Tuesday, 24 February 2009

Calpol call

Night shift: Ten calls; one treated on scene; the rest by ambulance.

Stats: 1 Asthma; 1 Faint; 1 Drug withdrawal; 3 Chest pain; 2 High temperature; 1 Fall with facial injuries; 1 RTC with neck injury.

I’ve got five of these nights to do this time round and this one kicked off with a call to a GP surgery for a young female suffering exacerbated asthma. To be honest, this wasn’t a life-threatening emergency and she'd been left alone in a treatment room with a nebuliser on her face. The only reason the doctor wanted her to go to hospital was because nothing she’d tried was working.

Out of area again for a 50 year-old man who fainted more than once in a pub. Initially I thought I’d be dealing with a drunkard but, although he’d been drinking, he certainly wasn’t drunk. He’d passed out, got up, walked to the bar, fallen down again and then repeated the whole getting up and falling down thing again until his friend finally gave in and called an ambulance. He had high blood pressure and this wasn’t like him at all, so the crew took him aboard to check him out.

On Euston Road a 37 year-old man who’d taken Heroin earlier was developing withdrawal symptoms and so he needed an ambulance. He’d called from a call-box and I couldn’t locate him, even though he’d seen me go past, apparently. By the time I got on scene, so had the crew. I was a second-responder.

Teenagers with chest pain are unusual and so the call for a 16 year-old at a train station who’d collapsed clutching his chest seemed unlikely. When I arrived he was in the first aid room. He was a tall, thin but muscular lad and this gave me a clue to the possibility of a spontaneous pneumothorax but his breathing wasn’t affected. His ECG had tall ‘R’ waves but you can get that with tall, athletic people, so it meant nothing. Hypertrophy is a possibility too and he wouldn’t be exempt from that, so he was taken to hospital.

I didn’t have to do anything except give a little Calpol (a drug I don’t believe should be given to kids as if it’s a sweet). The 4 month-old baby had a high temperature but his mother thought he was having breathing problems. The heat in the flat was up was too high and even I was breaking out in a light sweat, so I suggested that this might be a factor.

I left her reassured and with the necessary paperwork because she couldn’t go to hospital anyway – she had three other children in the flat and only a 15 year-old to take care of them.

Birthdays are for celebrating…or falling flat on your face on concrete steps at a train station because you are so drunk that you could kill yourself by accident. This is what my next patient, a 20 year-old man, did as he made his way home with his drunken, rowdy mates.

I arrived with the crew and we found him in a heap at the bottom of the first flight. He’d fallen about 3 meters and had a nasty deep cut on his chin where he’d landed. He had also been unconscious, according to his mates and because he was drunk and the mechanism was serious enough, he was collared and scooped for his own good.

‘I’m alright, seriously’, he kept saying.

Later on in the night – the early hours in fact – I was called to a military barracks to attend to one of the police officers in the guard house. He had suddenly collapsed after feeling unwell all night. He was on the floor and looked quite unwell; pale, sweaty…you get the picture. He had been suffering with the ‘flu on and off and I think it had caught up with him. This wasn’t ‘Man-flu’, this was real enough, so I kept a breath’s distance because I can’t afford to catch it.

On my way back from that call I watched a police car fly past on blue lights and I received another call almost immediately after it had gone. I was heading the same way and I arrived at a RTC that had just happened. A man was sitting on the pavement, cradling his head. His car had been side-swiped at speed on a busy junction and the force had spun it around so that it was facing the wrong way and crushed into a barrier.

He complained of neck pain, so I spent the next ten minutes waiting for an ambulance, with my hands around his head to keep him still. Working solo, that’s just about all I can do in these situations until help arrives. He too was collared and scooped.

During these proceedings the cops attempted to breath-test him but he just wouldn’t blow into the thing properly (I don’t know if this was deliberate) and five tries later, they gave up and told him he’d be urine tested later. He may not have had a drink at all but if you wait long enough without a test your blood-alcohol level will eventually creep below the illegal drive limit. A few hours in hospital would do it.

Sometimes we are given location for calls that are completely incorrect and I found myself u-turning when the City police advised me that the hotel I was trying to find didn’t exist where I was sent. We went back down the road and the ambulance past on the other side – the crew was heading the wrong way too. It took a few minutes for us to sort ourselves out and it’s just as well because this was a chest pain call and the woman was sitting in the lobby…fortunately stable.

Another chest pain and an awkward place to have it. The driver of a large lorry slumped forward onto his steering wheel in agony and his colleagues called 999. I had to climb into the cab and gather info and obs across the passenger seat. He was a big man and seemed genuinely in pain. He had no cardiac history but he got the same treatment everyone does with this complaint – GTN and aspirin, until a crew turned up to help me. There was no way I was going to be able to get him down from there on my own, so a trolley bed was positioned underneath his door and he was lowered down but he slipped and almost ripped my arm off because I was holding onto him. He landed on the road quite hard but wasn’t hurt.

His ECG was very normal and that surprised all of us – he had all the classic signs of a heart attack going on. Even at the hospital the doctor remarked on how convinced he’d been that this was an M.I. – it just goes to show you…

I’m a bit annoyed now because I think I left my wrist BP cuff in the cab of that lorry. I’ll probably never see it again and it wasn’t cheap and it wasn’t the ambulance service’s either.

Be safe.


Jon Stall said...

I have heard rumours in my service that the call you went to for a 4 month old with pyrexia would have had to have been taken to hospital.

Apparently the local paediatricians have agreed that any <2year old that generates a 999 call will be admitted. Somehow I don't feel thats even in the slightest bit sustainable or necessary. Would be interested to know what happened to cause this reaction.

Medic Monkey said...

Leaving things behind is a constant fear a clutz like me; As a paramedic student I am dreading the day that I leave my crew's paperwork or cardiac monitor or stretcher at somebody's house.

Fortunately it hasn't happened yet . . .

Stu Jackson said...

I saw one of those bikes in manchester last year. Apparently they're Ghost Bikes...