Night shift: Eight calls; one declined; two left at scene; one false alarm; five by ambulance; one by car.
Stats: 1 faint; 1 RTC bus v sped; 1 head injury; 2 cut feet; 2 eTOH; 1 assault with head injury.
A 26 year-old gave blood earlier in the day and then fainted when she was queuing with her friends at a restaurant. She was recovering well when I arrived and her obs were all normal. She didn’t want to go to hospital and she didn’t need to, so I asked the restaurant people if they could put her and her friends at the front of the queue (she needed to eat) and then got her to sign my paperwork, leaving her in the care of her mates.
No sooner had I finished this call when another came in – a 22 year-old man had been hit by a bus on Oxford Street. When I arrived, there were a few PCSO’s on scene and a grey car parked in front of a bus. The windscreen of the bus had a large bulls-eye on it – two in fact and I was shown inside to where the patient was sitting, chatting merrily away with one of the PCSOs.
He’d been walking across the road and got hit by the bus at around 20mph; his head and shoulder hit the windscreen, thus the two bulls-eyes. All he complained about was a sore shoulder. His head was marked but there was no bleeding and no other visible injury of any significance. His neurological signs were good and he generally looked okay. I spent a long time with him because there were no ambulances available and in all that time (30 minutes) he showed no sign of deterioration.
I had explained to him that he would be ‘boarded’ when the crew arrived. I’d already put a collar on him but he needed to know that it was all precautionary. I got another FRU colleague to assist me while I waited for an ambulance and while he held the man’s head still, I asked about the grey car that was still in front of the bus. Police had arrived by then and Oxford Street traffic was being controlled. I was told that the man was hit by the bus, flew across the road a few feet and then hit this car. I looked at the side of it and there was a huge dent in the back door. If this young man escaped injury he was very lucky indeed.
When he finally got to hospital, boarded and immobilised, the doctor gt a little excited about the impact speed and the fact that he'd been thrown across the road and into a car, so he was rushed into Resus, looking bemused. Later on he was walking out of the hospital and thanking me as I entered with another patient - just goes to show you, doesn't it?
The second trauma call of the night was to a 33 year-old man who was hit by a chunk of brick that apparently flew off some covered scaffolding as he walked innocently underneath – and not directly underneath either; the only way that bit of masonry could have reached him was if it had been lobbed or kicked. He had a head injury and I found him sitting at a tube station entrance near the scaffolding. Two witnesses told me what happened and the works manager, who came out after the incident, was also hanging around, although he was very quiet about it all.
I asked for police to come and check it out because I had concerns about how this brick had flown off the scaffolding and what possibility there might be that another would follow. From three or four floors up, one of these missiles could kill someone. The site Manager was very cagey, to say the least and the police found him a little fidgety about the whole incident.
I asked for an ambulance and got the patient on a board; I wasn't prepared to take any chances with him. The same doctor took delivery of him at the hospital and he must have thought I was deliberately bringing in walking-talking serious stuff.
Later on a 27 year-old woman cut her foot on glass – she was walking barefoot in an underground station and thought she may have stepped on a broken beer bottle. The undergrounds staff called an ambulance (even though there was a first aider on scene) and all I had to do was listen to the woman, who was a soldier apparently, and her three mates, laugh about the fact that I would take her to hospital if she wanted me to.
I put a dressing on it and she said she’d either just leave it or go and see her doctor. I think they’d all had a drink but her underlying point was made – a 999 call for a cut foot? Crazy, surely? In what other country on Earth (apart from the obvious few) would that be considered an emergency to life?
So, another cut foot made me look silly again but this time, the 25 year-old woman hadn’t called and neither had the train station staff. The first aiders were dealing with a very minor laceration to the bottom of her foot but some strange person, who wouldn’t stop pestering them apparently, went off to the nearest payphone and dialled 999 – thus I arrived ready for the emergency. This type of behaviour is akin to taking money out of our pockets and chucking it down a drain – it’s so easy to do.
Another easy thing to do is get drunk while on antidepressants, fall to the floor of the toilet, retch, foam at the mouth and struggle to vomit on an empty stomach... apparently. The rescue mission took me to a bar where an off-duty nurse (yes nurse) was carrying out vital research for the NHS. The crew was on scene just ahead of me (‘cos I went the wrong way and got there late), so I helped them get her onto the chair and up the stairs to sanctuary. ‘Why am I like this?’ she asked as she lolled around trying to throw up. It would have been easy to say ‘because you have had too much alcohol’ and that would probably have been true but factor in the drugs and she may just have been having a good old fashioned reaction to them - either way, she should have known better but she didn’t get a leaflet or a lecture; she got Metoclopramide and a free ride to the nearest A&E.
As Soho racked up another couple of drunks, fighters and arrested wasters, I was asked to go up north to visit a man who’d been introduced to a bottle – in the face. I was told to ‘stand by’ for police. I have no idea what this means any more – do I travel towards the call and then wait somewhere? Do I wait where I am and then go? It all used to be so simple but now it’s all got a bit stupid. So, I waited, pressed my ‘please talk to me’ button and waited some more. Then I waited a bit more... and more until a driver pulled up alongside my car and told me a man was lying in the road, so I called in a running call and went to check on him.
The young lad was half-in, half-out , body on the pavement, legs in the road. Any vehicle coming along and cutting up the corner would also have cut his limbs off. A lady had stopped to help him but she couldn’t wake him up (everybody knows only the LAS can wake people up, right?). She put his keys and his wallet into his rucksack and zipped them away. Then she left when I arrived and after she’d told me this.
I woke the man up and told him where he was. He seemed surprised. ‘I’m very tired’, he said, eyes half shut. ‘Well, go and find somewhere safe to sleep... not the road’, I replied, eyes wide open. He shook my hand and staggered off into the early morning. My God, it’s July already – where’s my life gone?
Assaults involving gangs that pounce on individuals and stamp on their heads are among the worst calls to go to because there is always an element of anger and shock at the brutality of it. My next patient, a 34 year-old gay man, was sitting on a step with his boyfriend and two police officers. He’d been set upon by four people, punched, kicked and thrown to the ground. Then they’d stamped on his head so hard that the boot print could clearly be seen on his cranium. He had other cuts and bruises but it was the mark on his head that concerned me most.
I couldn’t get an ambulance and he was stable, so I took him and his partner in the car. They swore a lot but I guess this was all anger and frustration.
Two for one next when I went to a call on which police were standing guard over two semi-conscious drunken males, both from the same group of friends, who’d collapsed in the street and had been there so long they’d both become hypothermic. No ambulances were available and there’s no Booze Bus running (this is exactly what it exists for), so with the prospect of waiting a while, I covered them both to keep them warm and plumbed them both in to keep them hydrated and to dilute the alcohol in their blood. The Summer has arrived and this is what we are all up against for the next few months. It will get much, much worse when the schools break up. It can be like treating in a war zone.
I got two ambulances after a while and my patients were carted off one by one to the great drying-out centres we call hospitals.
Be safe.
Wednesday, 30 June 2010
Sign up and ask about stuff
The Guardian is running an online live Q&A discussion for those of you interested in becoming a paramedic - or for those of you that just want to know what it's all about.
I've been asked to participate and will be around (in the ether) to answer questions and chat. Feel free to get involved; it's running from 1pm til 4pm on Thursday, 1st July - here's the link for advanced questions - http://bit.ly/aGrsic
I'll 'see' you there!
Xf
I've been asked to participate and will be around (in the ether) to answer questions and chat. Feel free to get involved; it's running from 1pm til 4pm on Thursday, 1st July - here's the link for advanced questions - http://bit.ly/aGrsic
I'll 'see' you there!
Xf
Tuesday, 29 June 2010
The electric fan - a medical miracle!
Night shift: Seven calls; one by ambulance; one taken to a nearer tube station; two left at scene; three by car.
Stats: 1 faint; 1 DIB; 1 near faint; 1 tachycardia; 1 swollen foot; 1 chest pain; 1DOAB.
A muggy start and a trip out to help a fainted pregnant woman. The 25 year-old collapsed in the stupid heat of the underground as she made her way home. She was recovering well and being fanned by a staff member when I arrived. I took her to a nearer train station so that she could avoid sitting in the heat again for too much longer. I also advised her to get a fan and use it when she travelled. Things are set to get much worse over the next month or so.
Just as pizza was a possibility, I was dragged away to the north into an ugly, badly planned estate for a 72 year-old swearing man with DIB; he had a long history and was feeling the effects of the weather, just as thousands of others with COPD and asthma are, or will soon. The crew arrived within a few minutes and he was their patient from that moment on. He continued to swear and bemoan the people in charge of the estate... and doctors who told him that the electric fan in his house was as good as extra oxygen. I wonder if NASA knows this; maybe astronauts should be going into space with a little personal fan to keep them alive?
I’ve deliberately separated the faint from the near-faint because this second swooning call was an almost faint and not the real thing. The actress from the show ‘Love Never Dies’ was in the dressing room up in the top floor of the Adelphi Theatre when she collapsed and had to be laid down with her feet raised to avoid a little catastrophe. The pins and needles she felt were the result of her body panicking and the swoon may, or may not, have been caused by the heat, pregnancy, a virus or the height at which she and her colleagues had to dress and undress. This was a bit like the underwear shop I visited last week (not personally but on a call) – I was focussed on the patient and trying to avert my eyes, lest I see something I shouldn’t ought to (as they say on the boards).
The patient (let’s call her ‘Potty P’, which is what I dubbed her anyway) was taken down to ground level in the lift and out through the eager autograph-chasers at the Stage Door. I took her to hospital in the car.
Thankfully, it is quieter tonight, so the next call came in an hour or so later – it was for a 22 year-old male with ‘heart problems’. At that age, I expect to find nothing wrong with the patient, or drugs are involved – or panic but sometimes I get someone with a diagnosed condition, like this one. He had Cardiomyopathy and was worried about a tachycardic event he had but that had now settled down. He didn’t want to go to hospital, he just wanted checked out and reassured. Personally, I’d rather he’d gone to hospital but it’s his choice.
His ECG was all over the place but generally, his vital signs were normal and he looked fine, so I left him with the paperwork and a copy of the ECG. As I looked at the ECG and considered it he said ‘What looks strange to you guys, is normal for me’.
As soon as I was ready, another call came in and I was off to a police station to see a woman about a foot. She was a homeless person who’d gone to the police and reported her injury – a swollen foot – and this triggered a 999 call. I can’t believe we run on lights and sirens to things like this; it’s ridiculous because I’ve been to a few calls from this location and I had already sensed what was coming. Homeless people use the police to get an ambulance so that they can be taken to hospital and sleep in the waiting area.
The 33 year-old woman was sitting on the police station steps with a police officer looking after her. She had a very slightly swollen foot but this had been a problem for her for a number of years. Now she couldn’t stand on it, she claimed. This was strange because she walked – practically ran – to the car when I said I would drive her to A&E.
To be honest, I have no problem helping a homeless female to get off the street and into somewhere safe but if she’s been homeless for a ‘long time’ as she stated, then I suspect there’s a reason for that.
Another young person with chest pain but no related condition was the 24 year-old who sat on the pavement with ‘ten out of ten’ pain and asked a passer-by to call an ambulance. He denied any drug taking but admitted he’d been drinking ‘a little’. He also said he’d had this problem before – a fast heart rate – and I did an ECG in the street to get to the bottom of it.
He was non-diaphoretic and seemed perfectly comfortable, even though he had the equivalent level of pain as, say, a dust mite giving birth to an elephant. So, I took him to hospital in the car and my critics will all gather around the pond to have a go no doubt. The fact is, his ECG wasn’t screaming anything and he just didn’t come across as real. The hospital was two minutes away and I followed my instincts.
And my instincts were also followed for the 60 year-old male, ‘unconscious’ on a bus. The old drunk-on-a-bus (DOAB) card is being played every night at the moment... two reports in the space of a few minutes when I went to this one and I think, as is the norm, there will be a rash of DOAB calls throughout the Summer.
He was easy to wake and a bit stubborn but he got off the bus after a five minute debate in which he slurred stuff at me and I replied, hoping that I was making sense – ‘get off the bus’ seems pretty straight-forward, right?
Be safe.
Stats: 1 faint; 1 DIB; 1 near faint; 1 tachycardia; 1 swollen foot; 1 chest pain; 1DOAB.
A muggy start and a trip out to help a fainted pregnant woman. The 25 year-old collapsed in the stupid heat of the underground as she made her way home. She was recovering well and being fanned by a staff member when I arrived. I took her to a nearer train station so that she could avoid sitting in the heat again for too much longer. I also advised her to get a fan and use it when she travelled. Things are set to get much worse over the next month or so.
Just as pizza was a possibility, I was dragged away to the north into an ugly, badly planned estate for a 72 year-old swearing man with DIB; he had a long history and was feeling the effects of the weather, just as thousands of others with COPD and asthma are, or will soon. The crew arrived within a few minutes and he was their patient from that moment on. He continued to swear and bemoan the people in charge of the estate... and doctors who told him that the electric fan in his house was as good as extra oxygen. I wonder if NASA knows this; maybe astronauts should be going into space with a little personal fan to keep them alive?
I’ve deliberately separated the faint from the near-faint because this second swooning call was an almost faint and not the real thing. The actress from the show ‘Love Never Dies’ was in the dressing room up in the top floor of the Adelphi Theatre when she collapsed and had to be laid down with her feet raised to avoid a little catastrophe. The pins and needles she felt were the result of her body panicking and the swoon may, or may not, have been caused by the heat, pregnancy, a virus or the height at which she and her colleagues had to dress and undress. This was a bit like the underwear shop I visited last week (not personally but on a call) – I was focussed on the patient and trying to avert my eyes, lest I see something I shouldn’t ought to (as they say on the boards).
The patient (let’s call her ‘Potty P’, which is what I dubbed her anyway) was taken down to ground level in the lift and out through the eager autograph-chasers at the Stage Door. I took her to hospital in the car.
Thankfully, it is quieter tonight, so the next call came in an hour or so later – it was for a 22 year-old male with ‘heart problems’. At that age, I expect to find nothing wrong with the patient, or drugs are involved – or panic but sometimes I get someone with a diagnosed condition, like this one. He had Cardiomyopathy and was worried about a tachycardic event he had but that had now settled down. He didn’t want to go to hospital, he just wanted checked out and reassured. Personally, I’d rather he’d gone to hospital but it’s his choice.
His ECG was all over the place but generally, his vital signs were normal and he looked fine, so I left him with the paperwork and a copy of the ECG. As I looked at the ECG and considered it he said ‘What looks strange to you guys, is normal for me’.
As soon as I was ready, another call came in and I was off to a police station to see a woman about a foot. She was a homeless person who’d gone to the police and reported her injury – a swollen foot – and this triggered a 999 call. I can’t believe we run on lights and sirens to things like this; it’s ridiculous because I’ve been to a few calls from this location and I had already sensed what was coming. Homeless people use the police to get an ambulance so that they can be taken to hospital and sleep in the waiting area.
The 33 year-old woman was sitting on the police station steps with a police officer looking after her. She had a very slightly swollen foot but this had been a problem for her for a number of years. Now she couldn’t stand on it, she claimed. This was strange because she walked – practically ran – to the car when I said I would drive her to A&E.
To be honest, I have no problem helping a homeless female to get off the street and into somewhere safe but if she’s been homeless for a ‘long time’ as she stated, then I suspect there’s a reason for that.
Another young person with chest pain but no related condition was the 24 year-old who sat on the pavement with ‘ten out of ten’ pain and asked a passer-by to call an ambulance. He denied any drug taking but admitted he’d been drinking ‘a little’. He also said he’d had this problem before – a fast heart rate – and I did an ECG in the street to get to the bottom of it.
He was non-diaphoretic and seemed perfectly comfortable, even though he had the equivalent level of pain as, say, a dust mite giving birth to an elephant. So, I took him to hospital in the car and my critics will all gather around the pond to have a go no doubt. The fact is, his ECG wasn’t screaming anything and he just didn’t come across as real. The hospital was two minutes away and I followed my instincts.
And my instincts were also followed for the 60 year-old male, ‘unconscious’ on a bus. The old drunk-on-a-bus (DOAB) card is being played every night at the moment... two reports in the space of a few minutes when I went to this one and I think, as is the norm, there will be a rash of DOAB calls throughout the Summer.
He was easy to wake and a bit stubborn but he got off the bus after a five minute debate in which he slurred stuff at me and I replied, hoping that I was making sense – ‘get off the bus’ seems pretty straight-forward, right?
Be safe.
Friday, 25 June 2010
Staff sickness
Day shift: seven calls; two treated but not conveyed; one left at work; four by car.
Stats: 2 hypoglycaemic; 1 unwell; 1 cut foot; 1 abdo pain; 1 psychiatric; 1 dizzy; person.
Before we had a chance to get north and breakfast, a 34 year-old diabetic was found semi-conscious in bed by his girlfriend and she called an ambulance because she didn’t know what to do with him. He’d never shown her how to measure his blood glucose and had never told her what to do to treat him if he became low.
We gave him Glucagon and he was back to his normal self within fifteen minutes. A few tablespoons of honey helped to keep his sugar level up and we left him at home with his partner (and some advice on what to do next time). 'I'm too good for him', she told us, as if we needed to know.
Immediately after this, when back on station, we were asked to check on a Control colleague who was feeling unwell. She just needed her BP taken and it was fine, so she was left at work. It's one of the ironies of working for a large ambulance service like this that those who work for us still have to 'call and ambulance'. They don't even get a discount.
A 25 year-old woman who cut her foot on the escalator at an underground station could (and should) have hopped herself across the road to A&E if she felt the need. Instead, we were called out and I drove her around the corner. Please be sure to let me know that an ambulance should have taken her instead.
An hour or so past before we encountered our next patient, a 28 year-old restaurant worker who had her boss call an ambulance for ‘chest pain’. She had abdominal pain and a momentary fainty feeling, so an ambulance was not required and we took her to hospital where, for reasons I cannot fathom, the A&E department was full of people – it seems everyone is calling 999 today just so they can end up sitting in a corridor waiting... just as they would if they’d just walked themselves in.
Hot weather increases instances of hypoglycaemia in diabetics, so I wasn’t surprised when we received our second such call in the afternoon. The police had called us on this one because he’d been acting strangely and when questioned, had been vague with them. He did ask them to get him to McDonalds, which was nearby, but they decided he was too unwell.
A crew was just ahead of us and the student paramedic worked with them to get the 42 year-old man’s blood sugar back up from the low two’s but, even after three Glucogels had been given and twenty minutes had elapsed, the man’s BM remained low.
He had been swallowing the gel too fast - it would have gone straight to his gut with very little buccal absorption, so giving him Glucagon would have been an unnecessary intervention. It was best to wait or give him a small amount of IV glucose if his condition didn’t improve. But he caught everyone out by suddenly becoming lucid when he was about to be taken into the ambulance. His recovery was starting and it would, once the sugar he’d been given, continue until his BM was normal or high-normal.
He was given chips to eat by a friend and he turned human again. Then he went on about his day with his mate.
A call to a train station for a 49 year-old female who ‘had a nosebleed’ and who stated she had a blood disorder, turned into a bit of a joke when my student went missing trying to find the patient and I bumped into her by accident (the patient) on my way out of the station to find the student. I heard a voice say ‘are you looking for me?’ and saw a large woman sitting on a bench nowhere near the location given (thus my lost colleague). She told me she ‘needed’ an ambulance because she had suffered a nose bleed and it had stopped and she had a blood disorder... also that she suffered depression and had just come out of jail – she’d been arrested for fighting. ‘A man beat me up’, she said. I have to say I doubted that.
Opinions aside, we took her to hospital and left her in care because there was no evidence upon which to base a clinical referral at all.
Another LAS colleague felt dizzy when, once again, we visited HQ on an errand. I’m sure they see us and get ill – we make them sick obviously. The woman was suffering from giddiness and vision problems and her ECG was abnormal (but not enough that it merited a panic). She may just need her eyesight checked or she may be having a more significant medical event. We took her to hospital just in case.
Be safe.
Stats: 2 hypoglycaemic; 1 unwell; 1 cut foot; 1 abdo pain; 1 psychiatric; 1 dizzy; person.
Before we had a chance to get north and breakfast, a 34 year-old diabetic was found semi-conscious in bed by his girlfriend and she called an ambulance because she didn’t know what to do with him. He’d never shown her how to measure his blood glucose and had never told her what to do to treat him if he became low.
We gave him Glucagon and he was back to his normal self within fifteen minutes. A few tablespoons of honey helped to keep his sugar level up and we left him at home with his partner (and some advice on what to do next time). 'I'm too good for him', she told us, as if we needed to know.
Immediately after this, when back on station, we were asked to check on a Control colleague who was feeling unwell. She just needed her BP taken and it was fine, so she was left at work. It's one of the ironies of working for a large ambulance service like this that those who work for us still have to 'call and ambulance'. They don't even get a discount.
A 25 year-old woman who cut her foot on the escalator at an underground station could (and should) have hopped herself across the road to A&E if she felt the need. Instead, we were called out and I drove her around the corner. Please be sure to let me know that an ambulance should have taken her instead.
An hour or so past before we encountered our next patient, a 28 year-old restaurant worker who had her boss call an ambulance for ‘chest pain’. She had abdominal pain and a momentary fainty feeling, so an ambulance was not required and we took her to hospital where, for reasons I cannot fathom, the A&E department was full of people – it seems everyone is calling 999 today just so they can end up sitting in a corridor waiting... just as they would if they’d just walked themselves in.
Hot weather increases instances of hypoglycaemia in diabetics, so I wasn’t surprised when we received our second such call in the afternoon. The police had called us on this one because he’d been acting strangely and when questioned, had been vague with them. He did ask them to get him to McDonalds, which was nearby, but they decided he was too unwell.
A crew was just ahead of us and the student paramedic worked with them to get the 42 year-old man’s blood sugar back up from the low two’s but, even after three Glucogels had been given and twenty minutes had elapsed, the man’s BM remained low.
He had been swallowing the gel too fast - it would have gone straight to his gut with very little buccal absorption, so giving him Glucagon would have been an unnecessary intervention. It was best to wait or give him a small amount of IV glucose if his condition didn’t improve. But he caught everyone out by suddenly becoming lucid when he was about to be taken into the ambulance. His recovery was starting and it would, once the sugar he’d been given, continue until his BM was normal or high-normal.
He was given chips to eat by a friend and he turned human again. Then he went on about his day with his mate.
A call to a train station for a 49 year-old female who ‘had a nosebleed’ and who stated she had a blood disorder, turned into a bit of a joke when my student went missing trying to find the patient and I bumped into her by accident (the patient) on my way out of the station to find the student. I heard a voice say ‘are you looking for me?’ and saw a large woman sitting on a bench nowhere near the location given (thus my lost colleague). She told me she ‘needed’ an ambulance because she had suffered a nose bleed and it had stopped and she had a blood disorder... also that she suffered depression and had just come out of jail – she’d been arrested for fighting. ‘A man beat me up’, she said. I have to say I doubted that.
Opinions aside, we took her to hospital and left her in care because there was no evidence upon which to base a clinical referral at all.
Another LAS colleague felt dizzy when, once again, we visited HQ on an errand. I’m sure they see us and get ill – we make them sick obviously. The woman was suffering from giddiness and vision problems and her ECG was abnormal (but not enough that it merited a panic). She may just need her eyesight checked or she may be having a more significant medical event. We took her to hospital just in case.
Be safe.
Thursday, 24 June 2010
No-one's talking sense any more
Day shift: Six calls; three by ambulance; two by car; one with police.
Stats: 2 unwell adults; 1 chest pain; 1 ? circulation problems; 1 abdo pain; 1 eTOH.
The unwell man was a 69 year-old who’d been lethargic, weak and sick for a while until his wife decided enough was enough and called an ambulance. He needed one and, despite the call being read as a possible car journey, a crew turned up and he was quickly taken away. His breathing wasn’t good and he looked off-colour.
The other unwell man was a 39 year-old at work who decided he didn’t feel well and had his bosses call an ambulance two hours later. He was the silent, emotional type who doesn’t talk much and doesn’t answer questions and the crew was understandably stressed that they were getting nowhere with the details. We get this a lot and it’s okay if you are very ill and can’t speak but it is kind of selfish to have an ambulance crew attend and then not even talk to them when they need to know what’s wrong. We can’t use psychic abilities to guess what’s up and we can’t treat things that are emotional or psychological.
After an hour or so of sunning ourselves on Trafalgar Square and running back and forth with radio swap problems, we were sent to a 64 year-old woman with chest pain. She walked out of the callbox and over to the car before we had much of a chance to park up. An ambulance joined us very soon after we landed, so the student had very little to do, although she stayed with the patient and crew to get the ECG results.
A 20 year-old female with Guillain–Barré syndrome told her boss she suddenly couldn’t feel or move her leg, so we were called to deal with it. At first it looked as though an ambulance would be the only option because she had varicosed veins and stated she couldn’t weight bear at all. We were in the basement of a ladies underwear shop and we waited for a while before I finally decided that, once I’d learned all I could about some of the stock, courtesy of the Supervisor, and had gleaned info on what the Hell a ‘Tankini’ is, we could probably wheel her out on a chair with castors and use the lift to get her to street level. Then I’d physically lift her into the car. That was the plan and that’s how it was executed, much to the amusement of the customers.
After taking a man to the local police station after he told us he’d been hit by a motorcycle (he’d swapped details with the guy and let him leave the scene), we went to a 25 year-old who’d fainted and who now had abdominal pain – a very common combination on a call. She was fully recovered, if she’d passed out at all, and was still complaining of abdo pain – an ambulance wasn’t required, so when the crew turned up, after they’d been cancelled, they were happy enough to leave it with us.
We took her with a colleague in the car and had to stop when we were informed by kindly drivers that the hatch had been left open. Luckily, nothing fell out. My student doesn’t want me to report that it was her fault for leaving the hatch open. But it was. So there :-)
A useless journey for a 55 year-old drunken woman next and police were on scene standing over her when we arrived. Another FRU was also arriving and so we were very much surplus. It’s been a day of duplicates and communication drops.
Be safe.
Stats: 2 unwell adults; 1 chest pain; 1 ? circulation problems; 1 abdo pain; 1 eTOH.
The unwell man was a 69 year-old who’d been lethargic, weak and sick for a while until his wife decided enough was enough and called an ambulance. He needed one and, despite the call being read as a possible car journey, a crew turned up and he was quickly taken away. His breathing wasn’t good and he looked off-colour.
The other unwell man was a 39 year-old at work who decided he didn’t feel well and had his bosses call an ambulance two hours later. He was the silent, emotional type who doesn’t talk much and doesn’t answer questions and the crew was understandably stressed that they were getting nowhere with the details. We get this a lot and it’s okay if you are very ill and can’t speak but it is kind of selfish to have an ambulance crew attend and then not even talk to them when they need to know what’s wrong. We can’t use psychic abilities to guess what’s up and we can’t treat things that are emotional or psychological.
After an hour or so of sunning ourselves on Trafalgar Square and running back and forth with radio swap problems, we were sent to a 64 year-old woman with chest pain. She walked out of the callbox and over to the car before we had much of a chance to park up. An ambulance joined us very soon after we landed, so the student had very little to do, although she stayed with the patient and crew to get the ECG results.
A 20 year-old female with Guillain–Barré syndrome told her boss she suddenly couldn’t feel or move her leg, so we were called to deal with it. At first it looked as though an ambulance would be the only option because she had varicosed veins and stated she couldn’t weight bear at all. We were in the basement of a ladies underwear shop and we waited for a while before I finally decided that, once I’d learned all I could about some of the stock, courtesy of the Supervisor, and had gleaned info on what the Hell a ‘Tankini’ is, we could probably wheel her out on a chair with castors and use the lift to get her to street level. Then I’d physically lift her into the car. That was the plan and that’s how it was executed, much to the amusement of the customers.
After taking a man to the local police station after he told us he’d been hit by a motorcycle (he’d swapped details with the guy and let him leave the scene), we went to a 25 year-old who’d fainted and who now had abdominal pain – a very common combination on a call. She was fully recovered, if she’d passed out at all, and was still complaining of abdo pain – an ambulance wasn’t required, so when the crew turned up, after they’d been cancelled, they were happy enough to leave it with us.
We took her with a colleague in the car and had to stop when we were informed by kindly drivers that the hatch had been left open. Luckily, nothing fell out. My student doesn’t want me to report that it was her fault for leaving the hatch open. But it was. So there :-)
A useless journey for a 55 year-old drunken woman next and police were on scene standing over her when we arrived. Another FRU was also arriving and so we were very much surplus. It’s been a day of duplicates and communication drops.
Be safe.
Tuesday, 22 June 2010
Return of the professional timewaster
The elephants are going to auction and before they leave, they are 'on parade'Day shift: Nine calls; one woken up; three left on scene; one referred to GP; two by car; two by ambulance.
Stats: 2 sleeping persons; 2 abdo pains; 1 headache; 1 RTC with 3 patients; 1 back pain; 1 nosebleed; 1 RTC with ? spinal.
The first call of the morning cost me ten seconds of my life to get to – the bus in
which the ‘unconscious male’ temporarily resided was across the road from where I had parked. It took another ten seconds to shake him awake and walk him off. The well-tanned man apologised and groggily made his way to wherever he had planned to be this morning; he wasn’t a drunk and he wasn’t homeless – he was just tired and the bus driver, being told not to take any risk, had done nothing to wake him up.
A request to travel further south than normal took me to an underground station where a 27 year-old female was suffering abdominal pains, dizziness and nausea. She had recently been diagnosed with an Ovarian Cyst and Endometriosis and by the time I arrived, she was getting better. The pain had eased and she felt less sick than before, so I did the paperwork and spent twenty minutes chatting to her, ensuring that she didn’t actually need to go to hospital because she didn’t want to.
I left her in the very good hands of the London Underground staff and they ensured she got home by taxi. Hopefully, she will seek advice from her GP if this pain returns.
Another female abdo pain with a gynaecological aetiology came in just as I was about to enter the Post Office. I am trying to mail out a package and I need to do it today but, as Sod and his laws will confirm, it will probably be a failed mission because calls are bound to come in just as I walk towards the entry door.
I took the 26 year-old to hospital and then up to Emergency Gynae. She has already had a miscarriage and this is her second. She was, understandably, very upset. I felt a lot of sympathy for her of course because I think women experiencing this ‘common’ problem are generally left to fend for themselves.
The 32 year-old female with a headache who called an ambulance from her workplace probably has anaemia (she has a history). She told me she felt weak, dizzy and tired. I empathised – I feel the same a lot of the time, except for the dizzy bit, unless you have a point of view on my personality.
I left her with her colleagues and advice to go and see her GP as soon as possible.
Not far from where I had just been, if you know what I mean, a multi-casualty, walking-wounded call was generated when a 13 year-old female – part of a school group visiting from Germany – was hit by a moped and the driver and his passenger were thrown off onto the road. All of them sustained very minor injuries; grazes to various exposed body parts, and so I asked for one ambulance and the police. No helicopter or line of vehicles for this one.
I dressed the graze of the moped driver and the teenager was checked out in the ambulance while her teacher chatted to her and made sure she was okay, which, apart from the emotion of being hit by a vehicle, she was. She was left in the care of her teachers as her friends clicked away on their cameras and used their mobile phones to record the mini spectacle. No doubt it will all show up on You Tube. No doubt she will be more careful to look both ways next time too.
After a break I was sent out to deal with a back injury that sounded as if the patient would need an ambulance. Instead I found a 25 year-old Masters student sitting against a wall complaining of muscular pain that developed hours earlier when she was cycling. To be fair to her, she didn’t call an ambulance for it, the security and teaching staff of the college did. She was prepared to make her own way to see her doctor about it.
I took her in the car to A&E and she sat waiting, with other minor ailments, for what will probably be a good few hours.
A regular caller, timewaster and self-harmer is back on this ‘patch’ – I’ve known him for almost five years and have often referred to him in these posts. He’s been gone for about a year but now he’s up to his old tricks and there seems nothing we can do about it. He generated a call for a ‘person lying in alley with bleeding nose’ and when I got there he was crying out to ensure that people would take notice of him and call an ambulance. This is what he always does and he self-harms to ensure he gets a response. There is never anything truly wrong with him. He’s the same person that got turfed out of hospital as soon as I got him there a few shifts ago. It’s all getting very boring with him.
The crew that arrived didn’t know him and I gave them the SP before they got near. I didn’t want to patronise them but if they don’t know him they could be in for a shock – he will throw blood at you, spit at you and attack you if given the chance. He’s not a nice man at all.
He claimed he’d fallen from a height, then changed his story to one in which he was attacked by someone he owes money to. It was obvious from his position and the blood smears on the cardboard he was laying on that he had cut himself (broken glass all around him) then rubbed his nose across the cardboard for dramatic effect. One day very soon, this guy will take a resource away from a dying person - or will be the dying person.
As the day closed I was sent to a park where a 7 year-old girl had been knocked down by a bicycle. The bike had hit her at around 20mph and she was instantly rendered unconscious for two minutes, according to witnesses (and there were plenty of them). The little girl was Arabic she and had a large family with her. The witnesses reported that as soon as she was hit, family members lifted her up, hung her upside down and began shaking her in an effort to bring her back to consciousness. This report appalled me because if the girl had a neck injury, the poor cyclist that had hit her (she ran out in front of him and he was in a cycle lane), regardless of how you judge his speed in a public park, would be blamed when the cause of any harm to her spine could be traced to the actions taken by her family afterwards. This is a very bad approach to first aid - it is deeply ignorant.
The girl was conscious but in some distress when I got there and an ambulance was with me because we’d arrived at the same time to find nobody to guide us in (nobody official anyway) and the only gate we could use was locked. So we drove all the way to the top of the park and went back to the incident scene the long way – rubbish really.
She was collared and boarded and blued in as a precaution. She’d been unconscious and that meant she’d hit her head hard enough to cause potential damage, so she would need to be treated seriously until cleared at hospital.
I have a lot to say about the backward way in which 'first aid' is practised by some people. If you have kids, go and learn some first aid – properly. Stop living in the Stone Age and get educated.
Finally, on the way back and with little time left on the clock, I was asked to wake yet another sleepy-head who was on a bus. This time the vehicle was parked up on Hyde Park Corner and I went around it twice before seeing the bus I was going to. Traffic is so heavy in that area that getting a good look at anything near the pavement when you are solo is almost impossible.
Stats: 2 sleeping persons; 2 abdo pains; 1 headache; 1 RTC with 3 patients; 1 back pain; 1 nosebleed; 1 RTC with ? spinal.
The first call of the morning cost me ten seconds of my life to get to – the bus in
which the ‘unconscious male’ temporarily resided was across the road from where I had parked. It took another ten seconds to shake him awake and walk him off. The well-tanned man apologised and groggily made his way to wherever he had planned to be this morning; he wasn’t a drunk and he wasn’t homeless – he was just tired and the bus driver, being told not to take any risk, had done nothing to wake him up.A request to travel further south than normal took me to an underground station where a 27 year-old female was suffering abdominal pains, dizziness and nausea. She had recently been diagnosed with an Ovarian Cyst and Endometriosis and by the time I arrived, she was getting better. The pain had eased and she felt less sick than before, so I did the paperwork and spent twenty minutes chatting to her, ensuring that she didn’t actually need to go to hospital because she didn’t want to.
I left her in the very good hands of the London Underground staff and they ensured she got home by taxi. Hopefully, she will seek advice from her GP if this pain returns.
Another female abdo pain with a gynaecological aetiology came in just as I was about to enter the Post Office. I am trying to mail out a package and I need to do it today but, as Sod and his laws will confirm, it will probably be a failed mission because calls are bound to come in just as I walk towards the entry door.
I took the 26 year-old to hospital and then up to Emergency Gynae. She has already had a miscarriage and this is her second. She was, understandably, very upset. I felt a lot of sympathy for her of course because I think women experiencing this ‘common’ problem are generally left to fend for themselves.
The 32 year-old female with a headache who called an ambulance from her workplace probably has anaemia (she has a history). She told me she felt weak, dizzy and tired. I empathised – I feel the same a lot of the time, except for the dizzy bit, unless you have a point of view on my personality.
I left her with her colleagues and advice to go and see her GP as soon as possible.
Not far from where I had just been, if you know what I mean, a multi-casualty, walking-wounded call was generated when a 13 year-old female – part of a school group visiting from Germany – was hit by a moped and the driver and his passenger were thrown off onto the road. All of them sustained very minor injuries; grazes to various exposed body parts, and so I asked for one ambulance and the police. No helicopter or line of vehicles for this one.
I dressed the graze of the moped driver and the teenager was checked out in the ambulance while her teacher chatted to her and made sure she was okay, which, apart from the emotion of being hit by a vehicle, she was. She was left in the care of her teachers as her friends clicked away on their cameras and used their mobile phones to record the mini spectacle. No doubt it will all show up on You Tube. No doubt she will be more careful to look both ways next time too.
After a break I was sent out to deal with a back injury that sounded as if the patient would need an ambulance. Instead I found a 25 year-old Masters student sitting against a wall complaining of muscular pain that developed hours earlier when she was cycling. To be fair to her, she didn’t call an ambulance for it, the security and teaching staff of the college did. She was prepared to make her own way to see her doctor about it.
I took her in the car to A&E and she sat waiting, with other minor ailments, for what will probably be a good few hours.
A regular caller, timewaster and self-harmer is back on this ‘patch’ – I’ve known him for almost five years and have often referred to him in these posts. He’s been gone for about a year but now he’s up to his old tricks and there seems nothing we can do about it. He generated a call for a ‘person lying in alley with bleeding nose’ and when I got there he was crying out to ensure that people would take notice of him and call an ambulance. This is what he always does and he self-harms to ensure he gets a response. There is never anything truly wrong with him. He’s the same person that got turfed out of hospital as soon as I got him there a few shifts ago. It’s all getting very boring with him.
The crew that arrived didn’t know him and I gave them the SP before they got near. I didn’t want to patronise them but if they don’t know him they could be in for a shock – he will throw blood at you, spit at you and attack you if given the chance. He’s not a nice man at all.
He claimed he’d fallen from a height, then changed his story to one in which he was attacked by someone he owes money to. It was obvious from his position and the blood smears on the cardboard he was laying on that he had cut himself (broken glass all around him) then rubbed his nose across the cardboard for dramatic effect. One day very soon, this guy will take a resource away from a dying person - or will be the dying person.
As the day closed I was sent to a park where a 7 year-old girl had been knocked down by a bicycle. The bike had hit her at around 20mph and she was instantly rendered unconscious for two minutes, according to witnesses (and there were plenty of them). The little girl was Arabic she and had a large family with her. The witnesses reported that as soon as she was hit, family members lifted her up, hung her upside down and began shaking her in an effort to bring her back to consciousness. This report appalled me because if the girl had a neck injury, the poor cyclist that had hit her (she ran out in front of him and he was in a cycle lane), regardless of how you judge his speed in a public park, would be blamed when the cause of any harm to her spine could be traced to the actions taken by her family afterwards. This is a very bad approach to first aid - it is deeply ignorant.
The girl was conscious but in some distress when I got there and an ambulance was with me because we’d arrived at the same time to find nobody to guide us in (nobody official anyway) and the only gate we could use was locked. So we drove all the way to the top of the park and went back to the incident scene the long way – rubbish really.
She was collared and boarded and blued in as a precaution. She’d been unconscious and that meant she’d hit her head hard enough to cause potential damage, so she would need to be treated seriously until cleared at hospital.
I have a lot to say about the backward way in which 'first aid' is practised by some people. If you have kids, go and learn some first aid – properly. Stop living in the Stone Age and get educated.
Finally, on the way back and with little time left on the clock, I was asked to wake yet another sleepy-head who was on a bus. This time the vehicle was parked up on Hyde Park Corner and I went around it twice before seeing the bus I was going to. Traffic is so heavy in that area that getting a good look at anything near the pavement when you are solo is almost impossible.
Anyway, I woke him up and he got off the bus, complaining bitterly about being deposited on a hard seat at the bus stop.
Be safe.
Monday, 21 June 2010
Dizzy
Day shift: Four calls; three by car; one by ambulance.
Stats: 1 unwell adult; 2 vertigo; 1 ?PE.
The day started with warm sunshine and the return of the commuter run for the first day of the week. I’m working a few days of overtime this week, so will be on for seven days straight on this tour. I’ll be tired at the end of it, so my writing may slope off the page by Friday.
It starts with a request from a motorcycle colleague to transport a 41 year-old lady who began to feel unwell on her way to work. She had been suffering from a chest infection recently and vomited earlier. We found her sitting on a step with the MRU paramedic, looking under the weather (the patient, not the medic). It was a short hop to hospital, so, after a handover to the student, we delivered her to A&E.
We were then asked to investigate a 39 year-old female who’d started vomiting and felt dizzy at a children’s hospital. He child was waiting for an x-ray and her grandfather was taking care of her as mum languished on the bed of one of the medical rooms awaiting our arrival. No ambulance had been dispatched and the staff in the ward had been warned they may have to wait an hour for one but the problem was easy to solve. I gave her Metoclopramide to stop her from vomiting and then we got her to the car and took her to A&E. She had a history of Vertigo, so there was no clinical reason for her to wait for an ambulance.
This was closely followed by another Vertigo-related vomiting call; this time for a 36 year-old male at work. He hadn’t yet thrown up and he wasn’t given anything because his main complaint was dizziness. That soon turned to throwing up when he got into the car but he wasn’t nearly as bad as the previous patient.
A 20 year-old female called us from a train station after experiencing chest pain that she’d felt before – a few times in fact, when she’d suffered multiple Pulmonary Embolisms (PE) – okay, it’s emboli in the plural but I’m talking in the collective here. Anyway, grammar aside, she refused to go in the chair when the crew arrived and had no interest in the trolley bed either, even though she still had chest pain. A few paramedics have been sacked and struck off for walking a chest pain that subsequently collapsed and died, so she was asked again to allow the use of the chair but she was adamant. So, the PRF was signed to verify that she had refused this important element of her care.
She also refused to get her backpack off and to have her belongings carried by a colleague. She was very stubborn and I’m not sure if she had issues with us, herself or her fears. She got into the ambulance at least but the struggle to get her to comply for her own sake continued and I left the crew to it.
Be safe.
Stats: 1 unwell adult; 2 vertigo; 1 ?PE.
The day started with warm sunshine and the return of the commuter run for the first day of the week. I’m working a few days of overtime this week, so will be on for seven days straight on this tour. I’ll be tired at the end of it, so my writing may slope off the page by Friday.
It starts with a request from a motorcycle colleague to transport a 41 year-old lady who began to feel unwell on her way to work. She had been suffering from a chest infection recently and vomited earlier. We found her sitting on a step with the MRU paramedic, looking under the weather (the patient, not the medic). It was a short hop to hospital, so, after a handover to the student, we delivered her to A&E.
We were then asked to investigate a 39 year-old female who’d started vomiting and felt dizzy at a children’s hospital. He child was waiting for an x-ray and her grandfather was taking care of her as mum languished on the bed of one of the medical rooms awaiting our arrival. No ambulance had been dispatched and the staff in the ward had been warned they may have to wait an hour for one but the problem was easy to solve. I gave her Metoclopramide to stop her from vomiting and then we got her to the car and took her to A&E. She had a history of Vertigo, so there was no clinical reason for her to wait for an ambulance.
This was closely followed by another Vertigo-related vomiting call; this time for a 36 year-old male at work. He hadn’t yet thrown up and he wasn’t given anything because his main complaint was dizziness. That soon turned to throwing up when he got into the car but he wasn’t nearly as bad as the previous patient.
A 20 year-old female called us from a train station after experiencing chest pain that she’d felt before – a few times in fact, when she’d suffered multiple Pulmonary Embolisms (PE) – okay, it’s emboli in the plural but I’m talking in the collective here. Anyway, grammar aside, she refused to go in the chair when the crew arrived and had no interest in the trolley bed either, even though she still had chest pain. A few paramedics have been sacked and struck off for walking a chest pain that subsequently collapsed and died, so she was asked again to allow the use of the chair but she was adamant. So, the PRF was signed to verify that she had refused this important element of her care.
She also refused to get her backpack off and to have her belongings carried by a colleague. She was very stubborn and I’m not sure if she had issues with us, herself or her fears. She got into the ambulance at least but the struggle to get her to comply for her own sake continued and I left the crew to it.
Be safe.
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