Thursday, 5 August 2010

Head first

A 42 year-old woman with a recent history of severe headaches and nausea had her blood pressure tested at work and found it to be high. I double-checked and had to agree with the figures. This was one of those Green calls that turn out to be a little more significant. She was stable so I took her in the car and we chatted about the exclusive club where she worked. I might even join – if they take council-house-bred scum from Glasgow that is.

Later on I was called in support of a crew to attend a 30 year-old man who’d become unconscious in a pub. Now, I know what you’re all thinking and that’s what I was thinking too but this guy had collapsed with ‘exhaustion’ according to his mates.

He was in the recovery position and awake when I arrived with the crew and the first thing he told me – and pertinent to his ongoing care – was that this sort of tiredness collapse had happened to him before when he was a teenager and then again a few years earlier. He’d been drinking but it wasn’t the booze that was affecting him like this.

His ECG was abnormal, showing a possible long QT and his BP dropped in concert with his irregular pulse; none of which would manifest as a result of fatigue, unless he was almost tired to death, which he wasn’t. He was taken into hospital for further checks.

Drink, run and attempt to jump off the bottom four steps at a tube station in order to catch the last train home and you’ll probably fall onto your head – as did my next patient. The 30 year-old cracked the back of his skull open and bled onto the cold stone floor as his girlfriend leaned over him and underground staff mopped up what they could with a dressing.

Initially he looked in no danger but as things progressed (two crews and a collar & board), he became a bit irritable and only oxygen through a trauma mask seemed to settle him. That meant he was going to a more suitable hospital for his head injury. That also meant a long trip south for me.

Sort-of drunken young women entertained me as I drove two of them ahead of the Booze Bus containing their properly drunk mate and her twin sister (who wasn’t drunk). They were loud but funny and came out with some of the most amusing stuff I’ve heard in ages. Usually I get abuse and trouble from inebriated souls but tonight was happy night I think.

When we got to hospital they were freed from the car and allowed to cause havoc with their loud voices and inappropriate photographing. Security didn’t take too kindly to them but they meant no harm. Their friend, meanwhile, was given a cubicle to lie in while her sister fretted beside her. Eighteen year-olds learning the lessons of alcohol – possibly.

Don’t wind down your window when a complete stranger approaches your car and his friend arrives at the other side – especially when all they come out with is ‘Hi, we are from Switzerland. Where is the nearest pub?’ It was 4am and they were just setting out; breakfast in Soho.

Be safe.

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