Monday, 5 January 2009

New Year - same stuff

Night shift: Eight calls; one assisted-only, one by car; six by ambulance.

Stats: 1 ? drugs; 1 Chest pain (non cardiac); 1 Assault with facial injuries; 1 Cut wrist; 1 ? Pseudo chest pain; 1 ? Chest infection; 2 eTOH.

The economic climate will bite harder this year I think. I was told of a paper boy who was ‘made redundant’ from his round and given a £20 redundancy package, now that’s a telling tale if ever there was one. It seems nobody is safe.

Not long after my wheels started rolling I was on my way to an 18 year-old who had fainted at a bus stop. I got there and saw him verbally abusing the very people who were trying to help him. He saw me and slumped over the seats, for effect I guess. He wouldn’t communicate with me, preferring instead to loll around and roll his eyes. I’m pretty sure he’d taken something, with or without alcohol but I’m equally sure he didn’t need emergency care.

When the ambulance arrived I’d already walked him to the back seat of my car; it was too cold to stand around playing with him as he feigned unconsciousness. He lost the power of his legs however and when we transferred him to the ambulance he had to be carried.

A 28 year-old man with chest and back pain (there’s a lot of it about) was told by his GP that he probably had stress but he called 999 tonight because he had a ‘heavy heart’, so he went off for a second opinion.

Unprovoked attacks by maniacs can occur anywhere and to anyone but it probably doesn’t help if you are German. A 36 year-old was punched in the face three or four times by a man on a bus who just didn’t like him. He and his wife were minding their own business when the man launched at him as he left the bus. There were plenty of witnesses (a bus load in fact) and police were on scene in numbers when I arrived.

The man got away with a few bruises and a cut above his eye but he was badly shaken, as you would be after such a ferocious assault. I took him to hospital in the car; it was a two minute trip and no problem for me. Hopefully the man and his wife will visit the UK again and not consider the episode to be indicative of the behaviour of most of us. Even the English still get a bashing from the more ignorant Scots who just can’t let a three hundred year-old battle go.

Then a stupid 20 year-old Chinese man punched a café window in anger later in the night. He was of course drunk but he was also aggressive and unpleasant to the crew and police on scene. I arrived as the ambulance pulled up and watched as he was led to the vehicle to have a dressing put on his sliced wrist. The shattered remains of the window lay on the pavement and the owner of the premises stood in the doorway with a shocked look on her face.

The man’s injury was very deep and had bled a bit – he was very lucky not to have severed his radial artery when he chose to demonstrate his rage on an innocent window.

Last year I went to a call off the Marylebone Road, at a specific location for a man who’d called from a phone box to say he had chest pain. I remembered the call as I went back to that same place on a Red call for a man with 'chest pain and bleeding PR'. I recognised the name and the details gave a precise description of him. He’d had the time to go through this on the phone, even though he was supposed to be in agony. I always find that a bit suspect.

When I arrived the cynic in me took over and I asked him if he recognised me – he did. He lived in the south and he claimed he’d been to a concert with friends some distance from where he stood now. He had lots of bags with him but he wasn’t unkempt or unclean, so he probably didn’t live on the streets (no offence to those of you who do - the clean and tidy ones anyway). Neither was he drunk but his demeanour and the fact that this call had the exact MO of the one last year made me very suspicious of his motives for calling an ambulance.

The bus had brought him here, to a terminus, so he couldn’t go any further but it was nowhere near or in the direction of his home, so what exactly was he doing there? I stopped asking him questions about why and how because I could see he was becoming irritated by them. I think I needed to unravel this one because I’m sure he has a habit.

A 19 year-old girl was diagnosed with asthma by her GP, without a peak flow test or the use of a stethoscope, according to her family. She woke up with DIB but it didn’t look like an asthma attack to me, she was lying in bed hyperventilating, complaining of pain in her chest and back. She was genuine about her discomfort but something had been missed.

The first crew to arrive told me that their vehicle had died on them, so I waited for another ambulance as I carried out a second and third set of obs. Then the chair in which she sat as it was wheeled out to the not-dead vehicle got stuck in the smallest lift in history – it just wouldn’t fit until it was wedged in place against the back wall. Some calls take on a calamitous nature whether you like it or not.

In the small hours a man called claiming DIB, then hung up. I was sent to the address given to investigate and an update informed me that he’d been called back. This time he burped into the phone and hung up again. It sounded like a real emergency…

The crew arrived behind me at the address and I leaned on the buzzer, expecting a voice but got nothing. We all stepped back into the street to look up at the flats in the hope that a window would open or even be lit but it was all dark and quiet up there.

I called Control to request another ring-back. When the radio voice returned to me I was told to go to a different street entirely because now he was saying he’d been assaulted. Just how had he pulled that one off?

We trundled round to the alley given and found the police leaning over a tall thin man who was virtually crying in the unlit corner. Another patrol car had joined us just as we parked up. The man said he’d been hit, then changed his mind and said his drink had been spiked, then he said he was too cold. The only thing that was sure about him was that he was drunk.

We moved him to the ambulance and the crew settled him in with a vomit bowl and some inco pads, lest they have a nasty vehicle to clean later on. I chatted with the police outside and another man appeared out of the darkness and began to pull at the ambulance door. We asked him what he wanted (pretty much in unison) and he said ‘open the f**king ambulance door right now’.

I stopped him before he could break in and asked him who he was. ‘I’m his cousin and he’s going home with me’, he replied. He wasn’t nice about it.

I got in the back of the ambulance to let the crew know he was there and he tried to pull the door open again, this time with me holding onto it. I had to physically push him away from me. The police officers launched at him and all went quiet behind me.

When I got back out, a tall officer was telling him the rules about aggression and backchat, so now he was stepping back and offering his hands in prayer, apologising for his behaviour. He still wanted to take his drunken relative home but the crew had decided otherwise. Neither were they having him on board to keep the patient company, so he was sent away with instructions on how to become a good citizen. I doubt he'll absorb any of it.

I should point out that none of the apologies made by this man were intended for me or the crew but I didn’t feel hurt or offended, I know there are people out there who think we are just jumped up authoritarians. Maybe they should come out for a shift or two and see why we become what we appear to be.

The fiasco continued when another ambulance showed up for this call. Why this happened, I don’t know but they weren’t needed and neither was I, so we all departed after the dust had settled.

My first drunk on a bus (I think I shall dub them ‘DOBs’) of 2009 and it was a simple matter of hopping on, shaking him awake, (with some risk of assault) and then walking him off. He had been a little aggressive to start but I kept my distance and lowered my voice when he was conscious – that seemed to get me out of trouble. As I left, I saw him attempting to re-board the same bus. Probably for another nap.

Be safe.


Lewis said...

Hello there,
Its been just over a year since i started reading your blog and it is as provided me with an impressional quality read every occassion.

May I also take this time to comment your book. It certainly did not take me long to read, and I think ive lost count on how many times ive read it !

As a wanna-be-Paramedic, your day to day account as provided me with a better understanding on the job ive so longed to do, and for that, is something words cant describe.

Before i go, is they any good, decent paramedic textbooks you can recommend. Ive got another year in college to get through first but i would love to have a glipse on what the course entitles, text book wise.
Ive heard 'Emergency Care in the Streets ' is very good, as is 'Emergency Care: A Textbook for Paramedics', are quite good ?

Thank you for the enjoyable reads you brought to me last year, and i wish you the very best for 2009 !

Anonymous said...

The Nancy Caroline book you mention is the best. You could also try the Principles of Anatomy and Physiology by Tortora, expensive but worth it. Hope this help :)

Niall said...

im +1 with lewis, the same applies to me! Loving the book.....still

Would it be a good idea to send the lad with the bags up to the northmost hospital and furthest away from his home? Only if tere was time though! That'd teach him!

Lesley said...

Do you think that the 'credit crunch' and subsequent reduction in available spending money might in turn lead to less alcohol abuse and fewer drunks for you to treat?

But no.... probably it will lead instead to an increase in petty theft, they will abuse booze, get drunk and nasty, and you'll still be in a job!

Keep up the good work !

TonyF said...

It's a pity you can't just give the time wasters and frequent fliers a jab of something, then have them transported to an anonymous site, something dank and concrete, in the middle of nowhere. And leave them. One of the Martello Towers off the coast seems favourite.

Anonymous said...

"Even the English still get a bashing from the more ignorant Scots who just can’t let a three hundred year-old battle go."
Actually your comment is slightly ignorant in itself. Culloden was not between the English and Scottish - there were Scots and English on both sides. It was a religious not racial war.

Xf said...


Actually, I'm not...the fight was political and psuedo-religious involving Jacobites and Hanoverians. My comment, if you read it again, highlights the ignorance that still exists in some Scots that it was a battle between Scotsmen and Englishmen. The same ignorance that persuades people that all Iraqis are terrorists.