Wednesday, 19 May 2010

People keep falling down

Day shift: Six calls; four by ambulance; one by car; one left on scene.

Stats: 1 cardiac problem; 1 fall; 1 head injury; 1 hypoglycaemic; 1 infected arm; 1 tired person.

A strange start with a call that went Red1 for reasons I will never understand – for a 35 year-old cyclist who basically ‘tumbled’ off his bike, according to witnesses. The MOPs said he lost consciousness briefly but nothing hit him and he wasn’t going very fast when he fell from his bike. He lay on the pavement, confused and a bit restless, so I checked his BM and found it was normal. He denied having any medical problems, or having taken drugs or alcohol recently, so he was a bit of a mystery. His behaviour was erratic and childish but he was perfectly able to obey commands and got onto the trolley bed without much help when the crew arrived.

Meanwhile, an annoying whistle seller was standing nearby making repetitive bird sounds with one of his whistles. After a few seconds it was driving us all nuts – God know how he sells those things without getting one wrapped around his neck.

The patient was ‘blued’ in by the crew and I knew that the crew had found something that warranted it; his behaviour was abnormal and that usually indicates a brain insult of some kind. Later on, the crew told me that his ECG was anomalous – he had long QT syndrome in fact. This explains his loss of consciousness, which probably happened as he cycled along the road.

Next up, a 31 year-old man who works as a security officer in a large bank sustained a minor head injury when a heavy vault door lock hit his head as it shut. He had bent down to pick something up from the floor as the door was closing. He was lucky not to have been crushed by it.

I took him in the car because, head injuries with symptoms, such as the nausea and general weakness he still felt almost an hour after the accident, should be checked out.

Falls and bumps to the head, with no symptoms and a potentially emotionally fragile child should be left alone, however. So, the 1 year-old who fell down three wooden steps at his early years centre and had no mark, bruise, bump or other damage to his head, was left in his mum’s arms after she rushed to get there on a phone call. The worried young lady who was in charge of the child seemed weighted by guilt but kids fall – it happens... and they often bump their heads – very few of them require hospital treatment. They were told to keep an eye on him after I’d done a thorough check of his neurological state. Then I gave them the obligatory piece of paper and went on to the next call.

A crew arrived a few minutes after me, as I was giving a 70 year-old man who’d walked into a doctor’s surgery an injection of Glucagon to raise his blood glucose level, which had just been tested and was only 2.8. The man was a known diabetic and sat in a chair, looking very pale and sweaty. He didn’t respond much and wasn’t completely alert. The doc had given him milk (The American Diabetes Association (ADA) states that milk is better than juice or glucose because it has lactose, fat and protein that will help keep your blood sugar steady over time) but he wasn’t drinking it well, so a shot of Glucagon, taking no more than 30 seconds to give, would help... and it did. By the time the crew had checked him again, his BM was 3.1 and hopefully climbing. He also had a slow pulse and a wide-complex ECG, so something else was amiss and he was taken to hospital.

A large blue bag was left against the wall of Debenhams in Oxford Street and I thought I’d check it out. They tell us to be vigilant but it means we risk looking like idiots, so I asked for a cop to help me look inside the bag, just in case... I didn’t want the bomb squad sent.

I waited for ten minutes and managed to unzip the bag enough to see that a duvet was inside but I didn’t know what else, so I didn’t venture. Then a single female PCSO came to investigate. I thought they’d send the Met.

When we opened the bag, all that came out was a duvet but a point was proven. First of all, nobody seems to care if a large un-owned bag is left sitting in a prominent place and if you report it, you are likely to get one solitary PCSO.

The duvet probably belonged to a local street-person. Why he or she would leave it around like that is anybody’s guess. It’s like leaving your bedroom somewhere for the day at the risk of losing it (or having it blown up).

Off to a park for a 49 year-old man who was intelligent enough to know better than give me verbal abuse when I asked straight-forward questions. I’m a bit fed up of it to be honest. People actually think we are paid to take aggressive language and behaviour. I told him to stop swearing at me and to calm down – he seemed to get the point and did so.

He had a badly infected wound that had been stitched in hospital a few days earlier. The injury was the result of him sticking his arm into a unopened window. It was an angry, red, hot thing now and he needed antibiotics for it but I wasn’t going to take him in the car – he’d already proved how capable of turning on me he was.

While he was being checked out in the ambulance, a man with a dog on a leash toured the perimeter of the parked vehicle to have a nosey. It was ridiculous to watch because he was spinning around the ambulance, stretching his neck to see if there was anything interesting going on inside, while driving his mobility scooter.

Exhaustion can shut you down completely. Your body will go to sleep, whether you like it or not, no matter where you are or what you’re doing. If it wasn’t for this reflex, you’d die of tiredness. If you don’t die, you may run yourself so far into the ground that ill health, sometimes chronic ill health, creeps in.

It took me and the crew no more than a few minutes to figure out that the large 19 year-old man on the floor of his place of employment was just over-tired. He had a headache and claimed to be dizzy too but he couldn’t keep his eye open and he soooo needed to sleep. He’d been found ‘collapsed’ on the shop floor at work. It wasn’t until I asked his Manager to leave the office so that I could have a quiet word that he confessed to having College work to get through, as well as this job. He had exams coming up and that stress can certainly cause sleep-deprivation. But he needed sleep, no matter how much he tried to work through it, so off he went to hospital.

Be safe.


Anonymous said...

What if the diabetic was lactose intolerant (possibly not even knowing they were?) That'd obviously make the milk inappropriate for increasing their blood sugar as it'd just pass through with the bacteria converting it and using the sugars themselves.

JB102 said...

If your call was given as a fall, and the caller gave the patient as being unconscious the call goes red 1.
It works on the basis that anyone that can knock themselves unconscious after a fall has a good chance of doing some serious damage, as ever its only as reliable as the caller.

Anonymous said...

Hi, I know this comment is totally unrelated to the post, but I have a question that I'm hoping you can answer, so hope you don't mind!

A friend of mine just recently committed suicide, and paramedics were called to the scene. I am going to be studying paramedics come September, and this incident just made me wonder what kind of training you would receive in order to deal with a situation where you turn up and you know the casualty. Has this ever happened to you?

Thanks. Great blog by the way!!

Xf said...


We get no training for this and no, so far I haven't gone to a call where I've known the person well. It's always a good idea to work in an area that is far away from where you live so that you can avoid this possibility.