Friday, 7 May 2010

Elephants in London

Lots of these beautiful elephants are dotted around London. Apparently they will be auctioned off for charity. I might buy one for Harry :-)

Night shift: Eight calls; one by car; seven by ambulance.

Stats: 3 eTOH; 1 faint; 1 eTOH with head injury; 1 chest pain; 2 eTOH with cuts; 1 unwell patient.

If you like to calculate my job number and verify it with the stats then this will confuse you because the first call of the night was for two drunken men who were found lying in the street. One of them was hugging the other so tightly that he couldn’t breathe properly and one of the cops who found them worried that he may have breathing difficulties – he was gasping for air when relieved of the dead drunken weight of his equally inebriated friend. In fact, one was the uncle to the other, or so he slurred and it took less than a minute for them to work out I was from Glasgow, so Uncle Drunk called me a Scottish c*** and Nephew Drunk told him to stop it – a balanced family I felt.

A crew arrived and took them both on board, the cops man-handling them as if they were naughty children, which, in essence, is what they were. They hadn’t done any harm apart from being nasty and sort of racist (like I really cared) and so a trip to the great NHS drunk tank was required.

Later on a 32 year-old man collapsed, presumably fainted, in a restaurant. He was recovering in a chair when I found him and he’d been placed there by the Manager. Unfortunately, he was seated with two men who knew nothing about him and they were rather nervous looking. It can’t be comfortable to have booked a table, sat down, prepared yourself for a lovely meal with your friend only to have an unwell man fall down in front of you and then recover in a chair at your table while you try to think about useful or engaging conversation as a means of distraction.
I apologised to them for having to carry out my obs there but he looked ill; diaphoretic, weak and pale and his blood pressure was low, so I wasn’t going to ask him to stand up and move to the table where his actual friends were. Luckily, the restaurant Manager found another table for the two guests. In fact, she moved the guests from the table next to me too – I was probably bad PR.

An ECG in the ambulance revealed a few anomalies that I thought he should get checked out (long P-R and wide QRS) and his friends travelled with him after settling their bill. This man had fainted before with no explanation and yet his GP – from what he’d told me – had done very little in the way of checks. No ECG was carried out and his blood pressure wasn’t taken. So, he probably hadn't gone to his GP.

I caught up with my son, who is working nights this weekend too and we ran on the same call to a 70 year-old man who’d fallen in the road and had a head injury. Police were on scene, as well as a host of helpers/witnesses and the man was standing against a wall with his bleeding head and a cigarette in one hand. He was very, very drunk.

On the ambulance he threw up and at first it looked like blood had been vomited – the witnesses had reported him ‘coughing up blood’ on the pavement when they brought him out of the road – but it was only red wine. He’d been drinking the stuff all day and had intended to make his way home by train to the West Country, where his wife waited for him. He was in no fit state for that trip and his ECG was abnormal too, so he went to hospital.

On a train, a 36 year-old woman developed chest pain. She was a known asthmatic but she gave the train guard a fright and I was called to meet the train when it arrived to check her out. The crew arrived with me and we found her panicking inside the carriage. Plenty of rail staff surrounded her and she certainly gave the impression that she was having a cardiac event, except that she had various histories, including depression and anxiety that made the possibility of a heart problem less likely and panic more likely. Her ECG was normal and, although she insisted on puffing on her inhaler needlessly, she wasn’t having any problems with her breathing. In fact, the over-use of Ventolin was probably exacerbating her condition. Oh, and she’d downed a bottle of wine earlier, so she was quite drunk and that didn't help.

If you drink too much, you are likely to fall down and if you do that in the wrong place, you may end up with a scar or two for the rest of your life. That way, I guess, you can mark up your jolly nights out in style – permanently. The next patient, a 29 year-old woman, tumbled drunkenly onto the pavement and got herself a bump to the head, a deep cut to her hand and an even deeper laceration to her left breast – just how she managed that is a mystery and I didn’t want to pry, so I got her into the ‘Booze Bus’ which was on scene a minute after I arrived and then I had to argue with her boyfriend and brother because they were insisting on jumping into the ambulance with her without invitation. The cuts to the patient were the result of alcohol but the minor altercation that ensued with her posse was just bad manners.

Another drunken lacerated person cut his hand somehow while drinking with friends in a club. The 30 year-old was shouting abuse at someone when I was led to him in the kitchen, where an on-duty nurse had decided one of his cuts was deep enough to warrant a trip to A&E for closing. We need a 24-hour Minor Injuries Unit in the West End. I’ll open it myself if I get the time and money to do so.

I took him in the car once he’d settled down and I’d dressed the wound, which was quite deep but not life-threatening by any stretch of the imagination. His anger had been directed at someone in the kitchen who’d given him a hard time over the insignificance (in their opinion) of the wound.

I was approached by a young woman and asked if I could ‘go check’ on her drunken collapsed friend while on standby in Leicester Square. What’s worse, I think, is that I was also approached by a Spanish man who said ‘four friends, me and we go to Kilburn Park. How much?’ I don’t mind being mistaken for a taxi but I object to the insistence that I am even when I have pointed out, repeatedly, that, yellow car or not, I won’t be taking them anywhere.

Anyway, the drunken girl was slumped in a doorway and her sister and a whole load of other mates were hanging over and around her. I could hear the young men lecturing her about what an ‘idiot’ she was drinking like that and ending up so drunk she couldn’t be woken up. ‘She needs to learn how to drink’, said one of them. Ironically, that’s not what she needs; she needs to learn how not to drink.

I called in the Booze Bus and she was taken away for her own good while her brother took photographs of her for posterity and a young man impressed his girlfriend by sitting on the bonnet of my car until I told him in no uncertain terms to get off. Taxis get more respect.

The last job was a late one and I went to check on an 81 year-old man who had a UTI but was still unwell despite completing his antibiotic course. He was in bed and his worried wife explained that he had a medical history that included heart attack and stroke. The poor man looked pale and weak, so when the crew came in I left him to be taken to hospital in the hope that his infection could be sorted out properly.

Be safe.


Anonymous said...

I really feel for the asthmatic women - I too have a history of anxiety and I have worked very hard over the years to figure out the difference between a panic attack and a genuine medical problem.

Nine times out of ten I can tell the difference, but there are occasions where it just gets you and feels completely different from all the other times. I'm ashamed to admit that I did once have an ambulance called out as it looked to me and the people I was with that I was having heart trouble. I wanted to sink through the floor when they told me (very nicely, I should add) that it was just anxiety. It's such a sneaky and elusive enemy - I don't know if I'll ever beat it. But I do feel terrible that I wasted ambulance time. I'm sure the woman in the train felt just the same.

Anonymous said...

Anxiety attacks are such a common call for us. In 23 yrs as a Paramedic I must've seen at least 150 cases most of which were genuine many were not and were alcohol related. At first, I was quite dismissive of them until, many years ago, I suffered from a one-off episode, it came completely out of the blue, no previous history and no apparent cause although there was stress in my life at the time. It was frightening because I had no control (I felt) Since then I have been more sympathetic to those who suffer genuine panic attacks, many of whom are Asthmatics, because, once that feeling that you cant breathe grips you, it soon becomes self-fulfilling and you descend into and ever increasing fear of doom. Dont feel embarrassed that this happens to you and you , or someone else, calls an ambulance. To the uninitiated it looks far worse than it actually is. Most ambulance staff would treat it sympathetically and with re-assurance that you are perfectly safe.