Day shift: Five calls; four by car, one by ambulance.
Stats: 1 Lacerated lip; 1 Asthma; 1 eTOH and vomiting; 1 eTOH and falling down.
I had the pleasure of hosting, on behalf of the Service, a paramedic from Yorkshire and so the first part of my shift was about tours and history and the usual rubbish I can ply people with when they are caught unawares. He was a thoroughly good chap and I enjoyed our chats, which mainly focussed on the differences between London’s ambulance service and his. He seemed suitably impressed with the way things are done down here, so I am hoping his report back home will be favourable. I'm also wondering what it is we are doing right.
So, first off – a 3 year-old boy, reported as being variably 8 years-old and 5 years-old, depending on who you spoke to, fell onto the back of his little sister’s buggy, splitting his lip open and puncturing a decent hole through it at the same time. The bleeding had stopped and his mum was quite happy to travel to hospital in the car (it was a three minute trip) rather than expose him to the further stress of an ambulance. He was bawling his eyes out and took some time to settle down but once in hospital, he seemed to calm.
A wasted trip later on for an unknown person who dialled 999 and proceeded to press the buttons on his phone rather than respond to the call-taker. It was either a hoax or an accidental call but either way, we had to check it out and an area search, that including the public toilets in Leicester Square, led to nothing.
A 23 year-old girl with asthma had an attack at work and one of my motorcycle colleagues was on scene dealing. He suggested that a trip to hospital in the car may be useful but when we got there, she’d pretty much fully recovered and was chatting away cheerily with him after agreeing to go and see her GP about it instead. I wasn’t needed but I spent the next 20 minutes or so chatting to her, her mum and her cheeky cousin, who worked in the same place. While my colleague continued his paperwork and my observer got cornered in conversation, I was privy to discussions about boyfriends who had no sense of direction when it came to faces and other amusing side-subjects. Sometimes the people I meet and interact with make this job a lot more fun - these three ladies did just that.
I left them to it after being offered cups of coffee and a job with a possible one million quid bonus.
Drunken street people shouldn’t carry large amounts of cash on them – for their own good. It was a mystery for me and the police officer who called us, to find a very inebriated, constantly vomiting 34 year-old alcoholic with a plaster cast on one leg, one shoe on and over a thousand pounds cash in his pocket. He wanted to go to hospital and said he had pancreatitis but he wasn’t complaining of abdominal pain – his vomit smelled of alcohol, so all he wanted was a bed, although he could easily afford to check in to any good hotel in London, he chose the 4-star L’hotel d’NHS instead. Rooms are free for a limited time (see the nurse for details).
Drunk number two fell onto the escalators at an underground station and cut his face. He probably broke his nose too; there was evidence of damage to it along the bridge. He’d been rescued by the staff after attempting to continue his travels by tube with a messy, bloody face and a drunken stagger. They caught up with him at a station near me and I was asked to look at him and decide whether or not he should travel. Obviously, he couldn’t and an ambulance arrived to take him away for his own safety.
He was a pleasant Spanish man who apologised every ten seconds for the trouble he was causing and in my book the very recognition of that fact makes it okay with me. So he got smiley Stu and a hand up the steps into the ambulance. Then he went and spoiled the moment by tripping up and once again falling onto his face in the ambulance as he took the last step inside – silly sausage (as they say in the old country... wherever sausages are famous... Germany probably).
Be safe.
Thursday, 18 February 2010
Wednesday, 17 February 2010
Fly boy
This is a Highland Cow - Hairy, horny and not very happy that I interrupted him while he was eating. A typical Scotsman!I’m sitting in the departure lounge of Prestwick Airport, waiting to make my return flight after teaching a first aid course up here today but I am flying Ryanair and, as seems normal with these airlines (cheap as chips but not always reliable) my fellow passengers and I have been treated to a 4-hour delay, courtesy of a ‘technical problem’. These things happen I guess but I am on an early shift tomorrow and really needed to be home before dawn on the day I work! I therefore have time to add this to my blog because I haven’t been on duty for almost a week and it looks a bit threadbare.
Aficionados of Elvis will know that this little airport, near Kilmarnock in South Ayrshire, is famous because the King himself visited it whilst returning from his tour of duty for the US Army in 1960. The transport plane carrying him (and others obviously) landed to refuel as it travelled from Germany. This is supposed to be the only time that he ever stood on UK soil, although this was disputed by Tommy Steele who said he was in London with him during the 1950’s but that has never been proven and Prestwick jealously guards its historical claim with photographic evidence.
And because of that single visit to Scotland (when, on seeing the Scottish countryside the King is alleged to have said ‘where the f**k is this?’) – Prestwick has its own dedicated lounge and pictures of the great man are displayed around the terminal building. Bless. It is still one of the quietest airports I have ever flown to and from.
Going through security is a bit of fun too, isn’t it? We are all so used to having to remove our footwear that a little girl in front of me, who was no more than 8 years-old, deftly removed her softer than soft boots (nothing could be planted in them, even if you tried) and put them in the little basket for inspection. Then a wheelchair-bound man was asked to stand up (stand up, that’s right), to be searched when he came through the security gate, like he doesn’t have enough trouble and really wants to threaten everyone on the flight. We’ve gone a bit mad with this – we can’t be selective without being called racist and we can’t get a grip, so we are forced to go through this awful charade. All the while someone will be shouting in your ear ‘it’s for our own good. What if a plane blows up?’. Yes, there is a threat but there's dealing with it and there's being a paranoid, emotional wreck about it.
We could just make peace with people and stop irritating other nations to the point of hating us. We could butt out of the affairs of other ‘superpowers’ and get on with life – Switzerland isn’t currently being threatened with terrorism, is it? Or maybe that’s all a bit naive. Maybe reducing our liquids and gels to 100ml containers, all of which MUST be carried in a clear plastic bag, will radically cut the threat level. Has anyone even considered that as little as 100mls of any high explosive could do a good job of destroying a plane... or that having five bottles of liquids, masquerading as after shave, amounts to... hold on, I’m working it out... 500mls? Suddenly the volume of one container seems irrelevant and the whole idea stupid.
The rub is that if you get as far as the civilian security people, who hardly ever smile and are often just downright arrogant about their role, and you haven’t put your stuff into a clear plastic bag, they will take it away and bin it (you paid for it but now it’s gone) or, as in the case of Prestwick, point you in the direction of a handy machine, owned by the same company that makes those chewable toothbrushes, so that you can buy ‘security bags’ at £1 per 4. Twenty-five pence for a 2p plastic bag that calls itself a ‘security bag’ – is it any wonder people are being turned off the whole flying adventure?
To be fair, at Stansted, on my way out, I'd forgotten to remove toileteries from my hand luggage but, after a scan, search and rub down with explosive-detecting chemicals, the smiling (yep, friendly) security man gave me a plastic bag for them. See, getting on a plane can be a nice experience.
But then, inside the departure lounge, after all that security checking and plastic bag enclosing, they still put up signs advising you not to leave your bag unattended. Why the hell not? I’ve just been through a long and boring exercise with people who seem to judge me for the colour of my socks and now it’s still not safe to leave my bag alone for a few seconds? Is there something I should know?
Sometimes it’s good to get these things off my chest. I’m not very big on this whole authoritarian Government-led, terrorist-fed police state that we are entering into. Sure, we all need to be safe but safety is never guaranteed in life, however, being bullied and manipulated into thinking you need extra security is certainly guaranteed these days.
Xf
Wednesday, 10 February 2010
Threats and laughs
Night shift: Five calls; one false alarm; four by car; none by ambulance.
Stats: 1 Alcoholic in pain; 1 Faint; 1 Head injury; 1 Sleeping person; 1 eTOH.
And here comes the snow again. It’s freezing out there and my second night with my Uni Student starts with a call to a less-than-beloved hostel for alcoholics and drug addicts. An abusive male has been calling for an ambulance on behalf of a female that is having chest pains, so it goes Red and I am sent to check it out because (and I don’t blame them) nobody on the desk is sure if this is a genuine call. When we arrive the staff has no idea what’s going on and we are shown up to the room where the call originated. That’s when the staff member decides to tell us that the guy inside has brandished a knife before and has a bit of a temper.
The door isn’t answered for nearly three minutes as we stand outside and the staff member shouts through it ‘Open up, the ambulance is here’. The man takes his sweet time to open up (remember this was a 999 call) and almost as soon as I step forward I am treated to verbal abuse and attitude. All I did was ask if the girl, who can clearly be seen in the room with another man, could put her cigarette out before we went in – that request sparked a spittle-loaded response.
I went in and asked what the problem was but the loud-mouthed man wouldn’t stop shouting and swearing, so it was difficult to get any sense out of the situation. The girl looked as if she was clucking for lack of booze or drugs, I didn’t know for sure which, and she was writhing around and yelling that her whole body hurt. She too became abusive after I informed them that I wasn’t going to take her anywhere under these circumstances. I needed them to calm down and let us do our job but this unleashed an even more personal and poisonous attack on me and I had noticed where his knife was, so I was keeping a corner of my eye on it. The student was behind me – this wasn’t really a suitable job for her to learn how to get attacked. We left the room to a rising melee of anti-Scottish, anti-ambulance abuse which had now been joined by the complete choir in the room and went back to the reception office with the staff member, who seemed embarrassed by this behaviour.
I asked for police and requested that no ambulance should be sent to this call. I knew the man upstairs would call 999 again and he did, several times. So we waited for the cops and when they arrived we all went back up and the two men were asked to leave the room so that we could assess the young woman who was in pain. The resident of the room, who had until then been fairly quiet, started shouting and swearing, telling us that he was not leaving his own room. Despite the fact that he was not this woman’s kin, he couldn’t see why she needed privacy during a clinical examination. But he caved in when I suggested the woman could walk out of the room instead (she’d told us that she couldn’t walk).
She was an alcoholic but denied taking drugs, even though she was a known Methadone user. Her body was a mess and the main problem affecting her health, which could never be fixed, was that her Liver was failing. She had generalised pain but it was the pain of a person who had inflicted it upon herself in a short lifetime of self-abuse. I will be surprised if she reaches the age of 30 - she's 23 now.
I can honestly say that this was one of the most menacing, threatening calls I've been on for a while and I would normally be working alone. This man was quite capable of taking that knife of his and sending me to the morgue. Why we, as a society, continue to put up with the evil that lives with us I will never know.
A 33 year-old American lady fainted outside a pub and we arrived to find her being tended by her husband and a few of the customers. Broken shards from a dropped glass lay around her as she recovered. She had a history of stomach problems but had never fainted before. We found her BP to be high, so we took her to hospital so that she could be assessed more thoroughly – rather that than miss something important. She was a very emotional person and I think this had a lot to do with current condition.
As the night ground into the late hours a 23 year-old woman fell down the stairs at an underground station and cracked her head on the floor when she landed. Her friend was with her and they’d both been drinking but not enough to be described as drunk. There was a good size bump on the crown of the falling girl’s head but she hadn’t been knocked out and she simply complained about how painful it was. It was a straight-forward transfer in the car – again because she’d been drinking, it was better safe than sorry.
A false alarm for a male ‘collapsed’ inside an office turned out to be one of the workers who’d decided to kip down on the floor for the night, either because he’d been drinking and couldn’t get home or because his wife had chucked him out. Whatever the reason, he was quite embarrassed when two police officers, the staff from an office above him and London Ambulance turned up.
Another embarrassed person; an Irish lady who fell onto her face and broke her tooth after being out with her daughter on a drinking marathon, will wake up in the morning and completely forget how she lost it. The ‘almost 50 year-old’ as she reminded me repeatedly, was conscious but unable to get up from the sitting position she’d been found in by PCSO’s when they arrived to help. Her daughter was a little worse for wear too and asked me to marry her a few times before finally understanding that I already was. They both went in the car and they kept us entertained all the way to hospital.
To be honest, I don’t mind a funny, well-meaning drunken person. I much prefer them to hard-nosed aggressive alcoholics or drug addicts who actually hate us because we spoil their party when it all goes wrong for them. This mother and daughter duo were funny and sincere. All the while the patient complained about losing a perfectly good tooth, her daughter laughed, like it was Ireland’s best joke. The young lady’s swearing was a bit too much to start with but I realised that was how she spoke and she meant no harm by it. I doubted the hospital staff could see that point of view on behalf of the other patients.
And the night ends with quite possibly the first slip and fall of the new day when a 40 year-old female slid on black ice at a crossing, falling onto her back. She was in some distress when we arrived and a MOP was taking care of her as best she could but a lot of the tears she was crying were in consequence of the event, rather than the pain I think.
My student almost came down just as hard when she too slipped on the treacherous surface as I tried to warn her. I had tested it when I got out of the car and what looked like surface water was in fact an ice rink – not funny for anyone and I could see how this day was going to develop unless the council got its act together and start gritting the pedestrian areas. We have only had a week’s warning about these conditions after all.
Be safe.
Stats: 1 Alcoholic in pain; 1 Faint; 1 Head injury; 1 Sleeping person; 1 eTOH.
And here comes the snow again. It’s freezing out there and my second night with my Uni Student starts with a call to a less-than-beloved hostel for alcoholics and drug addicts. An abusive male has been calling for an ambulance on behalf of a female that is having chest pains, so it goes Red and I am sent to check it out because (and I don’t blame them) nobody on the desk is sure if this is a genuine call. When we arrive the staff has no idea what’s going on and we are shown up to the room where the call originated. That’s when the staff member decides to tell us that the guy inside has brandished a knife before and has a bit of a temper.
The door isn’t answered for nearly three minutes as we stand outside and the staff member shouts through it ‘Open up, the ambulance is here’. The man takes his sweet time to open up (remember this was a 999 call) and almost as soon as I step forward I am treated to verbal abuse and attitude. All I did was ask if the girl, who can clearly be seen in the room with another man, could put her cigarette out before we went in – that request sparked a spittle-loaded response.
I went in and asked what the problem was but the loud-mouthed man wouldn’t stop shouting and swearing, so it was difficult to get any sense out of the situation. The girl looked as if she was clucking for lack of booze or drugs, I didn’t know for sure which, and she was writhing around and yelling that her whole body hurt. She too became abusive after I informed them that I wasn’t going to take her anywhere under these circumstances. I needed them to calm down and let us do our job but this unleashed an even more personal and poisonous attack on me and I had noticed where his knife was, so I was keeping a corner of my eye on it. The student was behind me – this wasn’t really a suitable job for her to learn how to get attacked. We left the room to a rising melee of anti-Scottish, anti-ambulance abuse which had now been joined by the complete choir in the room and went back to the reception office with the staff member, who seemed embarrassed by this behaviour.
I asked for police and requested that no ambulance should be sent to this call. I knew the man upstairs would call 999 again and he did, several times. So we waited for the cops and when they arrived we all went back up and the two men were asked to leave the room so that we could assess the young woman who was in pain. The resident of the room, who had until then been fairly quiet, started shouting and swearing, telling us that he was not leaving his own room. Despite the fact that he was not this woman’s kin, he couldn’t see why she needed privacy during a clinical examination. But he caved in when I suggested the woman could walk out of the room instead (she’d told us that she couldn’t walk).
She was an alcoholic but denied taking drugs, even though she was a known Methadone user. Her body was a mess and the main problem affecting her health, which could never be fixed, was that her Liver was failing. She had generalised pain but it was the pain of a person who had inflicted it upon herself in a short lifetime of self-abuse. I will be surprised if she reaches the age of 30 - she's 23 now.
I can honestly say that this was one of the most menacing, threatening calls I've been on for a while and I would normally be working alone. This man was quite capable of taking that knife of his and sending me to the morgue. Why we, as a society, continue to put up with the evil that lives with us I will never know.
A 33 year-old American lady fainted outside a pub and we arrived to find her being tended by her husband and a few of the customers. Broken shards from a dropped glass lay around her as she recovered. She had a history of stomach problems but had never fainted before. We found her BP to be high, so we took her to hospital so that she could be assessed more thoroughly – rather that than miss something important. She was a very emotional person and I think this had a lot to do with current condition.
As the night ground into the late hours a 23 year-old woman fell down the stairs at an underground station and cracked her head on the floor when she landed. Her friend was with her and they’d both been drinking but not enough to be described as drunk. There was a good size bump on the crown of the falling girl’s head but she hadn’t been knocked out and she simply complained about how painful it was. It was a straight-forward transfer in the car – again because she’d been drinking, it was better safe than sorry.
A false alarm for a male ‘collapsed’ inside an office turned out to be one of the workers who’d decided to kip down on the floor for the night, either because he’d been drinking and couldn’t get home or because his wife had chucked him out. Whatever the reason, he was quite embarrassed when two police officers, the staff from an office above him and London Ambulance turned up.
Another embarrassed person; an Irish lady who fell onto her face and broke her tooth after being out with her daughter on a drinking marathon, will wake up in the morning and completely forget how she lost it. The ‘almost 50 year-old’ as she reminded me repeatedly, was conscious but unable to get up from the sitting position she’d been found in by PCSO’s when they arrived to help. Her daughter was a little worse for wear too and asked me to marry her a few times before finally understanding that I already was. They both went in the car and they kept us entertained all the way to hospital.
To be honest, I don’t mind a funny, well-meaning drunken person. I much prefer them to hard-nosed aggressive alcoholics or drug addicts who actually hate us because we spoil their party when it all goes wrong for them. This mother and daughter duo were funny and sincere. All the while the patient complained about losing a perfectly good tooth, her daughter laughed, like it was Ireland’s best joke. The young lady’s swearing was a bit too much to start with but I realised that was how she spoke and she meant no harm by it. I doubted the hospital staff could see that point of view on behalf of the other patients.
And the night ends with quite possibly the first slip and fall of the new day when a 40 year-old female slid on black ice at a crossing, falling onto her back. She was in some distress when we arrived and a MOP was taking care of her as best she could but a lot of the tears she was crying were in consequence of the event, rather than the pain I think.
My student almost came down just as hard when she too slipped on the treacherous surface as I tried to warn her. I had tested it when I got out of the car and what looked like surface water was in fact an ice rink – not funny for anyone and I could see how this day was going to develop unless the council got its act together and start gritting the pedestrian areas. We have only had a week’s warning about these conditions after all.
Be safe.
Tuesday, 9 February 2010
Adjustments
Night shift: Four calls; two declined; one by car; one by ambulance.
Stats: 2 Assaults; 1 eTOH; 1 Epistaxis.
I have a couple of nights with my student paramedic on board and before we’d even got a proper job, a man ran at the car in Soho and complained that he’d been assaulted and that we should treat him and call the police. He was a bit wild-eyed and edgy, so I called for police and watched as my student attempted to deal with his childishly minor injury, caused by a punch to the mouth. He got predictably annoying and aggressive and so I asked him to go and that the police would deal with it.
By the time the cops arrived on foot he’d long gone and the people he’d been talking with and who knew him instantly denied they had any knowledge of him, his assault or his whereabouts. I could tell what kind of night this was going to be...
A 55 year-old Scot fell down drunk on the pavement at a bus stop and the good people standing around called an ambulance. We arrived and he was shocked at the fuss being caused. You see, where he and I come from, calling an ambulance is almost unheard of unless your head is falling off – and his wasn’t; he had a minor bruise to the side of it. Nevertheless, as he sat in the back of the car protesting his detention, we found his pulse to be a little too slow for his age (and it was irregular) and his blood pressure a little too high for his own good. So, with a good deal of repetitive arguing to and fro, we took him to hospital for an ECG. My suspicion was heart block but he could easily just have fallen down as a result of his inebriated state – he certainly wasn’t steady on his feet at all but the risk was also high that he didn’t just happen to have a slow, irregular pulse and high blood pressure as part of his design.
He was pleasant enough, in-between the odd profanity, which he denied spitting out when I asked him to refrain and my Glaswegian helped break the ice when our accents and colloquialisms collided.
Later on we were asked to go to an assault scene to check the welfare of the crew that had been assigned, as they’re vehicle was still showing on scene but nobody had called in to update Control, so there was concern about what may have happened to them. When we got there, outside a closed pub, there was no sign of an ambulance. This was a good thing because it meant the system had gone awry and not the crew, who’d obviously cleared the area and either taken the patient to hospital or left her alone and gone home after their shift.
The second assault of the night had us running south to a dodgy estate where an even dodgier flat contained a dodgy drug-user/dealer. He had a minor head injury and the police had been called by a neighbour who’d heard a disturbance earlier and then ‘some men’ had been seen scuttling away from the premises. I had a quick look around the place while the student did the obs and chatted with the 60 year-old Liverpudlian about what had happened. He said he had no recollection of being hit but that somebody had stolen his stash of drugs.
His injury had been caused by a narrow, pointed weapon and I noticed that he was sitting on a nasty looking crow-bar. This was probably what did the damage. He’d had a disagreement with his lugubrious druggy mates and during the inevitable scuffle he’d probably been smacked in the face with his own weapon. He’d started to become aggressive and verbally abusive towards us all now anyway and me noticing the iron bar had at least made it possible for one of the officers to remove it and make him less of an immediate danger to us. ‘I want you people to leave’ he said. It took less than a second for me to agree with him and do as we were told. I am not going to get injured doing this job if I can help it and neither am I going to be responsible for any injury done to someone in my charge.
As the early hours became late early we were sent to an 84 year-old lady with a nose bleed. She had suffered a stroke a few years ago and was bed-bound with hemiplegia. Her partner in the cramped little flat suffered COPD and was on an oxygen lifeline and it was almost sadly comical to watch when he shuffled in to her bedroom as we checked her over; he gasped and wheezed his way to the chair and began to chat about how much he worried about his friend. I was worrying more about him now.
The patient seemed back to normal after her fright – she’d woken up with blood in her mouth and her nose was pouring blood out onto the sheets. A few heavy dark clots sat around her and we cleaned her up as best we could. Her top had to be changed but after a half hour of wiping away red stains from her chin, neck and face, she was fine again.
Both of them had a wicked sense of humour and I exploited that to help me adjust my decision making because I initially wanted to leave her at home, where she was happier, and get a doctor to come and see them both to ensure they were okay but as we chatted and laughed I noticed that her hand was clawed in and she was trying to open it up. Her arm was paralysed but she could usually open the hand – now she couldn’t, so there was a change in her that needed further investigating. I asked for an ambulance and a crew arrived within ten minutes to take her to hospital. Given her history and this recent change, notwithstanding that sudden nosebleed, it was no longer safe to leave her at home, even in the care of her friend. I also organised a doctor to visit her partner because his breathing needed to be stabilised.
This couple have been living like this for years; both of them are quite ill but both have reached a good age and have no bitterness or regrets. They laughed and joked their way through our visit with them and we spoke about ‘getting on with it’ even though things aren’t great. I have the greatest respect for them. We deal with many younger people, in better circumstances, who have no sense of fortune and who cannot see that their fate is ultimately designed by themselves.
Be safe.
Stats: 2 Assaults; 1 eTOH; 1 Epistaxis.
I have a couple of nights with my student paramedic on board and before we’d even got a proper job, a man ran at the car in Soho and complained that he’d been assaulted and that we should treat him and call the police. He was a bit wild-eyed and edgy, so I called for police and watched as my student attempted to deal with his childishly minor injury, caused by a punch to the mouth. He got predictably annoying and aggressive and so I asked him to go and that the police would deal with it.
By the time the cops arrived on foot he’d long gone and the people he’d been talking with and who knew him instantly denied they had any knowledge of him, his assault or his whereabouts. I could tell what kind of night this was going to be...
A 55 year-old Scot fell down drunk on the pavement at a bus stop and the good people standing around called an ambulance. We arrived and he was shocked at the fuss being caused. You see, where he and I come from, calling an ambulance is almost unheard of unless your head is falling off – and his wasn’t; he had a minor bruise to the side of it. Nevertheless, as he sat in the back of the car protesting his detention, we found his pulse to be a little too slow for his age (and it was irregular) and his blood pressure a little too high for his own good. So, with a good deal of repetitive arguing to and fro, we took him to hospital for an ECG. My suspicion was heart block but he could easily just have fallen down as a result of his inebriated state – he certainly wasn’t steady on his feet at all but the risk was also high that he didn’t just happen to have a slow, irregular pulse and high blood pressure as part of his design.
He was pleasant enough, in-between the odd profanity, which he denied spitting out when I asked him to refrain and my Glaswegian helped break the ice when our accents and colloquialisms collided.
Later on we were asked to go to an assault scene to check the welfare of the crew that had been assigned, as they’re vehicle was still showing on scene but nobody had called in to update Control, so there was concern about what may have happened to them. When we got there, outside a closed pub, there was no sign of an ambulance. This was a good thing because it meant the system had gone awry and not the crew, who’d obviously cleared the area and either taken the patient to hospital or left her alone and gone home after their shift.
The second assault of the night had us running south to a dodgy estate where an even dodgier flat contained a dodgy drug-user/dealer. He had a minor head injury and the police had been called by a neighbour who’d heard a disturbance earlier and then ‘some men’ had been seen scuttling away from the premises. I had a quick look around the place while the student did the obs and chatted with the 60 year-old Liverpudlian about what had happened. He said he had no recollection of being hit but that somebody had stolen his stash of drugs.
His injury had been caused by a narrow, pointed weapon and I noticed that he was sitting on a nasty looking crow-bar. This was probably what did the damage. He’d had a disagreement with his lugubrious druggy mates and during the inevitable scuffle he’d probably been smacked in the face with his own weapon. He’d started to become aggressive and verbally abusive towards us all now anyway and me noticing the iron bar had at least made it possible for one of the officers to remove it and make him less of an immediate danger to us. ‘I want you people to leave’ he said. It took less than a second for me to agree with him and do as we were told. I am not going to get injured doing this job if I can help it and neither am I going to be responsible for any injury done to someone in my charge.
As the early hours became late early we were sent to an 84 year-old lady with a nose bleed. She had suffered a stroke a few years ago and was bed-bound with hemiplegia. Her partner in the cramped little flat suffered COPD and was on an oxygen lifeline and it was almost sadly comical to watch when he shuffled in to her bedroom as we checked her over; he gasped and wheezed his way to the chair and began to chat about how much he worried about his friend. I was worrying more about him now.
The patient seemed back to normal after her fright – she’d woken up with blood in her mouth and her nose was pouring blood out onto the sheets. A few heavy dark clots sat around her and we cleaned her up as best we could. Her top had to be changed but after a half hour of wiping away red stains from her chin, neck and face, she was fine again.
Both of them had a wicked sense of humour and I exploited that to help me adjust my decision making because I initially wanted to leave her at home, where she was happier, and get a doctor to come and see them both to ensure they were okay but as we chatted and laughed I noticed that her hand was clawed in and she was trying to open it up. Her arm was paralysed but she could usually open the hand – now she couldn’t, so there was a change in her that needed further investigating. I asked for an ambulance and a crew arrived within ten minutes to take her to hospital. Given her history and this recent change, notwithstanding that sudden nosebleed, it was no longer safe to leave her at home, even in the care of her friend. I also organised a doctor to visit her partner because his breathing needed to be stabilised.
This couple have been living like this for years; both of them are quite ill but both have reached a good age and have no bitterness or regrets. They laughed and joked their way through our visit with them and we spoke about ‘getting on with it’ even though things aren’t great. I have the greatest respect for them. We deal with many younger people, in better circumstances, who have no sense of fortune and who cannot see that their fate is ultimately designed by themselves.
Be safe.
Friday, 5 February 2010
Assault
Day shift: Five calls; two by car; three by ambulance.
Stats: 1 Epistaxis; 2 Chest pain;1 Collapsed person; 1 Assault.
An epistaxis at the start of the shift and with no ambulance available in support. Most of these turn out to be little trickles of nothingness or are under control by the time I get on scene but this one, at a hotel/hostel, was different. The 55 year-old alcoholic and drug addict had been suffering 30-minute nosebleeds for the past few days but had been dealing with them himself. This morning, however, he became more concerned when yet another nosebleed struck and couldn’t be stopped.
When I arrived he’d already been bleeding for half an hour and he was holding a blood-soaked bar towel to his nose. The flow was watery and constant – not a clot in sight – and he admitted to having taken heroin and cocaine (brown and white) the day before, as well as drinking alcohol but he didn’t snort the coke, so there was probably another, possibly unrelated reason for this flood of blood.
I put a heavy dressing on the nose and wrapped it around his head but the blood just soaked through it, so I put another on after I’d done his basic obs and made it a little tighter – this seemed to work. Then I got him in the car and took him quickly to hospital. No ambulances had been assigned and there was nothing on the horizon. I wasn’t prepared to sit there while he bled and bled, so I took him myself without a hitch or a complaint.
After a morning meeting and a quick run to help out with a regular caller who feigns chest pain for a hospital bed (a call on which I was no use at all because an ambulance had been sent) I went to the aid of a 39 year-old nurse who was complaining of chest pain with shortness of breath (SOB). This had been going on, minus the SOB, for a year and she’d been ignoring it as it always got better but now that her breathing was being affected she felt it best to get checked out, as she should. All her obs were normal and her ECG shouted out nothing of any consequence that I could see but something was amiss and her SOB was related, so she was taken by ambulance to hospital.
A Red call for a collapsed ‘unconscious’ woman resulted in myself and a crew arriving at the same time and climbing lots of narrow little steps to a flat at the top of a building in Soho. She wasn’t unconscious but her husband was dramatically bent over her starfish body as her eyelids fluttered (the tell-tale sign of someone who wants to be unconscious but actually isn’t). She has been suffering from post-natal depression and this was not her first dramatic collapse. She needs further medical care I feel because she isn’t getting better. I’m not unsympathetic here though because PND is a very real and significant problem and she wasn’t coping well with it, so her husband was being left literally ‘holding the baby’. We can do nothing for her and the support she gets from her own is really crucial.
Racism and the general hatred of uniforms and authority of any kind is on the rise in my opinion, regardless of the soap the statistics are being washed with by the Government. A 30 year-old Iranian Traffic Enforcer (Warden?) was allegedly assaulted by two men who chased him, challenging him to a fight and hurling verbal abuse, including some nasty racist comments after he’d issued a ticket. They allegedly grabbed him and used his own ticketing machine to thump him in the chest, right where he’d broken a rib earlier in his life. Now he had sharp pain which was worse when he breathed in deeply.
None of us like getting tickets and parking fines but it’s the system and costs we dislike, not the people doing the job, although most react as if it is personal. A lot of these enforcers will actually be lenient with you and give you a bit of a break if your reaction to them is positive. If they don’t, that’s tough and we all have to pay the fines if they are valid. What we can’t do is assault them for doing the job. And as for racist taunts about not being in this country and taking jobs from Brits, well, where are these Brits? Clearly, they don’t want to do those jobs. This man is in the country, working hard and paying taxes – contributing to society, like it or not. He's not leeching from the State or causing trouble.
We chatted about his country’s current predicament, given that there are practically unveiled threats to attack it and he said ‘why does everyone hate us’ - the man was genuinely distressed about what had happened to him. That’s the problem with the media – they report the ‘evil axis’ stuff and yes, there may be a problem developing in terms of possible nuclear weapons but haven’t we heard all this before? And Iranian people should not be demonised as a population just because of the bad apples. You don't see them falling about drunk in the street and you will rarely, if ever meet an Iranian who is disrespectful. The meat and two veg of my repeated complaints about what is happening to our society is relative to everyone who behaves badly and shouldn't - nothing whatsoever to do with who they are or where they come from because we Brits can often be the worst examples of how to live as a society.
I'm only five foot seven, so I needed a box to stand on for that. Phew!
Be safe.
Stats: 1 Epistaxis; 2 Chest pain;1 Collapsed person; 1 Assault.
An epistaxis at the start of the shift and with no ambulance available in support. Most of these turn out to be little trickles of nothingness or are under control by the time I get on scene but this one, at a hotel/hostel, was different. The 55 year-old alcoholic and drug addict had been suffering 30-minute nosebleeds for the past few days but had been dealing with them himself. This morning, however, he became more concerned when yet another nosebleed struck and couldn’t be stopped.
When I arrived he’d already been bleeding for half an hour and he was holding a blood-soaked bar towel to his nose. The flow was watery and constant – not a clot in sight – and he admitted to having taken heroin and cocaine (brown and white) the day before, as well as drinking alcohol but he didn’t snort the coke, so there was probably another, possibly unrelated reason for this flood of blood.
I put a heavy dressing on the nose and wrapped it around his head but the blood just soaked through it, so I put another on after I’d done his basic obs and made it a little tighter – this seemed to work. Then I got him in the car and took him quickly to hospital. No ambulances had been assigned and there was nothing on the horizon. I wasn’t prepared to sit there while he bled and bled, so I took him myself without a hitch or a complaint.
After a morning meeting and a quick run to help out with a regular caller who feigns chest pain for a hospital bed (a call on which I was no use at all because an ambulance had been sent) I went to the aid of a 39 year-old nurse who was complaining of chest pain with shortness of breath (SOB). This had been going on, minus the SOB, for a year and she’d been ignoring it as it always got better but now that her breathing was being affected she felt it best to get checked out, as she should. All her obs were normal and her ECG shouted out nothing of any consequence that I could see but something was amiss and her SOB was related, so she was taken by ambulance to hospital.
A Red call for a collapsed ‘unconscious’ woman resulted in myself and a crew arriving at the same time and climbing lots of narrow little steps to a flat at the top of a building in Soho. She wasn’t unconscious but her husband was dramatically bent over her starfish body as her eyelids fluttered (the tell-tale sign of someone who wants to be unconscious but actually isn’t). She has been suffering from post-natal depression and this was not her first dramatic collapse. She needs further medical care I feel because she isn’t getting better. I’m not unsympathetic here though because PND is a very real and significant problem and she wasn’t coping well with it, so her husband was being left literally ‘holding the baby’. We can do nothing for her and the support she gets from her own is really crucial.
Racism and the general hatred of uniforms and authority of any kind is on the rise in my opinion, regardless of the soap the statistics are being washed with by the Government. A 30 year-old Iranian Traffic Enforcer (Warden?) was allegedly assaulted by two men who chased him, challenging him to a fight and hurling verbal abuse, including some nasty racist comments after he’d issued a ticket. They allegedly grabbed him and used his own ticketing machine to thump him in the chest, right where he’d broken a rib earlier in his life. Now he had sharp pain which was worse when he breathed in deeply.
None of us like getting tickets and parking fines but it’s the system and costs we dislike, not the people doing the job, although most react as if it is personal. A lot of these enforcers will actually be lenient with you and give you a bit of a break if your reaction to them is positive. If they don’t, that’s tough and we all have to pay the fines if they are valid. What we can’t do is assault them for doing the job. And as for racist taunts about not being in this country and taking jobs from Brits, well, where are these Brits? Clearly, they don’t want to do those jobs. This man is in the country, working hard and paying taxes – contributing to society, like it or not. He's not leeching from the State or causing trouble.
We chatted about his country’s current predicament, given that there are practically unveiled threats to attack it and he said ‘why does everyone hate us’ - the man was genuinely distressed about what had happened to him. That’s the problem with the media – they report the ‘evil axis’ stuff and yes, there may be a problem developing in terms of possible nuclear weapons but haven’t we heard all this before? And Iranian people should not be demonised as a population just because of the bad apples. You don't see them falling about drunk in the street and you will rarely, if ever meet an Iranian who is disrespectful. The meat and two veg of my repeated complaints about what is happening to our society is relative to everyone who behaves badly and shouldn't - nothing whatsoever to do with who they are or where they come from because we Brits can often be the worst examples of how to live as a society.
I'm only five foot seven, so I needed a box to stand on for that. Phew!
Be safe.
Thursday, 4 February 2010
Saying it like it is
Day shift: Five calls; one assisted-only; one by ambulance; three by car.
Stats: 1 Feeling weak; 1 Abdo pain; 1 Period pain; 1 Shoulder injury; 1 eTOH.
A 65 year-old man with advancing Alzheimer’s found himself unable to stand due to weakness and his carer on scene told me of his recent UTI and vascular problems, none of which were likely culprits. He wasn’t eating or drinking fluids well, so I suspect he may have had an electrolyte imbalance and his ECG, despite him having a pacemaker fitted, was throwing off PVC’s with a resulting bradycardia and pulse irregularity. He was taken to hospital for treatment and to have the pacemaker checked.
Following on after a pause, a 21 year-old at college felt the need to roll around the floor and ‘pass in and out of consciousness’ as he experienced abdominal pain that was probably brought on by constipation. He hadn’t opened his bowels for a while (in fact he couldn’t remember the last time but then again, he couldn’t remember his address when I asked him) and he had no medical problems, past or present. He continued to roll about a bit when security had shown me to where he’d been deposited but his ‘passing out’ phase had ended, thank goodness.
Until this call, the one I’m about to relate, I thought I was in for a day of wasted reasons to drive anywhere in a hurry. The call was for a 28 year-old female who had severe period pains / food poisoning, an anomaly that was explained to me later on by the patient. So, I walked into the store where the call had originated (a place I’ve visited many times and who seem hell bent on calling 999 every time they have the most minor of problems) and was taken, after a long delay while they tried to find someone to guide me, to the basement rabbit run and then the first aid room where my patient lay, somewhat embarrassed, on a couch. ‘Don’t worry, I think its only period pain’, she said after describing her dizziness and vomiting and abdo pain. This was normal for her on the first day of her period and she’d asked the management of the store not to call an ambulance but they’d insisted. In fact, when she’d asked for a hot water bottle, which she knew would help (filled with hot water obviously), they refused to get her one – even though she’d offered to pay for it. She'd mentiond food poisoning as a possibility but ruled it out but panic set in with the manager I think.
This was a thoroughly sensible young lady who knew that a trip to A&E for her problem would be an exaggeration of need, so I did a full set of obs, found her to be normal, alive and well then made a pact with her to sign my PRF and take a copy away in case she needed urgent medical help. She wouldn’t be going to hospital and she smiled acknowledgment to sense. Then, as she should in order to therapeutically resolve her current issue, she went back to continue shopping.
During this call, I was sent another and went west to transport a patient of one of our cycle buddies. The man, a 55 year-old Englishman now residing in South Africa with his wife, fell down a few steps in a shop, landing on his arm and damaging his shoulder. He could bend his arm but he could not lift it, indicating a problem with the joint at the shoulder itself.
I had a long and very interesting conversation with them both as they travelled to hospital with me. We talked about South Africa, how dangerous it could be and how beautiful it was. We touched on all kinds of politics, some of which would be angrily protested by anyone with a mind that was closed to free thought. It was refreshing to speak my mind and hear others do so too. Actually, just typing that statement is a damning indictment on the current state of free speech in this country.
Freedom, while we are on the subject, also allows alcoholic East European gentlemen to come to the UK and lie on the pavement (conveniently outside a pub), thrashing around pretending to have an epileptic fit when, (and the proof was there), it was patently obvious that he just wanted an excuse to be conveyed to a hospital. In fact, in between ‘fits’ he was able to make demands and one of them was that he wanted to go to a specific hospital. Believe me, I would be just as harsh about this behaviour if it was a fellow Scot but we are actually importing this nonsense and to concern ourselves about it is to risk being dubbed ‘racist’ by some. It’s not of course; it’s about being blindsided and stupid enough to fall for it in a country where liberal leniency has gone off the deep end and where, no doubt, it wouldn’t be tolerated quite as much in its country of origin.
So, I knew him because he’s done this before, many times. There are people with genuine epilepsy who would not appreciate his efforts at replicating it. His burden on you and me is financial at a time when we are seriously worried about funding cuts for schools, hospitals and universities. Yet he is given money to go and get drunk then when he runs out of booze he pretends to be ill, goes to hospital and, no doubt, attempts to find the means to substitute it for something else drinkable. He does this while chucking verbal abuse at us all.
He attempted to smoke several times in the car as I took him, with an accompanying police officer, to hospital. Then he tried it again as he waited to be seen by a nurse. They all knew him but nothing will be done about him because we have no solution that satisfies everyone – like when I write this stuff; someone, somewhere will always take offence, either because they think I’m saying all East Europeans are like this, which I am not or that I am saying all alcoholics are like this – which I am not. I’m trying out my freedom of speech thing to see if it flies.
And he said something profoundly ironic in the car as he argued with the cop, ‘I drink but I don’t take drugs’.
Be safe.
Stats: 1 Feeling weak; 1 Abdo pain; 1 Period pain; 1 Shoulder injury; 1 eTOH.
A 65 year-old man with advancing Alzheimer’s found himself unable to stand due to weakness and his carer on scene told me of his recent UTI and vascular problems, none of which were likely culprits. He wasn’t eating or drinking fluids well, so I suspect he may have had an electrolyte imbalance and his ECG, despite him having a pacemaker fitted, was throwing off PVC’s with a resulting bradycardia and pulse irregularity. He was taken to hospital for treatment and to have the pacemaker checked.
Following on after a pause, a 21 year-old at college felt the need to roll around the floor and ‘pass in and out of consciousness’ as he experienced abdominal pain that was probably brought on by constipation. He hadn’t opened his bowels for a while (in fact he couldn’t remember the last time but then again, he couldn’t remember his address when I asked him) and he had no medical problems, past or present. He continued to roll about a bit when security had shown me to where he’d been deposited but his ‘passing out’ phase had ended, thank goodness.
Until this call, the one I’m about to relate, I thought I was in for a day of wasted reasons to drive anywhere in a hurry. The call was for a 28 year-old female who had severe period pains / food poisoning, an anomaly that was explained to me later on by the patient. So, I walked into the store where the call had originated (a place I’ve visited many times and who seem hell bent on calling 999 every time they have the most minor of problems) and was taken, after a long delay while they tried to find someone to guide me, to the basement rabbit run and then the first aid room where my patient lay, somewhat embarrassed, on a couch. ‘Don’t worry, I think its only period pain’, she said after describing her dizziness and vomiting and abdo pain. This was normal for her on the first day of her period and she’d asked the management of the store not to call an ambulance but they’d insisted. In fact, when she’d asked for a hot water bottle, which she knew would help (filled with hot water obviously), they refused to get her one – even though she’d offered to pay for it. She'd mentiond food poisoning as a possibility but ruled it out but panic set in with the manager I think.
This was a thoroughly sensible young lady who knew that a trip to A&E for her problem would be an exaggeration of need, so I did a full set of obs, found her to be normal, alive and well then made a pact with her to sign my PRF and take a copy away in case she needed urgent medical help. She wouldn’t be going to hospital and she smiled acknowledgment to sense. Then, as she should in order to therapeutically resolve her current issue, she went back to continue shopping.
During this call, I was sent another and went west to transport a patient of one of our cycle buddies. The man, a 55 year-old Englishman now residing in South Africa with his wife, fell down a few steps in a shop, landing on his arm and damaging his shoulder. He could bend his arm but he could not lift it, indicating a problem with the joint at the shoulder itself.
I had a long and very interesting conversation with them both as they travelled to hospital with me. We talked about South Africa, how dangerous it could be and how beautiful it was. We touched on all kinds of politics, some of which would be angrily protested by anyone with a mind that was closed to free thought. It was refreshing to speak my mind and hear others do so too. Actually, just typing that statement is a damning indictment on the current state of free speech in this country.
Freedom, while we are on the subject, also allows alcoholic East European gentlemen to come to the UK and lie on the pavement (conveniently outside a pub), thrashing around pretending to have an epileptic fit when, (and the proof was there), it was patently obvious that he just wanted an excuse to be conveyed to a hospital. In fact, in between ‘fits’ he was able to make demands and one of them was that he wanted to go to a specific hospital. Believe me, I would be just as harsh about this behaviour if it was a fellow Scot but we are actually importing this nonsense and to concern ourselves about it is to risk being dubbed ‘racist’ by some. It’s not of course; it’s about being blindsided and stupid enough to fall for it in a country where liberal leniency has gone off the deep end and where, no doubt, it wouldn’t be tolerated quite as much in its country of origin.
So, I knew him because he’s done this before, many times. There are people with genuine epilepsy who would not appreciate his efforts at replicating it. His burden on you and me is financial at a time when we are seriously worried about funding cuts for schools, hospitals and universities. Yet he is given money to go and get drunk then when he runs out of booze he pretends to be ill, goes to hospital and, no doubt, attempts to find the means to substitute it for something else drinkable. He does this while chucking verbal abuse at us all.
He attempted to smoke several times in the car as I took him, with an accompanying police officer, to hospital. Then he tried it again as he waited to be seen by a nurse. They all knew him but nothing will be done about him because we have no solution that satisfies everyone – like when I write this stuff; someone, somewhere will always take offence, either because they think I’m saying all East Europeans are like this, which I am not or that I am saying all alcoholics are like this – which I am not. I’m trying out my freedom of speech thing to see if it flies.
And he said something profoundly ironic in the car as he argued with the cop, ‘I drink but I don’t take drugs’.
Be safe.
Wednesday, 3 February 2010
Hop it
Day shift: Five calls; one treated on scene; two by ambulance; two by car.
Stats: 1 Feeling faint; 1 ? Fractured Humerus; 1 Sprained ankle; 1 TIA; 1 Epistaxis.
I started the day with a ‘feeling faint’ that may or may not have had more to do with stress than the assumed cardiac connection made and given a resultant Red category. The 56 year-old man was at work in an office and has had two days of feeling like he was ‘missing a breath and a heartbeat’ every now and then. He also felt dizzy and faint and had visual disturbances at times, especially when he was sitting in front of his computer for any length of time concentrating.
He was taking beta blockers for diagnosed high blood pressure and when I checked it I found it to be up there at 180/90, so this gave the call a non-routine complexion but, before we all dive off the deep end, he looked stressed. He looked like he was the stressy type and he admitted to being so. He also knew what white coat syndrome was and so his blood pressure would probably have been behaving according to his disposition at the time. I will doubtless hear the ‘but his beta blockers would surely have been controlling that’ argument but I’ve seen this a lot and stress is a major factor for such changes in non-critical circumstances. His visual problems and that feeling of missing a breath could be down to anxiety. Nevertheless, he needed an ECG (incidentally, he had no chest pain) and a more thorough check up before a conclusion based on his lifestyle could be determined. If I was able to describe this man and then the environment in which he worked, you’d understand my reluctance to worry too much about him.
Then an 84 year-old lady stumbled over a quite frankly stupid and impractical device, comprising a length of rope and a few metal posts at ankle height, designed to prevent people from getting to close to works of art (paintings) at a gallery. She fell onto her knees and then slammed into the wall below the painting, damaging and probably fracturing, her mid-shaft humerus. This is a painful and significant injury at any age, never mind mid-80’s.
Luckily she was the strong type and, apart from the arm injury, had sustained no other damage on her trip. There was no first aid room or anywhere suitable to take her for obs and conversation about her personal medical history (this is, as you know, a real bug for me) and so, with the help of security and her friends, we wheeled her to the best place we could find for this – a conference room in which a small meeting was taking place. People were cleared and apologised to but I think this elderly lady will be writing harsh words about the stupidity of that small barrier (what’s it for, nosey dogs?) and the lack of proper facilities in a crowded place.
Sprained ankles are not generally life threatening, so if you are 28 years-old and can hop, either get a taxi or a friend to take you to the nearest A&E or Minor Injuries Unit where you will wait for possibly hours as they wheel in one true emergency after another. This man, who was on his way to work when he slipped on steps and twisted his ankle, continued on until he could no longer put weight on it before allowing his colleagues to dial 999 and declare it an emergency. There was no first aider to be seen, even though in a company that large there should have been and he had been given no treatment for it. His shoe and sock were still on his affected foot. A smart first aider would have assessed it, seen it for what it was (a sprain), given it the old RICE treatment and then had him taken to hospital for an x-ray, if required (and under the Ottowa rules it probably was) and that would have been the end of it. That being done, someone dying in the street elsewhere would get a timely ambulance response in the hope that the dying thing could be reversed.
At one of the nicest hotels in London a 65 year-old American woman had a small stroke – a TIA – whilst having her hair done. One of the other FRU’s on duty was called first and I got there a few seconds behind in support because the initial call sounded like it was going to become a suspended (cardiac arrest).
The woman had been put in the recovery position by a member of staff and she was completely unaware and unable to communicate. One side was weak and she was mildly combative when things were done to her, such as the BM check but oxygen helped her to recover and she went from incapable to survivor in ten minutes. She was able to speak a little when we started to move her down to the ambulance, where her frail and elderly husband waited in the street, hotel staff members all around him.
The lady’s ECG showed PVC’s after every normal beat, running in pairs – known as bigeminal couplets; something we don’t get to see much of, so it was interesting to analyse. She was taken, with her husband, to hospital on blue lights and the hotel manager promised a car would pick one or both of them up and return them to their room, depending on the outcome, which is hopefully favourable.
In a cruel twist they sent me to women-only spa where a 45 year-old lady was having a nosebleed that had gone on for 30 minutes. So, I was chaperoned all the way through to the changing rooms and had to stand in a small toilet with the lady and her friend as I covered her poorly nose until it stopped bleeding and we could all put it behind us. Actually, she was the sensible type and had experienced these epistaxal experiences before; they always occurred after having a cold and then going into warm places (like a spa for example). This was her longest bleed though, so her friend got panicky and made the patient feel embarrassed when I walked in to help her with something she’d been able to deal with all her adult life. I made things better for her by assuring her that she didn’t have to go to A&E if she didn’t want to, (which she didn’t) and that HEMS were being stood down.
Then I went home.
Be safe.
Stats: 1 Feeling faint; 1 ? Fractured Humerus; 1 Sprained ankle; 1 TIA; 1 Epistaxis.
I started the day with a ‘feeling faint’ that may or may not have had more to do with stress than the assumed cardiac connection made and given a resultant Red category. The 56 year-old man was at work in an office and has had two days of feeling like he was ‘missing a breath and a heartbeat’ every now and then. He also felt dizzy and faint and had visual disturbances at times, especially when he was sitting in front of his computer for any length of time concentrating.
He was taking beta blockers for diagnosed high blood pressure and when I checked it I found it to be up there at 180/90, so this gave the call a non-routine complexion but, before we all dive off the deep end, he looked stressed. He looked like he was the stressy type and he admitted to being so. He also knew what white coat syndrome was and so his blood pressure would probably have been behaving according to his disposition at the time. I will doubtless hear the ‘but his beta blockers would surely have been controlling that’ argument but I’ve seen this a lot and stress is a major factor for such changes in non-critical circumstances. His visual problems and that feeling of missing a breath could be down to anxiety. Nevertheless, he needed an ECG (incidentally, he had no chest pain) and a more thorough check up before a conclusion based on his lifestyle could be determined. If I was able to describe this man and then the environment in which he worked, you’d understand my reluctance to worry too much about him.
Then an 84 year-old lady stumbled over a quite frankly stupid and impractical device, comprising a length of rope and a few metal posts at ankle height, designed to prevent people from getting to close to works of art (paintings) at a gallery. She fell onto her knees and then slammed into the wall below the painting, damaging and probably fracturing, her mid-shaft humerus. This is a painful and significant injury at any age, never mind mid-80’s.
Luckily she was the strong type and, apart from the arm injury, had sustained no other damage on her trip. There was no first aid room or anywhere suitable to take her for obs and conversation about her personal medical history (this is, as you know, a real bug for me) and so, with the help of security and her friends, we wheeled her to the best place we could find for this – a conference room in which a small meeting was taking place. People were cleared and apologised to but I think this elderly lady will be writing harsh words about the stupidity of that small barrier (what’s it for, nosey dogs?) and the lack of proper facilities in a crowded place.
Sprained ankles are not generally life threatening, so if you are 28 years-old and can hop, either get a taxi or a friend to take you to the nearest A&E or Minor Injuries Unit where you will wait for possibly hours as they wheel in one true emergency after another. This man, who was on his way to work when he slipped on steps and twisted his ankle, continued on until he could no longer put weight on it before allowing his colleagues to dial 999 and declare it an emergency. There was no first aider to be seen, even though in a company that large there should have been and he had been given no treatment for it. His shoe and sock were still on his affected foot. A smart first aider would have assessed it, seen it for what it was (a sprain), given it the old RICE treatment and then had him taken to hospital for an x-ray, if required (and under the Ottowa rules it probably was) and that would have been the end of it. That being done, someone dying in the street elsewhere would get a timely ambulance response in the hope that the dying thing could be reversed.
At one of the nicest hotels in London a 65 year-old American woman had a small stroke – a TIA – whilst having her hair done. One of the other FRU’s on duty was called first and I got there a few seconds behind in support because the initial call sounded like it was going to become a suspended (cardiac arrest).
The woman had been put in the recovery position by a member of staff and she was completely unaware and unable to communicate. One side was weak and she was mildly combative when things were done to her, such as the BM check but oxygen helped her to recover and she went from incapable to survivor in ten minutes. She was able to speak a little when we started to move her down to the ambulance, where her frail and elderly husband waited in the street, hotel staff members all around him.
The lady’s ECG showed PVC’s after every normal beat, running in pairs – known as bigeminal couplets; something we don’t get to see much of, so it was interesting to analyse. She was taken, with her husband, to hospital on blue lights and the hotel manager promised a car would pick one or both of them up and return them to their room, depending on the outcome, which is hopefully favourable.
In a cruel twist they sent me to women-only spa where a 45 year-old lady was having a nosebleed that had gone on for 30 minutes. So, I was chaperoned all the way through to the changing rooms and had to stand in a small toilet with the lady and her friend as I covered her poorly nose until it stopped bleeding and we could all put it behind us. Actually, she was the sensible type and had experienced these epistaxal experiences before; they always occurred after having a cold and then going into warm places (like a spa for example). This was her longest bleed though, so her friend got panicky and made the patient feel embarrassed when I walked in to help her with something she’d been able to deal with all her adult life. I made things better for her by assuring her that she didn’t have to go to A&E if she didn’t want to, (which she didn’t) and that HEMS were being stood down.
Then I went home.
Be safe.
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