Monday, 18 July 2011

Help the aged

A 40 minute Epistaxis, a concerned first aider and a little office bin full of bloody tissues started the shift off. The 58 year-old had been in a meeting and his nose had started to bleed without warning. It kept bleeding, despite the valiant efforts of the first aider who'd been summoned to help. The man was taking aspirin every day, so this was not exactly a shock for me.

I reassured him, as you do, and checked that he had no sinister medical history I needed to know about, before taking him and his newly-dressed nose ( a dressing is tied tightly around the head and under the nose) to A&E in the car. There was no further drama; the dressing was doing its job. He'd have a good old clot in his nose when they removed it though.

A 'pain all over' job for ? Meningitis was nothing of the sort. The 25 year-old Spanish woman, whose 12 year-old daughter acted as my interpreter, had seen her GP the day before and been given cream for a rash on her arms and legs. The rash had cleared up but now she was claiming that she couldn't move and that her neck hurt.

The history of a rash, regardless of the fact that it was now gone, the neck pan and 'pain all over' syndrome, meant it would go RED for Meningitis and so I went to the house to check it out. The absence of a headache and photophobia gave me cause to doubt the alarm.

She was in her bed, feet elevated for some reason, and her daughter was deeply concerned. It turned out she had no rash (obviously) and that her neck pain was caused by what looked like a Ganglion Cyst on the back of it. As for the 'couldn't move' thing; I gave her the option of walking down to the car with me, or waiting a long time for an ambulance to come. This gave her the inspiration, power and energy to make it to the car.

Another minor drama - and one of those calls that make me deeply unhappy about the state of humanity - was to a 38 year-old cleaner who, when dusting around a fluorescent strip light, had an unfortunate meeting with it when it collapsed and slapped her on the head. Now, the thing weighs a few kilos for sure, but she had insisted on an ambulance, even though her only injury was a minor scratch to the forehead.

Please, please do NOT harangue me about the possibilities for serious injury etc, with this kind of mishap, because she was fine. Absolutely fine. She needed a gauze swab and a sit-down for a few minutes. She'd had a glancing blow to the head and nothing had been broken - not even the strip light!

This is all about ensuring the most is made of a minor event - turn it into a crisis and there may be a few quid at the end of it. That, I'm afraid is all it was about in my humble opinion. The cleaner was working for one of the big name food supermarkets and they are notorious for shelling out when people complain, just to keep bad Press away. You see, the big names have a lot to lose if they get too many injury-associated complaints, so they just pay people off. My advice to them, as if they'd listen, is STOP doing this! You are absolutely encouraging such individuals to make stupid claims. Force people to prove their claims in court!

For example, I was involved in a call recently, where an ambulance had been demanded by a customer of one of these stores. She'd slipped on tomato ketchup that was spilled on the floor. Whether it was actually spilled by staff or not is irrelevant, but when she was told that an ambulance would be a while (it was a very busy night), she went crazy and moaned about her aches and pains. I have to tell you that prior to me calling her, she had made no complaint of actual bodily harm. The poor store Manager was very upset because she knew there was nothing wrong with this woman.

As my conversation with her progressed, she started to escalate her injuries. Now she had neck pain. Obviously we have no choice but to send an ambulance and she knew this. Not only that but while I was talking to her, another 999 call was made by her sister, who was elsewhere in the store, claiming that staff were causing undue stress to her sibling and making her injuries worse. Now, I'm asking you all, as sensible people here, and I'm making no judgement on this... but does this sound like a planned set-up to you?

I took fluorescent strip woman to hospital in the car. En-route, she made several phone calls, each one of which was to a close friend or relative, and each one made her injury sound more than it actually was.

And the last call of the shift made me stop and think about all the stuff that had gone before. It was a 'trapped behind locked doors' for an 80 year-old woman who hadn't been seen in two days. She normally answers her phone when her friend calls, like clockwork every weekend, but this time she hadn't. Two days had gone by without a word from her, so her two old friends called the police and we all gathered - her friends, the police and myself - on the balcony, figuring out a way to get in. The door was protected by an iron gate, so the small bedroom window was our only option.

I have to say, there didn't seem much hope in this case. I have done a lot of these and when the person hasn't been seen for a while, and they have a very set pattern of behaviour (and they are house-bound), then the chances of finding them alive are slim to nothing. I think her friends knew this.

Anyway, we borrowed a chair from a neighbour - they were all out watching this show - and I teetered on it, quite literally, preparing to go through the window when the cops had forced it open. However, there was a delay because the officer in charge of cracking it open with a crow-bar, didn't have the heart to damage it, so the process was slow.

'I don't want to break her window,' he said.

'But if you don't we'll be waiting even longer to get in. She could be in trouble in there,' I suggested.

'Yeah, but it's the poor old lady's window,'

'It's the poor old lady's life,' I said.

This prompted a bit more aggression because this thoughtful cop had clearly forgotten why we were there. Or maybe he thought another few minutes wouldn't make any difference. I don't know. Either way, he meant well.

The window burst open and I clambered in. Now, I say clambered and I mean it. I usually get stuffed into windows because I am (usually) the smallest of the bunch in a gang of cops and paramedics, and anyone whose seen me go through a window will tell you I'm no athlete. I was standing on the thinnest ledge imaginable; if I fell backward and they didn't catch me, I would go right over the balcony and drop off the third floor. I had no faith in the ledge or the cops waiting to grab me.

I fell into the little room and a tall cop followed me immediately. he just stepped over the ledge with his lanky legs. We went into the flat and I was expecting to see a dead body. I walked into the front room and there, in front of me and sticking out from behind a wall, were a pair of legs. Not moving legs I should add.

'Hello, are you alright?' I shouted. This made the legs move. I was very relieved, as was the police officer standing with me.

I went to my patient and she was conscious. She'd been lying in the corner for two days, although she repeatedly told me, and the crew that arrived later on, that she'd only been there since this morning. Her front room was a wreck; it looked like she'd tripped several times and launched herself into the wall, landing in that corner - probably knocked out. I think she'd had a stroke.

I had to claim stroke anyway for this lady, just to get an ambulance in good time for her. You see, this is why I get so annoyed with certain people. This poor old woman, who could have died in that corner, had to wait almost an hour until a crew came for her. This was because ambulances were being cancelled on my call and sent to 'higher priority' calls, one of which was a 'headache'. Come on now, that's just not fair. So, I advised Control that I suspected a CVA and that changed the priority.

None of this is the fault of our crews or the Control staff; it is the fault of people who think their every little ailment is a major emergency. Or those who will not go and see their GP, or take the trip to A&E themselves.

It's time the elderly, vulnerable and genuinely sick of this city (and indeed entire country) got a fairer deal. This, as you know, gets much, much worse at weekends.

Be safe.


Cat said...

I'd just like to thank you for your blog and books, they've inspired me to finally get on and apply to work in the ambulance service. I'm now training with the north east AS and I'm loving it! Your writing has given me a good idea of what it's like out on the road so there's been not big surprises (yet!).

Keep writing, and maybe one day there'll be enough ambulance staff on the road!

Captain Sketchy said...

You, sir, deserve a bloody medal. Several in fact. I know your job often gets to you from reading this blog, but you still have a considerably larger patience threshold than I would under the same circumstances.

The modern world gets crazier by the week, but we need strong people like you who can see through the crap, ignore it, and continually strive to do the right thing.

Everyone in the country should be made to read this blog. It might just start to make a difference. Keep going Stuart, there are still those of us out here who appreciate, understand and empathise with you.

Oh, and I wouldn't call an ambulance unless my flippin' leg was hanging off!

Lynda Halliger-Otvos said...

It seems to be an unsolvable issue, Stu. Our ERs are jammed with those who cannot afford to see a GP and use the ED as an advise nurse/urgent care facility.

Harry said...

As ever I am in total agreement Stu, they are causing harm to people with their actions.

Xf said...

Captain Sketchy

Thank you, I needed the boost!