Day shift: Six calls; all by ambulance.
Stats: 1 Back pain; 1 Transfer; 1 Generally unwell; 1 ? Drug O/D; 1 Suicidal; 1 EP fit.
Two ambulance shifts coming up, starting with this one on my birthday and a routine day starting with a 25 year-old female with back pain who was 20 weeks pregnant. Her pain was severe enough to put her on her hands and knees at work and that’s how we found her, like a wounded animal on all fours on a sofa. She had retained her sense of humour, which is always useful if I’m going to be treating you, and she accepted pain relief as we moved her to the ambulance. She remained in her unbalanced position on the trolley bed and I had to drive like an old lady (no offence if you are an old lady who drives like a demon) to the hospital in case she fell over on to the floor.
Then a transfer from one hospital to another for a 76 year-old woman with Mitral Valve Stenosis and a need to be scanned and tested before any work could be done on her by the surgeons (if that was required). She remained quiet and calm as we moved her, accompanied by her daughter, two miles across town to the specialist unit that awaited her. There she was popped into a bed and we left her to the attention of other professional people.
A 77 year-old with a high temperature and a recent diagnosis of Swine Flu by her GP, lay in bed with an antibiotic (given to her by the GP despite the diagnosis) resistant cough as his worried family gathered around, thinking the worse. His age was certainly not in his favour and that cough sounded bad but it was more than likely due to a viral infection, thus the ineffectiveness of the antibiotics. Taking him to hospital by ambulance may not have been necessary but I guess if it had been my father/grandfather, I’d want him properly checked out and not given a dismissive and totally contradictory diagnosis over the phone.
The next call was given as a 25 year-old man ‘fitting’ in the street but he wasn’t. He had taken something. He was sitting on the pavement, where passers-by had apparently placed him after ‘some kind of seizure’, according to a local publican, who had come out to help deal with him when he collapsed. He was a tall, thin black man and his behaviour didn’t check the boxes for epilepsy. He looked and behaved as if he was under the influence of drugs. This made him an unknown entity to have on board, so we were cautious with him and, although he showed no sign that he may become violent, he remained silent and edgy all the way to hospital. Every now and then he would tense up and lash out with his fists and feet. He wasn’t aiming at anyone in particular but if I happened to be near enough to be caught by one of his out of control limbs, I would probably have felt the result. Security was placed on his cubicle when he arrived at hospital because they they too recognised his potential.
A no trace on the next call in the south and the police were on scene, waiting for our arrival. We searched three floors of a hostel for a man who said that he was about to kill himself. The hostel manager explained, in apologetic tones, that the man regularly called 999 claiming that he was suicidal and that, of course, he was a complete waste of time. The trouble is, one day he will probably go through with his intended act and we will look around for him, not find him and go away believing that he had, once again, given us a fire drill. I left the scene not knowing if I really cared or not.Our last call of the day was to a train station in which a Glaswegian lady was having a fit. She seemed totally recovered when we got there and, even though I asked her several times about her lifestyle and the possible involvement of lots of alcohol, she was adamant that she didn’t drink (much). Her face, physical appearance and attitude said otherwise and her fit may have been the result of withdrawal and not epilepsy. Nevertheless, experience, judgment and a sense of clinical targeting counts for nothing in the public domain and I wouldn’t want to be seen as arrogantly judgmental.
While she was lying on the floor of the pub (yep, the bar inside the station), one of the ladies working there pointed to a lump on her wrist and said that she may have broken it after falling to the floor. I had a look at it and realised it was nothing more than a ganglion; a neglected anomaly attached to the extremity of a woman in denial of her own self-abuse, so she was taken to hospital and that’s where she decided to be more forthcoming about her drinking habits (heavy and frequent).