Wednesday, 8 July 2009

Medic alert

Day shift: Three calls; two by car and one by ambulance.

Stats: 1 Near faint; 1 Dizzy person; 1 Heart attack.

A 39 year-old doctor who travelled a long way on the tube suddenly felt faint but didn’t quite go the distance and pass out. Initially he wanted to go home after all his obs showed how healthy he was but for some reason he changed his mind and began to worry about possible cardiac problems he may have developed (in the hour or so on the train I guess), so I took him to hospital and he lay on the back seat of the car, chatting nervously to his wife about his possible dramatic conditions. Differential diagnoses by proxy.

All the obs were normal again for my next patient, a 58 year-old man who felt dizzy at work. He had a bit of nausea too, so this prompted him to take the rest of the day off and keep me company as he travelled in the back to hospital. His history of hypertension must have given him cause for concern, despite his normal reading and the fact that he was looking very well as he entered A&E. The Swine-flu ridden 'panademic emergency area' (or, as we simply call it - the waiting room) was stuffed full but this didn't put my patient off at all.

The only real emergency call I took today was my last. An 88 year-old man lay in the street having a heart attack. He had a previous history of two MI’s and so he was being taken very seriously. A couple of very kind MOPs, a police officer and an off-duty nurse were on hand to help as I worked to keep him stable but his condition was deteriorating fast and there were no ambulances available (probably because they were tied up dealing with dizzy people and faints).

The busy crossing in which he lay provided endless entertainment and local drama for those wanting to move from one side of the street to the other and so I asked the MOPS, two young men who wouldn't leave him and wanted to help as much as possible, to give him a blanket screen for privacy. He grew paler and less alert and I had time, given that I was on scene with him for almost 40 minutes, to do a 12-lead ECG in the street. The result was pretty bad and there was no doubt that if he didn’t get to hospital soon, he’d become a work-in-progress for CPR.

Just as time was running out on us all, the crew arrived and he was taken to hospital for specialist treatment. One day soon, all my moans and groans about silly calls and time-wasting do-gooders who think we are simply a taxi service will be highlighted with the demise of a patient on the street like this. A lack of resources, caused primarily by the type of call that dominates our system will be to blame. In the meantime, I have to rely on luck and as much of my own judgment and skill as possible. Thank goodness for nick and time.

Be safe.


Anonymous said...

When will the management and the Government wake up to the fact that what saves pepoles lives is definitive treatment in a fully equipped hospital and do away with meeting needless targets. I have had to sit alone outside patients addresses on 2 occasions tonight waiting for (a) the police and (b) a crew because we "had" to acheive a cat A response. Whats the point of getting there in -8 mins if I then cant attend to the patient. My other gripe is like you Stuart... why do we keep on getting sent to jobs that we should never be contemplating... why this so called perfect AMPDS system is so flawed. I wish we had experienced despatch staff who can identify a waste of time call before it gets as far as being sent to a "resource"

Anonymous said...

Lucky escape on that one!!

Do your control not divert an ambulance from a different job if a RR paramedic on scene is screaming for back up?

There's nothing worse than being with a time critical patient, trying your best to stop a downward spiral whilst constantly thinking "where's my bloody crew?"

intellileg said...

I was reading this morning that 'swine flu' calls have gone up by 40% in the last week. Ridiculous. I wish the nanny state would tell its 'children' to grow up.

las_emd said...

hi anonymous. Please don't think it doesn't frustrate the calltakers who have to use ampds that almost every call which should be a green turns to red or amber. Most of us can recognize waste of time calls but also recognize our feet wouldn't touch the ground if we were to say that to the caller, we would be out of a job quicker than you could blink. Hopefully the next cad system will allow us emds to use a bit more of our own common sense.

Sewmouse said...

Just a question - but did you mutter loudly enough for the kind MOP's to hear, your frustration at being unable to get an ambulance because someone was probably using it for a broken toenail?

Nothing like being "one of the crew" feeling for the helpful ones to train them a bit in appropriate calls? <- that sentance makes no sense at all but I think you're smart so you'll know what I mean maybe.