Monday, 12 July 2010

Park life

Here's a letter I received, demanding 35p which was still outstanding from a cleared bill. Above it is the cost of postage in order to get this 'threat of further action' to me. Dumb arses.

Day shift: Seven calls; three by ambulance; two left at scene; two by car.

Stats: 1 RTC with # foot; 1 alcoholic (withdrawing); 1 fall; 1 chest pain that never was; 1 ? aortic aneurysm; 1 faint; 1 near-choking.

It’s cooling down a bit thankfully and the shift started early with a call to Piccadilly for a cyclist who claimed he was hit by a bus which went over his foot. He was sitting in the middle of the road and two MOPs had stopped to help him but his feet, one of which was broken, were sticking out into the lane and vehicles were passing very close by.

The bus driver stated the man had fallen in front of him and that he hadn’t made contact with his body. Neither man – the cyclist and the bus driver – spoke good English so it was difficult to ascertain exactly what had happened. There were no witnesses, although I’m willing to bet that at least a dozen motorists saw the incident but chose to continue driving to work or wherever.

The man complained of spinal pain, so as soon as the crew arrived, he was collared and boarded. He also complained of abdominal pain but there were no marks on him. His foot had a nasty lump on it and the skin had been torn away from the heel, so something had certainly gripped and dragged his foot along the ground. Something had gone over it too, thus the fracture. He had one flip-flop near him but the other one; the one that would have shown damage and blood staining consistent with a bus going over it, was nowhere to be seen – so the 'smoking gun' was missing - very strange.

It’s too early in the day for alcoholic calls but the emergency services are here at the beck and call of those who are shaking and nervy and have ‘chest pain’ as the result of alcohol withdrawal; those who live in parks and who call almost every day for the same reason – like the Polish man whose fellow drinkers dialled 999 and asked for an ambulance because he was having a ‘heart attack’. Calls like this only annoy me because I think of all the elderly, fragile and needy people who are unwell and who have never abused themselves to the point of suicide – individuals with a tax-paying right to the service we provide and who will wait while we collect and deliver yet another quick turn-around NHS special on behalf of the righteous.

The man wasn't having a heart attack or any other kind of attack - unless you count the kind of attack your body initiates when you don't drink alcohol when it needs it.

At a bookshop a 62 year-old lady stumbled and fell down a few steps; she wasn’t hurt but the staff wanted her checked out just in case. The lady had a history of double Laminectomy but had experienced no back trouble since the ‘90s – she had full function and no pain, so it was a simple case of getting her cleared fully in the ambulance and then dropping her off around the corner where she was heading anyway.

When a call comes in for a 14 year-old ‘with chest pain’ outside a popular tourist location, you can pretty much bet your savings that you’ll be risking your life on the road to get to a kid with issues – not all of the time but 99.9% of the time. So, we run on the eight-minute timer because someone has said ‘yes’ to the chest pain lead, even though the probability is low but there is no concern about the much higher probability of risk to myself or a member of the public while I am driving ‘safely but efficiently’ (that means do the damned eight minutes) to the job.

Of course, I win my bet and its absolute nonsense. The kid is face down on the ground having some kind of mood swing while his mother and siblings from abroad look on. Common sense had left the location as an ambulance and myself got on scene, all blue lights and fuss, just so he could walk off again after a quick check, smiling and none the worse for wear. Send them all a bill in the post I say!

Aortic aneurysms are serious and have the potential to cause sudden death – so sudden in fact, that the patient can die in mid-sentence. Surprisingly this call, to a 76 year-old man with a previous history of aneurysm, was given an Amber, so no need to rush then. If he’d been drunk, I would have been ordered in on a Red and eight minutes, as the prescription demands but with this I could trundle down there and take almost twenty minutes about it. I didn’t, however – I got to him in eight minutes, as would have any of my colleagues because we all understand the nature of this particular beast.

He wasn’t pale and he didn’t seem in too much pain but his finger pressed gently down on the specific point from which the pain emanated ‘sharply’ every now and again. The location, over his Liver, gives rise to suspicion and when the crew arrived he was taken to the ambulance fairly quickly.

In the basement of a very hot restaurant (no air con) a 32 year-old Dubai lady fainted. This was her second fainting and it happens when she starts her period. Her husband was with her but soon enough the entire family appeared – even dad came out of nowhere to show deep concern. At the same time a General Broadcast on the radio announced a chest pain collapse that urgently required an ambulance, so I decided this lady could go in the car.

Her husband travelled with her and the family was already in the packed waiting area when I put her there. No seats were available, so I got her a wheelchair to sit in and she’d have to endure up to four hours in the heat of the hospital now. I think this obviously rich family will probably be disappointed with the service – they must be used to something quite different. Still... it’s free.

The last (and late) job was for a 3 year-old who ‘swallowed’ a coin. In fact, he didn’t swallow it – the little silver thing was still stuck between his trachea and oesophagus; when I arrived on scene there was no ambulance because the call had been downgraded as the boy was ‘breathing normally’. That’s all fine but if the coin is still in situ there is a high risk of damage or choking if it is not removed as soon and as safely as possible. That’s why I took him in the car, with mum, on lights into Paediatric A&E.

The boy’s father – a doctor – saved his son’s life when he saw him turning purple in the face. A quick thump on the back and he was breathing but the coin had dislodged and gone into the oesophagus, where it could be seen pressing the edge. This is a high-risk scenario and no amount of 'he's breathing normally' should have been allowed to change the nature of it - he hadn't been breathing normally at all for a short while; he's only three - so why not just treat him as an emergency? Why not let the alcoholic park dwellers sleep it off while we get to these genuine problems quickly? It's time the Government gave us all a break and let us do our jobs.
Be safe.


Anonymous said...

I think you'll like this:

The comment from Dr JG is particularly noteworthy.

joan said...

Hi Xf
Re post, I had a letter from work to say enhancements were stopping, they put normal 1st class stamp on A4, so i had to pay £1.10p to have the pleasure of being told im going to get less pay! charming lol
take care joan

Anonymous said...

I hope the aneurysm man is ok! A few years ago I had a suspected abdominal aortic aneurysm (which fortunately turned out to be peritonism instead) and had a long scary wait for an ambulance in the middle of the night as I had been classified by the system as a Green priority call for abdominal pain and (as always?) LAS was very busy that night. The paramedics literally freaked out when they finally got here and seemed to have a few angry things to say about the system, so I know from personal experience quite how seriously you guys take these things.

Strangely this isn't the only time I've been classified as a green priority call and then rushed into the major trauma unit, followed by a few weeks confined to a hospital bed. Am I just very unlucky or is there something very wrong here?