Day shift: Five calls; two by ambulance; three by car.
Stats: 2 abdo pains; 1 headache; 1 infection; 1 chronic cellulitis.
Pregnancy causes problems as the baby gets heavier. A 33 year-old Chinese woman lay on a first aid couch in a museum as her husband looked on anxiously. She’d developed a sharp abdominal pain and both were concerned that the baby may be in trouble. Her last scan showed the baby to be in a breech position but that can change easily over the next few months. However, it meant that (and palpation of her bump confirmed this), her bladder was probably being squashed, thus the discomfort.
She had complained recently of not being able to urinate freely when she went to the loo, despite an urge to pass more, so a UTI couldn’t be ruled out - this can be caused by hormonal changes leading to relaxed smooth muscle.
I asked for an ambulance, rather than risk the car for her. She’d be more comfortable laying left side down anyway (less pressure on the Vena Cava).
Period pain can also cause problems but generally speaking, it should be controlled by the person experiencing it. Time after time we will be sent on calls for period pain where the female, usually young, has taken nothing to deal with it. So, she goes to hospital and gets a couple of Ibuprofen. This was the case with a 17 year-old Italian tourist who collapsed in the middle of a pedestrian bridge. Her boyfriend was with her and an ambulance was called by a MOP when she seemed unable to cope with her pain.
She admitted herself that it was normal for her to feel like this during her period and, when she’d seemingly recovered, I was prepared to leave her to get on with her day. Unfortunately, she collapsed (not fainted) again, and again... and again, so I took her to hospital in the car.
Green, green, green...all the calls are green. As was this 34 year-old woman with ‘headache and dizziness’. She had her young daughter with her and she was being given a first-hand lesson on how to insist on going to hospital by ambulance, even though you can walk, talk and call every single one of your friends and relatives on the phone as you sit in the back of the car less than a mile from A&E.
Another headache and this time the 30 year-old hotel worker had a high temperature and a sore throat to go with it. He had an infection, possibly bacterial, judging by the white matter on his tonsils, so I took him in the car to hospital. He should have gone to his GP but he’d left it late and his boss dialled 999.
Towards the end of the shift, I was sent to a fairly regular patient (the ill type, not the time-wasting type); an 82 year-old man with Cellulitis. His leg had become worse than usual, with ulcers suppurating so badly that a plastic bag had been wrapped around the limb to catch the fluid and pus running down it. I could smell decaying flesh before I was even introduced to it. Clearly, he was going to hospital in an ambulance.