Sunday, 30 November 2008

Bus encounters

Night shift: Four calls; one declined; three by ambulance.

Stats: 1 RTC with minor injuries; 1 Fractured rib(s); 1 Fall with facial injuries; 1 Abdo pain.

Luckily I am in the habit (as I should be) of checking the tyres on the car before I set off into the world and tonight I spotted a huge screw sticking out of one of them. Oddly, the point was protruding, so either the head of the thing had embedded inside the tyre or it was pointy at both ends. Either way, I wasn’t taking the vehicle out until it was changed, so I found another car and the Hi-Q man was left to do his job. It’s the fourth tyre change on the vehicle in as many weeks.

Two people literally walked into a bendy bus as it turned a corner (I prefer to say meandering around corners ‘cos it takes them a week). They were tourists and were looking the wrong way by all accounts. They were knocked off their feet and one of them, the man, sustained a minor head injury amounting to a large bump at the back. The woman got a grazed knee as her reward. Neither wanted to go to hospital because they had other, more pressing things to do, so they were examined, their troubles and details documented and then let go by the crew.

A pub landlord slipped on cellar steps and lifted into the air for a second before crashing back down onto his back on the concrete. When I arrived there were two members of staff waiting for me but they weren’t pleased to see me. ‘You’ll need something a bit bigger than that mate’, the man greeting me said as he pointed critically at my car.

‘Its all you’ve got for the moment, I’m afraid’, I told him.

The initial aggression with which I was met was down to someone allegedly being rude to him on the phone when he made the 999 call. I wasn’t sure if that was the case or not but I was feeling the heat of it, as if I represented everyone wearing this uniform.

Inside the pub, the landlord sat on the floor with an ice pack on his back. He was having problems breathing without pain and when I listened to his back I could clearly hear the creak and click of a fragmented rib…or possibly two. He wasn’t in immediate danger because his intercostals were doing a good job of splinting his injury. He had no neck pain and no other significant problems but he needed pain relief.

The crew arrived after a failed attempt to get a line in for morphine; he wasn’t interested in trying entonox because he couldn’t breathe in with enough force to inhale the gas. His vein had cheekily come up for the cannula but then ran away once it was inserted – he wriggled a lot too, so those are my excuses for poor performance on this occasion.

I was back on my usual car soon after that – the tyre had been changed and I was no longer in danger of skidding off the road as the result of a sudden blow-out (I hoped).

The next call took me to Tottenham Court Road, where an 86 year-old man had fallen in front of a bus as he attempted to flag it down. He’d stepped into the road to signal it to stop and when it approached him, he panicked and tripped over himself in the rush to get back on the pavement. The fall was witnessed by a few people at the shelter and they were helping him when I pulled up.

The well-spoken gentleman had lost three of his teeth (well, a bridge and two supporting teeth either side) and he kept referring to the gap that now existed at the front of his mouth. Someone had picked them up and wrapped them for me and I was presented with them when I started my obs. They were handed to me like a prize.

There was some bleeding going on and his nose looked damaged. He had no memory of falling and kept repeating himself a lot, so concussion was a possibility. His pulse was irregular and when the ECG was done in the ambulance, I found that he had a Mobitz block. We don’t see many on the road, so it was an interesting graph to take away.

I don’t expect he stayed in hospital too long but at least the accident had given us the opportunity to spot a potential cardiac problem in the making.

Very early in the morning and I was heading out towards Kings Cross to help a 16 year-old girl who’d developed acute abdominal pain and vomiting whilst out with her friends. She had no medical problems and she didn’t drink alcohol. Her pain was genuine and she vomited while I was going through my obs as she stood, bent over, with five of her mates close by.

I sat her in the car but it took a long time to get her there – she was unwilling to walk or change her position because the pain was extreme. When the crew pulled up I gave her entonox but she barely had the strength to draw it in. I felt very sorry for her.

She was put straight onto the trolley bed and taken away to hospital. Her friends went home and she was left in a crumpled heap, crying out in agony. She would need something stronger than gas for this.

Be safe.

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