Twelve emergencies; one assist-only, two refused and nine taken by ambulance.
Mechanisms. I’ve used the word many times throughout this diary. The word describes the causes for injury. For example, if someone falls 20 feet onto concrete, the mechanisms for injury include the height, the landing surface (and its ability to absorb energy) and the person’s body and state of health, among other things. If you were to show a REAL interest and it was relevant, you might also look at objects on the way down, the weather and other things that may influence injury but we rarely have time to be that scientific about it.
Medical emergencies also have mechanisms; the pills a person takes or doesn’t take, the state of a person’s heart when they have chest pain, etc. Every tell-tale sign or symptom is a lead to a potential mechanism.
My first call of the day was to a 33 year-old man who had come off his bicycle at speed while going downhill. A wall had abruptly stopped him and he had gone over the top of his handlebars at around 30 mph. Now he was sitting on a step outside his home with a friend a few hours after the incident. He had decided it wasn’t worth an ambulance at the time and had simply hobbled home.
His main complaint was that he felt dizzy and faint. He also had severe pain in his shoulder and ribs on the same side (the side he had landed on). He had a tender spot on his cervical spine at the level of his mid-neck. His breathing was rapid and his BP was low. He hadn’t been knocked out and there was no visible bleeding. The mechanisms, however, suggested a possible neck injury, a possible fracture to his upper arm and ribs and the possibility of an internal bleed. So, he was treated for all of those.
I asked him to lie flat on the ground (which helped him feel less faint) and held his head so that he couldn’t move his neck. The ambulance arrived at that moment and I explained the situation to the crew. The man was immobilised on an orthopaedic stretcher (a scoop) and taken to hospital for further investigation. His mate was left behind wondering what the hell had just happened.
My next call was to a 20 year-old female with a history of anaemia who now felt dizzy and complained of her ‘throat swelling’. I couldn’t work out whether she had eaten something and was now having a mild reaction or she was relating two different problems to me; her anaemia-induced dizziness and the fact that she had reacted to something. When I carried out my obs, she seemed absolutely fine and had no history for anaphylaxis. The call had come in as a ‘DIB’ but she was having no difficulty with her breathing at all.
She was taken to hospital anyway. If she had reacted to something it was possible she could relapse.
Choking children present one of the worst scenarios for us. This call was for a one year-old boy who was ‘choking and vomiting’. I arrived with the ambulance at my heels and we all entered a small, dimly-lit flat together. Inside a woman was sitting with a child in her arms. He looked perfectly happy and was active and playful. I asked if this was the child who was choking and she said 'yes'.
On the bed, there was a little mound of vomited food and an benign object that caused the whole panic in the first place. It was a large, badly cut piece of apple. Apples are notorious for causing choking in small children, they get stuck in their little windpipes and are difficult to get back out again. In this case, the child had vomited in distress and the apple core had been forced out with the pressure.
I checked the child over and could find no reason to take him to hospital; he had cleared the obstruction himself and was now fully recovered. I asked the mum if she was happy to keep him at home and she said she was.
‘Can I still feed him?’ she asked
‘Well, yes but I wouldn’t advise anything but liquids at the moment.’ I replied
Let’s not tempt fate, eh?
I was sent to an underground station for a 32 year-old man who had collapsed and was vomiting. He was, of course, extremely drunk. He was taking a cocktail of drugs for gout and back problems, none of which deterred him from downing as much alcohol as his body could possibly hold – ‘I think I’m an alcoholic’, he said apologetically. I agreed with him.
The crew arrived and a chair was wheeled out for him.
Meanwhile, the beautiful people of London were hurrying past us in their suits and dresses, on their way to happier places where people don’t lie in their own vomit until well after chucking out time. The man painted a pathetic picture of his future history and everyone passing him knew it, judging by the looks of pity and disgust he was receiving...or maybe they were looking at the men in green.
No break yet and off to see a 27 year-old male suffering abdominal pains at home. He had a history of Hep B and was complaining of a burning pain in his stomach. It could have been an isolated gastric problem and nothing more but he had taken an antacid with no relief and had not vomited or experienced heartburn prior to it. His medical history meant that he could suffer all sorts of complications arising from liver disease and there was a palpable lump on his abdomen, directly above that organ, so he went to hospital for further investigation.
I got back to my home station for a cuppa and a short rest before being sent up north for a 25 year-old man who had allegedly been pushed down a flight of stairs by the doormen at a club. I couldn’t find the place because I had an approximate location on my navigation system, so I tail-gated a police van that I felt sure was running to the same call. Of course, I ran the risk of ending up miles from the job but I was willing to take it. Luckily, they pulled up in front of the club I was heading to.
There was an ambulance already on scene and I wasn’t required. The young man was conscious, alert and appeared to have no significant injury, regardless of the fact (which couldn’t be proven) that he had been pushed down stairs.
Back in Leicester Square I found myself hovering over yet another drunken female who had vomited all over her clothes and for whom all glamour and excitement of the evening out had evaporated. She was in a mess but insisted she was alright. A police officer stood over her and was ‘guarding’ her when I arrived. She had a low temperature and a low BM (although she wasn’t known to be diabetic) but this combination is common when too much alcohol is taken.
The crew arrived and swept her off the pavement and into the ambulance. She would spend the night in hospital, vomiting and crying about the injustice of it all.
My next call, immediately after this one, was to a collapsed female. I was being directed to a bus stop at the Aldwych. This strangely shaped road runs straight until you get toward The Strand, where it becomes an arch before straightening out again. It reminds me of an aneurysm.
There are a LOT of bus stops in this road and, although I was given the bus stop number, I couldn’t see it for...buses. So, I had to crawl from one to the other. Then I was waved down by a young lad who was sitting with a seemingly collapsed person next to him. He was holding this person up. I stopped, got out of the car and approached him but he gave me a stupid grin that warned me I had been set up.
‘Did you call an ambulance?’ I said
‘No, but my mate is drunk’, he replied
‘Why did you wave at me to stop?’
‘I was just saying hello’
Arrgh!!!
So, I started the whole search all over again until I met up with the assigned ambulance crew and we searched together. Eventually, a windmill directed us to a collapsed woman, lying in her own vomit. She had been drinking all night and couldn’t get home without falling down. Her ‘friends’ had abandoned her to this fate.
A noisy basement club in Soho next for a 19 year-old pregnant girl who fainted. The noise and heat were incredible in the pits of this place, so I wasn’t surprised she had passed out. She refused to go to hospital and promised me she would see her GP in the morning. She signed my form and I watched her make her way home with her boyfriend.
I stopped at a shop to get something to eat and was accosted by a lunatic who demanded I call the police or he was going to beat people up. He was threatening two of the staff from the shop I had entered. He seemed to mean business, so I asked for police to attend and waited in case he decided to make real his threat. In the end, he was all talk and no action. The police arrived and calmed him down.
I got a break after this and made my way to sanity and a cup of coffee (and a sandwich...and chocolate). There was nobody else on station; it’s still busy out there and the ambulance crews are working flat out, mainly to recover the human detritus produced by alcohol.
My next call was for a 30 year-old male with ‘cuts to arms and neck, ? cause’. It was an amber, so I had plenty of time to get there but when I arrived I found a young man collapsed on the floor of a petrol station with two very obvious and very deep stab wounds to his arm. He also had nicks in his neck where attempts had been made to stab him in the throat. One of the fingers of his hand had been sliced open, probably as he tried to defend himself, and he had a bloody mouth, where he had been punched or kicked.
He was stable at the moment and his obs were normal but he said that he had been attacked by two or three men at a club and couldn’t remember what happened. He had probably been knocked out, so there was always the possibility of hidden injuries, including a head injury. Young people tend to cope well with injury until the last possible moment, and then their compensatory mechanisms fail. I wasn’t prepared to take that risk with him, so when the crew arrived, I had him ‘blued’ into hospital.
A rude 26 year-old next – she stormed off as I tried to help her in the early hours of the morning. Her boyfriend had called an ambulance because she had collapsed in a drunken heap at a train station. She wasn’t happy with him but took it out on me instead. She didn’t care a jot who I was, what I represented or why I was there.
My shift ended with a ‘not required’ when I arrived on scene for an 82 year-old with DIB. The crew were there and I could go home, so I did.
Be safe.
Wednesday, 15 August 2007
Monday, 13 August 2007
A hard act to follow
An Australian paramedic sent me this article. I thought you'd like to read it.
Who would do this? Step into a stranger's emergency and all its bloody detail, breaching the sanctity of someone else's home at their lowest point, knowing that all those people clamouring around as you work are relying on you to produce a miracle?
Who would willingly set out for work each day expecting that at least once, and probably several times on that single shift, you’ll be the first point of help in someone else’s disaster?
Even by the most conservative estimate, Paul Featherstone has done this close to 10,000 times over the course of his 35-year career as an ambulance officer.
In an industry that is largely underpaid and under-recognised, Featherstone is Australia’s best known paramedic. He is the man who comforted Stuart Diver through those terrible hours in which he lay entombed by the landslide in Thredbo in 1997. And last year, 925 metres underground, he was part of a team who talked miners Todd Russell and Brant Webb through the psychological nightmare of their entrapment until they were finally freed from deep inside the Beaconsfield mine.
At 57, Featherstone has been a crucial figure in some of the country’s most notable rescues, from the Granville train disaster to major bushfires and floods. Yet what he remembers most are the private tragedies. Of all the dramas that he has tried to salve, the domestic shootings, heart attacks, industrial accidents, car crashes, even being attacked by someone wielding a knife, it’s the very old and the very young whose impact has proven to be most enduring.
What does he remember? Returning from holidays years ago with his wife and kids, towing the family boat along a busy highway and right up to a terrible accident. A family car had collided with a truck and gone over a guard rail, sliding down an embankment and coming to rest on its roof. He remembers scrambling down to the car, realising that a family just like his own had been suddenly struck by tragedy. “I can still see the car, unsecured and moving (on its roof) and inside were a number of children all pretty much deceased, except one who had primitive breathing, just gasping for air. There was no way you could get to her.”
He remembers the tragedies of elderly people, too: “Eighty-year-olds, they’ve been married 60 years, and there’s a frantic phone call and of course when we arrive there he couldn’t wake his partner up and there’s just total disbelief that she has gone after all those years.”
Stepping into such intensely personal dramas was not something Featherstone had ever contemplated, even in early adulthood. Trained as a toolmaker, he first saw emergency services working together up close when he witnessed an industrial accident. “There was a young fella, he got his arm caught in a conveyor belt. It was one storey up and you could just see his feet hanging in the air and hear him screaming … We couldn’t do anything except shut the machine down and wait for the emergency services personnel to come,” he says. “When I saw these guys doing this at the top end of human life, I thought it would probably be interesting to have a shot at it.”
With an interest in medicine, he opted to join the ambulance service, and in 1976 was one of the first paramedics to graduate in NSW. Having since conceived and developed the service’s Special Casualty Access Team, which attends emergencies in a variety of hazardous situations, Featherstone has been trained in everything from canyoning and caving to hostage survival and mountaineering, and these days spends much of his time as a helicopter rescue paramedic.
But when it comes to what he’s known for – being one of the best listeners in the nation – there has been no formal training. What he has learnt about people, and how best to help them emotionally, comes from years of working on the street.
“At the end of the day it’s all about human faces,” he says. “We’re dealing with the highest end of the human element. Even if it’s not life and death it’s still injury, it’s still pain, it’s still psychological torment for people. A man who has a heart attack at home and he’s the breadwinner and all of a sudden he’s got these guys coming in and sticking monitors on him and putting lines in him and they’re saying: ‘I’m sorry, mister, but it looks like you’ve had a heart attack’ – all of a sudden he’s going through his head: ‘How am I going to pay the bills? I’m not going to be able to be the man that I was.’ The exacting science is knowing what drugs to give him. But the human value stuff is the art form.”
And it’s one that Featherstone has crafted well. Todd Russell, who was trapped underground for 14 days, says: “For us to be able to communicate with him, day in, day out – and he was putting it into our terms rather than a doctor or a paramedic’s terms – it helped us immensely. He gave us the confidence to find our way through it.”
But there’s also an element of intuition to what Featherstone does, a sixth sense that he says comes with working so closely with colleagues over so many years and at such high risk. And these are the people who inspire him – quiet achievers like his workmates, who spend their days achieving extraordinary feats with little acclaim, but always with the hope of a happy ending. “You do have to care,” he says. “I think most people do. I think there is more good in the world than bad; we just hear a lot of the bad. I think people don’t know what they are capable of in bad situations.”
Ultimately it is humanity – his own, and that of others – that sustains Featherstone. As he says: “The reason you’re doing it is because you’ve got to remember that the most important thing we’ve got in the world is life.”
The Australian newspaper- Fiona Harari
Who would do this? Step into a stranger's emergency and all its bloody detail, breaching the sanctity of someone else's home at their lowest point, knowing that all those people clamouring around as you work are relying on you to produce a miracle?
Who would willingly set out for work each day expecting that at least once, and probably several times on that single shift, you’ll be the first point of help in someone else’s disaster?
Even by the most conservative estimate, Paul Featherstone has done this close to 10,000 times over the course of his 35-year career as an ambulance officer.
In an industry that is largely underpaid and under-recognised, Featherstone is Australia’s best known paramedic. He is the man who comforted Stuart Diver through those terrible hours in which he lay entombed by the landslide in Thredbo in 1997. And last year, 925 metres underground, he was part of a team who talked miners Todd Russell and Brant Webb through the psychological nightmare of their entrapment until they were finally freed from deep inside the Beaconsfield mine.
At 57, Featherstone has been a crucial figure in some of the country’s most notable rescues, from the Granville train disaster to major bushfires and floods. Yet what he remembers most are the private tragedies. Of all the dramas that he has tried to salve, the domestic shootings, heart attacks, industrial accidents, car crashes, even being attacked by someone wielding a knife, it’s the very old and the very young whose impact has proven to be most enduring.
What does he remember? Returning from holidays years ago with his wife and kids, towing the family boat along a busy highway and right up to a terrible accident. A family car had collided with a truck and gone over a guard rail, sliding down an embankment and coming to rest on its roof. He remembers scrambling down to the car, realising that a family just like his own had been suddenly struck by tragedy. “I can still see the car, unsecured and moving (on its roof) and inside were a number of children all pretty much deceased, except one who had primitive breathing, just gasping for air. There was no way you could get to her.”
He remembers the tragedies of elderly people, too: “Eighty-year-olds, they’ve been married 60 years, and there’s a frantic phone call and of course when we arrive there he couldn’t wake his partner up and there’s just total disbelief that she has gone after all those years.”
Stepping into such intensely personal dramas was not something Featherstone had ever contemplated, even in early adulthood. Trained as a toolmaker, he first saw emergency services working together up close when he witnessed an industrial accident. “There was a young fella, he got his arm caught in a conveyor belt. It was one storey up and you could just see his feet hanging in the air and hear him screaming … We couldn’t do anything except shut the machine down and wait for the emergency services personnel to come,” he says. “When I saw these guys doing this at the top end of human life, I thought it would probably be interesting to have a shot at it.”
With an interest in medicine, he opted to join the ambulance service, and in 1976 was one of the first paramedics to graduate in NSW. Having since conceived and developed the service’s Special Casualty Access Team, which attends emergencies in a variety of hazardous situations, Featherstone has been trained in everything from canyoning and caving to hostage survival and mountaineering, and these days spends much of his time as a helicopter rescue paramedic.
But when it comes to what he’s known for – being one of the best listeners in the nation – there has been no formal training. What he has learnt about people, and how best to help them emotionally, comes from years of working on the street.
“At the end of the day it’s all about human faces,” he says. “We’re dealing with the highest end of the human element. Even if it’s not life and death it’s still injury, it’s still pain, it’s still psychological torment for people. A man who has a heart attack at home and he’s the breadwinner and all of a sudden he’s got these guys coming in and sticking monitors on him and putting lines in him and they’re saying: ‘I’m sorry, mister, but it looks like you’ve had a heart attack’ – all of a sudden he’s going through his head: ‘How am I going to pay the bills? I’m not going to be able to be the man that I was.’ The exacting science is knowing what drugs to give him. But the human value stuff is the art form.”
And it’s one that Featherstone has crafted well. Todd Russell, who was trapped underground for 14 days, says: “For us to be able to communicate with him, day in, day out – and he was putting it into our terms rather than a doctor or a paramedic’s terms – it helped us immensely. He gave us the confidence to find our way through it.”
But there’s also an element of intuition to what Featherstone does, a sixth sense that he says comes with working so closely with colleagues over so many years and at such high risk. And these are the people who inspire him – quiet achievers like his workmates, who spend their days achieving extraordinary feats with little acclaim, but always with the hope of a happy ending. “You do have to care,” he says. “I think most people do. I think there is more good in the world than bad; we just hear a lot of the bad. I think people don’t know what they are capable of in bad situations.”
Ultimately it is humanity – his own, and that of others – that sustains Featherstone. As he says: “The reason you’re doing it is because you’ve got to remember that the most important thing we’ve got in the world is life.”
The Australian newspaper- Fiona Harari
And don't worry, the posts are coming. I'm busy editing for the book and it's costing me my eyesight.
Be safe.
Sunday, 12 August 2007
Question answered
Thanks for all your replies to the last posting. I will continue as I have been doing as it is clear the vast majority of you prefer it.
In answer to the queries set in the many comments I received (including by email); the glossary (TPD Glossary), which you can find on the left hand bar, will explain all the terms I use in this blog. Remember this isn't written just for medically minded people.
TPD is written to include the jargon and some of the technical terms because that's how we speak and the diary wouldn't reflect my job if it wasn't included. The glossary is designed to familiarise you with these terms so that you can 'translate' as you read. Many of you will already have become familiar with most of these terms now, I'm guessing.
Cutting down the postings so that only a few calls are written in would probably ruin the timeline, although I'll be careful about repeating too many 'drunk' jobs where possible but I also think that those REAL jobs that come along will catch you out when you have become used to my routine, just as they do for me and my colleagues. That, I think, gives you the feeling of 'being there'.
Once again, thanks for the feedback.
In answer to the queries set in the many comments I received (including by email); the glossary (TPD Glossary), which you can find on the left hand bar, will explain all the terms I use in this blog. Remember this isn't written just for medically minded people.
TPD is written to include the jargon and some of the technical terms because that's how we speak and the diary wouldn't reflect my job if it wasn't included. The glossary is designed to familiarise you with these terms so that you can 'translate' as you read. Many of you will already have become familiar with most of these terms now, I'm guessing.
Cutting down the postings so that only a few calls are written in would probably ruin the timeline, although I'll be careful about repeating too many 'drunk' jobs where possible but I also think that those REAL jobs that come along will catch you out when you have become used to my routine, just as they do for me and my colleagues. That, I think, gives you the feeling of 'being there'.
Once again, thanks for the feedback.
Thursday, 9 August 2007
Verbal diarrhoea
During a discussion in which the readership numbers for this blog were being discussed, it was suggested that my postings may be a little too long. I am a prolific writer and can churn out between 1500 and 2500 words every time I 're-live' my shift for you. The AOL blog started out as a sort of 'highlights of my day', which meant that my postings were shorter (500 to 1,000 words) and therefore more frequent.
If the majority of blog readers are put off by long postings and prefer to 'dip in and out' for shorter entries then it may be beneficial to revert back to my original style; shorter postings written more frequently (daily).
I would, of course, continue to write ALL of my day's work down so that readers would experience it with me but I could publish the full version in a book for a more leisurely read.
I'd like your views on this.
Xf
If the majority of blog readers are put off by long postings and prefer to 'dip in and out' for shorter entries then it may be beneficial to revert back to my original style; shorter postings written more frequently (daily).
I would, of course, continue to write ALL of my day's work down so that readers would experience it with me but I could publish the full version in a book for a more leisurely read.
I'd like your views on this.
Xf
Wednesday, 8 August 2007
Hot & bothered
Twelve emergency calls. Four assist-only, one false alarm, one refused and one hoax. The others went by ambulance.
I probably watched more people (men) urinate in the street tonight than on any single shift.
Did I mention how hot it was down in the underground system? My first call was to a 35 year-old female having an epileptic fit on the platform of one of these hell holes. She was so near the edge that there was a real risk of her, or me, falling onto the track.
She had suddenly collapsed and started fitting with brief pauses and seizures in repeating cycles; never a good thing. I had already established from her friend that she was epileptic and that she had been drinking so when the crew arrived I prepared to give her diazepam. Trains were still coming into the platform and people were running and shuffling all around us. Even with the help of the staff there was little we could do, short of closing down the entire platform. We dragged her further away from the edge because every time she fitted she moved perilously near to it. It was too dangerous to lift and move her just yet, so I tried to gain IV access for the drug I was going to administer but her vein was thin and useless. I tried again elsewhere but with no better luck, so I was left with the only option open - rectal administration. In such a public place it's not a choice I make initially but I had run out of immediate options and something had to be done about her condition. She had oxygen and her airway was clear but she would be impossible to move safely.
We got the staff and a few of her friends to create a 'sheet wall' around us while I administered the drug. She seemed to settle down after a few minutes and we prepared to move her but then she had another violent seizure, so another 5mg of diazepam was administered. She settled again and we decided it was time to go. She was put into a chair, strapped down as securely as possible and wheeled all the way up to ground level. She fitted twice more on the way up, the second time slipping dangerously out of the chair at the top of some steps. The stretcher was brought to her and we moved her swiftly onto it and into the ambulance. I left my car at the station and joined the attendant in the back of the ambulance with the patient.
During the trip to hospital, I attempted once more to gain IV access. She was fitting again. I still had no luck, even with the smallest needle. I had to administer more rectal diazepam. Despite this, she fitted twice more on the way to hospital.
When we arrived she had settled down. All her obs were settling and she went into Resus in a more stable condition...the diazepam had finally worked.
I thought I might be losing my touch - I had tried three times to get a cannula in and failed but when I went back into Resus twenty minutes later, she had two inserted - one in her neck and one in her ankle, that's how difficult her veins were.
I was sweating through my shirt after that job. I had to throw my stab vest off in the ambulance because I felt so uncomfortable - the thing doesn't allow your body to breathe and hot, sticky environments are the worst places for high-exertion jobs.
I went back to my base station to replenish my drugs and cool down a bit, then I was off to a police station to aid a woman who had fainted in the front office area. She had been waiting for news of her newly-arrested son and the stress had been too much for her. She had a few family members with her and they explained that the boy had never done anything wrong in his life and that this was the first time any member of the family had been in a police cell. I felt sorry for the patient and I stayed until she felt ‘normal’ again; she didn’t want to go to hospital.
Another ‘unconscious thru drink’ call sent me to Soho where a young man greeted me by vomiting in the direction of my boots as I approached him. His sober(ish) friends were apologetic and the man on the ground looked up and realised what was going on. He was embarrassed that an ambulance had been called – he had passed out momentarily but was fully recovered now, albeit too drunk to think straight. He could, however, walk fairly straight and with assistance from his gang of mates, he made his way home without the help of the NHS.
My next patient was also very drunk but he too realised that an ambulance was probably over the top. He was in a tube station (thankfully in the ticket hall) and his friends had called us because he had cut his thumb, seen the blood (a mere trickle) and promptly passed out. I have to tell you that I have more personal experience of men fainting than women – especially at the sight of blood. Even when I teach first aid, every now and then a male student will faint at the very mention of the stuff.
He went home with his buddies and all was well with my shift so far.
Then I got a call while driving around the West End for a 35 year-old male ‘fitting’. I couldn’t find him at first and the person who had made the call didn’t make themselves known, so I drove into the street and looked around for someone fitting. All I could see was a thin, drunken man sitting in a doorway eating a pizza. I had seen him earlier in the night and thought his behaviour was strange. He had one of those extreme twitches where he almost throws a punch. If anyone got close enough during one of those reactions, they were going to get clobbered...by accident of course.
So, there he was, sitting on the step, twitching away, minding his own business. That’s when I realised the ‘patient’ had to be him. I got out of the car, approached him and asked him if he had called us. He looked up, eventually, (the pizza was just too good) and shook his head. Then he mumbled incoherently. I nodded sagely, although I had no clue what he had said. It bought me time to retreat.
I called it in and as I was speaking on the radio a young girl approached the car with the ‘I have just dialled 999’ look on her face.
“Did you call an ambulance?” I asked
“Yes” she replied
“For someone who is fitting?”
“Yes”
“But he isn’t. He just twitches and he’s eating a pizza.”
“I know but I couldn’t get in.”
She had seen the man sitting on the step twitching away and had called us because she was too scared to pass him on her way into the building where she lived. I know she may have been nervous about him but come on, he was eating a pizza. How many random assaults have taken place during the act of eating a pizza?
I walked her to the step and around the man sitting on it. He took the hint after that and moved along, deeply offended that anyone would think the worst of him. I watched him go, twitching and eating.
Just around the corner my next patient stood on the pavement, waiting for me to rescue him. He was a 20 year-old complaining of ‘cold sweats, sore tonsils and pain in the neck’. Hmm. Just for good measure and a guaranteed emergency response, the word ‘chest pain’ had been added. Everybody knows how to play the system these days.
He was a tall, healthy looking young man and he had a viral infection - I would put money on it. I had to stop myself from getting too wound up about his stupidity. Personally, I would be highly embarrassed if an ambulance came for me just because I had a cold...and before anyone goes on about tonsillitis, I know all about it and I know it can become complicated but I also know a healthy person with a mild infection when I see one. I knew that if I sent him on his way by bus he would end up dramatising the whole thing and complaining to his local MP, so I took him to hospital myself. I literally taxied him to the A&E door. I’ll keep you posted on his condition if you want...
A 50 year-old diabetic man whose confusion and lack of co-ordination was causing a good citizen enough concern to dial 999 turned out to be a drunken diabetic who couldn’t walk or find his way home because he was full of alcohol. His BM was normal. The crew had no choice but to take him to a place of safety. He would have generated calls all night otherwise.
Later on in the night I was sent to a collapsed male who was lying in the street. This usually means he is too drunk to move any further. It always amazes me the distance people achieve before suddenly becoming too drunk to move another inch. They must get drunker the further away from the pub they get. Or they get weaker the closer to home they get.
Anyway, there he was, lying on the pavement area in front of a shop. I approached, shook, pinched and eventually got him to open his eyes and look at me. He spat something in Russian and I continued my vocal onslaught until he began to move. Using words like ‘police’ and ‘arrest’ normally provoke a reaction with East European drunks – they fear the police but they generally have zero respect for the ambulance service – they know we have no real power to do anything. Not that there’s a lot the police can do either but it’s always good to have something in the armoury.
Unfortunately he was stubborn and wouldn’t budge. My ploy was failing.
A few likely looking guys were hanging around shouting at him and generally provoking him while I tried to make him get up and go home. This was making the situation less stable for me and there was no ambulance on scene yet. I asked the trouble makers to leave but they hovered around behind me, so I kept myself alert.
Eventually I got the man to stand up as the ambulance arrived but he ignored the crew and they accepted his ignorance as a refusal. I found myself back where I was at the beginning – he lay down, refusing to move and I waited in the car until police arrived to move him along. If I drove off and left him there I would be called back again and again.
The shop owner obviously had enough of this and he stormed out of the premises and immediately began to provoke the man on the ground. This developed very quickly into a stand-up scuffle. I got out of the car and tried to calm them down but I was in the middle of two fairly large men and my voice wasn’t being heard at all. They were shouting at each other and the drunken Russian was gripping the shop owner's arm so tightly it was causing him a lot of pain. That didn’t stop him from threatening him to his face, however. It was clear that someone was going to get hit soon. I asked Control for urgent police assistance because the other men were starting to get involved and I could see it all blowing up. Luckily a passing police unit stopped and the officers quickly dragged the protagonists off each other. The other men disappeared around the corner.
The drunken man was sent on his way and he staggered unevenly down the road and into the dimly lit narrows of Covent Garden. He will stop somewhere, lay down and if someone sees him, another ambulance will be called. On and on it goes.
I had always thought that sooner or later one of those pedicabs that work around Central London is going to be involved in an accident. This was my first call to one but it wasn’t the ‘driver’ who was to blame, it was his passenger, a 40 year-old New Zealander. She was so drunk that she decided to skip the cab in the middle of the road – she threw herself off the back and into the path of traffic, smashing her head on the ground and giving herself an injury that bled a decent amount, not to mention a massive headache in the morning. At first she was compliant and friendly but when the crew arrived she became abusive and stormed off the ambulance, despite her just-as-drunk friends insisting that she behave herself. There is no behaving with alcohol.
Then she tried to get back on the ambulance and the crew were more than a little bemused. She had a scalp injury but there was no way of knowing if she had a more significant problem because she was so drunk. Head injuries and drink do not mix well.
A passing patrol of armed cops sorted the antipodean group out and sent them on their way. She had refused and was frankly too much to handle. Zero tolerance.
The wee small hours is when we get our ‘drunk on a bus’ type calls and sure enough, at about 5am, I was activated with an ambulance to an ‘unconscious male, ?cause’. I boarded the bus with my colleagues and there he was, in the usual place at the back. He was slumped on the back seats and there was a large stain of dried vomit next to him, soaked right into the fabric where some poor commuter will sit in the morning. If only you knew what went on at night, poor commuter.
We got him to open his eyes but he refused to budge. The police arrived and they soon had him on the move but when he got outside he stood with his hands behind his back, preparing to be cuffed. It was an almost instinctive move; he had obviously done this so many times that it had become second nature. At the sight of the police, assume the position. Just how guilty can a person become?
He wasn’t arrested of course, this is the UK and technically he hadn’t done anything illegal, so he was taken to hospital to sleep it off instead. Liberal values cost us a fortune.
Near the end of my shift I got a wakeup call. I met a 36 year-old Iranian man who had been tortured in his home country, simply for objecting to the regime. He had been thrown from a fifth floor window, breaking his legs, pelvis and arms only to be sent to prison and tortured further after a seven month stay in hospital. I can’t imagine the feelings he must have endured as he lay on his hospital bed, knowing his fate.
Now he needed an ambulance for a headache. He calls us a lot apparently; the crew knew him from previous times. He is so depressed and scared that the smallest thing is now too much for him to cope with and he needs help and reassurance. I felt terribly sorry for him. Nothing brings you back to Earth quicker than the sight of a broken man.
Just as I made my way back at the end of my shift I was asked to ‘investigate’ an abandoned call. I arrived at a posh block of flats and the security staff told me that they thought they knew who was making the calls (I was the second ambulance in an hour) but couldn’t prove it. I helped them out by asking Control to confirm the source telephone number. An ambulance arrived behind me and I told them it was a false alarm and explained what the security man had said. The crew agreed to take the job and let me get home, which was very nice of them.
Now I was tired; I had dealt with a genuine emergency and worked my way through the usual run of drunken calls to find myself watching the inside of my eyelids close on another night shift. I’m on earlies next and the sun is coming back.
Be safe.
I probably watched more people (men) urinate in the street tonight than on any single shift.
Did I mention how hot it was down in the underground system? My first call was to a 35 year-old female having an epileptic fit on the platform of one of these hell holes. She was so near the edge that there was a real risk of her, or me, falling onto the track.
She had suddenly collapsed and started fitting with brief pauses and seizures in repeating cycles; never a good thing. I had already established from her friend that she was epileptic and that she had been drinking so when the crew arrived I prepared to give her diazepam. Trains were still coming into the platform and people were running and shuffling all around us. Even with the help of the staff there was little we could do, short of closing down the entire platform. We dragged her further away from the edge because every time she fitted she moved perilously near to it. It was too dangerous to lift and move her just yet, so I tried to gain IV access for the drug I was going to administer but her vein was thin and useless. I tried again elsewhere but with no better luck, so I was left with the only option open - rectal administration. In such a public place it's not a choice I make initially but I had run out of immediate options and something had to be done about her condition. She had oxygen and her airway was clear but she would be impossible to move safely.
We got the staff and a few of her friends to create a 'sheet wall' around us while I administered the drug. She seemed to settle down after a few minutes and we prepared to move her but then she had another violent seizure, so another 5mg of diazepam was administered. She settled again and we decided it was time to go. She was put into a chair, strapped down as securely as possible and wheeled all the way up to ground level. She fitted twice more on the way up, the second time slipping dangerously out of the chair at the top of some steps. The stretcher was brought to her and we moved her swiftly onto it and into the ambulance. I left my car at the station and joined the attendant in the back of the ambulance with the patient.
During the trip to hospital, I attempted once more to gain IV access. She was fitting again. I still had no luck, even with the smallest needle. I had to administer more rectal diazepam. Despite this, she fitted twice more on the way to hospital.
When we arrived she had settled down. All her obs were settling and she went into Resus in a more stable condition...the diazepam had finally worked.
I thought I might be losing my touch - I had tried three times to get a cannula in and failed but when I went back into Resus twenty minutes later, she had two inserted - one in her neck and one in her ankle, that's how difficult her veins were.
I was sweating through my shirt after that job. I had to throw my stab vest off in the ambulance because I felt so uncomfortable - the thing doesn't allow your body to breathe and hot, sticky environments are the worst places for high-exertion jobs.
I went back to my base station to replenish my drugs and cool down a bit, then I was off to a police station to aid a woman who had fainted in the front office area. She had been waiting for news of her newly-arrested son and the stress had been too much for her. She had a few family members with her and they explained that the boy had never done anything wrong in his life and that this was the first time any member of the family had been in a police cell. I felt sorry for the patient and I stayed until she felt ‘normal’ again; she didn’t want to go to hospital.
Another ‘unconscious thru drink’ call sent me to Soho where a young man greeted me by vomiting in the direction of my boots as I approached him. His sober(ish) friends were apologetic and the man on the ground looked up and realised what was going on. He was embarrassed that an ambulance had been called – he had passed out momentarily but was fully recovered now, albeit too drunk to think straight. He could, however, walk fairly straight and with assistance from his gang of mates, he made his way home without the help of the NHS.
My next patient was also very drunk but he too realised that an ambulance was probably over the top. He was in a tube station (thankfully in the ticket hall) and his friends had called us because he had cut his thumb, seen the blood (a mere trickle) and promptly passed out. I have to tell you that I have more personal experience of men fainting than women – especially at the sight of blood. Even when I teach first aid, every now and then a male student will faint at the very mention of the stuff.
He went home with his buddies and all was well with my shift so far.
Then I got a call while driving around the West End for a 35 year-old male ‘fitting’. I couldn’t find him at first and the person who had made the call didn’t make themselves known, so I drove into the street and looked around for someone fitting. All I could see was a thin, drunken man sitting in a doorway eating a pizza. I had seen him earlier in the night and thought his behaviour was strange. He had one of those extreme twitches where he almost throws a punch. If anyone got close enough during one of those reactions, they were going to get clobbered...by accident of course.
So, there he was, sitting on the step, twitching away, minding his own business. That’s when I realised the ‘patient’ had to be him. I got out of the car, approached him and asked him if he had called us. He looked up, eventually, (the pizza was just too good) and shook his head. Then he mumbled incoherently. I nodded sagely, although I had no clue what he had said. It bought me time to retreat.
I called it in and as I was speaking on the radio a young girl approached the car with the ‘I have just dialled 999’ look on her face.
“Did you call an ambulance?” I asked
“Yes” she replied
“For someone who is fitting?”
“Yes”
“But he isn’t. He just twitches and he’s eating a pizza.”
“I know but I couldn’t get in.”
She had seen the man sitting on the step twitching away and had called us because she was too scared to pass him on her way into the building where she lived. I know she may have been nervous about him but come on, he was eating a pizza. How many random assaults have taken place during the act of eating a pizza?
I walked her to the step and around the man sitting on it. He took the hint after that and moved along, deeply offended that anyone would think the worst of him. I watched him go, twitching and eating.
Just around the corner my next patient stood on the pavement, waiting for me to rescue him. He was a 20 year-old complaining of ‘cold sweats, sore tonsils and pain in the neck’. Hmm. Just for good measure and a guaranteed emergency response, the word ‘chest pain’ had been added. Everybody knows how to play the system these days.
He was a tall, healthy looking young man and he had a viral infection - I would put money on it. I had to stop myself from getting too wound up about his stupidity. Personally, I would be highly embarrassed if an ambulance came for me just because I had a cold...and before anyone goes on about tonsillitis, I know all about it and I know it can become complicated but I also know a healthy person with a mild infection when I see one. I knew that if I sent him on his way by bus he would end up dramatising the whole thing and complaining to his local MP, so I took him to hospital myself. I literally taxied him to the A&E door. I’ll keep you posted on his condition if you want...
A 50 year-old diabetic man whose confusion and lack of co-ordination was causing a good citizen enough concern to dial 999 turned out to be a drunken diabetic who couldn’t walk or find his way home because he was full of alcohol. His BM was normal. The crew had no choice but to take him to a place of safety. He would have generated calls all night otherwise.
Later on in the night I was sent to a collapsed male who was lying in the street. This usually means he is too drunk to move any further. It always amazes me the distance people achieve before suddenly becoming too drunk to move another inch. They must get drunker the further away from the pub they get. Or they get weaker the closer to home they get.
Anyway, there he was, lying on the pavement area in front of a shop. I approached, shook, pinched and eventually got him to open his eyes and look at me. He spat something in Russian and I continued my vocal onslaught until he began to move. Using words like ‘police’ and ‘arrest’ normally provoke a reaction with East European drunks – they fear the police but they generally have zero respect for the ambulance service – they know we have no real power to do anything. Not that there’s a lot the police can do either but it’s always good to have something in the armoury.
Unfortunately he was stubborn and wouldn’t budge. My ploy was failing.
A few likely looking guys were hanging around shouting at him and generally provoking him while I tried to make him get up and go home. This was making the situation less stable for me and there was no ambulance on scene yet. I asked the trouble makers to leave but they hovered around behind me, so I kept myself alert.
Eventually I got the man to stand up as the ambulance arrived but he ignored the crew and they accepted his ignorance as a refusal. I found myself back where I was at the beginning – he lay down, refusing to move and I waited in the car until police arrived to move him along. If I drove off and left him there I would be called back again and again.
The shop owner obviously had enough of this and he stormed out of the premises and immediately began to provoke the man on the ground. This developed very quickly into a stand-up scuffle. I got out of the car and tried to calm them down but I was in the middle of two fairly large men and my voice wasn’t being heard at all. They were shouting at each other and the drunken Russian was gripping the shop owner's arm so tightly it was causing him a lot of pain. That didn’t stop him from threatening him to his face, however. It was clear that someone was going to get hit soon. I asked Control for urgent police assistance because the other men were starting to get involved and I could see it all blowing up. Luckily a passing police unit stopped and the officers quickly dragged the protagonists off each other. The other men disappeared around the corner.
The drunken man was sent on his way and he staggered unevenly down the road and into the dimly lit narrows of Covent Garden. He will stop somewhere, lay down and if someone sees him, another ambulance will be called. On and on it goes.
I had always thought that sooner or later one of those pedicabs that work around Central London is going to be involved in an accident. This was my first call to one but it wasn’t the ‘driver’ who was to blame, it was his passenger, a 40 year-old New Zealander. She was so drunk that she decided to skip the cab in the middle of the road – she threw herself off the back and into the path of traffic, smashing her head on the ground and giving herself an injury that bled a decent amount, not to mention a massive headache in the morning. At first she was compliant and friendly but when the crew arrived she became abusive and stormed off the ambulance, despite her just-as-drunk friends insisting that she behave herself. There is no behaving with alcohol.
Then she tried to get back on the ambulance and the crew were more than a little bemused. She had a scalp injury but there was no way of knowing if she had a more significant problem because she was so drunk. Head injuries and drink do not mix well.
A passing patrol of armed cops sorted the antipodean group out and sent them on their way. She had refused and was frankly too much to handle. Zero tolerance.
The wee small hours is when we get our ‘drunk on a bus’ type calls and sure enough, at about 5am, I was activated with an ambulance to an ‘unconscious male, ?cause’. I boarded the bus with my colleagues and there he was, in the usual place at the back. He was slumped on the back seats and there was a large stain of dried vomit next to him, soaked right into the fabric where some poor commuter will sit in the morning. If only you knew what went on at night, poor commuter.
We got him to open his eyes but he refused to budge. The police arrived and they soon had him on the move but when he got outside he stood with his hands behind his back, preparing to be cuffed. It was an almost instinctive move; he had obviously done this so many times that it had become second nature. At the sight of the police, assume the position. Just how guilty can a person become?
He wasn’t arrested of course, this is the UK and technically he hadn’t done anything illegal, so he was taken to hospital to sleep it off instead. Liberal values cost us a fortune.
Near the end of my shift I got a wakeup call. I met a 36 year-old Iranian man who had been tortured in his home country, simply for objecting to the regime. He had been thrown from a fifth floor window, breaking his legs, pelvis and arms only to be sent to prison and tortured further after a seven month stay in hospital. I can’t imagine the feelings he must have endured as he lay on his hospital bed, knowing his fate.
Now he needed an ambulance for a headache. He calls us a lot apparently; the crew knew him from previous times. He is so depressed and scared that the smallest thing is now too much for him to cope with and he needs help and reassurance. I felt terribly sorry for him. Nothing brings you back to Earth quicker than the sight of a broken man.
Just as I made my way back at the end of my shift I was asked to ‘investigate’ an abandoned call. I arrived at a posh block of flats and the security staff told me that they thought they knew who was making the calls (I was the second ambulance in an hour) but couldn’t prove it. I helped them out by asking Control to confirm the source telephone number. An ambulance arrived behind me and I told them it was a false alarm and explained what the security man had said. The crew agreed to take the job and let me get home, which was very nice of them.
Now I was tired; I had dealt with a genuine emergency and worked my way through the usual run of drunken calls to find myself watching the inside of my eyelids close on another night shift. I’m on earlies next and the sun is coming back.
Be safe.
Thursday, 2 August 2007
Melting snowballs
Nine emergency calls and one running call. One assisted only, one refused and one conveyed (the running call). Seven went to hospital by ambulance.
The shift kicked off with a call to an unconscious male. The call had come from someone who could see the man lying on the road but would not go out to see if he was okay. We get a lot of calls like that.
When I arrived I found him lying in a car park space. He was sleeping; just another homeless person trying to get a kip but unable to because everyone who sees him thinks he's dead...or worse, undesirable.
I woke the poor bloke up and asked him to find another bed. I felt sorry for him because he looked so tired. He is a Big Issue seller (I saw his ID) and it must be hard work to stand around all day trying to sell a copy or two to make ends meet. Most of these people are dead on their feet by evening time. Next time you see someone selling the Big Issue, buy one. Then leave him/her alone when you see him/her sleeping in a doorway (or parking space).
As I left the scene, I saw a woman's head pop back inside a window just above me. She had been watching all the time and had probably been the person who rang in. Show yourself.
A 28 year-old who felt faint at an underground station next. The crew had arrived at the same time as I did so I wasn't really needed but I went down for a nosey anyway. It was extremely hot down there.
She was okay, just weak. The poor crew had to carry her all the way up to the top because she claimed she couldn't walk. I have to say I think she was being a bit unfair on those two guys. She could have walked if she'd tried. Oh and I did offer to help.
Another tube station call - this one immediately after the first and I was only a few metres away from it when I got it (makes Orcon look good) - on scene within one minute :-)
This lady was drunk. She was so drunk in fact that no amount of induced pain would make her react. It wasn't until her gag reflex was tested with an oropharyngeal airway that she responded...and even that took some time. Getting so drunk you lose your gag reflex is a very stupid thing to do.
Her Portuguese friend was translating from Italian, spoken by the station staff member (he couldn't speak Portuguese but the girl spoke Italian). Oh, it’s all too confusing these days.
Anyway, we managed to get her to stand up and walk with support until we got her to the last escalator where, at the very top, she decided to pass out again. We almost fell into a heap on the floor. Her landing was clumsy and undignified and she was told in no uncertain terms to behave and keep her eyes open. Alcohol makes you selfish - she didn't care about the possible injuries she could have caused if that fall had happened half way up the escalator. Obrigado indeed.
As I was returning to my standby point I was sent back to Regent Street, where I had been earlier, to deal with a RTC involving a motorcyclist and a taxi. As I pulled up on scene I had a bit of a flashback. This is almost exactly where the hit and run had taken place earlier this year and more ironically the same FRU colleague was attending to the patient who was lying on the ground, his bike smashed and leaking petrol and oil on the road.
There was a group of noisy and boisterous individuals, mainly kids, milling around my colleague as he tried to render aid to the injured man. I shooed them away but they didn’t go far and were all standing in the middle of this busy London Street. The traffic had halted on one side but not the other. This was a dangerous scene and the crowd were a little hostile - a couple of them were arguing viciously with each other. One young lad was taking photographs as we tried to deal with the patient. I moved him away and he got abusive - he must have been 14 years old. It was all getting stupid.
I called for the police and the Fire Service (we would need to make the petrol and oil safe) and I could hear LAS sirens approaching, so I knew the ambulance was on its way too.
Eventually we had control of the scene and the police turned up to deal with trouble-makers and the traffic. The injured man had slammed into a taxi and was now complaining of pain in his leg. He didn't seem to have any life-threatening injuries but he was collared, immobilised and given pain relief nevertheless. He had hit the taxi at speed, with no braking so there was the possibility of hidden injuries which could manifest later on.
As I played my small part in this incident, I noticed the taxi driver (whose cab had been hit by the motorcyclist) standing at a distance, watching us. He had that familiar worried frown on his face; the one that portrays personal guilt (even though, from the story, it sounds like it wasn’t his fault at all). I asked him to talk to the police about what had happened but I realise now that I didn’t ask him if he was okay. I felt a bit guilty about that myself.
I spoke to my colleague later on about the Regent Street hit and run. I told him that I had been trying to get information about the young woman’s fate after we had rushed her to hospital that horrible morning a few months ago. I was surprised when he told me that he had followed it up directly and found out that the girl had survived. Not only that but she went home within five weeks of the incident. Considering the extent of her facial injuries that day, I was very happy to hear it.
I made my way back to the Wild West End and cut through Trafalgar Square to look in on the many people who choose to sleep on the grassy areas at night. I was just about to set off when one of the roller-bladers who frequent the Square approached the car. He asked me to look at one of his friends who had fallen badly and hurt her wrist. I went over to a tall (well her blades made her look tall) young Russian girl who was nursing her left arm. She was in some discomfort and I asked her what had happened. She told me she had fallen backward awkwardly and now she had a lot of pain in her arm.
Her wrist was swollen and very tender to touch. It looked a little deformed over the ulna and I suggested that she may have broken it but that I would take her to hospital to get it checked. She was very upset and began to cry. Although I sympathised, I found it ironic that she felt so emotional about it – she must have known the risks she took every time she put on her wheeled boots.
I called it in and took her and a friend to A&E as promised.
Somewhere in the next few hours I got a break and a well deserved cup of coffee...
Then I was sent to the north for a collapsed 35 year-old male. A gentleman with a private ambulance had been flagged down to help the man, who had been seen lying on the ground by several passers-by. He was in the recovery position and some obs were being taken.
The man looked agitated. He was conscious but he looked as if he had a neuro-physical problem – something that was causing myoclonus; possibly MS. He couldn’t communicate clearly either, his speech was badly slurred but he hadn’t suffered a stroke – he confirmed that he was normally like this. Although he gave me his date of birth, he wouldn’t tell me anything about what had happened and why he was on the pavement.
There were two police officers on scene with us and they had even less success getting information but he had said something earlier about being attacked and kicked around the head and body. He kept referring to his ribcage and guarded it with his hand. I had a look but could see nothing significant – no marks, no bruising. It was a strange call.
The ambulance arrived after twenty minutes and the crew took the man inside for further checks. All his obs were normal and he didn’t appear to have any injuries. He still wouldn’t tell anyone what had happened and we only got his name and address through an ID check with the police. I left the crew with that little mystery and headed back to my own area.
Calls to police station cells are never any fun. I found myself inside one of these small, smelly places in the early hours, asking a man to confirm whether or not he had swallowed a number of ‘wraps’ containing cocaine. He had told the police earlier that he had removed them from his storage place (his anus) and swallowed them in his cell. Considering how long it had been since he had allegedly done this, I found it incredible that he was still breathing, never mind making any sense when he spoke. He was a very angry man and refused all help from me (and my colleagues, who arrived as I stood there listening to him). We got his recent life story and the police got loads of abuse. A fairly balanced call, I thought.
When I went to deal with a 35 year-old male with DIB, I got a surprise. I opened the callbox in which the man stood waiting for me and saw that it was a frequent flyer that I’d not laid eyes on for some months now. He is an annoying and persistent problem. He claims chest pain when he has none and is verbally abusive if challenged about his behaviour. Most of the hospitals know him and few tolerate him. I handed him over to the crew as soon as they arrived. My colleague referred to him (as we all do) by one of his names – he uses up to three different names in an attempt to disguise who he is.
My next call was to a hostel in south London for a 23 year-old female who had overdosed on a heroin and cocaine mix (known as a snowball). She had paid £35 for this single hit and I was about to ruin her day by reversing it with one injection of Naloxone. She was too groggy and her breathing was depressed, so she needed it. We took her to hospital and she stormed out with her boyfriend as soon as she ‘recovered’. Not a happy bunny.
Finally, a 34 year-old with chest pain who walked to the car when I arrived. I got him to sit down on a bench while he explained that he had gastric problems and that the pain felt similar to past episodes. He had no cardiac problems and was usually healthy; his obs said the same. When the ambulance arrived, he was swiftly taken to hospital – you can never be too sure.
I was cancelled no fewer than ten times tonight as I set off on calls. The new version of FRED that has been rolled out is even more frustrating than the old one. If it was a real person, he’d be taken aside and beaten up by now. Some shifts are all about rapid response and very little to do with pre-hospital care. I did nothing important tonight – I didn’t save, or contribute to the saving of a life (unless you count the overdose girl) and I used few skills. It was a routine night and my ‘rapid response’ technique has sharpened to a point where I am highly tuned to one probable outcome for any call. Cancellation.
Be safe.
The shift kicked off with a call to an unconscious male. The call had come from someone who could see the man lying on the road but would not go out to see if he was okay. We get a lot of calls like that.
When I arrived I found him lying in a car park space. He was sleeping; just another homeless person trying to get a kip but unable to because everyone who sees him thinks he's dead...or worse, undesirable.
I woke the poor bloke up and asked him to find another bed. I felt sorry for him because he looked so tired. He is a Big Issue seller (I saw his ID) and it must be hard work to stand around all day trying to sell a copy or two to make ends meet. Most of these people are dead on their feet by evening time. Next time you see someone selling the Big Issue, buy one. Then leave him/her alone when you see him/her sleeping in a doorway (or parking space).
As I left the scene, I saw a woman's head pop back inside a window just above me. She had been watching all the time and had probably been the person who rang in. Show yourself.
A 28 year-old who felt faint at an underground station next. The crew had arrived at the same time as I did so I wasn't really needed but I went down for a nosey anyway. It was extremely hot down there.
She was okay, just weak. The poor crew had to carry her all the way up to the top because she claimed she couldn't walk. I have to say I think she was being a bit unfair on those two guys. She could have walked if she'd tried. Oh and I did offer to help.
Another tube station call - this one immediately after the first and I was only a few metres away from it when I got it (makes Orcon look good) - on scene within one minute :-)
This lady was drunk. She was so drunk in fact that no amount of induced pain would make her react. It wasn't until her gag reflex was tested with an oropharyngeal airway that she responded...and even that took some time. Getting so drunk you lose your gag reflex is a very stupid thing to do.
Her Portuguese friend was translating from Italian, spoken by the station staff member (he couldn't speak Portuguese but the girl spoke Italian). Oh, it’s all too confusing these days.
Anyway, we managed to get her to stand up and walk with support until we got her to the last escalator where, at the very top, she decided to pass out again. We almost fell into a heap on the floor. Her landing was clumsy and undignified and she was told in no uncertain terms to behave and keep her eyes open. Alcohol makes you selfish - she didn't care about the possible injuries she could have caused if that fall had happened half way up the escalator. Obrigado indeed.
As I was returning to my standby point I was sent back to Regent Street, where I had been earlier, to deal with a RTC involving a motorcyclist and a taxi. As I pulled up on scene I had a bit of a flashback. This is almost exactly where the hit and run had taken place earlier this year and more ironically the same FRU colleague was attending to the patient who was lying on the ground, his bike smashed and leaking petrol and oil on the road.
There was a group of noisy and boisterous individuals, mainly kids, milling around my colleague as he tried to render aid to the injured man. I shooed them away but they didn’t go far and were all standing in the middle of this busy London Street. The traffic had halted on one side but not the other. This was a dangerous scene and the crowd were a little hostile - a couple of them were arguing viciously with each other. One young lad was taking photographs as we tried to deal with the patient. I moved him away and he got abusive - he must have been 14 years old. It was all getting stupid.
I called for the police and the Fire Service (we would need to make the petrol and oil safe) and I could hear LAS sirens approaching, so I knew the ambulance was on its way too.
Eventually we had control of the scene and the police turned up to deal with trouble-makers and the traffic. The injured man had slammed into a taxi and was now complaining of pain in his leg. He didn't seem to have any life-threatening injuries but he was collared, immobilised and given pain relief nevertheless. He had hit the taxi at speed, with no braking so there was the possibility of hidden injuries which could manifest later on.
As I played my small part in this incident, I noticed the taxi driver (whose cab had been hit by the motorcyclist) standing at a distance, watching us. He had that familiar worried frown on his face; the one that portrays personal guilt (even though, from the story, it sounds like it wasn’t his fault at all). I asked him to talk to the police about what had happened but I realise now that I didn’t ask him if he was okay. I felt a bit guilty about that myself.
I spoke to my colleague later on about the Regent Street hit and run. I told him that I had been trying to get information about the young woman’s fate after we had rushed her to hospital that horrible morning a few months ago. I was surprised when he told me that he had followed it up directly and found out that the girl had survived. Not only that but she went home within five weeks of the incident. Considering the extent of her facial injuries that day, I was very happy to hear it.
I made my way back to the Wild West End and cut through Trafalgar Square to look in on the many people who choose to sleep on the grassy areas at night. I was just about to set off when one of the roller-bladers who frequent the Square approached the car. He asked me to look at one of his friends who had fallen badly and hurt her wrist. I went over to a tall (well her blades made her look tall) young Russian girl who was nursing her left arm. She was in some discomfort and I asked her what had happened. She told me she had fallen backward awkwardly and now she had a lot of pain in her arm.
Her wrist was swollen and very tender to touch. It looked a little deformed over the ulna and I suggested that she may have broken it but that I would take her to hospital to get it checked. She was very upset and began to cry. Although I sympathised, I found it ironic that she felt so emotional about it – she must have known the risks she took every time she put on her wheeled boots.
I called it in and took her and a friend to A&E as promised.
Somewhere in the next few hours I got a break and a well deserved cup of coffee...
Then I was sent to the north for a collapsed 35 year-old male. A gentleman with a private ambulance had been flagged down to help the man, who had been seen lying on the ground by several passers-by. He was in the recovery position and some obs were being taken.
The man looked agitated. He was conscious but he looked as if he had a neuro-physical problem – something that was causing myoclonus; possibly MS. He couldn’t communicate clearly either, his speech was badly slurred but he hadn’t suffered a stroke – he confirmed that he was normally like this. Although he gave me his date of birth, he wouldn’t tell me anything about what had happened and why he was on the pavement.
There were two police officers on scene with us and they had even less success getting information but he had said something earlier about being attacked and kicked around the head and body. He kept referring to his ribcage and guarded it with his hand. I had a look but could see nothing significant – no marks, no bruising. It was a strange call.
The ambulance arrived after twenty minutes and the crew took the man inside for further checks. All his obs were normal and he didn’t appear to have any injuries. He still wouldn’t tell anyone what had happened and we only got his name and address through an ID check with the police. I left the crew with that little mystery and headed back to my own area.
Calls to police station cells are never any fun. I found myself inside one of these small, smelly places in the early hours, asking a man to confirm whether or not he had swallowed a number of ‘wraps’ containing cocaine. He had told the police earlier that he had removed them from his storage place (his anus) and swallowed them in his cell. Considering how long it had been since he had allegedly done this, I found it incredible that he was still breathing, never mind making any sense when he spoke. He was a very angry man and refused all help from me (and my colleagues, who arrived as I stood there listening to him). We got his recent life story and the police got loads of abuse. A fairly balanced call, I thought.
When I went to deal with a 35 year-old male with DIB, I got a surprise. I opened the callbox in which the man stood waiting for me and saw that it was a frequent flyer that I’d not laid eyes on for some months now. He is an annoying and persistent problem. He claims chest pain when he has none and is verbally abusive if challenged about his behaviour. Most of the hospitals know him and few tolerate him. I handed him over to the crew as soon as they arrived. My colleague referred to him (as we all do) by one of his names – he uses up to three different names in an attempt to disguise who he is.
My next call was to a hostel in south London for a 23 year-old female who had overdosed on a heroin and cocaine mix (known as a snowball). She had paid £35 for this single hit and I was about to ruin her day by reversing it with one injection of Naloxone. She was too groggy and her breathing was depressed, so she needed it. We took her to hospital and she stormed out with her boyfriend as soon as she ‘recovered’. Not a happy bunny.
Finally, a 34 year-old with chest pain who walked to the car when I arrived. I got him to sit down on a bench while he explained that he had gastric problems and that the pain felt similar to past episodes. He had no cardiac problems and was usually healthy; his obs said the same. When the ambulance arrived, he was swiftly taken to hospital – you can never be too sure.
I was cancelled no fewer than ten times tonight as I set off on calls. The new version of FRED that has been rolled out is even more frustrating than the old one. If it was a real person, he’d be taken aside and beaten up by now. Some shifts are all about rapid response and very little to do with pre-hospital care. I did nothing important tonight – I didn’t save, or contribute to the saving of a life (unless you count the overdose girl) and I used few skills. It was a routine night and my ‘rapid response’ technique has sharpened to a point where I am highly tuned to one probable outcome for any call. Cancellation.
Be safe.
Wednesday, 1 August 2007
Hoax
Seven emergencies; two hoax calls, one assisted only and one standby. The rest went by ambulance.
Sheila's Wheels called me. I thought at first they had seen the blog and were about to complain but it was just to see if I needed anything after my accident. The 'Sheila' was actually very nice and kept asking if I had been hurt. She told me not to hesitate if I developed any neck pain or other problems. I wonder if there's a commission system for such claims. I certainly wouldn't lie about an injury because, at the very least, it would affect the young lady's insurance premium when she renews. I'm sure she is in enough trouble already now that she has made a claim.
It also occurred to me how easy it was to fall into the 'where's there's a blame, there's a claim' culture. So many people are getting rich at the expense of a few unfortunates. Some of those who do make a claim are no doubt genuine cases but how many have been enticed to say the word 'whiplash' at the behest of an insurance company? I'd only have to lie about neck pain and I could pay off some of my debts. I won't though because it's not me and never will be.
I didn't start my duties 'til just after 9pm. More than two hours were spent moving from one car to another because of confusion about who was assigned to what vehicle and where the keys were to the one I was given. I swapped a lot of equipment from one car to another, then another only to find out that the keys for the first vehicle had turned up. So, I moved everything back again. I was dehydrated at the end of it all. Who needs the gym?
First call of the shift and it's a hoax. Someone has been making calls every night over the past week from the same call boxes. He simply hangs up. On the single occasion that he called the police, he ranted abuse at them.
When the next call came in I was asked to scoot to the location and try and catch him in the act. Then the police could be called to arrest him. When I got there he was gone (having a bright yellow car isn't always an advantage). He was close by though because the call had only just been made, so I stuck around.
A gang of police officers came up to the car and asked if I had seen him yet. They had all been sent to track this guy down (there were six of them). While I was describing how I had just missed him a familiar shape walked into view. It was someone I have had a lot of trouble with in the past - he has attacked me with a bottle, threatened me and generally been unpleasant. I'll call him MD and I'm sure that any LAS bod from central who are reading this will know who exactly I'm describing.
The police formed a little circle around him and asked him about the calls. He denied everything of course but he is a practised liar. He has been calling us out for imaginary problems (and some that he has staged for impact) for years. I have known him for two years and I remember how gullible I was when I first came across him. I can say without much fear of reprisal that he is a time waster of the highest order. He is also dangerous.
This man contributes nothing to society. He costs the tax payer tens of thousands of pounds every year with his antics and he is known by almost every crew and almost every cop in this part of London. There seems to be nothing we can do about him. An ASBO has been suggested and it may well be that he has had one but it won't stop him. I think he wants to go back to prison.
Anyway, the police couldn't prove he was the hoax caller, so they had to let him go. As soon as they were gone, he made threatening gestures at me while I sat in the car doing my paperwork. I moved along to somewhere else. It was the wise thing to do.
It felt like a Friday night out there; so many drunken people spilling out of bars and clubs in the middle of the week. My next two calls were for 'collapsed' males, one of whom was so out of it he could barely see. His friends became aggressive when I tried to help. He had collapsed outside a tube station and his mates, who were French, started in on me. I was threatened in French by a tall, skinny guy and he was getting kinda close, so I told him to back off and said I could understand everything he had said to me. I did, in fact.
Meanwhile, his other mate (an Israeli) would not stop talking at me and prodding me for no reason. Enough was enough; I asked for the police. When they arrived they dragged every one of the drunk man's friends off him and let me get close enough to start my obs. The crew had arrived by now and it was decided just to get him into the ambulance where it was safer. I left them to it.
Around the corner another male had collapsed. A 40 year-old man in a suit and a decent pair of shoes lay motionless on the ground. Two doormen from Stringfellows were watching him and told me he had just fallen down and stopped moving. I was glad to have them behind me - they were big guys and I knew that, at the first sign of trouble, they would wade in.
The man was easily roused and I explained that he was lying on the pavement.
"Do you need an ambulance?" I asked
"Yes" he said
Why?" I asked
"You just told me that you have no medical problems and that you are just drunk"
Then he mumbled stuff I couldn't decipher because I haven't learned to speak drunk yet.
The crew arrived (they had parked down the road a little because they thought this was a no-trace...so did I at first) and I let them finish what I had started. I had him sitting up with his eyes open and they got him to his feet and on the way to a taxi. He'll probably fall down or be found 'unconscious' on a bus in someone else's territory.
Meanwhile, the hoaxer had been making a few more calls and the police had arrested someone in the callbox where one or two of the calls had originated. It's unlikely it was the real culprit because I believe it was MD and no other. Nobody hates us more than he does.
After my break I was asked to investigate a call which had originated from a callbox in the same area that the hoaxer was haunting. This 999 plea was for a 35 year-old male who had been stabbed in the chest. There had been a lot of stabbings all over London tonight, including at least one fatality but because we had been running around in circles for this caller, it was up to me to decide whether or not it was genuine.
Control advised me to "be careful". I put the eyes into the back of my head.
On scene and a few telephone boxes later but no sign of a stabbing victim. Usually there is a degree of panic - people shouting and screaming, that sort of thing but nothing seemed out of the ordinary. I reported back to Control and told them I would do a quick area search but, in the meantime, perhaps it would be best to cancel the ambulance (someone may get stabbed for real somewhere else). I had just completed that call when a small group of police officers (they were all running about in gangs tonight) approached the car and told me that a man had been stabbed and was in another street. Uh oh. Then the man appeared from the shadows. He had a bloodied shirt wrapped around his chest.
I advised Control and the ambulance was updated. The crew arrived as I was calming the man down. He had a single stab wound to his chest; it had penetrated but didn't look too deep. He had no breathing problems and he seemed in good shape, considering.
He was taken to the ambulance for a thorough check and then transported to hospital. Allegedly, he had been set upon by three black men wearing hoodies. They had dragged him into an alley and demanded his ipod. He had refused, so one of them pulled up his shirt and deliberately stabbed him in the chest with a screwdriver (or similar instrument). It sounded like a cold-bloodied and callous attack, more to do with the rite of passage earned through stabbing someone (anyone) than through material gain. This is far more common than you'd think.
He will survive because the assailant was clumsy. If the wound had gone deeper, it would have penetrated his lung and collapsed it. His life would then be in danger. Surviving the assault was more luck than chance.
I rolled down toward Leicester Square to do my paperwork and a cordon had appeared. There were police vehicles building up in the area and I thought it might have something to do with the stabbing. Then I thought it was all a bit too much for that. My DSO turned up and he explained that a suspicious package had been found.
The cordon quickly began to fill up; 5 Fire engines, 2 HART vehicles, myself and the DSO and at least a dozen police vehicles, not including the dog handlers and bomb disposal unit. It was 4.30am and the whole area around Leicester Square was closed off. It was eerily quiet and for a while there was a little sea of blue lights.
I waited on standby with the DSO and my colleagues from the HART teams until the all-clear was given. The culprit had been caught and arrested and the 'bomb' turned out to be nothing of importance (a bag with some bottles of liquid I believe).
I got a real sense of just how seriously these suspect devices are taken. It wouldn't take much to bring Central London to a halt without even planting a real device.
Finally, I get back to my base station only to be pulled out with ten minutes to go. Luckily, it’s a job just around the corner, ‘60 year-old male fallen from bike, head injury’. Well, he had grazes to his face after he went over the handlebars of his bike. He was lying on the ground with a couple of people around him to help out. One man in particular seemed a little over zealous and before I knew what was going on he had got someone to ‘phone for the police. The police weren’t interested – it was a simple accident, so I took the ‘phone and told them all was well...
I cleaned the man up, listened to how he came to land on the ground so hard (his front brakes seized) and offered him up to the ambulance crew when they arrived. It was going home time and my eyes were stinging with tiredness. It all starts again tonight...
Be safe.
Sheila's Wheels called me. I thought at first they had seen the blog and were about to complain but it was just to see if I needed anything after my accident. The 'Sheila' was actually very nice and kept asking if I had been hurt. She told me not to hesitate if I developed any neck pain or other problems. I wonder if there's a commission system for such claims. I certainly wouldn't lie about an injury because, at the very least, it would affect the young lady's insurance premium when she renews. I'm sure she is in enough trouble already now that she has made a claim.
It also occurred to me how easy it was to fall into the 'where's there's a blame, there's a claim' culture. So many people are getting rich at the expense of a few unfortunates. Some of those who do make a claim are no doubt genuine cases but how many have been enticed to say the word 'whiplash' at the behest of an insurance company? I'd only have to lie about neck pain and I could pay off some of my debts. I won't though because it's not me and never will be.
I didn't start my duties 'til just after 9pm. More than two hours were spent moving from one car to another because of confusion about who was assigned to what vehicle and where the keys were to the one I was given. I swapped a lot of equipment from one car to another, then another only to find out that the keys for the first vehicle had turned up. So, I moved everything back again. I was dehydrated at the end of it all. Who needs the gym?
First call of the shift and it's a hoax. Someone has been making calls every night over the past week from the same call boxes. He simply hangs up. On the single occasion that he called the police, he ranted abuse at them.
When the next call came in I was asked to scoot to the location and try and catch him in the act. Then the police could be called to arrest him. When I got there he was gone (having a bright yellow car isn't always an advantage). He was close by though because the call had only just been made, so I stuck around.
A gang of police officers came up to the car and asked if I had seen him yet. They had all been sent to track this guy down (there were six of them). While I was describing how I had just missed him a familiar shape walked into view. It was someone I have had a lot of trouble with in the past - he has attacked me with a bottle, threatened me and generally been unpleasant. I'll call him MD and I'm sure that any LAS bod from central who are reading this will know who exactly I'm describing.
The police formed a little circle around him and asked him about the calls. He denied everything of course but he is a practised liar. He has been calling us out for imaginary problems (and some that he has staged for impact) for years. I have known him for two years and I remember how gullible I was when I first came across him. I can say without much fear of reprisal that he is a time waster of the highest order. He is also dangerous.
This man contributes nothing to society. He costs the tax payer tens of thousands of pounds every year with his antics and he is known by almost every crew and almost every cop in this part of London. There seems to be nothing we can do about him. An ASBO has been suggested and it may well be that he has had one but it won't stop him. I think he wants to go back to prison.
Anyway, the police couldn't prove he was the hoax caller, so they had to let him go. As soon as they were gone, he made threatening gestures at me while I sat in the car doing my paperwork. I moved along to somewhere else. It was the wise thing to do.
It felt like a Friday night out there; so many drunken people spilling out of bars and clubs in the middle of the week. My next two calls were for 'collapsed' males, one of whom was so out of it he could barely see. His friends became aggressive when I tried to help. He had collapsed outside a tube station and his mates, who were French, started in on me. I was threatened in French by a tall, skinny guy and he was getting kinda close, so I told him to back off and said I could understand everything he had said to me. I did, in fact.
Meanwhile, his other mate (an Israeli) would not stop talking at me and prodding me for no reason. Enough was enough; I asked for the police. When they arrived they dragged every one of the drunk man's friends off him and let me get close enough to start my obs. The crew had arrived by now and it was decided just to get him into the ambulance where it was safer. I left them to it.
Around the corner another male had collapsed. A 40 year-old man in a suit and a decent pair of shoes lay motionless on the ground. Two doormen from Stringfellows were watching him and told me he had just fallen down and stopped moving. I was glad to have them behind me - they were big guys and I knew that, at the first sign of trouble, they would wade in.
The man was easily roused and I explained that he was lying on the pavement.
"Do you need an ambulance?" I asked
"Yes" he said
Why?" I asked
"You just told me that you have no medical problems and that you are just drunk"
Then he mumbled stuff I couldn't decipher because I haven't learned to speak drunk yet.
The crew arrived (they had parked down the road a little because they thought this was a no-trace...so did I at first) and I let them finish what I had started. I had him sitting up with his eyes open and they got him to his feet and on the way to a taxi. He'll probably fall down or be found 'unconscious' on a bus in someone else's territory.
Meanwhile, the hoaxer had been making a few more calls and the police had arrested someone in the callbox where one or two of the calls had originated. It's unlikely it was the real culprit because I believe it was MD and no other. Nobody hates us more than he does.
After my break I was asked to investigate a call which had originated from a callbox in the same area that the hoaxer was haunting. This 999 plea was for a 35 year-old male who had been stabbed in the chest. There had been a lot of stabbings all over London tonight, including at least one fatality but because we had been running around in circles for this caller, it was up to me to decide whether or not it was genuine.
Control advised me to "be careful". I put the eyes into the back of my head.
On scene and a few telephone boxes later but no sign of a stabbing victim. Usually there is a degree of panic - people shouting and screaming, that sort of thing but nothing seemed out of the ordinary. I reported back to Control and told them I would do a quick area search but, in the meantime, perhaps it would be best to cancel the ambulance (someone may get stabbed for real somewhere else). I had just completed that call when a small group of police officers (they were all running about in gangs tonight) approached the car and told me that a man had been stabbed and was in another street. Uh oh. Then the man appeared from the shadows. He had a bloodied shirt wrapped around his chest.
I advised Control and the ambulance was updated. The crew arrived as I was calming the man down. He had a single stab wound to his chest; it had penetrated but didn't look too deep. He had no breathing problems and he seemed in good shape, considering.
He was taken to the ambulance for a thorough check and then transported to hospital. Allegedly, he had been set upon by three black men wearing hoodies. They had dragged him into an alley and demanded his ipod. He had refused, so one of them pulled up his shirt and deliberately stabbed him in the chest with a screwdriver (or similar instrument). It sounded like a cold-bloodied and callous attack, more to do with the rite of passage earned through stabbing someone (anyone) than through material gain. This is far more common than you'd think.
He will survive because the assailant was clumsy. If the wound had gone deeper, it would have penetrated his lung and collapsed it. His life would then be in danger. Surviving the assault was more luck than chance.
I rolled down toward Leicester Square to do my paperwork and a cordon had appeared. There were police vehicles building up in the area and I thought it might have something to do with the stabbing. Then I thought it was all a bit too much for that. My DSO turned up and he explained that a suspicious package had been found.
The cordon quickly began to fill up; 5 Fire engines, 2 HART vehicles, myself and the DSO and at least a dozen police vehicles, not including the dog handlers and bomb disposal unit. It was 4.30am and the whole area around Leicester Square was closed off. It was eerily quiet and for a while there was a little sea of blue lights.
I waited on standby with the DSO and my colleagues from the HART teams until the all-clear was given. The culprit had been caught and arrested and the 'bomb' turned out to be nothing of importance (a bag with some bottles of liquid I believe).
I got a real sense of just how seriously these suspect devices are taken. It wouldn't take much to bring Central London to a halt without even planting a real device.
Finally, I get back to my base station only to be pulled out with ten minutes to go. Luckily, it’s a job just around the corner, ‘60 year-old male fallen from bike, head injury’. Well, he had grazes to his face after he went over the handlebars of his bike. He was lying on the ground with a couple of people around him to help out. One man in particular seemed a little over zealous and before I knew what was going on he had got someone to ‘phone for the police. The police weren’t interested – it was a simple accident, so I took the ‘phone and told them all was well...
I cleaned the man up, listened to how he came to land on the ground so hard (his front brakes seized) and offered him up to the ambulance crew when they arrived. It was going home time and my eyes were stinging with tiredness. It all starts again tonight...
Be safe.
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