Sunday, 22 March 2009

One of ours

Day shift: Seven calls; three taken by car; four by ambulance.

Stats: 2 ? Food poisoning; 1 RTC with chest injury; 1 Fall ? injury; 1 Sprain; 1Kidney stone; 1 Faint; 1 Assault.

Although I have noted two cases of possible food poisoning they both occurred on the same call and bizarrely were unrelated – two Hungarian women were complaining of vomiting since the evening before and were now at work in a hotel. Although they both knew each other, they had eaten separate meals containing chicken at separate times and in different locations. Both had similar symptoms which had started at the same time. It was one of those odd coincidences and I conveyed them both to hospital in the the same time.

A member of LAS staff was knocked off his motorcycle on the way in to start his shift and I was asked to attend, along with another FRU. The staff member was, ironically, a Motorcycle Response Unit paramedic and he’d been hit when a car pulled out in front of him on a very busy road at rush hour. He was thrown from his bike and lay unconscious, according to witnesses, for a few minutes. He was at high risk of being run over but MOPs ran into the road and attempted to drag him to safety.

When I arrived he was up and around and an EMT was attending to him. A few minutes into the call an ambulance arrived, along with a Duty Officer (as is required for these incidents). Police were already on scene.

He was very lucky – badly shaken up and complaining of some chest pain which, being a paramedic himself, he quickly diagnosed as muscular. He was still collared and boarded as a precaution, just like everyone else.

An angry driver shouted at me as I walked into the flat of a regular caller who’d complained of chest pain. The crew had pulled up and we were about to attend to the patient when I heard the loud, angry voice swear at me for parking across his bay. I had nowhere else to go and I try not to park selfishly, even on emergency calls like this but this guy didn’t care at all and I asked him if he could wait until I had seen the patient but I got more abuse for that request. He could still be heard outside as we entered the flat. I thought at one point (and so did the crew) that he was going to come in with us or vandalise the car.

The patient was fine – he was just lonely and drunk, so I wasn’t required and I went outside, fully expecting an argument with the irate driver but he’d gone. Parked and gone.

I was in a park again for my next patient, a 31 year-old female roller-blader on her first lesson. She’d fallen and twisted her ankle. A MRU colleague was on scene and he radio’d a request for me to come and take her to hospital. I arrived to find her with a friend, head bowed and sitting on the ground. I took a look at her ankle and told her it was a grade II sprain (well, I told my colleague what I thought and she reacted) – she started to cry. This woman is 31 years of age. She was crying because she knew she wouldn’t be able to run in an up-and-coming race she had been booked to do.

Grade II sprains aren’t that bad but because the ligament is torn it will take while to heal and should be rested or at least exercised gently over a few weeks following the rupture.

I took the unhappy lady to hospital with her friend and tried to reassure her that the world had not ended. She was smiling by the time she got to A&E.

A very strange call to a pregnant woman who was suffering kidney-stone pain turned into a fiasco when, as the crew turned up, she began to writhe and gag as if choking. This came out of the blue because she had been talking to me and calming down. Suddenly her entire family was coming out of the woodwork to demonstrate their extremely over-the-top fear that she might be dying. I stood and watched with my mouth open for a few seconds before it registered that I’d better be seen to do something. So, I told her to calm down and behave.

One member of the family, a young man, remonstrated with us about having to lie on the phone to get an ambulance. Apparently ‘they’ had told him that an ambulance wasn’t available and ‘they’ had refused to get one, so he had called back to say she had severe DIB, which she didn’t. Although I sympathised with her pain and, yes, she did need to go to hospital, I thought it was unlikely the caller had been told this – more than likely he was told that there would be a delay and that someone would be there as soon as possible.

Amid this little crisis, we calmed her down until she began to behave more rationally. She was given entonox for her pain (morphine is too risky in pregnancy) and that seemed to do the trick. The melodrama subsided and the family, including young children, were ushered out of the room, leaving the patient, myself, the crew and one or two members of the family who could cope with it.

I have no doubt a complaint will wing its way to LAS as a result of what the family saw as neglect on the part of Despatch but I think its unfounded, based on what I witnessed. There was a point at which it even became threatening and that’s not right.

South next, for a 60 year-old lady who had become ill after a heavy meal with her family in a pub. She was slumped over the table, dessert half-eaten, looking very pale, sweaty and unwell. Her blood pressure had dropped, resulting in a near-faint but she had no medical history and its possible the meal itself was to blame for her condition – the stomach needs blood directed to it when its full, so there would be a temporary disruption in available circulation to other organs, including the brain. It explains why many heart attacks occur after eating.

The crew checked her out and she decided to go home because she was feeling (and looking) much better after twenty minutes of care.

A 16 year-old girl who had been assaulted by her druggie boyfriend earlier in the day developed a swelling on her neck, where her Carotid artery lies. She also complained of a headache. It looked like a haematoma had grown out of a leak there. He’d punched her on the neck, allegedly, so the force may have ruptured the artery or the muscle around it.

She was stable enough to convey in the car and I took her and her friend, both of whom lived in a hostel, to hospital.

Be safe.

No comments: