Friday, 25 June 2010

Staff sickness

Day shift: seven calls; two treated but not conveyed; one left at work; four by car.

Stats: 2 hypoglycaemic; 1 unwell; 1 cut foot; 1 abdo pain; 1 psychiatric; 1 dizzy; person.

Before we had a chance to get north and breakfast, a 34 year-old diabetic was found semi-conscious in bed by his girlfriend and she called an ambulance because she didn’t know what to do with him. He’d never shown her how to measure his blood glucose and had never told her what to do to treat him if he became low.

We gave him Glucagon and he was back to his normal self within fifteen minutes. A few tablespoons of honey helped to keep his sugar level up and we left him at home with his partner (and some advice on what to do next time). 'I'm too good for him', she told us, as if we needed to know.

Immediately after this, when back on station, we were asked to check on a Control colleague who was feeling unwell. She just needed her BP taken and it was fine, so she was left at work. It's one of the ironies of working for a large ambulance service like this that those who work for us still have to 'call and ambulance'. They don't even get a discount.

A 25 year-old woman who cut her foot on the escalator at an underground station could (and should) have hopped herself across the road to A&E if she felt the need. Instead, we were called out and I drove her around the corner. Please be sure to let me know that an ambulance should have taken her instead.

An hour or so past before we encountered our next patient, a 28 year-old restaurant worker who had her boss call an ambulance for ‘chest pain’. She had abdominal pain and a momentary fainty feeling, so an ambulance was not required and we took her to hospital where, for reasons I cannot fathom, the A&E department was full of people – it seems everyone is calling 999 today just so they can end up sitting in a corridor waiting... just as they would if they’d just walked themselves in.

Hot weather increases instances of hypoglycaemia in diabetics, so I wasn’t surprised when we received our second such call in the afternoon. The police had called us on this one because he’d been acting strangely and when questioned, had been vague with them. He did ask them to get him to McDonalds, which was nearby, but they decided he was too unwell.

A crew was just ahead of us and the student paramedic worked with them to get the 42 year-old man’s blood sugar back up from the low two’s but, even after three Glucogels had been given and twenty minutes had elapsed, the man’s BM remained low.

He had been swallowing the gel too fast - it would have gone straight to his gut with very little buccal absorption, so giving him Glucagon would have been an unnecessary intervention. It was best to wait or give him a small amount of IV glucose if his condition didn’t improve. But he caught everyone out by suddenly becoming lucid when he was about to be taken into the ambulance. His recovery was starting and it would, once the sugar he’d been given, continue until his BM was normal or high-normal.

He was given chips to eat by a friend and he turned human again. Then he went on about his day with his mate.

A call to a train station for a 49 year-old female who ‘had a nosebleed’ and who stated she had a blood disorder, turned into a bit of a joke when my student went missing trying to find the patient and I bumped into her by accident (the patient) on my way out of the station to find the student. I heard a voice say ‘are you looking for me?’ and saw a large woman sitting on a bench nowhere near the location given (thus my lost colleague). She told me she ‘needed’ an ambulance because she had suffered a nose bleed and it had stopped and she had a blood disorder... also that she suffered depression and had just come out of jail – she’d been arrested for fighting. ‘A man beat me up’, she said. I have to say I doubted that.

Opinions aside, we took her to hospital and left her in care because there was no evidence upon which to base a clinical referral at all.

Another LAS colleague felt dizzy when, once again, we visited HQ on an errand. I’m sure they see us and get ill – we make them sick obviously. The woman was suffering from giddiness and vision problems and her ECG was abnormal (but not enough that it merited a panic). She may just need her eyesight checked or she may be having a more significant medical event. We took her to hospital just in case.

Be safe.

1 comment:

SebastianF said...

A typical shift like over here in Germany... much people who mean they're ill and not much who are for real :-)