Saturday, 25 October 2008

Unwelcome sight

Day shift: Twelve calls; one assisted-only; four cancellations; one treated on scene; six by ambulance.

Stats: 1 Chest pain; 2 Faint; 1 Assault with back pain; 1 eTOH; 1 Cardiac problem; 1 Inhaled foreign body; 1 Hypoglycaemic.

Well, the first two calls – a chest pain and a faint, aren’t worth noting because I didn’t do anything. Indeed it was a day of cancellations either when or before I got on scene. A frustrating sort of day then...

Until I managed to secure my place in today’s history by attending the 30 year-old lady who was pushed to the ground by a complete stranger. Now she had back ache. The motive for this vicious assault on a busy street in broad daylight is a mystery but the description given by witnesses of the man who perpetrated it seemed to match a regular street person with mental health issues that I knew.

The patient was only five feet tall and her assailant came from behind at speed and simply brushed her aside like she was an irrelevant obstruction. He was much larger and stronger than her, so when she fell, she crashed to the ground violently, hurting her back in the process. The witnesses were appalled and, even though they had places to be and things to do, they stuck around until the police had arrived in order to give statements and accurate descriptions of the man to blame. Whether the offender will be caught and punished is one of those lengths-of-a-piece-of-string questions.

Posh hotels (4 star and up) don’t really enjoy our company – we make the places look bad and the quicker we are out the better. In general, they are very nice to us but underneath the chat and smile you can detect a growing concern that their guests from the upper echelons of society may not take too kindly to staying in a place where people get ill or die. It’s sooo common.

So when I appeared in the room of a 33 year-old man who was ‘unresponsive’ and surrounded by hotel security I instantly felt at home with the edited responses to my questions. The man had been dumped at another hotel, allegedly by police (I find that unlikely) and then carted over to this hotel when his room key was found on him. He was completely out of it.

‘So, if he was brought over here how did he get to his room and onto the bed?’ I enquired.

‘We got him up here in a wheelchair’, replied the tall, beefy, dangerous-looking security man (‘security man A’ I shall call him).

‘Oh, right. So he arrived here in this state and you called an ambulance after you moved him to his room?’ I knew I was treading thin ice with a loaded question but I couldn’t resist. I don’t get many opportunities to be patronising with someone as large as security man A (I shall now call him SMA, for the sake of abbreviation – I quickly tired of the last name I used).

They didn’t want him seen in their foyer, you see. It was early morning when he was dumped on their doorstep like some adult-sized, drunken newborn and the guests would soon be at breakfast. There was no way on Earth they were going to leave him where he was until we arrived – we are just too unpredictable; we might have taken hours to get there.

Anyway, the crew arrive and I explain the problem. He’s rousable but not with it. We’ve ruled out diabetes, other medical problems and drugs…mostly because he’d been out all night with his friends (where they were nobody knew) and I pulled a full miniature of vodka from his pocket. So he was drunk and intact BUT not fit to stay here. He hadn’t been robbed and he hadn’t been assaulted but I requested the police because it was all too suspicious for me. The security men (including SMA) didn’t like that one little bit.

We cart him off to the ambulance and the police search his pockets more thoroughly than I’d dared, just to make sure there was nothing untoward going on. No drugs were found, no evidence of robbery (he had his money and phone with him) and no evidence of assault. So we were very sure that he was just drunk.

We managed to get him off the premises and out of sight just in time and for that SMA was grateful. I’m sure that’s why he thanked me as we left the red carpet behind.

A very unwell looking 35 year-old with a Mesenteric aneurysm, DVT and valve replacement history and a dodgy double-beat on his radial pulse had to go to hospital fairly quickly. A pulse couldn’t be detected on his other wrist and he was feeling ‘strange’. He may have developed an infection or his aneurysm was about to go ‘pop’. We couldn’t tell but we weren’t taking any chances with him. His blood pressures were wildly different from one arm to the other – not a good sign and possibly indicating an obstruction an the artery on one side. The MRU, myself and the crew all agreed to scoot ASAP.

An embarrassed 45 year-old lady asked me not to bother with an ambulance because she’d just given blood and fainted in a cafĂ© as her worried friend looked on. He was the one who called the ambulance. She didn’t want the fuss. Neither did I. I told her I knew where I wasn’t wanted – she smiled and so did I.

But the 39 year-old crack-smoker who inhaled a piece of the metal upon which his delicacy was being cooked certainly needed me. The doctor who called us wasn’t too impressed with my ‘casual’ attitude. He’d asked for a blue light response because he was concerned that the patient’s airway would swell up and he’d die of asphyxia. Admittedly, the patient was a bit croaky and he had trouble swallowing but apart from that I saw no reason to rush into worry mode for him. I even considered taking him to hospital in the car such was the stability of his ‘condition’.

The small piece of metal had lodged in his throat somewhere to the right and just south of his pharynx and my best guess was that it affected his oesophagus more than his trachea. Okay, it had gone in red hot and he’d smelled burning flesh and had been in some pain initially but now that it had cooled, there was no imminent danger in my opinion. It was an accident that could have happened to any of us I reasoned. Well, any of us who use crack and have an unusually powerful suctioning action when smoking it.

He walked out to the street with me to wait for the ambulance because the doctor, who worked in the little surgery in the same building that housed the addicts, was making me feel uncomfortable. I think he took exception to my line of questioning and the presumption thereby that I thought he knew nothing of the matter. I just wanted a hand-over and I wasn’t prepared to get hyped up about it, that’s all.

I’ve said it before…sometimes saving a life is easy. A 27 year-old prop-hand and known diabetic was slumped in a chair at the back end of a theatre after collapsing during heavy lifting, which is his job. His boss and colleagues felt he must be hypo and called 999. I arrived, sussed out his BM at 2.1, gave him an injection of Glucagon, fed him on Lucozade and watched him slowly recover to 5.4 over a twenty minute period. See, easy.

He was left with a couple of donuts and after I’d done the paperwork, I saw him smoking a ciggie and leaning against a wall outside. ‘I’ve no idea why that happened’, he moaned, ‘I’m usually good at keeping my BM up.’

I believed him because most diabetics do their best to keep their condition under control but as they get older, more tired and more inclined to over-work, the delicate balance is ruined and a re-assessment of life is required. This was his second hypo in as many weeks and his boss promised him a lecture when I left.

After that, even the calls were rejecting me. I’d already had a day in which I felt unwanted by the public and professional faces I’d seen – now I was sent four calls and four cancellations in a row. I limped back to station wondering if Scruffs would turn his nose up at me when I got home.

Be safe.


Feathers said...

Very interesting re posh hotels :) not liking your company, they go to such lengths to protect their 'reputation'.

any of us who use crack and unusually powerful suctioning action :) hopefully he will be more careful next time.

Dogs never turn those noses up :) oddly enough thought you would be well liked and respected,in the emergency services, but guess you see too much drink/drug related problems for the case of the posh hotel bad for business.

Nigel said...

Wow.. wild. There's a certain style of writing you possess that's absolutely riveting. I'll be watching, cheers.

Zulu_Warrior said...

I was a London Firefighter and attended a major job at one of 'those' hotels after security had switched off the Fire alarms twice in 20 minutes so as not to disturb the guests.

After investigating and finding the 4th floor smokelogged, my guvnor went crazy at the staff and ordered me to lay a fully charged hose line straight through the front door and over the reception desk !!