there but the whole thing sounded very dodgy and when I got on scene I found myself walking cautiously up to the entry door of the flats. The buzzer was answered by a slow and very slurred female (Scottish) voice.
"Ambulance", I said
"No, we don't need an ambulance", came the reply
"But you have a crew in there, don't you?"
"Oh, ok then."
I pushed at the door but it didn't open. She hadn't pressed her door release and I was getting concerned now. I pressed the buzzer again. There was a delay and Mrs Slur came back on.
"Can you let me in please?", I asked politely
Eventually I got in and made my way to the floor where the flat was. When the lift door opened I walked into the corridor carefully. I had imagined her and whoever else harming the crew and then lying in wait for me!
I went into the flat and discovered that the crew were talking to a young man who didn't even want an ambulance. All the while this Glaswegian woman, who was extremely drunk, hung over my shoulder talking at me. I wasn't listening- I couldn't understand her to be honest.
It turns out there was no child in danger at this address, just three stupid drunk people who had nothing better to do than call an ambulance out. The woman claimed her boy had been fitting and it's quite possible he had but he was taking diazepam and alcohol at the same time, so I suppose he was heading that way. Nevertheless he declined to go to hospital and I left the crew to work it out with them. Anti-climax.
Later on I was called to a 53 year-old male with DIB. He did indeed have problems with his breathing and had been diagnosed with a chest infection. On top of that he was asthmatic, diabetic and suffered from angina, so he wasn't in good shape. I arrived to find him sitting in his cramped hallway with his family looking on anxiously. Once he was nebulised he began to recover but he went to hospital anyway, he needed a proper check up.
I rested for a bit at my base station and then I was off to another stabbing. This time it was a 16 year-old boy who had been stabbed in the chest and was on a stairwell in a block of flats, or at least that's what the call description stated. In fact, when I arrived at the RVP, along with another ambulance and a few police vehicles, there was nobody to be seen. A search of the location revealed nothing out of the ordinary; no blood, no signs of violence. My control updated me and said that the alleged victim had called again from another location but this time he refused to say where he was. This was typical of a hoax call but also likely to be a stabbing victim who didn't want the police involved. I never found out which because the search was called off and I went back to the station.
A few years back, I was told of a call just like this. It had come from a vague location and the caller had simply stopped talking and hung up after a while. Everyone searched but found nothing so it was assumed he was a prankster. The next day his body was found in a local graveyard. He had crawled his way there with multiple stab wounds and died in the night. Sad really.
A quick call to a train station for a man who claimed he was having palpitations. He had been seen by the hospital doctor two days previously and nothing was found wrong with him. He was a homeless Romanian man and all he wanted was a bed I think. He got his wish; the crew took him to hospital. The rail staff who had tended to him before I arrived were not impressed with him and they apologised for wasting our time. I told them not to bother, it's better for them to call us than to risk getting it wrong.
My last call of the night was to a 70 year-old female who was hypoglycaemic. She wasn't taking good care of herself at all and only had an elderly husband to help her. When I checked her BM it was extremely low - 1.5mMol.
The crew arrived soon after I did and we set about reversing her potentially life-threatening condition. She wouldn't take anything orally, so she got an injection of Glucagon and that was followed up by a little Glucose IV. This did the trick and within ten minutes she was wondering what all the fuss was about. Her blood sugar level returned to normal and she was taken to hospital for further checks.
All told, a good night's work I think.
Be safe.
Tuesday, 8 May 2007
A new definition of emergency
Eleven emergency calls; 1 non-convey, 1 running call and 1 on scene cancellation.
I started the day as N377, the call sign for the amber car. Then it all got a bit confusing when it was changed after my first job to CS47, the sector car call sign. Apparently that's the way it will stay from now on - I am told that the amber car is officially dead. We'll see.
My first job (as the amber car) was to a call 4.5 miles away; a RTC involving a cyclist and a van. I got on scene, eventually and the cyclist, a rather tall chap, was sitting on a wall with a police officer in attendance. The cyclist had been clipped by the wing mirror of a white Transit van and was consequently lobbed off his saddle and onto the road, where he accrued a few minor injuries (mainly abrasions and bruises) to his legs and hands. Fortunately for White-Van-Man the speed of the collision caused no serious injuries. Unfortunately for said WVM, the cyclist was a criminal barrister.
Pregnancy and back pain are common enemies. A call to an underground station for a pregnant woman with back pain had me thinking about poster advertising and how it could help to deliver this message to young pregnant persons: 'Your back will ache, see your G.P.' Followed possibly by a campaign aimed at the pre-imminent deliverers, simply captioned 'Contractions started? Get a taxi to maternity. You've had 9 months to save up'.
Every now and again, I will get a call for which nothing more than a plaster is required, these still tend to come in as emergencies but they don't need to go to hospital. Like the 70 year-old man who tripped on loose paving and fell on his head, resulting in a cut above his eye. He refused to go to hospital and, after carefully checking his obs., I agreed that he didn't need to anyway. He wasn't knocked out and he was fully alert and aware. I put a strip across the wound, got him to sign my 'get out of jail free' form and left him to it.
Then on to the tiniest alley in the world, to a posh(ish) hotel in the West End for a 36 year-old male with chest pain. It was very difficuly to squeeze down the lane leading to this establishment and when vans parked on the kerb, it became almost impossible. The ambulance must have had a great time trying to get out of the place by the time they had loaded the patient up. Luckily, he wasn't suffering any cardiac problems. It looked and sounded as if he had simply had a panic attack. The cycle responder was on scene before me and, after a quick chat and liaising with the ambulance crew, I left.
Another trip and fall, this time an elderly lady who had fallen and hit her head on the floor of an indoor market. She was knocked out, according to witnesses, but was conscious and alert when I got to her. The ambulance crew arrived within a minute and we took her in the chair for a proper check up. The lady had a nasty bump developing over her eye but she seemed fine otherwise. I assumed the gentleman with her was her husband and so I referred to him as such but he corrected me - "I'm her partner", he said. Oops.
Here's a classic failure of human communication and common sense. I got a Red3 call for a 'leaking catheter; patient to be transferred'. First of all, I'm on the car and can't do transfers, secondly, the patient lived literally on the corner of the hospital and finally, there was no way on Earth that this could be categorised as a RED call! It simply wasn't an emergency. How could it be? I called my Control desk to raise these points and was told that there was a new system in place and that these calls were going to slip through the net and we still had to respond to them as emergencies. This is despite the fact that anyone, absolutely anyone, looking at it would know that it was NOT a life-threatening emergency.
I arrived on scene and when I finally got to the flat the patient expected me to change his catheter and I can't do that. Shockingly, the call had been made by the District Nurse who was sitting on the sofa in the same room, shouting down her mobile phone. When I tried to talk to her she raised her hand and said "just a minute". Now that didn't please me at all and I know she saw what registered on my face at that moment.
The patient became annoyed with me because he had expected to be sorted out (quite rightly) as a result of my being called. He did not want to go to hospital (around the corner) but I explained to him that there was no option and then wondered why the nurse wasn't able to fix this leaky catheter for her patient. I couldn't see the point in her being here if she had no skills to use. Maybe one of my nursing readers can help with this one.
Believe me, I wasn't angry with the patient or the nurse, although she was incredibly rude (and loud). I was angry at being put in such an awkward situation by the new system, of which I was told nothing when I started my shift. Apparently, the Government are behind the new change of goalposts. Keep your eye on Tom Reynolds' blog for more detail; I don't do politics here, as you know.
Eventually, the man was taken to hospital (around the corner) by the ambulance crew, who were just as mystified as me.
Later, I was cancelled on scene by police after a RTC call in which a motorcyclist had been knocked off his vehicle. He didn't want to go to hospital and had stormed off in a huff.
A large part of Covent Garden was closed off because of a suspect package and I got myself stuck in a dead-end or two whilst trying to respond to a call for a male who was having an epileptic seizure in a park. I got there late as a result and the motorcycle responder was just ahead of me. Neither of us knew where exactly this patient was in the park and so we started looking around. I saw a woman running down the path and thought she may be connected but then I didn't want to move unless she actually was something to do with the call. As she got closer she waved at us and I got back in the car and headed towards her. I gave her a lift back to where the young man had been fitting. She was puffing and panting after her mini-marathon, so it would have been rude to drive off and leave her to hoof it back, right?
He was standing up, supported by a few people around him and one of his friends. He had been seen fitting on the grass, although his friend said he wasn't epileptic. He was still post ictal and had to be persuaded to sit in the car until I could complete my obs. Meanwhile, the police and the ambulance had arrived - communing on the grass in the sunshine. Lovely. If we weren't all on duty we could have had a 999 picnic.
Not a bad idea that.
Anyway, he was taken to hospital with his friend in tow and as soon as I had completed my paperwork, another call came in for yet another 'male fitting'. This time in a Knightsbridge store (no, not Harrods. Nice try).
I was taken a few floors up by security and found the man lying next to one of those long shoe-fitting benches. His wife was with him and she explained that he had been receiving treatment for a brain tumour recently and today he had suddenly collapsed and had a fit of some kind.
You may remember that I dealt with exactly the same type of call a month or so ago. After treatment for brain tumours, swelling can occur and this can lead to momentary deficits, headaches or seizures, as in this case. The man still wasn't fully recovered when I started talking to him; he was confused and a little agitated. His wife requested that he be taken to a private hospital where he was receiving his treatment. She became quite upset when I explained we couldn't do that. When the crew arrived, the attendant also explained that, as she had called 999, he would be taken to the nearest NHS hospital with an A&E department. He could then be transferred to his private hospital if it was deemed safe and appropriate to do so.
After that call, I got a few minutes to myself on stand-by. I was approached by a homeless man who asked me to check his eye, which had swollen after he had fallen down drunk the previous night. I know this because he was quite candid about it. I didn't recognise him and asked him if he was new to the area. He laughed and told me he had been sleeping rough for 40 years! I asked his name and told him mine (I usually do this). I shook his hand and off he went, happy with the advice I had given him.
Then a call to a male in his 60's who had fallen down some steep steps and bashed his head hard enough to knock himself out. He was drunk and he wasn't shy about it. Despite the fact that he was now fully aware and had nothing more than a minor head injury, he was taken to hospital for a proper examination...and a chance to sober up.
A ? anaphylactic reaction at a department store next. A 19 year-old female was lying on the floor of one of the stairwell landings, feeling unwell after eating shellfish. She had no allergies that she knew of and her airway was fine; no trouble talking at all, but she was vomiting regularly and this concerned me. After I had covered all the other bases; pregnancy, medication, etc., I assumed she must be reacting to something she ate, quite possibly the shellfish she mentioned. The ambulance crew took her to hospital with a bag under her chin, just in case.
My final call, a running call, was for a young Slovakian girl who felt she had something in her eye. She was with a male friend, who spoke English and was her translator for the trip to hospital. I had examined her eye and could find nothing in it. I flushed it with saline and still she felt something there. I knew it was possible that she had a corneal abrasion and the scratch could feel like an annoying foreign body in the eye. I was hoping the eye casualty would be open but it wasn't. I had to leave the girl and her friend in the crowded waiting area with a possible three hour wait time - especially if all you have wrong with you is a scratched eyeball.
On my way back to base I noticed a police patrol car with a couple of stickers on the side. Advertising stickers, one of which was for HSBC bank. Is that for real? Please tell me that isn't the future.
Be safe.
I started the day as N377, the call sign for the amber car. Then it all got a bit confusing when it was changed after my first job to CS47, the sector car call sign. Apparently that's the way it will stay from now on - I am told that the amber car is officially dead. We'll see.
My first job (as the amber car) was to a call 4.5 miles away; a RTC involving a cyclist and a van. I got on scene, eventually and the cyclist, a rather tall chap, was sitting on a wall with a police officer in attendance. The cyclist had been clipped by the wing mirror of a white Transit van and was consequently lobbed off his saddle and onto the road, where he accrued a few minor injuries (mainly abrasions and bruises) to his legs and hands. Fortunately for White-Van-Man the speed of the collision caused no serious injuries. Unfortunately for said WVM, the cyclist was a criminal barrister.
Pregnancy and back pain are common enemies. A call to an underground station for a pregnant woman with back pain had me thinking about poster advertising and how it could help to deliver this message to young pregnant persons: 'Your back will ache, see your G.P.' Followed possibly by a campaign aimed at the pre-imminent deliverers, simply captioned 'Contractions started? Get a taxi to maternity. You've had 9 months to save up'.
Every now and again, I will get a call for which nothing more than a plaster is required, these still tend to come in as emergencies but they don't need to go to hospital. Like the 70 year-old man who tripped on loose paving and fell on his head, resulting in a cut above his eye. He refused to go to hospital and, after carefully checking his obs., I agreed that he didn't need to anyway. He wasn't knocked out and he was fully alert and aware. I put a strip across the wound, got him to sign my 'get out of jail free' form and left him to it.
Then on to the tiniest alley in the world, to a posh(ish) hotel in the West End for a 36 year-old male with chest pain. It was very difficuly to squeeze down the lane leading to this establishment and when vans parked on the kerb, it became almost impossible. The ambulance must have had a great time trying to get out of the place by the time they had loaded the patient up. Luckily, he wasn't suffering any cardiac problems. It looked and sounded as if he had simply had a panic attack. The cycle responder was on scene before me and, after a quick chat and liaising with the ambulance crew, I left.
Another trip and fall, this time an elderly lady who had fallen and hit her head on the floor of an indoor market. She was knocked out, according to witnesses, but was conscious and alert when I got to her. The ambulance crew arrived within a minute and we took her in the chair for a proper check up. The lady had a nasty bump developing over her eye but she seemed fine otherwise. I assumed the gentleman with her was her husband and so I referred to him as such but he corrected me - "I'm her partner", he said. Oops.
Here's a classic failure of human communication and common sense. I got a Red3 call for a 'leaking catheter; patient to be transferred'. First of all, I'm on the car and can't do transfers, secondly, the patient lived literally on the corner of the hospital and finally, there was no way on Earth that this could be categorised as a RED call! It simply wasn't an emergency. How could it be? I called my Control desk to raise these points and was told that there was a new system in place and that these calls were going to slip through the net and we still had to respond to them as emergencies. This is despite the fact that anyone, absolutely anyone, looking at it would know that it was NOT a life-threatening emergency.
I arrived on scene and when I finally got to the flat the patient expected me to change his catheter and I can't do that. Shockingly, the call had been made by the District Nurse who was sitting on the sofa in the same room, shouting down her mobile phone. When I tried to talk to her she raised her hand and said "just a minute". Now that didn't please me at all and I know she saw what registered on my face at that moment.
The patient became annoyed with me because he had expected to be sorted out (quite rightly) as a result of my being called. He did not want to go to hospital (around the corner) but I explained to him that there was no option and then wondered why the nurse wasn't able to fix this leaky catheter for her patient. I couldn't see the point in her being here if she had no skills to use. Maybe one of my nursing readers can help with this one.
Believe me, I wasn't angry with the patient or the nurse, although she was incredibly rude (and loud). I was angry at being put in such an awkward situation by the new system, of which I was told nothing when I started my shift. Apparently, the Government are behind the new change of goalposts. Keep your eye on Tom Reynolds' blog for more detail; I don't do politics here, as you know.
Eventually, the man was taken to hospital (around the corner) by the ambulance crew, who were just as mystified as me.
Later, I was cancelled on scene by police after a RTC call in which a motorcyclist had been knocked off his vehicle. He didn't want to go to hospital and had stormed off in a huff.
A large part of Covent Garden was closed off because of a suspect package and I got myself stuck in a dead-end or two whilst trying to respond to a call for a male who was having an epileptic seizure in a park. I got there late as a result and the motorcycle responder was just ahead of me. Neither of us knew where exactly this patient was in the park and so we started looking around. I saw a woman running down the path and thought she may be connected but then I didn't want to move unless she actually was something to do with the call. As she got closer she waved at us and I got back in the car and headed towards her. I gave her a lift back to where the young man had been fitting. She was puffing and panting after her mini-marathon, so it would have been rude to drive off and leave her to hoof it back, right?
He was standing up, supported by a few people around him and one of his friends. He had been seen fitting on the grass, although his friend said he wasn't epileptic. He was still post ictal and had to be persuaded to sit in the car until I could complete my obs. Meanwhile, the police and the ambulance had arrived - communing on the grass in the sunshine. Lovely. If we weren't all on duty we could have had a 999 picnic.
Not a bad idea that.
Anyway, he was taken to hospital with his friend in tow and as soon as I had completed my paperwork, another call came in for yet another 'male fitting'. This time in a Knightsbridge store (no, not Harrods. Nice try).
I was taken a few floors up by security and found the man lying next to one of those long shoe-fitting benches. His wife was with him and she explained that he had been receiving treatment for a brain tumour recently and today he had suddenly collapsed and had a fit of some kind.
You may remember that I dealt with exactly the same type of call a month or so ago. After treatment for brain tumours, swelling can occur and this can lead to momentary deficits, headaches or seizures, as in this case. The man still wasn't fully recovered when I started talking to him; he was confused and a little agitated. His wife requested that he be taken to a private hospital where he was receiving his treatment. She became quite upset when I explained we couldn't do that. When the crew arrived, the attendant also explained that, as she had called 999, he would be taken to the nearest NHS hospital with an A&E department. He could then be transferred to his private hospital if it was deemed safe and appropriate to do so.
After that call, I got a few minutes to myself on stand-by. I was approached by a homeless man who asked me to check his eye, which had swollen after he had fallen down drunk the previous night. I know this because he was quite candid about it. I didn't recognise him and asked him if he was new to the area. He laughed and told me he had been sleeping rough for 40 years! I asked his name and told him mine (I usually do this). I shook his hand and off he went, happy with the advice I had given him.
Then a call to a male in his 60's who had fallen down some steep steps and bashed his head hard enough to knock himself out. He was drunk and he wasn't shy about it. Despite the fact that he was now fully aware and had nothing more than a minor head injury, he was taken to hospital for a proper examination...and a chance to sober up.
A ? anaphylactic reaction at a department store next. A 19 year-old female was lying on the floor of one of the stairwell landings, feeling unwell after eating shellfish. She had no allergies that she knew of and her airway was fine; no trouble talking at all, but she was vomiting regularly and this concerned me. After I had covered all the other bases; pregnancy, medication, etc., I assumed she must be reacting to something she ate, quite possibly the shellfish she mentioned. The ambulance crew took her to hospital with a bag under her chin, just in case.
My final call, a running call, was for a young Slovakian girl who felt she had something in her eye. She was with a male friend, who spoke English and was her translator for the trip to hospital. I had examined her eye and could find nothing in it. I flushed it with saline and still she felt something there. I knew it was possible that she had a corneal abrasion and the scratch could feel like an annoying foreign body in the eye. I was hoping the eye casualty would be open but it wasn't. I had to leave the girl and her friend in the crowded waiting area with a possible three hour wait time - especially if all you have wrong with you is a scratched eyeball.
On my way back to base I noticed a police patrol car with a couple of stickers on the side. Advertising stickers, one of which was for HSBC bank. Is that for real? Please tell me that isn't the future.
Be safe.
Monday, 7 May 2007
Heroes
Yeah, well these guys were part of a fancy dress cinema club. Batman and Robin were among a number of others whose costumes portrayed film characters but it’s not these guys I’m talking about – it’s the two young men who saved an old woman’s life when she toppled into the Thames. The two gentlemen, Dan and Mark (whose permission I have to name them incidentally) will probably never receive the thanks they deserve for what they did.
The call was to a 70-year-old female who had fallen in the river. No other information was given and, to be honest, on screen it looked like another tragedy and a fruitless search for a body. I arrived and there were a number of other colleagues already on scene. The woman had been fished out of the water by the rescue services and was being treated and kept warm by the medics attending. I was asked to check out the two lads who had also been in the river. This was news to me; the call had not described any others involved, so I wondered what kind of condition these two men would be in. I went around to the police office and found them standing in their shorts, drying themselves off. They both looked fine. I asked them what had happened and they described how they had seen the woman sitting on the embankment wall by the river when she suddenly frothed at the mouth and toppled in.
Dan immediately jumped in after her whilst Mark called the emergency services. I believe Mark then got in to help his friend, who admitted he had struggled against the strong (and lethal) current as he tried to keep the lady’s head above the water. All of this happened in broad daylight and in the most treacherous river conditions. You have to admire the sheer guts of these guys – there was no hesitation and they did this with no thought to the risk they put themselves in. It’s the kind of action we do not condone in our society, in fact, the more liberal minded among us tend to chastise risk-taking behaviour but how many of you have actually had to make such a choice? People who know me personally will tell you that I will take enormous risks for other people and many of my colleagues will do the same without a second thought but there are definitely things that take a lot more nerve to do. Jumping into that river is one of them.
So, I have named them and thousands of you now know their names, even though you will never meet them. Hopefully, the old lady will make a full recovery and will thank these lads personally – she definitely owes the rest of her life to them.
Last time I saw them they were walking along the embankment, on their way back to work, dressed only in their shorts.
My morning had started out as a calamity. The radio on the vehicle I was assigned to drive was malfunctioning (well, not functioning at all) and I had to go to the contractor’s depot to get it repaired. I arrived half an hour before they opened, so I waited until the engineers showed up. I explained my predicament - half an hour tops they told me and once again I sat and waited.
The call was to a 70-year-old female who had fallen in the river. No other information was given and, to be honest, on screen it looked like another tragedy and a fruitless search for a body. I arrived and there were a number of other colleagues already on scene. The woman had been fished out of the water by the rescue services and was being treated and kept warm by the medics attending. I was asked to check out the two lads who had also been in the river. This was news to me; the call had not described any others involved, so I wondered what kind of condition these two men would be in. I went around to the police office and found them standing in their shorts, drying themselves off. They both looked fine. I asked them what had happened and they described how they had seen the woman sitting on the embankment wall by the river when she suddenly frothed at the mouth and toppled in.
Dan immediately jumped in after her whilst Mark called the emergency services. I believe Mark then got in to help his friend, who admitted he had struggled against the strong (and lethal) current as he tried to keep the lady’s head above the water. All of this happened in broad daylight and in the most treacherous river conditions. You have to admire the sheer guts of these guys – there was no hesitation and they did this with no thought to the risk they put themselves in. It’s the kind of action we do not condone in our society, in fact, the more liberal minded among us tend to chastise risk-taking behaviour but how many of you have actually had to make such a choice? People who know me personally will tell you that I will take enormous risks for other people and many of my colleagues will do the same without a second thought but there are definitely things that take a lot more nerve to do. Jumping into that river is one of them.
So, I have named them and thousands of you now know their names, even though you will never meet them. Hopefully, the old lady will make a full recovery and will thank these lads personally – she definitely owes the rest of her life to them.
Last time I saw them they were walking along the embankment, on their way back to work, dressed only in their shorts.
My morning had started out as a calamity. The radio on the vehicle I was assigned to drive was malfunctioning (well, not functioning at all) and I had to go to the contractor’s depot to get it repaired. I arrived half an hour before they opened, so I waited until the engineers showed up. I explained my predicament - half an hour tops they told me and once again I sat and waited.
Three hours and thirty minutes later, they pronounced it alive and well. I got no further than back to base when it snapped, crackled and popped. Ominously, I could smell burning. I took the vehicle out of commission and found myself another, there were no managers around and so I managed it myself. I took on my usual vehicle and, after a clean out and a re-kit and a thorough wash, I was ready to earn my pay. I was five hours into my shift now and had not answered a single call.
When my first call came in it was for a 33 year-old female who had fainted at work. She was lying on the floor when I arrived and she made no effort to open her eyes for me, even though she was conscious and her eyes were probably working just fine. Neither would she speak above a whisper (I don’t do whispers very well) so it was difficult to communicate with her properly. It wasn’t until I stopped being so gentle about it all and hardened my voice a little that she responded. Now she was okay. All her obs. were normal and she was just a little emotional. The crew arrived and she was taken to hospital anyway. I think that’s what she wanted to be honest.
Then, an interesting call to a jewellers shop in the West End. A 60-year-old male had suddenly lost his peripheral vision in his right eye. He was working as normal when he became aware of his limited vision and a headache, which niggled him at the same time. I arrived to find him being taken care of by the shop staff. He was a bit pale and he was quite nervous about what might be going on. He had a slightly high BP but, apart from his visual deficit and his headache, he had no other obvious clinical (neurological) abnormalities. Neither did he have any significant medical history for heart attack or stroke.
The crew arrived to take him to hospital and I accompanied them to the street. I learned later that the man was thrombolysed because, although his CT scan was normal, the doctors suspected something abnormal was going on in his head. I couldn’t agree more.
A fainted female at another place of work but this time she refused to go to hospital to be checked out. My suspicion was that she had probably had a seizure; she was confused, vague and sleepy and didn’t really have the look of someone who had simply fainted. She looked post ictal to me and so I urged her to consider going to hospital but she just wasn’t interested. She had capacity to refuse and her colleagues were not happy to be left with her in their care in case something more serious occurred. Kind of selfish of her I thought.
A collapsed male next. He worked behind the security desk of a bank in the city. He had felt his legs go weak after a bout of pain in his side as a result of reaching over for something. The man’s colleagues were a hoot and kept making jokes about him but they were genuinely concerned and their banter was designed to keep him smiling, which it did - me too.
He looked very pale and I considered the possibility of a cardiac connection, although it’s not uncommon for people to semi-faint after a sudden crisis of pain, simply because the body releases adrenaline to cope. In fact, when the crew arrived and we looked at his vital signs and his ECG, he seemed to be in good shape, so I reckon the pain-crisis theory holds water in this case. I left the man in the care of the crew and I expect they let him get on with his day.
One minute away from this call there was a young woman lying in an alley after falling and cracking her head on a concrete window ledge. I was sent the call as soon as I greened up and off I went. There was a small crowd around this lady, who was eight months pregnant, and they were propping her up and tending to her bleeding head with a handkerchief. I took my usual position next to the lady and we chatted about what had happened.
I noticed on my short walk towards her that the street was very steep and the paving very uneven. I also noticed that this lady was wearing high heels - not really a good idea in late pregnancy. I presumed the combination had made her stumble and from what she told me, it sounds like that was the case. No loss of consciousness, no complications with the baby, no anxiety required. Her head wound had stopped bleeding, thanks in part to the beautifully white handkerchief (now available in crimson) and she was fully alert and aware. She was also very worried and tearful.
Once I had calmed her nerves (she was worried about her unborn child) and assured her that there was enough cushioning in there for her baby to be just fine, I walked her the few yards to my car. She was quite cold, so a blanket or two and a warm car were just what she needed.
The ambulance arrived and I thanked the gentlemen who had helped the lady when she fell, especially the one who lost his nice hankie.
My last call of the shift was to a block of flats not far from my station. I was attending an elderly lady, in her late 80’s, who was generally unwell after treatment for bowel cancer. Her neighbours were milling around her and I could sense their anxiety. She was a very frail woman but also quite independent; she lived on her own and relied on a once daily visit from a carer, otherwise she fended pretty much for herself. Her neighbours told me that the last time she went to hospital, her house was broken into and she was robbed. The lock had never been repaired since, despite the council being asked to do it repeatedly for the past few months. Disgusting. The lady had lived in the flat since the blocks were built in the 1930’s. I looked out of her window and wondered what she had seen from that view over those decades.
The crew arrived and gently carried her down the stairs and into the ambulance. A couple of kids were outside and they asked what was happening (estate kids always ask what is going on or who is ill). Then they saw the old lady being carried into the ambulance and one of them said, “I hope she gets better”, and you know, I think he meant it.
Be safe.
Wednesday, 2 May 2007
Dead or alive?
It was lovely and warm today. The wind kept me from being too hot in my uniform and stab vest (the shirt tends to stick a little to the vest at the back, which is unpleasant). Central London was busy with traffic, as it always is, and drivers were getting edgy. This was compounded by the many holes being dug around the place by men in yellow tabards whose aim is to re-lay something like a thousand miles of water pipe to replace the old Victorian ones - they lasted over a hundred years, I'll bet the new ones need to be replaced in a decade.
Strangely, as I sat in the car in the traffic and contemplated this, I heard the Python song, 'Always look on the bright side of life' floating in the air as a Royal Mail van passed. It seemed to parody the actual mood of the streets.
I was busy today. The amber car is dead (for the moment), so I am on a CS call sign day or night. That means only red and amber calls; mainly red. So, it all kicked off with a call to a male 'fitting. ? cause'. I arrived and the ambulance was already on scene and the crew were dealing. The man wasn't fitting at all, he was shivering.
Then a man who was described as collapsed and unconscious. He was sitting in the street with a little gang of his friends - all Czechs and none speaking much English, so it was a challenge from the start. Although my first thought was that he was just drunk, his friends assured me, in pidgin English, that he had not been drinking today/ He certainly didn't look well; very pale, quite confused and disorientated. I set about my obs. and all seemed normal, apart from his demeanour. The crew arrived and the paramedic on board - a good friend of mine from my old station, found his temperature was high. My thermometer had read normal but there you go, it just shows you how important a second opinion and a working thermometer are. There was also a familiar smell, which had become noticeable on moving him; the smell of bad urine, so a possible UTI. He was packed off to hospital and I drove back to my usual patch.
On the way I received a call for a RTC involving a motorcyclist and a van, only seconds up the road from where I was. I weaved around the queue of traffic and found the scene of the collision. The injured motorcyclist had been clipped by a van and thrown from his bike, luckily at low speed (sometimes the Central London traffic is a saving grace). He had nothing more serious than a sprained ankle, which he twisted on his journey from saddle to tarmac. An ambulance arrived before I could cancel it and the crew took him on board for a trip to A&E.
After a couple of cancelled calls that had me driving in a circle, I was sent to South London for a multiple stabbing. A rendezvous (RV) point was given and I had to wait there with the police until the all-clear to attend was given. Now these RV's can be tricky things to arrive at safely. I have, on one or two occasions, driven right past the incident address en route to said RV, quite embarrassing and possible dangerous. Receiving an RV and getting to it without crossing the actual danger zone is a distinct and nowhere near precise science. Rarely have I received the address of the incident, so that I can avoid it!
I arrived at the RV point, this time without getting confused and there was nobody there to meet me. I wondered if I had got it wrong and called my Control desk for more information. They told me that the police wanted me to move to another location, where I would find my patient. It was around the corner (literally) and took me all of 5 seconds to locate.
The police were up on a balcony in an estate and I was guided to a young man who was lying on the floor, his lower body covered in blood - at least his clothes were. Bizarrely, I was told that he had been stabbed hours earlier at about 5am and had only just been discovered when a couple of PCSO's had come across him in the street. He had been making his way home after the alleged assault.
I had a look at his injuries, which seemed confined to his lower limbs and could see at least one deep stab wound to his right leg. I dressed it and then found other, less significant wounds in other parts of the leg. He also had a few to his right hand, where he had been protecting himself from the onslaught. He was allegedly set upon for no reason by a gang of youths who had taken a dislike to him.
The man was still fully clothed, except for the ripped right trouser leg and I had him moved carefully into his flat so that I could examine him more thoroughly. It's important not to assume that the wounds you see are the only wounds around, even if the patient states he has no others, so his clothing was removed and I checked his head, neck, chest and pelvis. Nothing. Then I asked him to take his trousers off and there they were...at least five other stab wounds, two of which were very deep; one in this thigh and the other through the shin bone of his left leg. Surely he must have felt that one?
Many people claim to have been punched and this is what he thought had happened. He also had a wound to his eye and it was clear that the assailants had tried to stab him in the face too. He was very lucky, a couple of inches in the wrong direction and he would have staggered home whilst bleeding from an artery and I wouldn't be patching him up.
No rest and another call - an epileptic who had been fitting and was now recovering. When I got there the ambulance crew were already dealing. Not required.
After that I had a few minutes to myself and soaked up the sun by standing outside the car for a bit but that leisurely punctuation was disturbed by a call to a 30-year-old female who was fitting in the street. I arrived to find her lying on the pavement with helping hands on her. She was very confused and tearful. She kept repeating that she was a nurse and could I tell her what her BP was. She had fallen hard enough for witnesses to hear the thud of her skull on the concrete, so she was at least concussed and she was definitely post ictal. Her confusion was magnified by her repeated requests regarding where she was, who I was and if her BP was normal. I think she had experienced her first seizure and had been unfortunate enough to have it where the landing zone wasn't soft enough.
And the best call of the day, for sheer stupidity, was to a one month old baby, ? suspended. The worst kind of call for me and no doubt for a lot of my colleagues. I really don't want to be holding someone's dead child and explaining to them that I was "doing the best I could" because that's a rubbish deal.
The call description stated 'not crying' and this was all the information I had when I set off. I called Control and asked them for a little bit more info. In fact, I asked them if I was going to a suspended baby or not. They replied that they were still taking the call so had nothing else to offer yet, except that they were treating this as a Red1 - suspended.
When I arrived, an ambulance had just pulled up at the address and there was a motorcycle solo paramedic already inside. I felt that this must be a genuine dead baby - why else all the fuss? I went upstairs to the flat and entered the living room. I saw a very emotional mother, a worried relative, the ambulance crew, the solo paramedic and a baby lying on the floor...hiccupping.
I'm not even going to bother elaborating on this call.
Be safe.
Strangely, as I sat in the car in the traffic and contemplated this, I heard the Python song, 'Always look on the bright side of life' floating in the air as a Royal Mail van passed. It seemed to parody the actual mood of the streets.
I was busy today. The amber car is dead (for the moment), so I am on a CS call sign day or night. That means only red and amber calls; mainly red. So, it all kicked off with a call to a male 'fitting. ? cause'. I arrived and the ambulance was already on scene and the crew were dealing. The man wasn't fitting at all, he was shivering.
Then a man who was described as collapsed and unconscious. He was sitting in the street with a little gang of his friends - all Czechs and none speaking much English, so it was a challenge from the start. Although my first thought was that he was just drunk, his friends assured me, in pidgin English, that he had not been drinking today/ He certainly didn't look well; very pale, quite confused and disorientated. I set about my obs. and all seemed normal, apart from his demeanour. The crew arrived and the paramedic on board - a good friend of mine from my old station, found his temperature was high. My thermometer had read normal but there you go, it just shows you how important a second opinion and a working thermometer are. There was also a familiar smell, which had become noticeable on moving him; the smell of bad urine, so a possible UTI. He was packed off to hospital and I drove back to my usual patch.
On the way I received a call for a RTC involving a motorcyclist and a van, only seconds up the road from where I was. I weaved around the queue of traffic and found the scene of the collision. The injured motorcyclist had been clipped by a van and thrown from his bike, luckily at low speed (sometimes the Central London traffic is a saving grace). He had nothing more serious than a sprained ankle, which he twisted on his journey from saddle to tarmac. An ambulance arrived before I could cancel it and the crew took him on board for a trip to A&E.
After a couple of cancelled calls that had me driving in a circle, I was sent to South London for a multiple stabbing. A rendezvous (RV) point was given and I had to wait there with the police until the all-clear to attend was given. Now these RV's can be tricky things to arrive at safely. I have, on one or two occasions, driven right past the incident address en route to said RV, quite embarrassing and possible dangerous. Receiving an RV and getting to it without crossing the actual danger zone is a distinct and nowhere near precise science. Rarely have I received the address of the incident, so that I can avoid it!
I arrived at the RV point, this time without getting confused and there was nobody there to meet me. I wondered if I had got it wrong and called my Control desk for more information. They told me that the police wanted me to move to another location, where I would find my patient. It was around the corner (literally) and took me all of 5 seconds to locate.
The police were up on a balcony in an estate and I was guided to a young man who was lying on the floor, his lower body covered in blood - at least his clothes were. Bizarrely, I was told that he had been stabbed hours earlier at about 5am and had only just been discovered when a couple of PCSO's had come across him in the street. He had been making his way home after the alleged assault.
I had a look at his injuries, which seemed confined to his lower limbs and could see at least one deep stab wound to his right leg. I dressed it and then found other, less significant wounds in other parts of the leg. He also had a few to his right hand, where he had been protecting himself from the onslaught. He was allegedly set upon for no reason by a gang of youths who had taken a dislike to him.
The man was still fully clothed, except for the ripped right trouser leg and I had him moved carefully into his flat so that I could examine him more thoroughly. It's important not to assume that the wounds you see are the only wounds around, even if the patient states he has no others, so his clothing was removed and I checked his head, neck, chest and pelvis. Nothing. Then I asked him to take his trousers off and there they were...at least five other stab wounds, two of which were very deep; one in this thigh and the other through the shin bone of his left leg. Surely he must have felt that one?
Many people claim to have been punched and this is what he thought had happened. He also had a wound to his eye and it was clear that the assailants had tried to stab him in the face too. He was very lucky, a couple of inches in the wrong direction and he would have staggered home whilst bleeding from an artery and I wouldn't be patching him up.
No rest and another call - an epileptic who had been fitting and was now recovering. When I got there the ambulance crew were already dealing. Not required.
After that I had a few minutes to myself and soaked up the sun by standing outside the car for a bit but that leisurely punctuation was disturbed by a call to a 30-year-old female who was fitting in the street. I arrived to find her lying on the pavement with helping hands on her. She was very confused and tearful. She kept repeating that she was a nurse and could I tell her what her BP was. She had fallen hard enough for witnesses to hear the thud of her skull on the concrete, so she was at least concussed and she was definitely post ictal. Her confusion was magnified by her repeated requests regarding where she was, who I was and if her BP was normal. I think she had experienced her first seizure and had been unfortunate enough to have it where the landing zone wasn't soft enough.
And the best call of the day, for sheer stupidity, was to a one month old baby, ? suspended. The worst kind of call for me and no doubt for a lot of my colleagues. I really don't want to be holding someone's dead child and explaining to them that I was "doing the best I could" because that's a rubbish deal.
The call description stated 'not crying' and this was all the information I had when I set off. I called Control and asked them for a little bit more info. In fact, I asked them if I was going to a suspended baby or not. They replied that they were still taking the call so had nothing else to offer yet, except that they were treating this as a Red1 - suspended.
When I arrived, an ambulance had just pulled up at the address and there was a motorcycle solo paramedic already inside. I felt that this must be a genuine dead baby - why else all the fuss? I went upstairs to the flat and entered the living room. I saw a very emotional mother, a worried relative, the ambulance crew, the solo paramedic and a baby lying on the floor...hiccupping.
I'm not even going to bother elaborating on this call.
Be safe.
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