Thursday, 1 January 2009

An end to the year

Day shift: Five calls; all by ambulance.

Stats: 1 AF; 1 Haematemesis; 1 ?TIA; 1 Flu.

Atrial Fibrillation (AF) is an arrhythmia that is perfectly survivable, especially with early treatment. I went to the aid of a 52 year-old female who’d recently been diagnosed and told that should her heart beat too fast for too long she was to call an ambulance.

She and her husband were visiting London from the north and were staying until the New Year celebrations finished, so obviously both were concerned about her new bout of tachycardia. We chatted about the condition for a while (there are so many people out there who don’t realise the heart has its own natural pacemaker) and I think it reassured her to know that I wasn’t overly concerned about her.

The crew arrived and she was taken away to hospital after a fairly normal ECG had been done (it was irregular but otherwise everything was in place). I’m sure she and her husband will enjoy New Year by the river.

A gang of Italians in an Italian restaurant met me at the top of the stairs leading into the kitchen and dining areas. A 67 year-old non-English speaking man was on the floor after vomiting blood. A translator was at hand and his wife stood anxiously in the doorway. The man on the floor was very pale but otherwise alert and in no pain. Coincidentally the vomited blood was kept in a little plastic cooking tub for me to inspect, courtesy of another Italian gentleman; an off-duty surgeon from Verona I think. They do that in Italy – medical people proudly announce the school from which they sprang – us Brits don’t like to lay claim to anything that might make us look big-headed.

The contents of the plastic container included something red indeed but it was mainly tomato sauce with various lumps mixed in. There was some blood there but not a lot. I disposed of the vile stuff down the toilet – there was no need for it to be left in a working kitchen.

The crew arrived and the man and his wife were taken to the ambulance shortly after my obs were completed. There was nothing amiss but his near-faint and blood-tinged vomit had to be investigated.

During a bridge tournament at a hotel one of the players became weak and faint. He hadn’t been playing well, despite being an accomplished ‘bridger’ and his game was off because of more than simple fatigue I suspect. He told me he’d been feeling unwell all day and that his mood had been ‘snappy and aggressive’ at times. He’d had a headache and very little concentration until the moment he felt like he was going to pass out – that’s when an ambulance was called for him.

The 62 year-old was sitting at a table among hundreds of people who were busily playing their games when I arrived. His friends tried to help and fussed around him but he clearly wasn’t in the mood. He’d recently been diagnosed and treated for prostate cancer but this new porblem had little to do with that he thought. His blood pressure was high and the events of the day strongly suggested he’d suffered a neurological insult; possibly a TIA.

The crew was on scene for a 43 year-old woman with ‘flu and a cough. I wasn’t required and I wondered why people still called us for these things after all that’s been said and publicised.

For some reason I was sent after the ambulance had left the station to a 68 year-old woman with pneumonia at a medical centre. Obviously by the time I arrived I wasn’t needed, so I did my paperwork and sloped off. After that the shift wound down with nothing new to report.

Be safe.

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