Sunday, 24 May 2009

The OK corral

Night shift: Nine calls; one treated on scene, three conveyed (including one to a hostel), one went home and four by ambulance.

Stats: 1 Head injury; 1 ?CVA; 4 eTOH; 1 Oesophageal obstruction; 1 Stabbing.

It’s relentless; the booze-ridden masses and their bad habits descend on the hub of the city in ever-increasing numbers as the weekend progresses.

So, to start with a 28 year-old man gets assaulted whilst waiting in a queue at Tesco’s. Someone cuts in and he objects – his reward is a bottle over the head. It shatters and the force of the blow drives a sharp end of the shard into his skull, so he’s effectively been stabbed by it.

By the time I get there, the police are on scene, his wound has stopped bleeding and the assailant is long gone. The cops give him an honest estimate of the possibility of catching the thug – practically nil – and the man (both he and his girlfriend, who is with him, are Polish) accepts the statistic and simply replies ‘I knew what I was coming into in Central London’.

I conveyed him to hospital in the car. He was perfectly stable, hadn’t been knocked out and the wound was now dressed and bandaged. I, like my FRU colleagues, have a well developed sense of the chances of getting an ambulance to a job like this in fair time and I judged them to be very low.

At a care home, an 85 year-old man has ‘stopped responding’. I can’t find staff to guide me properly to where I need to be, even though they have called this in as an emergency, and I wait until someone bothers to appear with rushed instructions of where to go before I can make up for wasted seconds. Then I have to mess around at the floor where his room is located until another staff member puts in a word about which room he might be dying in. It’s bloody ridiculous.

He’s lying flat on the bed and he’s not well at all. ‘How long has he been like this?’ I ask the ‘nurse’ or ‘carer’ or whatever she calls herself, whose been standing over him – literally - and doing nothing else. She fumbles with an answer or anything like an explanation to help me out and then she has to leave the room entirely to get his records so that I can find out what exactly might be wrong with him.

He’s breathing a little noisily but his airway is patent and his obs are normal, apart from a deficit of oxygen giving him a low sat reading, but after a few other tests, I discover that his right side doesn’t want to play any longer and I suspect he’s having a stroke. I have nothing else to go on of course because the people who work there seem to know next to nothing about him; the ‘nurse’, ‘carer’, whatever, had to go to the door where his name is printed on a large card, to tell me his surname.

The crew arrives and I explain the situation. He’s on oxygen and it has helped to wake him up a bit but he’s not doing well otherwise and they take him away rapidly.

The next call was a NPC for a bleeding PR; the crew was arriving at the same time.

An emergency dash for a drunken 33 year-old female resulted in a twenty minute check over in the back of the ambulance and a freedom pass to go home in the hired Limo that she and her friends had organised. She would stagger and vomit all the way home and, of course, her friends swear she’s only had a few.

Never judge a book by its cover – especially if the book is a 6ft Russian doorman made of steel who gets his mates to dial 999 for an ambulance because he’s eaten something and it’s now stuck in his craw! Okay, it’s a frightening thing if you’re not used to it but it’s common and not really life threatening. He had an uncomfortable feeling half way down his gullet and that was about it but this had been converted to ‘difficulty in breathing’, as usual and so I rushed to save his life.

I cancelled the ambulance because I had a plan. I asked him to go and throw up. He did and five minutes later he was a new man – all smiley and relaxed... with a clear oesophagus. Little did I know I’d be back at this club for an entirely different and much more serious emergency.

A small crowd of people gathered around a 19 year-old girl who was known to be diabetic. She’d had a few drink and a couple of ecstasy tablets and was behaving strangely, as if she were drunk... so her mates logically concluded that she was hypo, completely ignoring the other, more likely factors contributing to her lolling head, vomiting and confused conversation. Clever, eh?

I did my BM and it was a little high – not a lot, just a bit. I gave my honest opinion and her friends didn’t want to agree.

‘She’s drunk’ I said.

‘No, she only had a few’, they said. I’m thinking about getting a little sign to stick on my jacket, it will read ‘Don’t tell me he/she’s only had a few because I’ve heard it before and it’s boring’.

She and her mate went in the car to hospital. Believe it or not, her insulin was being brandished about and I think one or two of her mates were preparing to use it before I arrived.

A man lay in the street getting very cold in the smallest hours of the morning but I didn't see him and I almost drove past but a police van stopped beside my car and an officer pointed out the human debris. I went over to check him out as the officer asked him questions like ‘what are you doing?’

He was from the local hostel and so we picked him up, walked him to the car and I took him home. It took a couple of minutes to get there around the one-way system but when I went in with him the reception staff asked if he had any medical problems. They obviously assumed I was going to dump him with them if he had medical needs. ‘No’, I said. ‘you’re safe. He’s drunk and he’s now yours again’. They welcomed him like a long-lost son.

This drunken Irishman had even offered to pay me for what he believed was his cab home.

I rushed back to the club where the doorman had worried about his un-swallowed food to deal with the first of many fight casualties of the night. A 25 year-old had been stabbed in the head and was lying, bleeding on the road. Plenty of cops were there when I arrived and an ambulance had just pulled up with a trainee crew and their paramedic supervisor.

The man was conscious and had no other injuries except the deep wound to his forehead and various large bruises around his eye and ear, where he’d taken a beating. This was a potentially life-threatening injury, so he was treated as rapidly as possible and loaded onto the ambulance.

As I prepared to leave the crew to it, a call came over on the police radio reporting another incident further up the road – this time it sounded like someone had been shot, so I ‘greened up’ and asked if I could help. Control sent me to it but the location given matched the area in which another person needed help for a lesser reason.

I had seen the police cars fly past in the direction of the supposed shooting and my MDT report stated ‘caller said we have killed him’. It was a Red1 call for a cardiac arrest, so all of those elements indicated a serious call. I headed to where the given location was and saw one police vehicle, three armed cops and a body lying on the pavement. What I didn’t see, and fully expected to, was a taped-off area, bystanders being ushered away and plenty more officers.

Then one of the cops approached the car with a fairly relaxed swagger. ‘It’s nothing, he’s just drunk’, he said. Instantly I knew I was on the wrong call (I was later to find out that this call hadn’t even been made). I was stuck here though because there was a young man lying unconscious on the pavement. All around him was a pool of red liquid which turned out to be wine.

The crew was on scene very quickly and I handed over but I had to stay with them because the guy’s BP was stupidly low and he needed fluids. Once I’ve started a treatment like that I have to stay with the patient to hospital, so I was going nowhere else.

Another FRU had turned up at this scene, with the same confused location details. He’d been put on an RVP for the shooting and I directed him to where all the police cars had gone, further up the road. Somebody may as well be doing something useful, I thought.

The shooting turned out to be a pistol-whipping that had been dealt and the assailant was still at large with the gun, so a radio broadcast warned every vehicle to stay away from the area, although they neglected to say how long for and I found myself back there a few hours later as I drove for home. Luckily, I drew no gunfire.

Be safe.


Uncle J said...

2-for-the-price-of-one. If sent to incident 'A' and discover incident 'B' on the way - do you get Call Connect Credit for negative response time?

ViatorT said...

I like your thinking Uncle J!
I know theres a gun problem in the country, but as a paramedic how often to you directly encounter gun shot victicms etc?

jdas1990 said...

I called the Ambulance for the 19yr old diabetic. I knew she was drunk but when i found out she was diabetic too i thought it might be a dodgy combination.
Never met you before but I read this page regularly and I thought it was you who arrived!
Thanks for helping her. Shes not a personal friend but girlfriend of a guy on my Uni course.

Xf said...

Uncle J

Hey, wouldn't that be cool. Maybe get to go home early as a reward?

Xf said...


Well, its a small world, isnt' it? I hope I wasn't too rude with you but, as you can see, I was having a night of it.

Always, always, call an ambulance for diabetics who have been drinking then fall down...its safer. However, the falling down is mostly due to alcohol.

Take care.

Adam said...

Isn't it sad, that to even non british citizens, London has a reputation of stabbings and shootings. A classic example of Broken Britain, and shows nothing of what this great country is all about.

Keep up the great work, take care too.

Claire said...

What's a NPC? I've googled and tried to work it out but to no avail. Could you add it to your glossary?

Xf said...


No Patient Contact - means I didn't see or treat the patient, although I went to the call.

I'll add it to the glossary; to be honest I thought I already had.

Anonymous said...

this is the first time i have read this diary. i thought it was amazing!

i am applying for a paramedic course at uni, your diary would probably scare people off, but it makes me even more determined to continue in pursuing a career as a paramedic

thanks for this