Thursday, 20 May 2010

Welcome to London

Day shift: Seven calls; four by ambulance; one by car; one left in care; one left with police.

Stats: 1 unknown problem; 1 SOB; 1 fall; 1 ? rib fracture; 1 poisoning; 1 fall with head and hand injury; 1 sleeping person.

Mystery calls can turn into something or nothing, depending on everything.

Before breakfast, a 40 year-old man was found collapse half-in and half-out of the road and police officers were on scene by the time I got there to check on him. He was conscious but making no sense – he kept repeating the same thing; some ‘boys’ had hurt him. He appeared to have no physical injury and he denied drugs or alcohol. His vital signs were normal but he couldn’t keep his eyes open and drifted in and out of sleep.

We managed to get him into the ambulance when it arrived but he remained vague about what had actually happened to him - very strange, although conjecture lends itself to several possibilities given the area he was in, the time of day he was found and the statement he kept repeating.

The man on the park bench complaining of shortness of breath (SOB) and who asked a member of the public to call an ambulance for him was known to me. I picked him up at the weekend and took him to hospital in the car. He recognised me and I asked him what happened at hospital because they wouldn’t have let him wander out and sleep rough if he still had this problem. He admitted that he didn’t let them complete their tests; he didn’t like being ‘prodded’ and ‘treated like a pin-cushion’.

An ambulance arrived for him this time and I handed him over to the crew. He is a non-compliant patient who, if he has a serious health problem, will never get it treated if he continues to run away from hospital after all the trouble we have gone just to get him in there. I explained this to him and he said he understood. Let’s see if he shows up again in a few days.

After a cancelled call for a man who stood on a rusty nail and then thought better of a full-blown 999 emergency response, deciding instead to do the grown-up thing and go to A&E himself, I was sent to assist a 52 year-old disabled man who stumbled down a Post Office step as he exited. The man had very limited use of his legs (they were stumps basically) and got around on a mobility scooter. When he had to move without it he had to go on all fours and 'walk' that way. He had no injuries and a police officer was with him when I arrived. All he needed was help with a major underpants and trousers malfunction – the clothing kept falling down and he was very frustrated about it – he shouted at them as if by magic they’d sort themselves out. Instead, I found myself dressing the man in the street. I suggested braces and he told us he already owned some but didn’t like them. I think, considering he was butt naked in front of women and children in broad daylight, he may want to reconsider his waistband suspension aversion.

His carer came to collect him and I handed the paperwork over to her.

A very pale 38 year-old man sat on the first aid couch with the office first aider, waiting for the ambulance to arrive. He’d fallen from his mountain bike at the weekend and thought nothing of the bashed rib he received. Then, when he came into work this morning he coughed and this produced acute, severe pain, making him feel faint. He was quite off-colour when I saw him and he coughed a few times and certainly seemed to be experiencing pain in one area of his ribcage each time. I listened to it but only heard air going in as normal. There was no ‘bone against bone’ crepitus either but a fractured rib couldn’t be ruled out, so he went to hospital by ambulance.

The next call was for a Polish alcoholic man who’d been taken off a train at a station because he collapsed after drinking stolen spirit gel. He then collapsed again when they tried to make him walk away. So British Transport Police took him to their little office and we were called.

He had two pump-bottles of gel - a hand sanitizer that contains a concentration of alcohol. Some alcoholics mix it with juice to get rid of the taste of the chemical that is supposed to inhibit the drinking of it – they can’t get the real thing or the real thing just isn’t strong enough, so they poison themselves with this stuff. One of my known patients from a few years ago died as a result of continually drinking this. I told the man he could die but he just shrugged and then made a hand-washing gesture. He had filthy hands, so I was reluctant to believe that he carried so much of the stuff because he had a hygiene habit.

A crew turned up and took him to hospital and I went on ahead for two reasons – firstly, the man had over a dozen aliases, according to the police, so I went to see which one he had registered with when he last went to hospital (I found one immediately) and secondly, to give the nurse a heads-up on his habit because they still have lots of these gel bottles around and he was absolutely positively going to steal as many as he could before being discharged... or walking out, which was more likely.

There once were two girls from Vienna... well, anyway, one of them fell down a few concrete steps while touring London (as you do) and got herself a minor head injury, comprising a small cut to the forehead and a painful, swollen, possibly sprained little finger. Two police officers were with her and her friend when I arrived and, after a few bad jokes and an examination, I conveyed them to hospital.

Both girls had very un-Austrian names and both spoke good English. I happen to like Austria; it’s where I go to ski with the family whenever we can (not Harry yet of course). I’ve been to the country five or six times and visited Vienna once. It’s all very pretty in places, especially in the mountains. In fact, if it wasn’t for The Sound of Music, I wouldn’t have believed it was really like that, although I've yet to hear anyone yodelling out there.

I left the two of them in the waiting area. I hope they continued their mini-tour of London without any more mishaps.

A Red2 – ‘unconscious’ turned out to be a street-dweller who was fast asleep on the pavement outside a McDonald’s. She was curled into a ball and looked a bit dead to be honest, so people got a bit panicky and the Manager of the place called an ambulance. To her credit, she did prod the person a few times but there was no response, so I had a go, using my timed-honed LAS person-wakening skills. It took me three seconds to get an arm swung at my face and an abusive response from the person – who turned out to be a woman.

Once I’d got her to see sense, she got up but headed straight into McDonald’s, followed by the Manager and a PCSO she’d asked to help. She didn’t want the vagrant inside her restaurant. The rough sleeping woman was going to use the toilets but, as in any establishment like this, it is up to the Manager to decide who does and does not use the facilities and they preferred not to have her custom.

The woman was ejected under escort and proceeded to shout abuse at a complete stranger who happened to be standing outside. She’d asked her something and the unknown woman had said no. This was followed by ‘You f***ing miserable old cow’. Nice.

Be safe.

1 comment:

Uncle John said...

Re; 'gel and juice'

Standards are falling everywhere; whatever happened to good old fashioned 'meths-n-cider'(or scrumpy and after-shave)?