Thursday, 4 February 2010

Saying it like it is

Day shift: Five calls; one assisted-only; one by ambulance; three by car.

Stats: 1 Feeling weak; 1 Abdo pain; 1 Period pain; 1 Shoulder injury; 1 eTOH.

A 65 year-old man with advancing Alzheimer’s found himself unable to stand due to weakness and his carer on scene told me of his recent UTI and vascular problems, none of which were likely culprits. He wasn’t eating or drinking fluids well, so I suspect he may have had an electrolyte imbalance and his ECG, despite him having a pacemaker fitted, was throwing off PVC’s with a resulting bradycardia and pulse irregularity. He was taken to hospital for treatment and to have the pacemaker checked.

Following on after a pause, a 21 year-old at college felt the need to roll around the floor and ‘pass in and out of consciousness’ as he experienced abdominal pain that was probably brought on by constipation. He hadn’t opened his bowels for a while (in fact he couldn’t remember the last time but then again, he couldn’t remember his address when I asked him) and he had no medical problems, past or present. He continued to roll about a bit when security had shown me to where he’d been deposited but his ‘passing out’ phase had ended, thank goodness.

Until this call, the one I’m about to relate, I thought I was in for a day of wasted reasons to drive anywhere in a hurry. The call was for a 28 year-old female who had severe period pains / food poisoning, an anomaly that was explained to me later on by the patient. So, I walked into the store where the call had originated (a place I’ve visited many times and who seem hell bent on calling 999 every time they have the most minor of problems) and was taken, after a long delay while they tried to find someone to guide me, to the basement rabbit run and then the first aid room where my patient lay, somewhat embarrassed, on a couch. ‘Don’t worry, I think its only period pain’, she said after describing her dizziness and vomiting and abdo pain. This was normal for her on the first day of her period and she’d asked the management of the store not to call an ambulance but they’d insisted. In fact, when she’d asked for a hot water bottle, which she knew would help (filled with hot water obviously), they refused to get her one – even though she’d offered to pay for it. She'd mentiond food poisoning as a possibility but ruled it out but panic set in with the manager I think.

This was a thoroughly sensible young lady who knew that a trip to A&E for her problem would be an exaggeration of need, so I did a full set of obs, found her to be normal, alive and well then made a pact with her to sign my PRF and take a copy away in case she needed urgent medical help. She wouldn’t be going to hospital and she smiled acknowledgment to sense. Then, as she should in order to therapeutically resolve her current issue, she went back to continue shopping.

During this call, I was sent another and went west to transport a patient of one of our cycle buddies. The man, a 55 year-old Englishman now residing in South Africa with his wife, fell down a few steps in a shop, landing on his arm and damaging his shoulder. He could bend his arm but he could not lift it, indicating a problem with the joint at the shoulder itself.

I had a long and very interesting conversation with them both as they travelled to hospital with me. We talked about South Africa, how dangerous it could be and how beautiful it was. We touched on all kinds of politics, some of which would be angrily protested by anyone with a mind that was closed to free thought. It was refreshing to speak my mind and hear others do so too. Actually, just typing that statement is a damning indictment on the current state of free speech in this country.

Freedom, while we are on the subject, also allows alcoholic East European gentlemen to come to the UK and lie on the pavement (conveniently outside a pub), thrashing around pretending to have an epileptic fit when, (and the proof was there), it was patently obvious that he just wanted an excuse to be conveyed to a hospital. In fact, in between ‘fits’ he was able to make demands and one of them was that he wanted to go to a specific hospital. Believe me, I would be just as harsh about this behaviour if it was a fellow Scot but we are actually importing this nonsense and to concern ourselves about it is to risk being dubbed ‘racist’ by some. It’s not of course; it’s about being blindsided and stupid enough to fall for it in a country where liberal leniency has gone off the deep end and where, no doubt, it wouldn’t be tolerated quite as much in its country of origin.

So, I knew him because he’s done this before, many times. There are people with genuine epilepsy who would not appreciate his efforts at replicating it. His burden on you and me is financial at a time when we are seriously worried about funding cuts for schools, hospitals and universities. Yet he is given money to go and get drunk then when he runs out of booze he pretends to be ill, goes to hospital and, no doubt, attempts to find the means to substitute it for something else drinkable. He does this while chucking verbal abuse at us all.

He attempted to smoke several times in the car as I took him, with an accompanying police officer, to hospital. Then he tried it again as he waited to be seen by a nurse. They all knew him but nothing will be done about him because we have no solution that satisfies everyone – like when I write this stuff; someone, somewhere will always take offence, either because they think I’m saying all East Europeans are like this, which I am not or that I am saying all alcoholics are like this – which I am not. I’m trying out my freedom of speech thing to see if it flies.

And he said something profoundly ironic in the car as he argued with the cop, ‘I drink but I don’t take drugs’.

Be safe.


Chrisca50 said...

please go into politics - I and lots of people I know will vote for you!!!!!

Anonymous said...

Electrolyte imbalance, very interesting as a newbie sap, These are the things they dont tell you about in training school, I have been on the road for a year now and receive many calls to elderly people who the caller states the person is "not their usual self and weak", after ruling out many obvious possibilities I will now consider this imbalance (manly due to dehydration I expect, dont get many 85 year old's running for three hours). I know about high potassium levels peak T's (if you can rule out a hyperacute MI), I've looked out hyper and hypokalaemia, can imbalances of salt and chloride be seen on an ECG? Thanks mate.

Anonymous said...

RE: Electrolyte imbalance, I have just looked into dehydration and lack of water salts turning to hypovolemia, which I thought I was ok with, low BP ect... then I read about acute response to hypovolemia which can an increase in BP’s which makes sense as I remember the term peripheral shut down when loosing fluids. Is this confusing.... or am I an idiot???

Anonymous said...

Regarding fake epilepsy guy: Doesn't this kind of behaviour constitute fraud under UK law?

Xf said...


It may well be fraud but we can dream of justice. Dream and nothing else.