Thursday, 8 July 2010

Wobbly knees and cyclists

Day shift: Five calls; two by car; one declined; one treated on scene; one by ambulance.

Stats: 1 fall; 1 RTC taxi vs cyclist; 1 faint; 1 abdo pain; 1 dislocated knee.

Green calls are usually (but not always) irrelevant to the emergency ambulance service but we continue to run on them and find, in most cases, that the person could have walked/hopped/hobbled/skipped or crawled to a Minor Injuries Unit, or A&E, or their GP or reality. It seems we are blanketed as a society and must call ambulances, regardless of the actual need for one, simply because they are available.

So call number one was a typical green; a 45 year-old Spanish cleaner fell into a lift and bumped her hip, so inevitably it hurt a bit. She then sat down and let it stiffen for half an hour until we arrived. Of course it was painful now and she found it difficult to walk but not to weight-bear. After a few steps she was using it well enough to walk down to the car, get in the back and enjoy a ride to hospital... and the rest of the day off.

Cyclists don’t have it easy in London and many of them have collisions, some of which result in death or serious injury, Luckily, most of them are minor in nature, as was the case with the 25 year-old man who went over his handlebars after hitting the back of a taxi when it slowed in front of him. He admitted he was to blame because he hadn’t been watching the traffic and he may have been travelling a little too fast but when it came to the real crunch – the cost of repairing the dent in the cab – the police had to come and sort it out. Cyclists generally do not have insurance; at least they are not required to have it, like other road vehicles, so when they cause damage there is little or no compensation for those affected.

The taxi driver will have to foot the bill for a panel beating job to make good the tail of his cab – that seems unfair but the cyclist denied causing the small ding to the bodywork. We left it with the police officer to sort out; rather him than me.

Fainting at underground stations is very common; fainting anywhere when you are of a certain age needs medical checking. For example, if you are 76 and have had a faint before, then it is time for an ECG and a thorough check over at hospital. So, this lady, who collapsed at an underground station, got an ambulance. She was recovering well enough but her BP wasn’t impressive and she still seemed a little pale. The crew was with us in less than ten minutes and off she went, husband in tow.

Abdominal pain is one of those things that causes controversy when commented on by people like me in any negative way – for example, when I think there is nothing there but a hallucination of pain. Of course true abdominal pain can be a real emergency but most of the stuff we get is not and never will be. Some of it, like the 14 year-old girl who claimed 10/10 pain in the presence of her over-protective family, and then told me the needle in her skin (for morphine) was more excruciating, is nonsense.

I offered her all sorts of pain relief but she was less inclined when told her the more potent analgesia came via needle. In fact, she reported a drop in her pain immediately after I withdrew the cannula and abandoned the attempt due to her constant squirming. The smallest needle in the world was being used, trust me – a prick from a sewing needle is worse.

In the end, she walked, accompanied by five members of her family, to the car and we took her to hospital. This wasn’t her first visit for such complaints – none of the other problems were ever diagnosed.

A 32 year-old large lady with hypermobility syndrome and who has a long history of knee dislocations called us out to help her when she collapsed off the toilet and her patella popped out. She’d already pushed it back into place when we got there but was still unable to put her weight on it. This was because the knee cap was still a little too high in the leg, so I slid it down into its proper anatomical position and she was instantly cured – no pain and straight back onto the leg.

She didn’t need to go to hospital and we left her with the necessary paperwork and a bandage around the knee to support it.

Our day ended off the road when the car decided not to bother starting while we were on standby on Trafalgar Square – a more public place for a flat battery I couldn’t imagine. Two police officers roped in a white van man from TNT delivery services to ‘jump start’ the car (thank you WVM and TNT) and then the RAC rolled onto the Square and checked the battery, pronouncing it dead and replacing it. The RAC man then told us the battery wasn’t charging as it should and thus the shift ended with me driving back on only the energy inside the battery. Still, it’s warming up again weather-wise...

Be safe.

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