Friday, 10 July 2009

Fire and smoke

Night shift: Nine calls; one false alarm, one by car and the rest by ambulance.

Stats: 1 Dizzy person; 1 Allergic reaction; 1 RTC; 1 Chest pain; 1 Unknown problem; 1 ? Fit; 3 eTOH.

Here we go with night shifts again. You know I love them. A major fire in Soho meant that my car was stinking of smoke after it had been ‘on scene’ all day – no matter what I did to freshen it up, I couldn’t shift that lingering aroma. Ash stuck to the outside of the vehicle and contaminated a lot of the equipment inside too, so I was busy cleaning up for the first hour.

The dizzy person was a 30 year-old man who’d been smoking a Hookah outside a restaurant after taking a load of Ephedrine, a drug that can mimic the effects of epinephrine. He didn’t feel well (surprisingly) and as I handed over to the crew he was made to stand up by his friend – possibly in preparation for the walk to the ambulance – but promptly fell down on the ground behind us.

Then into a posh apartment block lobby in the expectation that the 20 year-old female who’d called an ambulance for an allergic reaction had informed the concierge that I was coming. Nope.

I stood there like a lemon because she hadn’t given her apartment number and nobody knew what was going on. It was another case of a rich person using us like servants – dialling 999, waiting til we arrive and then appearing when she felt like it without a word or a warning. She drifted down the stairs with her friend, her face covered to hide the hives and swept by me as I sat in the lobby waiting for an update on where the hell she was. The crew had arrived outside and were waiting too. She must have seen the ambulance and delivered herself to them without bothering about me. I didn’t even know she was the patient until the concierge pointed out the possibility as she exited the building.

I chased after her but she had already made her way into the ambulance and the crew began her treatment for a puffy face and red skin. I think I’ve become invisible.

A RTC later on and a 25 year-old lawyer, who’d been up late drinking in her office, was lying on the road after having been hit by a black cab on a pedestrian crossing. She’d been lifted into the air and slammed back to earth without losing consciousness. In fact, all she’d lost temporarily was a shoe. She had facial injuries and an obvious broken wrist. MOPs were milling around her when I arrived and it took a few seconds to establish that they had nothing to do with her, so I asked them to move away because they were obstructing my efforts to get the facts about the accident. The crew weren’t too long in arriving and all I had to do was keep her neck stable until we collared and boarded her.

She spent a few weepy moments in the back of the ambulance telling her friend (on her mobile) that she’d been knocked down. I sympathised; it must be a shock to the system, drunk or sober, to get whacked out of the blue by a fast travelling vehicle.

A windmilling 20 year-old man claiming chest pain outside a cinema confessed to being a substance abuser and alcoholic (he’s only twenty!) but only when he was in the privacy of the back seat of the car. He even asked me to move away so that his friends wouldn’t see him as they came out of the cinema building. He’d been in there watching a flick when the pain had started and it all sounded like withdrawal syndrome to me. He was tachycardic but stable, so I took him in the car.

In Oxford Street, a sleeping drunk caused mild panic when a MOP came across him, so 999 was dialled and I was sent to check it out on the premise that he might be dead, of course. I looked across at him in the shop doorway and suggested that he was (a) drunk and (b) asleep and (c) possibly not interested in my help but the worried MOP continued to harass me into ‘helping’ him somehow. Okay, I am paid to do this and I guess I should never ever be complacent (and I’m not, I just come across that way sometimes), so I obliged and went over to awaken my slumbering friend. I discovered that he was (a) drunk, (b) asleep and, at the high risk of getting a punch in the face, (c) not interested in my help. Job done. Oh, and the cans of lager lying next to him should really have been the biggest of all clues in the first place.

Now, at the risk of sounding awfully pedantic, please be aware that people who look unconscious in doorways in public places on weekend nights tend to be (and are very highly likely to be) drunk and asleep – just like on all buses. Don’t dial 999 yet (because your sick granny really needs us) – go and see if he’s breathing, perhaps ask him if he needs help but keep a reasonable distance because he is very likely to spit, vomit or swing a punch in your general direction. It’s not my job, nor that of my colleagues to experience this stuff just because he looks untidy.

The next patient was in a private taxi outside a night club. She had a history of unexplained loss of consciousness and she’d performed that trick a few times tonight, worrying her friend. Yes, they’d both been drinking but there was something about her behaviour that made me think twice about dismissing her problem. She wasn’t 100% with it and there may be a cardiac link for that, so I calmed her and got an ambulance to take her to hospital.

The 25 year-old woman was clearly agitated up about her condition, which was yet to be diagnosed and when she got to A&E her friend burst into tears after a comment was made at the door (by a uniformed person) about her mate being ‘yet another drunk off the streets’. She saw this as unprofessional and hurtful – the assumption that her friend was drunk and incapable, just because she was young, dressed up and flopped onto a trolley bed on a weekend night, was obviously hurtful to her. I tried to explain that, unfortunately, the norm of these nights gave most of us the same impression about everyone fitting that description – especially if female, but I also recognised her indignation on behalf of her friend and supported her annoyance that the remark had been made at all. It was unnecessary and potentially inflammatory.

I made sure she was okay and promised myself that I would try harder not to judge every case with such indifference, even when I was emotionally drained and physically tired of it all. I didn’t want to make someone cry like that and I don’t want to be connected to the callousness of the person who made the remark. I will, of course, always define my disrespect for all drunken people who waste our time but I will try harder to weigh the facts up before passing personal judgment.

A General Broadcast went out for a 25 year-old female said to have been fitting for 20 minutes, so I took the call and sped off in case the woman died through lack of medical attention, thanks to the drunks and idiots of London. Unfortunately, my valour, bolstered by my new-found determination to do better for the truly ill, was wasted because she wasn’t fitting at all and I don’t think she ever had been. The police were on scene with her friend and none of the stories I heard confirmed a seizure, certainly not one lasting 20 minutes, so that was someone’s imagination at work for sure. In fact, she was drunk and my soul searched for more reasons to carry on being a good paramedic tonight.

Just to be sure that my faith in humanity was fully crushed the next call detailed the Red3 – life-threatening emergency call as ‘acute alcohol intoxication’. It didn’t even try to hide itself and pretend to be a DIB or chest pain. So, I found yet another 25 year-old female lying on the ground in a pool of her own vomit, with concerned friends around her. These people look upon their mates with true horror, as if a new and deadly virus has struck them down. They seem to have no idea that alcohol is the culprit. They honestly seem to have no clue about its ultimate effect. What is wrong with these people?

Prior to getting on scene, I was sent to the wrong location, on the other side of town. The ambulance arrived and we both looked lost – ‘cos we were. When the correct location was given, we travelled across to the West End and arrived to find another FRU on scene and a second ambulance pulling up. There you go – two ambulances and two FRUs for one stupid drunken woman with apparently ignorant friends and zero dignity or common sense (or is that too harsh?). I am counting the cost of all this in my head as we all gather around her as if she is a major incident. I reckon it’s about a grand’s worth of tax payer’s money. I want to send her the bill on our behalf but I don’t have an invoice handy.

As we discuss the stupidity of this duplicated call, she lies there looking drunk and the pool of vomit mocks her. The crews are undecided about who should take her – it’s all about who is finishing first today. As I watch this comical scene, I realise that nobody is doing any obs and it all seems unprofessional. But it isn’t; if she were in trouble, they would be all over her and saving her life, I promise you that. She is drunk and they have seen a million of her kind, so there’s no hurry to scrape her up. In fact, the longer she lies there with no sympathy, the more her friends will learn about how not to end their evenings. Its harsh and no doubt a few of my pedants will find a platform to scream from but there isn’t a single paramedic, technician, nurse or doctor out there who will disagree with the impact of that moment.

Finally, a drunken prisoner lying in a cell pretends to be unconscious. He stops the pretence when I wake him up; it’s that easy. There is a nurse on duty at this police station for some reason but obviously the prisoner knows that there is a difference and that trying to fool one is easier than the other. He had a bump to his head and went to hospital when the crew arrived, simply because of that. Otherwise he was wasting everyone’s time and looking for an excuse to get out of his filthy little home.

Be safe.


Anonymous said...

Interesting, where he got Ephedrine from?

Anonymous said...

i am suprised that so many people acting like they are having fit. comment please

Tom said...

I'm sorry. But my response is much gnashing of teeth, and utter bewilderment.

L said...

You know, I'm sure your last job involved a girl vomiting in a bin... clue why.

Anonymous said...

ephedrine readily available internet mail order, despite being a table 1 precursor I think it might be legal UK. Can import lots of illegal stuff mail order very easily too, but a lot of the more obscure recreational chemicals are more-or-less legal

Xf said...


Yeah, what the hell was that all about? You couldn't even wait til the prisoner came out! :-)

L said...

...sorry. It must have been your driving... or that dodgy pizza you FORCED on me.

Anonymous said...

What in the world is up with 25 year old females, everything seems to happen to them!