Overbreathers

Okay, you are drunk and need the night bus home. You know its the N155 you need...oh wait, is it the N551? Oh no, what would you do? Thought you'd like to share the confusion. Taken by Lottiecam.


Night shift: Five calls; one treated on scene, one assisted-only and three by ambulance.

Stats: 2 Hyperventilations; 1 Chest pain; 1 Hyperglycaemic; 1 eTOH.


The Student Paramedic I’m supervising was out again with me tonight, so I did the driving and the watching.


What is it with panicky people? We are getting lots of calls for supposed ‘DIB’ and ‘chest pain’ where young people, who clinically should present with neither (normally), are hyperventilating and unable or unwilling to accept that there is nothing we can do for them. It doesn’t commonly kill you and it’s a hugely emotional thing, so calming them down is a job that could and should be done by the first aider on scene (at workplaces) or responsible adults when they recognise it.

So, the 16 year-old German girl who was breathing too fast for her own good after panicking when the lift became full at an underground station, could have been treated by her adult carers (both teachers) but, for some reason, the simplicity of it all was beyond them. It’s not rocket science.

I tried to cancel the ambulance but it was impossible to get a signal so far down in the bowels of the place, so I had to do it ‘manually’ (i.e. told them) when the crew actually turned up. Then it was simply a case of waiting while we calmed this teenager down and that cost a lot of minutes while other, possibly more emergent, calls were being held.


The chest pain call was indigestion. A 26 year-old Indian man, who was learning how to binge-drink as per the British way of life, fell afoul of the excess and his body resisted, mainly by chucking lots of hydrochloric acid, potassium chloride and salt into his stomach and oesophagus, producing the tell-tale lower chest pain that can mimic the cardiac kind. But at his age, it was unlikely to be a heart attack and we knew it as we sailed towards him.

He and his friend acknowledged this and when the crew arrived, they accepted the possibility that he’d just gone too far with the booze. In reply, they both seemed to triumph at their achievement of becoming truly one of the natives in getting drunk very fast. I’m so proud to be British; we export so much that is of value. I said three years ago when I wrote ‘Drunken Chinamen’ that we were heading for a nationally-induced change in international drinking habits....the Chinese and Indians (mainly visiting students) are in on the act already, watch this space for other nationalities.


While we sat on Oxford Street contemplating this, a small Asian lady approached the car and told me that her blood sugar was high – she said she was diabetic and felt a bit hyper, so the SP checked her out and found her BM to be a little high. Not enough to call out the frontline might of the NHS but enough for some friendly clinical advice and a smile. She was happy with that and was left in the care of her family.


Depression, as I know and have repeatedly been reminded of by those who seek to find a chink in my armour is a serious problem and very common but it is also the domain of those in need of nothing more than attention, regardless of the cost and humiliation to themselves and others (mainly others). I’ve lived with it (as the person’s other half) and I know this first-hand; it can be a hole to hide inside when things aren’t going right for you or there isn’t enough care being shown towards you. So, the emergency call for a woman suffering life-threatening asthma and who was lying flat on the bed when we saw her made me think immediately of someone who had other problems. Her demeanour, the way she was exaggerating her condition and insisting it was critical asthma, the fact that she could lie flat with supposed asthma and her boyfriend’s regulated concern (she was visiting him) had me on high alert for another wasted 999 call.

It took less than a minute to establish that she had ‘depression’ and other issues which required medication. She wasn’t having an asthma attack of course; she was forcing hyperventilation and refused to believe anything else we told her about the condition. She refused to calm down and insisted that she needed an ambulance, so one duly arrived and the crew recognised what every one of us recognise in individuals with needs beyond our remit.

Self-pity charades put real asthma sufferers and those with genuine clinical depression in danger, in my opinion. This lady was an alcoholic who’d just finished off two bottles of wine that evening (nice way to say hello to her boyfriend) and she sat up, breathed deliberately fast and made grunting animal sounds with her throat every now and then, punctuating any silence that was allowed.

‘I think I need a Fisherman’s Friend’, she said out of the blue.

You know what, I’m not even gonna end this story with what I had in mind. You can do it...comments welcome!


In the midst of all the calls, there were so many cancellations and wasted trips it’s not worth bothering about them here – except to say that much of course. And as we sat on stand-by in Leicester Square, watching the crowds milling by, a sudden dramatic cloudburst sent them all squealing and scattering in all directions. The rain flashed down for about 5 minutes and then it was all over.

One of the wasted journeys was to a baby, given as DIB of course, who was just very tired. The poor thing just wanted to sleep and the crew on scene had no choice but to take her because she’d been diagnosed with an infection and given a Tamiflu injection ‘just in case’ earlier on.


Meanwhile, back on the Square and right after the cloudburst (which was entertaining), an Italian man with poor English, by his own admission but also by evidence when he spoke, enquired about an earlier assault on his person involving a car, some youths in said car and a high-speed egg.

‘Excuse but I got car threw a egg at me.’

‘Oh really, well you need the police for that.’

‘Ahhh, police, okay.’ Then he rubs his hurting arm and reflects a little (in Italian I guess).

‘’It’s only a egg but, you know... is dangerous.’ He said with a sad voice – the voice of someone who has just realised that pursuing this any further is hopeless.

We both smiled as he walked away but I took his hurt seriously. Being hit by a flying object (especially a hard egg) at speed after it has been lobbed out the window of a moving vehicle by one, two or multiple street gorillas, is not funny (it's no yoke in fact) and, I have to agree, can be quite dangerous.


Oh but the Italian hilarity had to end and we were off to a 25 year-old man who was lying in a doorway in Soho after taking too much alcohol and possibly a hit of GHB. His friends were on scene and one of them in particular wasn’t impressed when I suggested we start a ‘name and shame’ campaign in which the details of everyone in this state who needed an ambulance would be published for all to see.

‘I’d do that if I had my way’, I’d said with a smile, to be friendly.

‘Yeah, your way’, the woman said with a tang of distaste and the sting of someone who felt I was being a judgmental prat.

I thought about her response for a few seconds and I realised that she truly believed her friend’s condition was brought about by fate, or the Gods or the local Council but NOT by his own doing. Therefore my comment would certainly be judgmental without any basis, right?

I asked her what she did for a living. I wanted to gauge what kind of person thinks this is right and that any punishment for the cost involved or even a warning off could be wrong.

‘I’m a teacher’, she told me.

Bravo. Now we have teachers who trust in their mates rather than the obvious. You go out, you drink lots, you take illegal drugs, you fall down, you become unconscious and you vomit... possibly die. It’s not their fault, they are misguided and society doesn’t do enough to help them. It’s the Government’s fault. It’s my fault for being a paramedic that gives a toss about real issues and real people with genuine problems but not too much about drunken idiots. I come across as the pedantic judgmental type because of people like her. It’s not hatred, it’s not bitterness (you are off base with that one) and it’s not being fed up with my job (which I still love) – it’s me being exactly who I am when faced with weakness, stupidity and costly self-abuse. I'm the same at home - even Scruffs dares not behave stupidly or selfishly.

I’m still smiling here.

Be safe.

Too early in the day for mad people

Another pierced person. Photographed with permission.

Day shift: Six calls; one treated on scene, one by car and the rest by ambulance.

Stats: 1 Cut scalp; 1 Impaled thumb; 1 eTOH; 1 Psychiatric problems; 1 Faint; 1 RTC.


I’m doing a bit of overtime, so am struggling to keep up with the posts on time. I’m currently using the time I can afford while my extended family are visiting to complete as many of these reports as possible, in-between showing my face and trying not to be rude, although they all know that I, like Scruffs (who is hiding in the bedroom), am not the most socially-friendly person, especially when all the kids descend. I’m not being obtuse, I’m just being me.


The first call of the day was to a 67 year-old with a cut scalp at an underground station after he caught his head on the closing doors of the tube train. He had the most minor graze imaginable and yet the first aid (qualified first aider) person decided it was worthy of a 999 call. The poor guy, who was on his way to work, was very embarrassed. I applied a plaster and he went on his way. The first aider could have done that! And please don’t annoy me with stories of liability or of not being sure, etc. If you do the training and you qualify, why don’t you take the role seriously?


A 27 year-old scaffolder managed to get a barbed piece of metal hooked through his thumb, to a decent depth as he dismantled scaffolding at a gallery. The metal bracket attached to the wire that ran into his digit was still hanging from it when I arrived, so I took care of that by having it cut free, leaving only the protruding metal extension – small but sharp and nasty. I didn’t need an ambulance for this but today was one of those days where nobody seemed to be listening, either to me or to the MRU control desk, so a crew turned up anyway, wasting more resources than necessary for such a minor thing.


A fellow Scot, Glaswegian and drunk, discharged himself from hospital after a diagnosis of internal bleeding was apparently made. The 50 year-old, who obviously thought I was his best mate (brother even) after establishing my roots, wouldn’t go back and was being persuaded gently by the PCSO’s around him and less gently (quite aggressively) by a man that had ‘befriended’ him earlier. In fact, as the PCSO in charge was telling me his story, I distinctly heard the unknown man threaten the patient. I pointed this out to the PCSO, who hadn’t heard it and the man was quickly removed from the scene.

It took a long time for me to persuade the man to go to hospital. He was homeless, teary-eyed and repeatedly wanted to get me closer for a ‘confidential’ chat, in which he’d simply say the same thing every time – ‘I’m ashamed’.


A possibly hydrophobic 25 year-old, described on my MDT as ‘foaming at the mouth’ was having a nervous breakdown and there was nothing I could do to help. He was inside a hostel and he wasn’t friendly – the police were on scene and they warned me not to go near him. Great, I could have done with this advice before I was sent alone to ‘treat’ him. He had to be cuffed and dragged out by the officers when the ambulance arrived.


A fainting 45 year-old walked into her GP surgery and performed a dying swan act across the reception chairs. She had a history of collapse, with no known cause after every test in the world had been performed on her, so her doctor, who was waiting for me when I arrived, stood doing nothing much because there simply wasn’t anything to do. I did all my baseline stuff and found nothing untoward and then she decided to fake a fit on me. Honestly, there was nothing in her little shake-about that convinced me or the doctor that she was in any trouble but it helped her friend get more worried and it turned out to be something she does regularly but hadn’t yet bothered to tell her GP about. It got at least one person's attention (her mate).

Not to be outdone by her performance and the fact that I had to be seen to act, I pushed a cannula into her vein. You never know, I may have been looking at a true seizure but miscalculated it through lack of compassion, so it was best to keep a vein open for a class A drug, knowing that it would never be needed.

Sure enough, she ‘recovered’ within ten seconds of jerking and twitching and was taken to hospital, fully alert and looking fairly healthy, for more tests that would probably show nothing was wrong. I know - I’m a cynic and should be shot at dawn – go get your guns.


The last call of the shift was to assist a colleague who was on scene with a man who managed to get squashed against his car door when a bus reversed into it as he opened it to get out (you'd think he'd have seen that coming). He suffered a badly cut hand and a leg injury, which may or may not have been a fracture (if it was, it was only a chipped bone but still an x-ray job). I was asked to convey him because there were no ambulances available and he could hop on it (the leg).

He faffed about so much that I was getting a bit frustrated. I wanted to get home on time for once and now I was late while he deliberated whether to go to hospital or not, or where his car would be kept and whether he could risk parking it, blah blah blah. It took a full twenty minutes for him to decide that A&E would be a good idea. His chauffeur and car were ready...had been for ages.

Be safe.

Fire and smoke

Night shift: Nine calls; one false alarm, one by car and the rest by ambulance.

Stats: 1 Dizzy person; 1 Allergic reaction; 1 RTC; 1 Chest pain; 1 Unknown problem; 1 ? Fit; 3 eTOH.


Here we go with night shifts again. You know I love them. A major fire in Soho meant that my car was stinking of smoke after it had been ‘on scene’ all day – no matter what I did to freshen it up, I couldn’t shift that lingering aroma. Ash stuck to the outside of the vehicle and contaminated a lot of the equipment inside too, so I was busy cleaning up for the first hour.


The dizzy person was a 30 year-old man who’d been smoking a Hookah outside a restaurant after taking a load of Ephedrine, a drug that can mimic the effects of epinephrine. He didn’t feel well (surprisingly) and as I handed over to the crew he was made to stand up by his friend – possibly in preparation for the walk to the ambulance – but promptly fell down on the ground behind us.


Then into a posh apartment block lobby in the expectation that the 20 year-old female who’d called an ambulance for an allergic reaction had informed the concierge that I was coming. Nope.

I stood there like a lemon because she hadn’t given her apartment number and nobody knew what was going on. It was another case of a rich person using us like servants – dialling 999, waiting til we arrive and then appearing when she felt like it without a word or a warning. She drifted down the stairs with her friend, her face covered to hide the hives and swept by me as I sat in the lobby waiting for an update on where the hell she was. The crew had arrived outside and were waiting too. She must have seen the ambulance and delivered herself to them without bothering about me. I didn’t even know she was the patient until the concierge pointed out the possibility as she exited the building.

I chased after her but she had already made her way into the ambulance and the crew began her treatment for a puffy face and red skin. I think I’ve become invisible.


A RTC later on and a 25 year-old lawyer, who’d been up late drinking in her office, was lying on the road after having been hit by a black cab on a pedestrian crossing. She’d been lifted into the air and slammed back to earth without losing consciousness. In fact, all she’d lost temporarily was a shoe. She had facial injuries and an obvious broken wrist. MOPs were milling around her when I arrived and it took a few seconds to establish that they had nothing to do with her, so I asked them to move away because they were obstructing my efforts to get the facts about the accident. The crew weren’t too long in arriving and all I had to do was keep her neck stable until we collared and boarded her.

She spent a few weepy moments in the back of the ambulance telling her friend (on her mobile) that she’d been knocked down. I sympathised; it must be a shock to the system, drunk or sober, to get whacked out of the blue by a fast travelling vehicle.


A windmilling 20 year-old man claiming chest pain outside a cinema confessed to being a substance abuser and alcoholic (he’s only twenty!) but only when he was in the privacy of the back seat of the car. He even asked me to move away so that his friends wouldn’t see him as they came out of the cinema building. He’d been in there watching a flick when the pain had started and it all sounded like withdrawal syndrome to me. He was tachycardic but stable, so I took him in the car.


In Oxford Street, a sleeping drunk caused mild panic when a MOP came across him, so 999 was dialled and I was sent to check it out on the premise that he might be dead, of course. I looked across at him in the shop doorway and suggested that he was (a) drunk and (b) asleep and (c) possibly not interested in my help but the worried MOP continued to harass me into ‘helping’ him somehow. Okay, I am paid to do this and I guess I should never ever be complacent (and I’m not, I just come across that way sometimes), so I obliged and went over to awaken my slumbering friend. I discovered that he was (a) drunk, (b) asleep and, at the high risk of getting a punch in the face, (c) not interested in my help. Job done. Oh, and the cans of lager lying next to him should really have been the biggest of all clues in the first place.

Now, at the risk of sounding awfully pedantic, please be aware that people who look unconscious in doorways in public places on weekend nights tend to be (and are very highly likely to be) drunk and asleep – just like on all buses. Don’t dial 999 yet (because your sick granny really needs us) – go and see if he’s breathing, perhaps ask him if he needs help but keep a reasonable distance because he is very likely to spit, vomit or swing a punch in your general direction. It’s not my job, nor that of my colleagues to experience this stuff just because he looks untidy.


The next patient was in a private taxi outside a night club. She had a history of unexplained loss of consciousness and she’d performed that trick a few times tonight, worrying her friend. Yes, they’d both been drinking but there was something about her behaviour that made me think twice about dismissing her problem. She wasn’t 100% with it and there may be a cardiac link for that, so I calmed her and got an ambulance to take her to hospital.

The 25 year-old woman was clearly agitated up about her condition, which was yet to be diagnosed and when she got to A&E her friend burst into tears after a comment was made at the door (by a uniformed person) about her mate being ‘yet another drunk off the streets’. She saw this as unprofessional and hurtful – the assumption that her friend was drunk and incapable, just because she was young, dressed up and flopped onto a trolley bed on a weekend night, was obviously hurtful to her. I tried to explain that, unfortunately, the norm of these nights gave most of us the same impression about everyone fitting that description – especially if female, but I also recognised her indignation on behalf of her friend and supported her annoyance that the remark had been made at all. It was unnecessary and potentially inflammatory.

I made sure she was okay and promised myself that I would try harder not to judge every case with such indifference, even when I was emotionally drained and physically tired of it all. I didn’t want to make someone cry like that and I don’t want to be connected to the callousness of the person who made the remark. I will, of course, always define my disrespect for all drunken people who waste our time but I will try harder to weigh the facts up before passing personal judgment.


A General Broadcast went out for a 25 year-old female said to have been fitting for 20 minutes, so I took the call and sped off in case the woman died through lack of medical attention, thanks to the drunks and idiots of London. Unfortunately, my valour, bolstered by my new-found determination to do better for the truly ill, was wasted because she wasn’t fitting at all and I don’t think she ever had been. The police were on scene with her friend and none of the stories I heard confirmed a seizure, certainly not one lasting 20 minutes, so that was someone’s imagination at work for sure. In fact, she was drunk and my soul searched for more reasons to carry on being a good paramedic tonight.


Just to be sure that my faith in humanity was fully crushed the next call detailed the Red3 – life-threatening emergency call as ‘acute alcohol intoxication’. It didn’t even try to hide itself and pretend to be a DIB or chest pain. So, I found yet another 25 year-old female lying on the ground in a pool of her own vomit, with concerned friends around her. These people look upon their mates with true horror, as if a new and deadly virus has struck them down. They seem to have no idea that alcohol is the culprit. They honestly seem to have no clue about its ultimate effect. What is wrong with these people?

Prior to getting on scene, I was sent to the wrong location, on the other side of town. The ambulance arrived and we both looked lost – ‘cos we were. When the correct location was given, we travelled across to the West End and arrived to find another FRU on scene and a second ambulance pulling up. There you go – two ambulances and two FRUs for one stupid drunken woman with apparently ignorant friends and zero dignity or common sense (or is that too harsh?). I am counting the cost of all this in my head as we all gather around her as if she is a major incident. I reckon it’s about a grand’s worth of tax payer’s money. I want to send her the bill on our behalf but I don’t have an invoice handy.

As we discuss the stupidity of this duplicated call, she lies there looking drunk and the pool of vomit mocks her. The crews are undecided about who should take her – it’s all about who is finishing first today. As I watch this comical scene, I realise that nobody is doing any obs and it all seems unprofessional. But it isn’t; if she were in trouble, they would be all over her and saving her life, I promise you that. She is drunk and they have seen a million of her kind, so there’s no hurry to scrape her up. In fact, the longer she lies there with no sympathy, the more her friends will learn about how not to end their evenings. Its harsh and no doubt a few of my pedants will find a platform to scream from but there isn’t a single paramedic, technician, nurse or doctor out there who will disagree with the impact of that moment.


Finally, a drunken prisoner lying in a cell pretends to be unconscious. He stops the pretence when I wake him up; it’s that easy. There is a nurse on duty at this police station for some reason but obviously the prisoner knows that there is a difference and that trying to fool one is easier than the other. He had a bump to his head and went to hospital when the crew arrived, simply because of that. Otherwise he was wasting everyone’s time and looking for an excuse to get out of his filthy little home.

Be safe.

Piercings

Ouch! See below. Photo printed with permission.

Day shift: Three calls; one by car and two by ambulance.

Stats: 1 Nail through hand; 1 Faint; 1 Eye injury.


I had a Student Paramedic (SP) working with me today, so I mostly stood and watched as she attended the patients. I also drove a lot.

At a building site a 30 year-old man somehow persuaded a long nail to pierce his hand and travel all the way through the flesh until it appeared on the other side. Sexily known as a penetrating puncture wound, we arrived to find that not only was the nail part of his mitten, it was also still firmly attached to a long piece of wood.

The only access to the floor that he was on was by ladder and the small opening afforded no escape for him if he or his work colleagues had decided to move him to the ground floor; the plank he was stuck to was just too long and he would have become wedged, or worse still, suspended by it as he tried to get through. There was no option for me but to decide on the best way to shorten the plank…or remove the nail from it.

The only cutting tools around would cause so much vibration that he would be in great pain if any of them were used. He was in enough pain as it was and had to be given morphine in preparation for what was to come.

The Fire Brigade were called out for this job – I had considered the options and thought it best to use their skills in the hope that they’d be able to remove him from his wooden implant gently and skilfully, and when they arrived, in full force as usual, they used a small saw to slice through the nail itself, just below the entry point in his palm, so that he’d be free of the board but still have the offensive metal in his hand. It took them 15 minutes to think it through and just 10 seconds to perform the operation.

Once free, his hand was bound and slung so that he could be taken down to the ambulance with the crew, who’d arrived shortly after the LFB. It was all over in a short time but had been a delicately precise and long-deliberated task. Nevertheless, I was happy with the outcome and so was he. He went to A&E looking like thevictim of a botched crucifixion. I just hope he isn’t religious.

During our conversations, he told me that he’d been in a car crash a short time earlier (he still had a scarred face) and had lost his wallet prior to this incident, so his run of three for bad luck seemed to have come to an end here.


After that call and later on in the day, we were sent to a 1 year-old female who had a coat hanger in her eye. I thought we were about to go through the whole embedded foreign object scenario again but when we arrived the little girl was with her mum and was coat hanger free. She’d been playing with the metal object when the bent top end, which was sharp to the touch, had fallen into her eye, catching on the conjunctiva and hooking itself into it. She’d frantically pulled on it, tearing into the tissue and causing minor trauma, resulting in a swollen and red lower lid. We took her and her mum to hospital in the car but this little girl was a bit hyperactive and to amuse herself on the way she unlatched the door while I was driving. I had forgotten to put the child lock on but luckily mum was holding her and I was able to stop before she got bored and threw herself onto the pavement for a laugh.

The well-to-do Middle Eastern woman made me feel like a chauffeur rather than a paramedic. I got the distinct feeling that she saw me and my kind as merely servants and not medical professionals. Still, she and her little bundle of mischief were delivered safely to hospital as required, so I must have fulfilled the criteria even though I barely got acknowledgement of my assistance with her emergency. It’s nice to be noticed.

Prior to this incident, our 'faint' call took us to the side of a restaurant chef who claimed chest pain, dizziness and who was described as 'delusional' by our system (although I don't know if that came from him, his manager, the caller or the call-taker). It would be funny, but completely unprofessional of course, to be able to put a short description giving our opinions on the caller's condition, wouldn't it? It would be entirely human to put things like 'mad as a box of frogs' or 'pissed as a rat' or 'total arse' when describing certain individuals who dial 999 and demand our presence for emergency itchy bottoms and life-threatening fungal toe. Shame we don't have that sense of humour (well, we do...we just don't tell you).

Be safe.

Medic alert

Day shift: Three calls; two by car and one by ambulance.

Stats: 1 Near faint; 1 Dizzy person; 1 Heart attack.

A 39 year-old doctor who travelled a long way on the tube suddenly felt faint but didn’t quite go the distance and pass out. Initially he wanted to go home after all his obs showed how healthy he was but for some reason he changed his mind and began to worry about possible cardiac problems he may have developed (in the hour or so on the train I guess), so I took him to hospital and he lay on the back seat of the car, chatting nervously to his wife about his possible dramatic conditions. Differential diagnoses by proxy.


All the obs were normal again for my next patient, a 58 year-old man who felt dizzy at work. He had a bit of nausea too, so this prompted him to take the rest of the day off and keep me company as he travelled in the back to hospital. His history of hypertension must have given him cause for concern, despite his normal reading and the fact that he was looking very well as he entered A&E. The Swine-flu ridden 'panademic emergency area' (or, as we simply call it - the waiting room) was stuffed full but this didn't put my patient off at all.


The only real emergency call I took today was my last. An 88 year-old man lay in the street having a heart attack. He had a previous history of two MI’s and so he was being taken very seriously. A couple of very kind MOPs, a police officer and an off-duty nurse were on hand to help as I worked to keep him stable but his condition was deteriorating fast and there were no ambulances available (probably because they were tied up dealing with dizzy people and faints).

The busy crossing in which he lay provided endless entertainment and local drama for those wanting to move from one side of the street to the other and so I asked the MOPS, two young men who wouldn't leave him and wanted to help as much as possible, to give him a blanket screen for privacy. He grew paler and less alert and I had time, given that I was on scene with him for almost 40 minutes, to do a 12-lead ECG in the street. The result was pretty bad and there was no doubt that if he didn’t get to hospital soon, he’d become a work-in-progress for CPR.

Just as time was running out on us all, the crew arrived and he was taken to hospital for specialist treatment. One day soon, all my moans and groans about silly calls and time-wasting do-gooders who think we are simply a taxi service will be highlighted with the demise of a patient on the street like this. A lack of resources, caused primarily by the type of call that dominates our system will be to blame. In the meantime, I have to rely on luck and as much of my own judgment and skill as possible. Thank goodness for nick and time.

Be safe.

Headless chickens

Day shift: Six calls; one assisted-only, one treated on scene, three by car and one by ambulance.

Stats: 1 ?Flu; 1 Abdo pain; 1 Burned foot; 1 Bee sting; 1 Cut scalp.


A beautiful sunny Sunday, marred only by the nature of the calls I had to deal with but, of course, that’s what I’m paid to do, apparently.


A 22 year-old man with ‘flu-like symptoms’ was attended to by the crew, who arrived with me, so I decided it was best not to get involved directly. He would be told to stay at home and get well soon… unless he insisted on going to hospital and you won’t believe how stupidly stubborn some people can be when it comes to their ‘rights’, so I expect there was a lively debate going on.


Then a call to a popular tourist area for a 32 year-old French man who was suffering abdo pain and looked very uncomfortable with it. At first there was a bit of confusion because the call I’d gone to was for an 80-something female who was ‘unwell’; I thought there might be two calls from the same area and, to be honest, this guy initially looked like he was hyperventilating, so I wasn’t desperate to give it a higher priority – it wasn’t until I started getting his story that I realised his condition might be worse than that. But I was concerned that some old lady was waiting for me somewhere nearby too, so the complex little scenario had me thinking on my feet. Oh, and to wrap it all up in a bow, neither he nor the family around him could speak much English, so I was once again forced to resort to my High School French, which is not great, even when I have had a drink of wine. Nevertheless, through badly constructed sentences and pidjin terminology, we managed to communicate effectively enough for me to establish that he did not have any serious medical conditions, was not suffering chest pain and had been through this before but, as yet, had not been diagnosed by his doctor.

It would have been cruel and unprofessional to say ‘avez-vous deux pieds?’ although it would have been nice to exercise my ‘parlais’; instead I offered to take him and his wife/sister/mother (I have no idea these days) to hospital in the car. Control had agreed with me that this was probably the one and only call from the area and that the confusion had been produced as the result of someone consulting a French-English dictionary as the call was taken, so off we all went.

At hospital, the man was given a cubicle and a bed and I was informed of the strong possibility that some old lady was still sitting in a nearby church hall (apparently), waiting for an ambulance or God to come and help her.


I also conveyed the next patient; a man with Parkinson’s who was very difficult to understand. The long journey south seemed wasted but he’d fallen a few hours earlier whilst on the loo and now he had leg pain, although he could weight-bear and move around with the help of his stick. It wasn’t an emergency really but the day was unfolding that way and, even with the pressure we are currently under, everyone’s ailment must have seemed important enough to dial 999. I just wish he’d cleaned the toilet before sending for us – it was an unpleasant sight to behold as I entered the little flat. He left it in a mess, even though he’d let hours go by and was quite able to clean it and himself.


But the call that took the biscuit was to a restaurant where a 24 year-old chef spilled hot soup onto his foot. He was sitting front of house with his damaged extremity in a bucket of water (which is the right thing to do). It had been soaking there for half an hour (also a good idea) and his colleague, a young woman who obviously ran the place, had decided to dial 999 and summon an emergency ambulance for it.

I’m sorry if I offend some of you with my attitude to this but if I burned my foot and had two blisters on it (which is all that he had), I’d pop a couple of paracetamol for the pain and elevate it for the rest of the day, applying Calamine as it healed over the next few days until the skin, which is perfectly capable of healing itself, repaired completely. That’s what I’d do. That’s what most of the population would do but I got an argument (and most likely a complaint made against me) for my ‘attitude’ when I asked her why she thought this was an emergency. I also asked her if she thought an ambulance would be better served going to someone’s heart attack but she was completely indifferent. In fact, she became so defensive that she ultimately made me believe that she thought of us as merely taxi drivers that should do as we are told and no more. If a doctor had arrived and queried her judgment, she probably wouldn’t have been so aggressive about it, and believe me, any doctor worth his or her salt, would have given her some grief. Let's be honest, a good nurse would have said the same.

‘If it is so minor, why didn’t they tell me not to bother with an ambulance when I called?’ she snapped.

‘Because they don’t do that – they send ambulances based on what you tell them and no more’, I answered.

The truth is, we have clinical decision makers who can sieve through calls like this and cancel ambulances but on this occasion it hadn’t been done – probably because they are too busy but the point I was trying to make was that she had called in the first place.

‘How am I supposed to know it’s not serious?’

She was making the ‘you are the professional and I know nothing about this stuff’ statement that I hear all too often. It’s a cop out because we all know what’s minor when it comes to this type of injury.

I cancelled the ambulance and took the man, who hadn’t even asked to go to hospital, to A&E, where he hobbled to the waiting area to do just that – wait. Even the triage nurse rolled her eyes when she saw the extent of his injury.


The next call was no better but I kind of understood it. I was sent miles away for a bee sting to the thumb. The patient was a 2 year-old girl and mum was just concerned about the possibility of her daughter puffing up and suffering a full-blown anaphylactic attack. They are from Africa and they believe that they can ‘catch’ these mostly Western diseases and problems just by being here – crazy really.

I checked the child’s thumb out – it was a tiny bit swollen; checked her airway and decided she needed no more than a smile, which she got and returned. Mum was happy too and I was able to leave them all to go out for the day, reassured that no bee was likely to kill her baby because, with her ethnic background, the chances were slim. This is a culture with hard-knocked immunity.


I have to admit I had a tear in my eye when I went to help the family of a 4 year-old boy who’d fallen and cut his scalp on the escalators at an underground station. His wound was very minor but the mum and dad (and grandmother) wanted to have it checked before they continued their journey. The little boy was very scared in case I did anything to hurt him, which I wouldn’t – I didn’t even do a BM, which is required of me for every child. I just put a makeshift bandage on his head and chatted to the family. I even managed to clumsily knock mum's head with my elbow as I tied the bandage on (whoops).

I am not pleased that grown up healthy people call ambulances for burned feet and other minor injuries and illnesses but I really don’t mind going to help a small boy with a little cut to his head who has just endured long and sickening chemotherapy for a brain tumour.

Be safe.

Silly Saturday

Day shift: Four calls; one hoax, one false alarm, one assisted-only and one by car.

Stats: 1 Head injury; 1 Faint.


These hot summer days are biting into the day-job-quota as people pass out all over the place for the want of a drink of water or attention (or both). Then there’s piggie flu which, predictably, is making a mockery of the system by clogging it up with people who should really know better and who think they will die if they sneeze too hard. On top of all this, we still have leftover drunkards from the weekend nights and those who think a minor injury (if it happened at home they wouldn’t dream of dialling 999) in the workplace is somehow elevated to an emergency simply because it is the workplace – I call this backside-covering.


So the first call was a hoax; of course it was – the guy calls us from a phone box to say that he will jump in front of a train in the next 30 minutes. He is warning us of his impending suicide and giving us more than a generous slice of ORCON time to get to him and cuddle him before he settles his score with God. I am sent to ‘investigate’ and sit outside a row of anonymous red phone booths waiting for something to happen but nothing does. He isn’t there and the next report tells me that he is making his way to Piccadilly Circus to end it all, so I am tasked with standing by, along with a couple of PCSOs and the British Transport Police (BTP), at said station for the next hour until it becomes obvious to all, and at great expense to the tax payer, that he isn’t going to show.

My theory is that he is a forgetful person who left the phone box, with the intention of doing himself harm but was distracted by something along the route – possibly the tourist tat sold in one of the little shops in Piccadilly Circus. He then completely forgot his mission and was probably standing on a corner, eating an ice cream and enjoying the sun – thinking how wonderful life is, as he watched us all converge on the tube station as if some kind of emergency was about to happen. ‘Hmm…I wonder what that fuss is all about?’ he probably thought to himself, as he crunched through the one and only flake that was embedded in his over-priced soft whip ‘99’.


The other side of the spectrum for my next call and I am sitting with an elderly lady who had fallen off a low step and banged her head. The 84 year-old didn’t think it was an emergency and I had to agree. There were two cops with her and they were playing safe, which is fair enough. She had a few members of her family with her too and they were keen to get on with being tourists, so when the ambulance arrived, we checked her out thoroughly (she hadn’t been knocked out and had no serious medical conditions) and she went on her way, family in tow. It’s always refreshing to meet a patient who knows s/he isn’t dying and can recognise a minor injury a mile away. Her age meant that a proper check was useful but her generation is still a bit mystified when we worry about such trifling things.


A ‘collapse in doorway’ turned out to be nothing more than a sleeping vagrant. MOPS had panicked and assumed he was dead (obviously), ignoring the fact that he was wrapped up as if asleep, he was positioned (curled up) as if asleep and he was snoring in a doorway (as if asleep). But hey, don’t let me get all arrogant ‘cos we all know that it takes years and years of medical training to spot the difference between slumber and death.

Two PCSOs were chatting to him when I got there – the road was closed at the top, so I had to get out and walk – tsk! I asked him if he was ok and he said yes. ‘Do you need an ambulance?’, I ventured. ‘Erm, no’, he replied as if I had been let loose from a dodgy institution.

Now this poor sod had been trying to get a decent sleep – he is already on the street so can’t be getting a good kip during the busy, noisy nights. He puts his head down in a doorway of a weekend; not bothering anyone and not asking for attention, then ends up with PCSOs and a paramedic bugging him about his health and lifestyle. Not fair really. If you are a concerned MOP, please check for signs of life and the presence of a sleeping bag before you call us out.


I climbed so many stairs to get to a 21 year-old girl who had fainted in a theatre that I thought I might join her myself. She was on the floor, legs raised in traditional fashion, with her boyfriend guarding her. She works there and the heat just got to her, although she admitted having a history of such events and being a generally poorly person, so I walked her gently and slowly down Everest until we got to the car. Then I took her and her partner to hospital where, unfortunately, she was made to sit in the crowded, Swine-Flu infested waiting room until someone could get round to seeing her – probably 12 hours later.

Be safe.