Sunday, 29 March 2009

Blunt trauma

Day shift: Nine calls; one treated on scene, three taken by car, the rest by ambulance.

Stats: 1 Punctured foot; 1 Collapse ? drugs; 1 Abdo pain; 1 Faint and sprain; 1 Febrile convulsion; 1 Bleeding PR; 2 Falls; 1 Chest pain.

I was in another TV studio this morning; this time it was the live-feed room where dozens of monitors decorate the walls. I was there to see a 34 year-old man who’d been on the roof of the building (adjusting something) when he stood on a blunt metal spike (see pic - the tape marks how deep it had gone into his foot), which travelled through his trainer and into his foot. The wound was small and had stopped bleeding by the time I arrived, so all I had to do was dress it and advise him about Tetanus. He declined to go to hospital and I agreed that he could wait until later on – it wasn’t life-threatening and his foot had good movement and sensation. That must have been painful though.

A man collapsed in a gay sauna and I was asked to join the crew to investigate. I arrived and found the male-female crew standing in a small crowd of naked men. Not half-naked but naked. Gay men aren’t shy.

I spent most of my time doing what the female crew member was doing – looking at the pretty walls and averting my eyes. Meanwhile the man who’d collapsed was recovering but it looked like he’d taken something, probably GHB. He was taken to hospital after a long, persuasive conversation.

An art gallery next for a 55 year-old woman with severe abdominal pain. She had no medical history and the pain seemed to be located over her Liver, an area that was particularly tender to palpation, so I gave her entonox and walked her carefully to the car with her friend. By the time she was at hospital, a big smile had replaced the grimace of pain. Entonox has some unusual psychological side effects.

Heat was also the theme for this next call, to a 31 year-old woman who’d fainted during a ‘heated yoga’ class. On the way down, she’d twisted her ankle badly and now had a sprain to cope with. I arrived to find her being nursed with ice packs and elevation (a good combination for this kind of injury). She found it impossible to weight-bear and getting her to the lift (we were in a basement) proved slow and painful, so I gave her entonox for a few minutes before we set off again.

On the way out this well-spoken young woman described the feeling of having the gas as ‘custard on her lungs’, which I found highly amusing and original. We chatted all the way to hospital – she had a soft voice and I thoroughly enjoyed listening to her talk.

I left her in the care of the x-ray department and bid her farewell.

A NPC call for a 2 month-old baby who was fitting next. I wasn’t needed at all because there was a MRU and crew on scene but I guess all the bases were being covered.

Two minutes from a hospital, a man sat in the doorway of Burger King complaining of a PR bleed and that he was going to faint. At first, to be honest, I didn’t think I could take him seriously but he seemed to have a genuine history. He’d bled on the toilet last night and now he felt that it was ‘all wet’ down there. He worked out in the gym five days a week and I wondered if he’d ruptured something or if a prolapse had occurred. In the middle of the day and in a public area, I don’t think it would have been prudent to have a look, so I got him into the car and took him up to the end of the road and into A&E.

A lovely 84 year-old granny was showing her grandson around London when she tripped and fell, cutting her hand open. She was at an underground station and I dressed her wound and joked to her about the possibility that she might have done it deliberately to get attention.

She was quite cold but otherwise not too concerned about her injury, so I took her and the boy to hospital.

My next call was also a NPC. A crew and MRU colleague were on scene with a 29 year-old man who’d fallen asleep while standing at the edge of a railway platform. He fell onto the tracks, got up and clambered out. He was very lucky not to have touched the live rail or timed it to coincide with a train coming. I wonder how many ‘suicides’ have died accidentally this way.

My last call was for a 28 year-old man with chest pain. He’d had an MI before as the result of cocaine use, so I was taking him seriously when he told me that his left arm was numb, just as it had been before. The crew was on scene as I carried out my obs and his ECG didn’t show anything alarming, so he was taken to hospital without fuss.

I’m finding that working on the amber car is so much better for my stress levels. I am talking to clinical human beings and not being pushed around like a pawn. I’m working in my own area and seldom have to travel miles away into other sectors and I get to spend time with my patients, something I miss when working on the sector FRU. I now have three nights coming up and will have to contend with working that way again for a while.

Be safe.


Abi said...

Hi Stuart
Thanks for the 15mins of fame!!
Hope you are well!
Turns out, apart from being the laughing stock of A&E ("how did you do that?"..."yoga"... "WHAT?!?!?") it turns out that I have fractured it in 2 places. :(
Take care!

Xf said...

Hey Abi!

Yes, I got an update later on. Unfortunately, sprains can mean fractures too. No wonder you were unwilling to walk for me!

Take care and keep well. Let me know when you are back on two feet :-)