Monday, 22 February 2010

Assembly line medicine

Probably the last thing you want to see after a hard-drinking
night out.

Day shift: Six calls; five by car; one by ambulance.
Stats: 1 Chest pain; 2 Faints; 1 Back pain; 1 Numbness; 1 head injury.

A grey, rainy day today and the first call was for a chest pain in poshville, W1. The 77 year-old man woke up with tightness in his chest and his wife called an ambulance. The apartment was one of the nicest I’ve seen – very light and open with the usual private lift and concierge deal chucked in for a measly five million, or whatever these places cost nowadays. That place would be my post lottery-win London pad, that’s for sure.

Anyway, the crew was just ahead of me and I wasn’t required because the man was stable and there were enough hands to deal with him.

On the subject of Lottery wins – imagine winning fifty-odd million quid on Euromillions and earning £200,000 a month in interest. Imagine going to your bank manager (the new one of course ‘cos you’re not sticking with HSBC or Lloyds, are you?) and saying ‘right, I’ll leave my fifty-odd million in your bank but I need a ten million pound loan over ten years at a fair interest rate for you and I’ll use the interest I’m earning to pay off the loan in that time’.

Now, I’m no financier but I figured out that, after paying the interest every month, you’d still be looking at around £80,000 a month in earnings plus the benefit of buying all you needed with your ten million PLUS not laying a finger on your original winnings. Obviously, I hadn’t figured in the taxman... still nice fantasy. And of course someone is gonna come along and burst this bubble for me, right?

The day seemed to roll out fainters in excess because, as well as hearing my colleagues running to them I was sent to two in a row. The first was a 23 year-old female bank worker who collapsed on the floor of her open-plan office and began a charade that she had apparently gone through the previous year – same M.O. but no problem ever discovered for her behaviour. She vomited by means of forced retching until phlegm and mucus was deposited into a little plastic food container that someone had obviously contributed (after removing their sandwiches) and rolled around on the floor, giving periodical shaking displays as though fitting, when she clearly wasn’t. When I tried to sit her up, she threw herself back on the floor and when I tried to get her into a chair with wheels so that I could roll her, with the help of one of her male colleagues, out to the car, she deliberately slid off that too.

I asked for an ambulance because I’d had enough of struggling to make her behave but there were none to send and I spent a further fifteen minutes trying to convince her to help me out. All of her work colleagues could see what was happening and it doesn’t make good publicity for a reputation in such a closed environment.

After a long and unnecessary delay, during which she simultaneously went through her ‘seizure’ act and answered her colleague’s questions, I eventually got her to sit on that chair and we wheeled her out of the office, down in the lift and across the lobby floor to the exit, where she finally found the strength to stand up and walk to the car.

During the trip to hospital, she retched close to my ear whilst helping me to fill in the PRF details I needed. Strange but true.

Even stranger was the next fainter – a 50 year-old tourist woman from Italy. She was in a shoe shop when she collapsed and became unconscious for a short time, according to the staff. Obviously, whether she was unconscious or not is debatable and I asked her all the pertinent questions that might shed light on her sudden condition. She was very wide-eyed and confused and I have to say, a bit crazy looking – on drugs crazy... that type of look.

She initially declined my invitation to take her to hospital but changed her mind after I’d asked her for the third time (I always ask at least three times to be sure). She took my hand without it being offered and I walked her to the car. I would have had an ambulance take her to hospital, considering how confused she seemed to be but there was something naggingly familiar about her behaviour and I thought it would probably be best if I took her myself as it would only cost me 5 minutes.

All the way there I watched her in the rear view mirror and turned my head frequently to make sure I knew where she was. She sat behind the passenger seat – I never allow anyone to sit directly behind me when I am working alone. Usually if I have someone like Lottie out on Obs and she can keep an eye out for me I am much more able to relax but I had to keep tabs on her because I didn’t fancy having an ice-pick stuck into my neck. Okay, my imagination’s gone a little OTT.

After a break I was sent on a mission to recover a person who had fallen from a chair and now ‘could not move’. This sort of call deserves a quick investigation before sounding the bells because history has proven that they were notoriously stupid in nature and didn’t require an emergency ambulance in the first place – but what do you do when you have someone on the floor of your office and you have no first aider on duty, as stipulated by law? Tut, tut.

The 35 year-old Asian lady was like a jelly when I tried to examine her back – she did that pull away and wobble thing that you do when you anticipate pain but don’t actually experience it. She’d either fallen or launched herself off the chair (my money’s on launch) during a visit to a place that helps you find work in the UK if you are not from the UK; it’s a Government financed private business and you will have to forgive my sarcasm but it seems that we are paying taxes to fill the job market that is being created by redundancies and reluctance within the actual UK populace.

I got her to stand up and walk to the car, gave her a bit of entonox which helped and trundled her to hospital in the car. The ‘gas and air’ worked and she complained no more. Inside the A&E department it was chaotic – very busy indeed and a nurse had to announce that the waiting time had grown from two and half to three and a half hours. People were getting off buses in rows to go into the department. What was going on today? Outside in the ambulance parking area, there was an assembly-line of patients coming in, most of whom were in no way emergency cases

For example – a 21 year-old Romanian man who walked into a large department store with his suitcases (he’d just arrived in the UK) and told the staff he had numbness down one side. A Cycle responder was on scene after 999 was called. There was nothing wrong with him except for an emotional crisis at home but I was asked to taxi him to the nearest A&E dept, where he would cause a longer queue.

Then to finish the shift, one of my cycle colleagues gave me a last-minute job – a 4 year-old boy who’d tripped over and smacked his head in the street. He had a swollen eye and a little cut but was otherwise okay. We don’t like quiet children post-injury and he was a little too quiet after a head injury, so I put the lights and sirens on for a while and he sparked up and became a normal just-minor-injured little boy again. See? A little distraction works wonders in diffusing the worrying aspects of children’s illnesses and injuries. Try it before rushing to the phone to dial 999. Please.

Be safe.


Anonymous said...

Awww bless the 4 year old boy!

My 3 year old has been learning about ambulances at pre-school. Every little bump causes him to hopefully ask if he needs an ambo.... I hope a ride in an ambulance is a wish he never has come true!

I started reading your book last night... you gave me a sleepless night because i couldn't put it down.

Take care of yourself,

Minty (who still hsn't remembered her password and really should be in bed).

Anonymous said...

Totally get all that you are saying about NHS Tourism except a little bit of me wondered whether the 35 year old lady was in fact in a safe place possibly the victim of abuse about which she could not talk, hoping that the injury she supposedly sustained 'falling off said chair' would cover all options. Just a thought.
Either that or she really really didn't want any further questions! I expect you are right thinking about it.

It seems in London many more people call an ambulance or 999. Living more rurally though the problem is probably different in that the waiting for a response is that which would be the problem. Quicker to go by car or see one's gp. I believe in bigger cities roundabout here there is a problem with hoax 999 calls. Sad but true.

Pseudo-seizures are indicative of a very real problem not one I think that A & E will be able to solve. A cry for help, I hope followed up by a caring gp.

I sometimes wonder whether your blog will pop up into my reader with the announcement that you have moved and are now serving the community in a rural area, fed up with the bright lights. Tales to be told no doubt equally as interesting with that hint of irony still as evident in your posts. Your patience in adversity continues to amaze me.