Day shift: Five calls; one taken by car; one dead at scene; three by ambulance.
Stats: 1 Faint; 1 ?EP fit; 1 eTOH fit; 1 ?Cardiac problems; 1 ?Suspicious death.
It’s getting darker and colder – winter is approaching and within a few months that means the season of goodwill and joy to all men (and women) will be upon us. Oh, wait, I mean the season of drunken debauchery and copious public vomiting. Yeah, that sounds more like it. I'd like to think the new TV campaign 'why end your night like this?' will have an impact and reduce the number of stupid people but I doubt it, especially after being called the 'booze taxi' by a passing Hen group in Leicester Square, one of whom went on to say 'I'll be seeing you later'.
Until then, I am working my way through the shifts with the usual routine alongside my brave and noble comrades.
A 31 year-old Norwegian man fainted twice at an underground station and he was recovering well when I got to him, although I advised him to go to hospital, or at least have an ECG done. He seemed keen to get on with his day and his colleagues stood around outside the station’s medical room waiting for word that he was okay to continue with them. BUT, two faints in a short period where no previous medical history exists can be ominous and so the crew took him to the ambulance and I left them to persuade him not to work today but to get his health checked.
Lying on the floor of her office was a 24 year-old American woman who’d had a fit, although nobody had actually witnessed it. She’d been found collapsed and confused and the assumption had been made. It turns out she has fitted once before but it had never been diagnosed, or at least she wasn’t sure if it was or not. She did have medicine for it but she couldn’t recall what it was or precisely why she took it. She was definitely confused.
It took more than 30 minutes before she made sense again and the same amount of time waiting for an ambulance before I decided that, clinically, she was fit enough to travel in the car.
My next fitting patient was lying on the rain-soaked pavement of a busy street and I took a short handover from an umbrella-bearing man who’d stopped to help him when he’d seen him suddenly fall down and have a seizure. I asked the man with the umbrella his name and thanked him for his help, while I covered my patient in a blanket and did my best to keep him (and myself) warm and dry. People rushed by with vaguely interested faces on them and I had neutral emotions about London for a time. If it hadn’t been for the umbrella man (and one other who’d left when I got on scene) this poor fitting person may well have been left to it on his own.
Umbrella man took his leave as soon as I was into my obs and once again I thanked him for his kindness. Then I spent fifteen minutes or so on my own crouching over the semi-conscious patient as he began to slowly recover on oxygen. Legs and feet passed within inches of us but they were all in a hurry to get somewhere. The people at the top of them were only marginally curious and the more hardened commuters defied their instincts and ignored the obstruction altogether.
Once the patient was able to speak, I asked his name and he gave me the same name that umbrella man had given – how unusual, I thought. The ambulance noisily pushed its way through the rush hour traffic and arrived just in time for my interest in the name coincidence to evaporate. A bed was brought over and the patient was loaded on board.
He was an alcoholic, we learned and he hadn’t been drinking for a while, so his fit was probably the result of withdrawal. At least he was out of the cold, rainy morning...as was I.
Another person who fainted twice in a short period of time was a 71 year-old Indian lady, whose daughter was very concerned about why this was happening. I would have reached them both quicker if the staff at the shop (I wish I could name it) had bothered to meet me and guide me to them but they were all too busy selling stuff to customers and I entered completely unnoticed by some and ignored by others. I had to approach one of the counters and ask where the patient was. I got a shrug of the shoulders and a blank, disinterested look. Only then did the woman’s daughter come up to me herself and show me where her mother sat.
The lady had fallen ‘like a stone’ according to her daughter. Once after walking around and again when she got off the bus. She had hurt her knees as a result but I was more concerned with why she was passing out.
A stoical woman, she showed little interest in going to hospital and I had to persuade her, with the help of the crew, after her ECG had been done. It looked like she may have a heart block, a cardiac condition that would result in faints. She took our advice and I left the scene knowing that if I was wrong at least she’d be properly checked out.
A Red1 for an ‘unconscious’ man, ‘not moving’ became a cardiac arrest with ‘caller declined to start CPR’ and I was on my way to a possible suspicious death. We are not officially allowed to state that something is suspicious but we can determine whether a death merits investigation or not.
The man had been found by his neighbour. He was on his knees and bent forward in the corner of a little brick shed in his garden. He had been preparing to paint it but not a drop of the stuff in the tin was touched. The ambulance crew had arrived on scene with me and as we approached from behind, we could tell he was dead.
He had a head injury and there was a good sized pool of blood on the floor where his head was resting. We had to move him in order to establish that he was beyond help, so we pulled his body over on to its back and during this process we saw enough evidence to support an evaluation of death - Post Mortem staining all over his trunk and head. Asystole was established over two minutes and I recorded a time, pronouncing him life extinct.
The police were called, as is normal under such circumstances but closer inspection of the head injury gave me cause for concern. I can’t describe the wounds in detail but I will say that I wasn’t sure if they were consistent with a fall post cardiac arrest. The police agreed and CID was brought in to investigate. It would be up to them and the Coroner to decide whether he’d died naturally or not.
Be safe.
Saturday, 4 October 2008
Friday, 3 October 2008
Foul
Day shift: Five calls; one taken by car; four by ambulance.
Stats: 1 Mental health issues/drugs; 1EP fit; 1 Abdo pain; 1 Haematuria; 1 eTOH.
It’s 6.30am and there’s a half-naked woman running around outside a club. The police are on scene and I’ve been called because they think she has mental health issues. She has come out of the nightclub, pulled her trousers down, removed them completely and left herself exposed in a T-shirt and knickers for the world (and their door staff) to see. Clearly she has issues of some kind.
She may have taken drugs and she is clearly unstable because she fights the police when they try to move her to the ambulance. I requested a female crew (or at least one female on board) because this would be a tricky one for an all-male crew. She won’t allow us to cover her up and keeps ripping the blanket away.
I leave the crew to sort it out and a police woman stays on the ambulance with them for extra security because she is behaving very strangely and nobody knows what she’s capable of doing. For this reason, she’s handcuffed.
A 29 year-old woman had an epileptic fit at a hostel but she was recovering when I arrived and a crew was with her, so I wasn’t required.
Abdo pain next and a 29 year-old shoe-shop worker was lying on the bench in the middle of her store (now closed due to ill person inside) when I arrived on scene. After a short chat and some basic obs I persuaded her to sit up. I don’t like it when patients loll around while I’m trying to help them – I don’t mind if they are really ill but this young lady, with her reported pain score of 9/10, was still capable of smiling and talking without dropping a word when she referred to her male colleague in the shop.
I gave her entonox and decided to take her to hospital myself, rather than wait the twenty minutes or so that I would have to endure because there were no ambulances available. There was no vomiting, no fainting, no medical history and no reason for me to waste a resource when I could pack her off myself, so I did.
She managed two phone calls on her mobile during the trip and only used the entonox for her pain when I reminded her that it was there if she needed it.
One of our frequent flyers, let’s call him ‘M’ generated a 999 call from an Ann Summers shop in Soho. He was lying face down on the carpet, just inside the doorway and strangely, there were no customers. He was drunk, smelly from the streets and was now urinating frank blood, which is why he requested the ambulance by being dramatic and falling into the shop. This is what he does and he has been doing it for years. The only time he isn’t abusing us is when he’s in prison…for abusing us.
I picked him up and persuaded him to get out of the store. He demonstrated how genuine his condition was by putting his hand down into his trousers and producing two bloodied fingers – ‘See, I told you I was pissing blood!’
Although it’s always nice to have evidence and to be sure of a diagnosis, I wasn’t really impressed with him, so I sat him in a corner and called Control so that the ambulance could be hurried up. Unfortunately, we were fresh out of ambulances at that particular time and I knew this guy so well that I put in a request for special treatment because he was liable to become aggressive and violent if he waited too long. He has attacked me in the past and it would suit him to be back inside, so an assault on me would buy him some time in the warm as winter approaches.
Control sent me a CRU as back-up but this just made things worse because M hates this particular CRU colleague, so he shouted, pointed and generally made it clear that he wasn’t happy to see him. Now I had an irate, drunken and potentially violent man stomping around the area. I had asked the cops, who’d turned up to see if I needed help, to leave me to it, on the basis that if I kept it nice and one-to-one, M would be quiet and compliant but now I needed them because his behaviour deteriorated as time went on.
An ambulance was despatched after twenty minutes or so and I asked a police officer to come and stand over him as he ranted and swore and thumped public property in an effort to show us how much he hated peeing blood. At one point he stood shouting his pain at me whilst drinking a lager that someone had donated in order to shut him up. Then he lit a cigarette and puffed at that until he collapsed again.
‘Why is it doing this to me?’ he wailed as he looked at his pint. I prayed that he’d answer the question himself and see the error of his ways but I may as well hope to win the lottery twice in a row.
My adventure with him ended when the crew turned up and he became a lamb. The appearance of transport to a free bed and perhaps an overnight stay has that effect on him. My years of dealing with him have taught me never to trust that quiet side of him because if I do, I will end up getting hurt (and I don’t mean my feelings).
Just to help me on my way home, the last call was to another drunken man. This one was slumped outside a Pizza Hut and they simply wanted shot of him because there were paying customers inside, eating their dinners. Fair enough; I wouldn’t want to be eating an over-priced pizza meal in plain view of an alcoholic who’d urinated all over the pavement and wasn’t even good humoured.
The crew was on scene when I arrived, so I assisted them in getting him on board the good ship NHS ambulance for his ride to a better place (where the food is free). As his obs were being done he helped us out enormously by passing the foulest and most persistent gas I’ve experienced in a long time. The vapour was actually sticky and couldn’t be removed from my uniform for hours afterwards. Not only did he offend us once to the point where the ambulance doors had to be flung open, he decided to repeat the performance again and again. This man had a real problem keeping it to himself. Jobs like this make me so glad I’m on the car; I can get away from it, the poor attendant had to stay in the back with him all the way to hospital. He will no doubt have been put off eggs for life.
Be safe.
Stats: 1 Mental health issues/drugs; 1EP fit; 1 Abdo pain; 1 Haematuria; 1 eTOH.
It’s 6.30am and there’s a half-naked woman running around outside a club. The police are on scene and I’ve been called because they think she has mental health issues. She has come out of the nightclub, pulled her trousers down, removed them completely and left herself exposed in a T-shirt and knickers for the world (and their door staff) to see. Clearly she has issues of some kind.
She may have taken drugs and she is clearly unstable because she fights the police when they try to move her to the ambulance. I requested a female crew (or at least one female on board) because this would be a tricky one for an all-male crew. She won’t allow us to cover her up and keeps ripping the blanket away.
I leave the crew to sort it out and a police woman stays on the ambulance with them for extra security because she is behaving very strangely and nobody knows what she’s capable of doing. For this reason, she’s handcuffed.
A 29 year-old woman had an epileptic fit at a hostel but she was recovering when I arrived and a crew was with her, so I wasn’t required.
Abdo pain next and a 29 year-old shoe-shop worker was lying on the bench in the middle of her store (now closed due to ill person inside) when I arrived on scene. After a short chat and some basic obs I persuaded her to sit up. I don’t like it when patients loll around while I’m trying to help them – I don’t mind if they are really ill but this young lady, with her reported pain score of 9/10, was still capable of smiling and talking without dropping a word when she referred to her male colleague in the shop.
I gave her entonox and decided to take her to hospital myself, rather than wait the twenty minutes or so that I would have to endure because there were no ambulances available. There was no vomiting, no fainting, no medical history and no reason for me to waste a resource when I could pack her off myself, so I did.
She managed two phone calls on her mobile during the trip and only used the entonox for her pain when I reminded her that it was there if she needed it.
One of our frequent flyers, let’s call him ‘M’ generated a 999 call from an Ann Summers shop in Soho. He was lying face down on the carpet, just inside the doorway and strangely, there were no customers. He was drunk, smelly from the streets and was now urinating frank blood, which is why he requested the ambulance by being dramatic and falling into the shop. This is what he does and he has been doing it for years. The only time he isn’t abusing us is when he’s in prison…for abusing us.
I picked him up and persuaded him to get out of the store. He demonstrated how genuine his condition was by putting his hand down into his trousers and producing two bloodied fingers – ‘See, I told you I was pissing blood!’
Although it’s always nice to have evidence and to be sure of a diagnosis, I wasn’t really impressed with him, so I sat him in a corner and called Control so that the ambulance could be hurried up. Unfortunately, we were fresh out of ambulances at that particular time and I knew this guy so well that I put in a request for special treatment because he was liable to become aggressive and violent if he waited too long. He has attacked me in the past and it would suit him to be back inside, so an assault on me would buy him some time in the warm as winter approaches.
Control sent me a CRU as back-up but this just made things worse because M hates this particular CRU colleague, so he shouted, pointed and generally made it clear that he wasn’t happy to see him. Now I had an irate, drunken and potentially violent man stomping around the area. I had asked the cops, who’d turned up to see if I needed help, to leave me to it, on the basis that if I kept it nice and one-to-one, M would be quiet and compliant but now I needed them because his behaviour deteriorated as time went on.
An ambulance was despatched after twenty minutes or so and I asked a police officer to come and stand over him as he ranted and swore and thumped public property in an effort to show us how much he hated peeing blood. At one point he stood shouting his pain at me whilst drinking a lager that someone had donated in order to shut him up. Then he lit a cigarette and puffed at that until he collapsed again.
‘Why is it doing this to me?’ he wailed as he looked at his pint. I prayed that he’d answer the question himself and see the error of his ways but I may as well hope to win the lottery twice in a row.
My adventure with him ended when the crew turned up and he became a lamb. The appearance of transport to a free bed and perhaps an overnight stay has that effect on him. My years of dealing with him have taught me never to trust that quiet side of him because if I do, I will end up getting hurt (and I don’t mean my feelings).
Just to help me on my way home, the last call was to another drunken man. This one was slumped outside a Pizza Hut and they simply wanted shot of him because there were paying customers inside, eating their dinners. Fair enough; I wouldn’t want to be eating an over-priced pizza meal in plain view of an alcoholic who’d urinated all over the pavement and wasn’t even good humoured.
The crew was on scene when I arrived, so I assisted them in getting him on board the good ship NHS ambulance for his ride to a better place (where the food is free). As his obs were being done he helped us out enormously by passing the foulest and most persistent gas I’ve experienced in a long time. The vapour was actually sticky and couldn’t be removed from my uniform for hours afterwards. Not only did he offend us once to the point where the ambulance doors had to be flung open, he decided to repeat the performance again and again. This man had a real problem keeping it to himself. Jobs like this make me so glad I’m on the car; I can get away from it, the poor attendant had to stay in the back with him all the way to hospital. He will no doubt have been put off eggs for life.
Be safe.
Tuesday, 30 September 2008
Viagra man
Day shift: Six calls; one assisted-only; one taken in the car and the rest by ambulance.
Stats: 1 Abdo pain; 1 Asleep; 1 Ankle sprain; 1 cardiac problems; 1 ?food poisoning; 1 non-cardiac chest pain.
An alcoholic staggered towards my car when I arrived on scene. He’d called us from a phone box and waited for my arrival at 7am. He had right-side upper abdominal pain and a history of liver problems – surprise, surprise. The 38 year-old seemed in genuine pain but the fact that he’d been drinking all night kind of put the brakes on my usual outpouring of sympathy, although he still got the same treatment everyone gets – pain relief and an ambulance to hospital.
An unconscious man on a bus got a rude awakening from the crew as they stepped on board just ahead of me. Before I’d reached the bottom of the stairs leading to the top deck, he was making his sleepy-headed way down with my colleagues behind him. Prior to this thirty-second action the bus driver and his mates at the terminus had stood and watched in what I can only describe as awe, as if this had all been an LAS magic trick. Once removed we felt it was our duty to remind the bus staff that it’s quite easy and not very dangerous to shout at someone and wake them up – ‘Kindly exit the vehicle because it has now terminated’ or ‘Oi! Get off the bus' will do.
A sunny weekend meant a lot of visitors to the centre and my next call was to an Italian man who’d stumbled down a few steps but had been clumsy enough to sprain his ankle in doing so. Only one member of his family spoke English, so she became my interpreter, although she wasn’t always accurate. When I suggested taking the patient to hospital in the car, she looked dumbfounded and asked me why I thought her father should be driving at all with a dodgy ankle, never mind in an emergency vehicle he’d never been trained to use!
I managed to untangle the conversation and took the hopping man and his daughter in the car. The rest of the family had to walk across the bridge to get to the hospital. I really need a special ‘patient’s friends and relatives roof rack’.
On a number of occasions I have bored you with the fact that I receive calls to the National Gallery or the vicinity of Trafalgar Square when I am sitting on it on stand-by. Once again, I proved to be in the right place…blah, blah, when I got a call for a 60 year-old man ‘not alert’ in the Gallery’s restaurant. It took me all of ten seconds to respond…I did a U-turn and parked up basically.
The man was with his wife and he’d passed out before proceeding to vomit a number of times. Other diners carried on eating and drinking, as they do but they donned their ‘not really looking’ faces and you only get that in places where food is being consumed at the same time as vomit is being expelled.
The crew arrived soon after I’d started my obs and the man never really showed any signs of improvement; he was very pale, very unwell looking and still unstable in terms of his level of consciousness. I could see a possible cardiac connection here and when his ECG was done in the ambulance (he had to exit on the bed because he needed to lie down) it showed a possible heart block, which had the effect of slowing his heart rate down and causing his blood pressure to drop. There was no doubt about him going to hospital of course.
Panicking neighbours flagged me down as I arrived at the address of the next patient. She had a history of CVA, so because she’d collapsed in the toilet and was suddenly weak and doubly incontinent, the assumption was that she’d had another. When I got to her she was lying on the toiler floor with a pool of fresh vomit around her head. She was well aware of what was going on and there was no weakness or lack of function as far as her limbs were concerned. In fact, her story, related to myself and the crew when they arrived, indicated a possible food link and food poisoning seemed likely, although a CVA can never be ruled out pre-hospital.
My shift ended with a 75 year-old man for whom an ambulance had been called because he was complaining of chest pain. I found him sitting in the doorway of a pub, surrounded by young women, all of whom seemed concerned about him. He was smiling, chatting and giving a tourist directions when I approached him. I had to wait until he’d finished before I could introduce myself, although the uniform and recent blue lights and sirens should have been the heaviest of hints. He was properly distracted, however. Well, he was until he was aware of me, then he clutched his chest and an agony crossed his face for my benefit.
‘What’s wrong?’ I asked.
‘It’s me chest. I fell onto a table three days ago and now it hurts’ he informed me.
‘Three days ago?’
‘Well, I thought it would get better if I just popped some paracetamol’.
At least I knew it wasn’t a cardiac complaint. He didn’t have any heart problems and he discussed his sex life at length to the crew when they joined me, proving that he still had life in him yet.
‘Yeah, she lets me have Viagra three times a week. I’ve got to perform twice tonight’, he tells us as we wince and smile at the same time.
Be safe.
Stats: 1 Abdo pain; 1 Asleep; 1 Ankle sprain; 1 cardiac problems; 1 ?food poisoning; 1 non-cardiac chest pain.
An alcoholic staggered towards my car when I arrived on scene. He’d called us from a phone box and waited for my arrival at 7am. He had right-side upper abdominal pain and a history of liver problems – surprise, surprise. The 38 year-old seemed in genuine pain but the fact that he’d been drinking all night kind of put the brakes on my usual outpouring of sympathy, although he still got the same treatment everyone gets – pain relief and an ambulance to hospital.
An unconscious man on a bus got a rude awakening from the crew as they stepped on board just ahead of me. Before I’d reached the bottom of the stairs leading to the top deck, he was making his sleepy-headed way down with my colleagues behind him. Prior to this thirty-second action the bus driver and his mates at the terminus had stood and watched in what I can only describe as awe, as if this had all been an LAS magic trick. Once removed we felt it was our duty to remind the bus staff that it’s quite easy and not very dangerous to shout at someone and wake them up – ‘Kindly exit the vehicle because it has now terminated’ or ‘Oi! Get off the bus' will do.
A sunny weekend meant a lot of visitors to the centre and my next call was to an Italian man who’d stumbled down a few steps but had been clumsy enough to sprain his ankle in doing so. Only one member of his family spoke English, so she became my interpreter, although she wasn’t always accurate. When I suggested taking the patient to hospital in the car, she looked dumbfounded and asked me why I thought her father should be driving at all with a dodgy ankle, never mind in an emergency vehicle he’d never been trained to use!
I managed to untangle the conversation and took the hopping man and his daughter in the car. The rest of the family had to walk across the bridge to get to the hospital. I really need a special ‘patient’s friends and relatives roof rack’.
On a number of occasions I have bored you with the fact that I receive calls to the National Gallery or the vicinity of Trafalgar Square when I am sitting on it on stand-by. Once again, I proved to be in the right place…blah, blah, when I got a call for a 60 year-old man ‘not alert’ in the Gallery’s restaurant. It took me all of ten seconds to respond…I did a U-turn and parked up basically.
The man was with his wife and he’d passed out before proceeding to vomit a number of times. Other diners carried on eating and drinking, as they do but they donned their ‘not really looking’ faces and you only get that in places where food is being consumed at the same time as vomit is being expelled.
The crew arrived soon after I’d started my obs and the man never really showed any signs of improvement; he was very pale, very unwell looking and still unstable in terms of his level of consciousness. I could see a possible cardiac connection here and when his ECG was done in the ambulance (he had to exit on the bed because he needed to lie down) it showed a possible heart block, which had the effect of slowing his heart rate down and causing his blood pressure to drop. There was no doubt about him going to hospital of course.
Panicking neighbours flagged me down as I arrived at the address of the next patient. She had a history of CVA, so because she’d collapsed in the toilet and was suddenly weak and doubly incontinent, the assumption was that she’d had another. When I got to her she was lying on the toiler floor with a pool of fresh vomit around her head. She was well aware of what was going on and there was no weakness or lack of function as far as her limbs were concerned. In fact, her story, related to myself and the crew when they arrived, indicated a possible food link and food poisoning seemed likely, although a CVA can never be ruled out pre-hospital.
My shift ended with a 75 year-old man for whom an ambulance had been called because he was complaining of chest pain. I found him sitting in the doorway of a pub, surrounded by young women, all of whom seemed concerned about him. He was smiling, chatting and giving a tourist directions when I approached him. I had to wait until he’d finished before I could introduce myself, although the uniform and recent blue lights and sirens should have been the heaviest of hints. He was properly distracted, however. Well, he was until he was aware of me, then he clutched his chest and an agony crossed his face for my benefit.
‘What’s wrong?’ I asked.
‘It’s me chest. I fell onto a table three days ago and now it hurts’ he informed me.
‘Three days ago?’
‘Well, I thought it would get better if I just popped some paracetamol’.
At least I knew it wasn’t a cardiac complaint. He didn’t have any heart problems and he discussed his sex life at length to the crew when they joined me, proving that he still had life in him yet.
‘Yeah, she lets me have Viagra three times a week. I’ve got to perform twice tonight’, he tells us as we wince and smile at the same time.
Be safe.
Monday, 29 September 2008
Man hits bus - bus hits back; bus wins
Day shift: Six calls; all by ambulance.
Stats: 1 RTC with minor injury; 1 Hyperglycaemic; 1 Dizzy person; 2 Chest pains 1 RTC with potentially serious injuries.
I had to take myself off to Moorfield Eye Hospital before I started my shift. This chronic conjunctivitis, stye or whatever I have been suffering for the past five months had finally got the better of me and a colleague suggested I do something about it. I’m lazy like that – I don’t go to see my doctor unless I think something will kill me or it gets so annoying that I’m left with no choice. I’m not the best ad for medical compliance.
So, I went and I got it diagnosed, after worrying that it may be cancer or something ugly and permanent. I have Blepharitis. It’s not dirty and it’s not infectious. I didn’t get it from a patient (which was one of my theories) and I have been walking around with the world’s reddest (and at times most swollen) eyelids for ages…for nothing. All I need to do is bathe them twice a day every day for as long as it takes. Silly me.
I was cancelled for the 6 year-old who’d fallen from a third floor window and given a bus vs. pedestrian call instead. I arrived to find her sitting on the bus, nursing a bruised leg, which she earned by crossing the vehicle’s path while it was still moving. Tsk!
A 33 year-old diabetic lady allowed her blood sugar to reach a level where my monitor (and hers) read ‘HI’, indicating that it was too high to be given a number, so she was given fluids and taken away from work and off to hospital. She’d been vomiting and feeling very unwell for days. That, I suggested, was the best hint she’d get.
My next job was a running call. I was flagged down by someone as I drove back from re-feuling my car. I thought he wanted a taxi and was just about to explain that I was an ambulance when he asked if I had been called to his office. I told him that I hadn’t but I checked with Control and they confirmed that an ambulance was on its way to this address. I stopped to help out and was directed to a very large builder who was sitting outside a construction site, looking quite pale. He’d suddenly become very dizzy and unsteady on his feet. He had to hold on to me when I moved him from the wall he was perched on to a nearby chair.
The ambulance turned up within a minute of my obs and I handed him over. I don’t think he was in danger but his dizzy spell would have to be investigated. Cardiac problems manifest in many ways.
My first of two chest pain calls led me to a van parked in the street, inside which a man sat, pale and sweaty, clutching his chest. His first words were ‘I’m HiV positive’ and I thanked him for telling me. I have no fear of this but it’s nice to be informed; it shows respect for another person’s safety.
The man had a history of MI and this looked real enough to be another, so he was taken to hospital without delay as soon as the ambulance arrived.
The second chest pain I was called to wasn’t my patient. An ambulance had been despatched but I was asked to take a piece of equipment to the crew because theirs had failed. I ended up following an ambulance, which I assumed was the one I was tasked to accompany, to the wrong call, half a mile away. Once I’d realised my mistake, I got back on track and found the crew and their patient at a private medical centre in the city.
It sounded more like a PE than cardiac-related and once I’d handed over the equipment required, I left them to it. I am the humble servant of those who need me. I would draw the line at delivering tea though.
On the way back, I came across a RTC in which a bus had hit a pedestrian. Three solos were on scene and I stopped to assist (I am basically nosey and like to keep busy). The man was on the ground and complained of shoulder and hip pain. The large crack (photo) on the windscreen of the bus indicated mechanisms for potentially serious injuries, especially if his head had made contact, so he was collared, boarded and taken away to hospital. I assisted by being yet another emergency vehicle obstructing the free-flow of traffic in the area. Still, it’s nice to know that I’m useful.
Stats: 1 RTC with minor injury; 1 Hyperglycaemic; 1 Dizzy person; 2 Chest pains 1 RTC with potentially serious injuries.
I had to take myself off to Moorfield Eye Hospital before I started my shift. This chronic conjunctivitis, stye or whatever I have been suffering for the past five months had finally got the better of me and a colleague suggested I do something about it. I’m lazy like that – I don’t go to see my doctor unless I think something will kill me or it gets so annoying that I’m left with no choice. I’m not the best ad for medical compliance.
So, I went and I got it diagnosed, after worrying that it may be cancer or something ugly and permanent. I have Blepharitis. It’s not dirty and it’s not infectious. I didn’t get it from a patient (which was one of my theories) and I have been walking around with the world’s reddest (and at times most swollen) eyelids for ages…for nothing. All I need to do is bathe them twice a day every day for as long as it takes. Silly me.
I was cancelled for the 6 year-old who’d fallen from a third floor window and given a bus vs. pedestrian call instead. I arrived to find her sitting on the bus, nursing a bruised leg, which she earned by crossing the vehicle’s path while it was still moving. Tsk!
A 33 year-old diabetic lady allowed her blood sugar to reach a level where my monitor (and hers) read ‘HI’, indicating that it was too high to be given a number, so she was given fluids and taken away from work and off to hospital. She’d been vomiting and feeling very unwell for days. That, I suggested, was the best hint she’d get.
My next job was a running call. I was flagged down by someone as I drove back from re-feuling my car. I thought he wanted a taxi and was just about to explain that I was an ambulance when he asked if I had been called to his office. I told him that I hadn’t but I checked with Control and they confirmed that an ambulance was on its way to this address. I stopped to help out and was directed to a very large builder who was sitting outside a construction site, looking quite pale. He’d suddenly become very dizzy and unsteady on his feet. He had to hold on to me when I moved him from the wall he was perched on to a nearby chair.
The ambulance turned up within a minute of my obs and I handed him over. I don’t think he was in danger but his dizzy spell would have to be investigated. Cardiac problems manifest in many ways.
My first of two chest pain calls led me to a van parked in the street, inside which a man sat, pale and sweaty, clutching his chest. His first words were ‘I’m HiV positive’ and I thanked him for telling me. I have no fear of this but it’s nice to be informed; it shows respect for another person’s safety.
The man had a history of MI and this looked real enough to be another, so he was taken to hospital without delay as soon as the ambulance arrived.
The second chest pain I was called to wasn’t my patient. An ambulance had been despatched but I was asked to take a piece of equipment to the crew because theirs had failed. I ended up following an ambulance, which I assumed was the one I was tasked to accompany, to the wrong call, half a mile away. Once I’d realised my mistake, I got back on track and found the crew and their patient at a private medical centre in the city.
It sounded more like a PE than cardiac-related and once I’d handed over the equipment required, I left them to it. I am the humble servant of those who need me. I would draw the line at delivering tea though.
On the way back, I came across a RTC in which a bus had hit a pedestrian. Three solos were on scene and I stopped to assist (I am basically nosey and like to keep busy). The man was on the ground and complained of shoulder and hip pain. The large crack (photo) on the windscreen of the bus indicated mechanisms for potentially serious injuries, especially if his head had made contact, so he was collared, boarded and taken away to hospital. I assisted by being yet another emergency vehicle obstructing the free-flow of traffic in the area. Still, it’s nice to know that I’m useful.
Be safe.
Sunday, 28 September 2008
Fresh meat in Fresher's Week
Night shift: Eleven calls; three assisted-only, all the others by ambulance.
Stats: 4 eTOH; 1 RTC with facial injury; 1 Unwell adult; 1 drug overdose; 1 DIB; 1 Mental health problems; 1 Faint; 1 Assault with minor injuries.
Fresher’s week and all hell breaks loose in the bars and clubs as young, soon-to-be doctors and scientists of all kinds learn how to become as drunk as possible in as little time as possible. To them it’s a rite of passage but to us it’s a long night and damaging for the all too important performance figures.
My first drunk was a 30 year-old alcoholic at a hostel. Known to be aggressive, he didn’t let anybody down and spent the time we had on scene with him abusing the crew, so he was left where he was, sitting in his own urine as the staff tried to figure out what to do next.
Up the road a 45 year-old man was hit in the face by the mirror of a bus. He had minor facial injuries and, after the crew had tidied him up, he declined to go to hospital. I couldn’t blame him, on a night like this you don’t want to be sitting in A&E waiting for hours to be seen. Not when it seemed like every eighteen to twenty year-old from the local Universities were being brought in out of their skulls.
A 30 year-old night shift worker lay on the floor of her sprawling workplace, feigning hypoglycaemia for some reason. Her comrades were so convinced of her illness that I arrived to find one of them shoving a spoonful of tomato sauce in her mouth. Her BM was normal, as were all of her vital signs. She didn’t speak at first but then she began to communicate once she realised the crew was going to take her to hospital. I don’t believe there was anything wrong with this lady – I think she just wanted to get away from work for the night. This happens commonly and I wish it was that easy for us sometimes.
The calls for ‘unconscious’ persons began soon after this and I attended a 25 year-old male who was slumped in the street after taking alcohol and drugs on board. The police were on scene and the crew arrived soon after me, so all I had to do, as usual in these circumstances, was carry out my obs.
Not only do the young learned people of this part of London get as drunk as possible but a good proportion of them, in denial by proxy, are said to have had their drinks ‘spiked’. You can usually tell the difference between a truly drugged drinker and a truly drunk one. The 26 year-old female I went to the aid of was truly drunk. Her friend, the proxy witness to the fact that she MUST have been drugged by some filthy man because she NEVER behaves likes this after a drink, couldn’t even tell us where she was exactly and it took an area search and a few more calls back to find her. By that time I’d grown bored of it and the crew took care of her (she walked onto the vehicle).
I had just got back to station when I was called out again with the crew who’d been there. A 22 year-old man was ‘unconscious’ in the street, a few hundred yards down the road from the station itself. He was lying on the pavement, surrounded by helpful people. He had vomited heavily and was clearly too drunk to go anywhere. In fact, how he got as far as he did was a miracle.
The helpers weren’t all impressed and one of them said ‘are you sure he needs to go to hospital?’ He followed this query with ‘is it worth taking him?’ Well, no I would have said but the man was useless to himself and everyone around him, so he had to go somewhere safe. Ironically, he’d chosen to fall down on the doorstep of a pub. Maybe he was trying to say something.
I wasn’t required for the next call; a 2 month-old who’d ‘gone stiff’ and now had DIB. The crew was on scene and this would probably turn out to be no more than a high temperature episode.
Back into the West End and I watched as a 22 year-old girl, who’d been drinking of course, howled and moaned her way into the ambulance with the struggling crew as her boyfriend and other men (who would consider themselves ‘decent types’ no doubt) harassed them. I put myself between them to diffuse the situation a little and let the crew get on with their job. The girl was convinced she was having a stroke. We were more convinced of the power of alcohol. The crew had probably just dealt with half a dozen of these calls earlier and had more to come as the night wore on.
I was flagged down as I attempted to get back to the station for a coffee. One of those pedicab drivers (cyclists) told me that someone was lying unconscious on the pavement, so I went to have a look and called it in as a running call. The man on the ground was known to me – he’s a Soho local and is always aggressive, even though he wears a selection of gold crucifixes and other religious bits and pieces. His hands are adorned with obscene rings and he has a large gold (he likes gold) watch on his wrist. None of the jewellery looks worth anything but that won’t stop someone from robbing him if he goes to sleep in public places like that, so I shook him awake and got the full-faced wrath of God for my trouble.
He leaped to his feet, threw down his jacket and postured for a fight with me. I calmed him down and took a step back until he simmered. Then he blessed me and told me how much God loved me. I had to accept that the miracle of not getting a punch in the face from him for trying to help must have been some indication of that love. He shuffled off and I went back to the car and stood down the Cavalry.
Back to someone’s workplace for a 30 year-old female with the most amazing brown eyes I have ever seen (and I don’t mean that in a sleazy way, of course – they were just very striking). She’d fainted on arrival at work and she had a history of this but nothing had ever been diagnosed. She declined to go to hospital because she felt better by the time I got to her but I managed to persuade her to go with the crew to the ambulance and get checked out. She was happy to do this but still insisted that she wasn’t going to hospital. At last, a night-shift worker who wasn’t using us as a means to get time off.
I’ve been to many calls where door security people at clubs have been accused, rightly or wrongly, of assault. I think in most cases the person making the allegation has done something wrong and during the ejection process has resisted, so that reasonable force became a little less reasonable. I won’t make a judgment on it because I never see these alleged assaults and door security have enough work as it is just dealing with some of the idiots they have to control after a boozy night out.
My last patient of the night, a 24 year-old man, claimed he was punched around the face and ‘strangled’ to the point where he believed he would die after an altercation with one of the doormen. To be fair, his story, related to me as he sat in my car and we waited for the ambulance, was full of holes. It sounded to me like he’d started an argument with one of the men when he was asked to leave for being too drunk and annoying. In the real world, if you argue when being asked to leave a club, you are more than likely going to be dragged out forcefully. During that process, if you continue to struggle or fight with them, more force will be used. That’s just the way it is, right or wrong, as I said.
I jump to nobody’s defence here you understand but if a drunken person tries to be aggressive with me, I will not allow it (I’d stop short at strangling, punching or kicking, however).
Be safe.
Stats: 4 eTOH; 1 RTC with facial injury; 1 Unwell adult; 1 drug overdose; 1 DIB; 1 Mental health problems; 1 Faint; 1 Assault with minor injuries.
Fresher’s week and all hell breaks loose in the bars and clubs as young, soon-to-be doctors and scientists of all kinds learn how to become as drunk as possible in as little time as possible. To them it’s a rite of passage but to us it’s a long night and damaging for the all too important performance figures.
My first drunk was a 30 year-old alcoholic at a hostel. Known to be aggressive, he didn’t let anybody down and spent the time we had on scene with him abusing the crew, so he was left where he was, sitting in his own urine as the staff tried to figure out what to do next.
Up the road a 45 year-old man was hit in the face by the mirror of a bus. He had minor facial injuries and, after the crew had tidied him up, he declined to go to hospital. I couldn’t blame him, on a night like this you don’t want to be sitting in A&E waiting for hours to be seen. Not when it seemed like every eighteen to twenty year-old from the local Universities were being brought in out of their skulls.
A 30 year-old night shift worker lay on the floor of her sprawling workplace, feigning hypoglycaemia for some reason. Her comrades were so convinced of her illness that I arrived to find one of them shoving a spoonful of tomato sauce in her mouth. Her BM was normal, as were all of her vital signs. She didn’t speak at first but then she began to communicate once she realised the crew was going to take her to hospital. I don’t believe there was anything wrong with this lady – I think she just wanted to get away from work for the night. This happens commonly and I wish it was that easy for us sometimes.
The calls for ‘unconscious’ persons began soon after this and I attended a 25 year-old male who was slumped in the street after taking alcohol and drugs on board. The police were on scene and the crew arrived soon after me, so all I had to do, as usual in these circumstances, was carry out my obs.
Not only do the young learned people of this part of London get as drunk as possible but a good proportion of them, in denial by proxy, are said to have had their drinks ‘spiked’. You can usually tell the difference between a truly drugged drinker and a truly drunk one. The 26 year-old female I went to the aid of was truly drunk. Her friend, the proxy witness to the fact that she MUST have been drugged by some filthy man because she NEVER behaves likes this after a drink, couldn’t even tell us where she was exactly and it took an area search and a few more calls back to find her. By that time I’d grown bored of it and the crew took care of her (she walked onto the vehicle).
I had just got back to station when I was called out again with the crew who’d been there. A 22 year-old man was ‘unconscious’ in the street, a few hundred yards down the road from the station itself. He was lying on the pavement, surrounded by helpful people. He had vomited heavily and was clearly too drunk to go anywhere. In fact, how he got as far as he did was a miracle.
The helpers weren’t all impressed and one of them said ‘are you sure he needs to go to hospital?’ He followed this query with ‘is it worth taking him?’ Well, no I would have said but the man was useless to himself and everyone around him, so he had to go somewhere safe. Ironically, he’d chosen to fall down on the doorstep of a pub. Maybe he was trying to say something.
I wasn’t required for the next call; a 2 month-old who’d ‘gone stiff’ and now had DIB. The crew was on scene and this would probably turn out to be no more than a high temperature episode.
Back into the West End and I watched as a 22 year-old girl, who’d been drinking of course, howled and moaned her way into the ambulance with the struggling crew as her boyfriend and other men (who would consider themselves ‘decent types’ no doubt) harassed them. I put myself between them to diffuse the situation a little and let the crew get on with their job. The girl was convinced she was having a stroke. We were more convinced of the power of alcohol. The crew had probably just dealt with half a dozen of these calls earlier and had more to come as the night wore on.
I was flagged down as I attempted to get back to the station for a coffee. One of those pedicab drivers (cyclists) told me that someone was lying unconscious on the pavement, so I went to have a look and called it in as a running call. The man on the ground was known to me – he’s a Soho local and is always aggressive, even though he wears a selection of gold crucifixes and other religious bits and pieces. His hands are adorned with obscene rings and he has a large gold (he likes gold) watch on his wrist. None of the jewellery looks worth anything but that won’t stop someone from robbing him if he goes to sleep in public places like that, so I shook him awake and got the full-faced wrath of God for my trouble.
He leaped to his feet, threw down his jacket and postured for a fight with me. I calmed him down and took a step back until he simmered. Then he blessed me and told me how much God loved me. I had to accept that the miracle of not getting a punch in the face from him for trying to help must have been some indication of that love. He shuffled off and I went back to the car and stood down the Cavalry.
Back to someone’s workplace for a 30 year-old female with the most amazing brown eyes I have ever seen (and I don’t mean that in a sleazy way, of course – they were just very striking). She’d fainted on arrival at work and she had a history of this but nothing had ever been diagnosed. She declined to go to hospital because she felt better by the time I got to her but I managed to persuade her to go with the crew to the ambulance and get checked out. She was happy to do this but still insisted that she wasn’t going to hospital. At last, a night-shift worker who wasn’t using us as a means to get time off.
I’ve been to many calls where door security people at clubs have been accused, rightly or wrongly, of assault. I think in most cases the person making the allegation has done something wrong and during the ejection process has resisted, so that reasonable force became a little less reasonable. I won’t make a judgment on it because I never see these alleged assaults and door security have enough work as it is just dealing with some of the idiots they have to control after a boozy night out.
My last patient of the night, a 24 year-old man, claimed he was punched around the face and ‘strangled’ to the point where he believed he would die after an altercation with one of the doormen. To be fair, his story, related to me as he sat in my car and we waited for the ambulance, was full of holes. It sounded to me like he’d started an argument with one of the men when he was asked to leave for being too drunk and annoying. In the real world, if you argue when being asked to leave a club, you are more than likely going to be dragged out forcefully. During that process, if you continue to struggle or fight with them, more force will be used. That’s just the way it is, right or wrong, as I said.
I jump to nobody’s defence here you understand but if a drunken person tries to be aggressive with me, I will not allow it (I’d stop short at strangling, punching or kicking, however).
Be safe.
Saturday, 27 September 2008
Ending it all
Night shift: Five calls; one false alarm; one dead on scene; three by ambulance.
Stats: 1 MI; 1 Suicide; 2 Chest pains.
An 82 year-old man with chest pain and DIB, a history of type II diabetes and heart failure probably had a UTI – he hadn’t urinated for three days and his condition was complicated by the fact that he was now having an MI. His ECG was textbook and the training crew that arrived to take him away had their first lesson in treating the obvious when they were told about it by their Supervisor.
I wasn’t required to do anything on the next call and the crew on scene simply completed the necessary ‘life extinct’ paperwork as I left. The 30 year-old had apparently committed suicide in the hostel where he stayed. He’d blocked the door to his room with a barrier of furniture and killed himself in the toilet, where his body was found by staff, lying on the floor at the side of the toilet bowl. Water surrounded him and he had had a head injury, which was probably sustained when he fell. The likely cause was an overdose but the police and Coroner would be left to work all that out – there was nothing we could do to help him and, with all the effort he’d put into his demise, it was unlikely he could be saved even if he’d been found earlier.
The water on the floor and the towels used to seal the gap between the bottom of the toilet door and the floor had served some purpose but I don’t know what it was – he certainly hadn’t drowned.
A false alarm (or not) next for a ‘person in the river’. Someone had been fished out dead earlier in the evening and now another man or woman had jumped in to drown. Despite a search by the river police and rescue boats, no-one was found. I stood on the bridge, looking over into the water alongside a few of my colleagues but it all came to nothing as we were told to stand down after a while.
Chest pain isn’t always cardiac-related and right-sided pain makes that possibility less likely, so my 58 year-old patient, whose BM and BP were both on the high side, may have been suffering from a pulmonary embolism. His ECG showed bradycardia and he was uncomfortable. He was given oxygen, monitored and taken to hospital.
On the other hand, chest pain in the absence of any clinical signs whatsoever can mean something and nothing. My last patient was 25 years-old and she insisted that she had severe chest pains, even though her vital signs were all good and her ECG was normal. I thought she may be making a drama out of it and it got her the night off work but I don’t want to be too quick to judge such things because every now and then you get calls like this – seemingly for nothing but they turn out to be significant. I still doubted her though, I have to say.
Stats: 1 MI; 1 Suicide; 2 Chest pains.
An 82 year-old man with chest pain and DIB, a history of type II diabetes and heart failure probably had a UTI – he hadn’t urinated for three days and his condition was complicated by the fact that he was now having an MI. His ECG was textbook and the training crew that arrived to take him away had their first lesson in treating the obvious when they were told about it by their Supervisor.
I wasn’t required to do anything on the next call and the crew on scene simply completed the necessary ‘life extinct’ paperwork as I left. The 30 year-old had apparently committed suicide in the hostel where he stayed. He’d blocked the door to his room with a barrier of furniture and killed himself in the toilet, where his body was found by staff, lying on the floor at the side of the toilet bowl. Water surrounded him and he had had a head injury, which was probably sustained when he fell. The likely cause was an overdose but the police and Coroner would be left to work all that out – there was nothing we could do to help him and, with all the effort he’d put into his demise, it was unlikely he could be saved even if he’d been found earlier.
The water on the floor and the towels used to seal the gap between the bottom of the toilet door and the floor had served some purpose but I don’t know what it was – he certainly hadn’t drowned.
A false alarm (or not) next for a ‘person in the river’. Someone had been fished out dead earlier in the evening and now another man or woman had jumped in to drown. Despite a search by the river police and rescue boats, no-one was found. I stood on the bridge, looking over into the water alongside a few of my colleagues but it all came to nothing as we were told to stand down after a while.
Chest pain isn’t always cardiac-related and right-sided pain makes that possibility less likely, so my 58 year-old patient, whose BM and BP were both on the high side, may have been suffering from a pulmonary embolism. His ECG showed bradycardia and he was uncomfortable. He was given oxygen, monitored and taken to hospital.
On the other hand, chest pain in the absence of any clinical signs whatsoever can mean something and nothing. My last patient was 25 years-old and she insisted that she had severe chest pains, even though her vital signs were all good and her ECG was normal. I thought she may be making a drama out of it and it got her the night off work but I don’t want to be too quick to judge such things because every now and then you get calls like this – seemingly for nothing but they turn out to be significant. I still doubted her though, I have to say.
Be safe.
Friday, 26 September 2008
Not all crashes are bad
Day shift: Five calls; two assisted-only, three by ambulance.
Stats: 1 MI; 1 eTOH fit; 1 Dizzy person; 1 eTOH; 1 ?CVA
An unusual case to start the day. A 57 year-old man crashed his van into the barriers at the side of a busy road after having what everyone thought was an epileptic fit. The crew was on scene and I arrived as they took him into the ambulance. He certainly looked as if he’d had some kind of fit and there was evidence of him having lost bladder control in the vehicle but his demeanour shouted a lot more about him and his ECG appeared to show that he was having an MI but our ECG’s can be unreliable at times and when he got to hospital they discovered that he was in unstable VT.
It turns out he’d gone into VF whilst driving and lost consciousness as he began to arrest – this caused him to roll into the barrier as his vehicle crossed the road under no control whatsoever. The collision wasn’t enough to hurt him badly but it did create a significant thump to his chest and this acted like a defibrillator, bringing him out of VF and into VT. His life was probably saved by it and he most likely had a seizure as a result of oxygen deprivation.
He lay on the bed in Resus telling everyone that he felt fine, while his ECG did strange things and the staff put defib pads on him. I probably won’t see that combination of events for the rest of my career.
A 67 year-old alcoholic had a fit at a train station (in fact, according to witnesses he had three). The crew was on scene with me and another turned up for good measure but he was stable and didn’t fit again as far as I’m aware.
The new drugs for Parkinson’s work well to control the symptoms and my next patient, afflicted with this condition, suffered a dizzy spell after walking around all morning with his wife. The man looked perfectly fine as he sat on a bus and if he hadn’t told me he had Parkinson’s I wouldn’t have known. After a long chat, in which I learned that he used to be an architect and that he dabbled in digital photography and knew more about computers than his grand-children, the crew arrived to take him on board for further checks before letting him and his wife continue their onward journey home.
Another alcoholic who was said to be fitting wasn’t in fact. He just lay on the pavement, worrying passers-by. He still had the pyjama bottoms on from his last trip to hospital and he wasn’t interested in another visit, so I helped him up and he staggered away to a better place for sleeping.
An off-duty nurse helped me with my last patient, a 40 year-old man who was suffering a ?CVA at a train station. Screens had been erected around him, which is always useful and something we can’t carry around because of the lack of space in our vehicles but they served me well and the privacy and dignity of the patient was preserved as people rushed around catching and leaving trains.
I had enough time to put a line in, just in case, before the ambulance arrived to take the confused and agitated man away.
Be safe.
Stats: 1 MI; 1 eTOH fit; 1 Dizzy person; 1 eTOH; 1 ?CVA
An unusual case to start the day. A 57 year-old man crashed his van into the barriers at the side of a busy road after having what everyone thought was an epileptic fit. The crew was on scene and I arrived as they took him into the ambulance. He certainly looked as if he’d had some kind of fit and there was evidence of him having lost bladder control in the vehicle but his demeanour shouted a lot more about him and his ECG appeared to show that he was having an MI but our ECG’s can be unreliable at times and when he got to hospital they discovered that he was in unstable VT.
It turns out he’d gone into VF whilst driving and lost consciousness as he began to arrest – this caused him to roll into the barrier as his vehicle crossed the road under no control whatsoever. The collision wasn’t enough to hurt him badly but it did create a significant thump to his chest and this acted like a defibrillator, bringing him out of VF and into VT. His life was probably saved by it and he most likely had a seizure as a result of oxygen deprivation.
He lay on the bed in Resus telling everyone that he felt fine, while his ECG did strange things and the staff put defib pads on him. I probably won’t see that combination of events for the rest of my career.
A 67 year-old alcoholic had a fit at a train station (in fact, according to witnesses he had three). The crew was on scene with me and another turned up for good measure but he was stable and didn’t fit again as far as I’m aware.
The new drugs for Parkinson’s work well to control the symptoms and my next patient, afflicted with this condition, suffered a dizzy spell after walking around all morning with his wife. The man looked perfectly fine as he sat on a bus and if he hadn’t told me he had Parkinson’s I wouldn’t have known. After a long chat, in which I learned that he used to be an architect and that he dabbled in digital photography and knew more about computers than his grand-children, the crew arrived to take him on board for further checks before letting him and his wife continue their onward journey home.
Another alcoholic who was said to be fitting wasn’t in fact. He just lay on the pavement, worrying passers-by. He still had the pyjama bottoms on from his last trip to hospital and he wasn’t interested in another visit, so I helped him up and he staggered away to a better place for sleeping.
An off-duty nurse helped me with my last patient, a 40 year-old man who was suffering a ?CVA at a train station. Screens had been erected around him, which is always useful and something we can’t carry around because of the lack of space in our vehicles but they served me well and the privacy and dignity of the patient was preserved as people rushed around catching and leaving trains.
I had enough time to put a line in, just in case, before the ambulance arrived to take the confused and agitated man away.
Be safe.
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