Saturday, 5 November 2011

Invisible paramedic

I had a few observers out with me on the latest run of shifts; a pharmacist from St Thomas’ Hospital, a medical student from UAE and a paramedic from the Welsh Ambulance Service.

Computerising a system is all well and good but a human eye or two is much more valuable when you are running an emergency service I think. I spent an entire shift out in my area, listening to sirens around me and wondering why I was being ignored. It was obviously busy but I hadn’t been given a single incident to deal with.

By the end of my shift I had begun to seriously doubt my normally cynical view of how we are an over-used and abused service. I had checked in and made myself available. I had given my call-sign and status at the start of the shift. If I wasn’t getting any calls, it was because there were more than enough resources already out there I figured.

This was the pharmacists shift and she wasn’t impressed at the lack of work we do out here!

When I called in to end my shift I was told that, although they’d known I was out there, the computer did not. My call-sign wasn’t registered with the system, so it was completely blind to me and calls were being routed to everyone else around me instead. This was the first shift I’ve experienced on the FRU where I did absolutely nothing all day long.

My next shift was Faye’s, the UAE doctor-to-be, and it was a little more useful to the London public. I was using an old call-sign and calls were sent, as usual, in my direction.

The first call was to a 97 year-old lady who was having difficulty in breathing. When I arrived her carer told me she’d been fine until the moment she was leaving; that’s when the old lady began to complain of breathing problems. In fact, she was having a panic attack and was hyperventilating. She was known to suffer from such attacks. She lived alone and her only contact with the outside world, apart from a visit to her church when she could, was her carer.

I spoke to her as she sobbed and I tried to calm her down. She was lonely and desperate for company and a change of environment. She was stuck on the fourth floor of a council block. She couldn’t use the lift, even though she was mobile, because it scared her (she’d been trapped in it when it broke down in the past), so she tended to use the stairs when she went to church. This is a major challenge for such a frail little old lady. Maybe Councils should consider where they put the elderly when it comes to accommodating them.

I left her in the safe hands of the crew, after chatting to her and holding her hand until she’d calmed down.

Soon after this, I was off to see a 30 year-old man who was fitting in the street. There were major demonstrations taking place in Central London, so things were getting tight, in terms of getting to and from places. This man, a street-dweller, was close to where everything was kicking off. As a result, after I’d carried out basic obs and got him into the car, a demo of about 200 people streamed past me. The police cordoned me into the pavement and the ambulance I had requested was stuck at the end of the slow-moving procession. It seemed ridiculous; although this patient was stable enough (he was shaking in the ‘I might have a fit’ fashion but it was mostly under his own control), if he’d gone into cardiac arrest I would have been hard pushed to get reinforcements to me in time.

When I asked the man about his medical history, he revealed that he’d been suffering seizures for a long time and that the doctors hadn’t diagnosed anything yet. He also told me they’d taken all his meds away from him on his last stay at hospital. This made me think. Although he did attempt a few tremorous warnings that he may fit again, it never looked likely to me. He always looked well enough in control of himself and Faye told me that when I looked away, he stopped shaking.

Eventually, the ambulance got through and I got him off to hospital. Central London was being cordoned off at Whitehall and The Mall, so I was about to become trapped inside a smallish footprint area.

But I was sent North and away from the protesters for a short while, as I searched for an elusive hospital-gowned angry woman who was, according to the caller, shouting abuse and being aggressive. I drove around the area a few times but couldn’t spot her; she either never existed, or had gone underground (quite literally)... or had wandered back to hospital to have her gown changed.

The police arrived on scene but, after a search of the park, they had similar luck. One of the officers is a friend of mine (that’s what you call a cop you’ve bumped into on dozens of jobs through the years) and we spent ten minutes jawing about this and that before calling it a day on the great search and rescue expedition dubbed the ‘phantom ranter’.

A few hours went by and I watched the demonstrations become larger and more central. This made the police very nervous and so, acting on intelligence I guess, they used their vans to completely block off the entrances to the important streets. It looked as if they were expecting a full scale riot. Instead, we got treated to an antique car rally that wound itself through the streets towards Piccadilly, the area of my next (and last) call of the shift. A 35 year-old woman was reportedly ‘collapsed’ and unconscious in a five star Hotel.

I’m afraid that when I get a report like that, the cynic in me comes out because over the years I can count on one hand the number of calls, described just like this, that actually turn out to be as given. Usually, there is a perfectly conscious person at the end of the trip. Conscious, breathing and laying on the floor waiting to be rescued for something that is nothing to do with the initial 999 request.

So, down into the bowels of the hotel we went... down until we reached the staff areas, where things are a little less than five star. The staff member showing me to the patient seemed surprised that she wasn’t where he’d left her. He was told that she’d ‘moved somewhere else’. This, of course, is a major feat for an unconscious person – Jesus being the only known historical exception to the rule of unconscious/dead equals’ inanimacy (I’m not entirely sure of this word but it sounds right).

When I was guided round to where she was, I found her lying on the floor, on her side and not willing to acknowledge me. She was conscious because her eyelids were flapping a bit and when I referred to her by name, she practically sat up... although she didn’t.

Now I don’t really mind if people want to display their emotional distress at feeling unwell by dramatically dropping to the floor, thus scaring the pants off those around them, who may think they’ve just witnessed a death, but there are people in real trouble out there and they really need an ambulance. I’d much rather be paying attention to them.

So I managed to get her to open her eyes and tell me what the problem was. She had a stomach ache. That was it. Painful as it may have been to her, it didn’t necessitate a Red emergency response.

The crew arrived within a few minutes and, as I watched in my rear-view mirror, she walked out with them, supported by a staff member. As I referred back to my paperwork, a strange and almost surreal thing caught my eye. I saw a man pushing an antique car up the hill towards Piccadilly. I think the vehicle was person-powered because the running man seemed to be comfortable doing what he was doing – pushing a car with someone sitting in it. I suddenly felt the urge to shout out ‘What’s the point? Why don’t you both just jog?’ But I didn’t.

On the way back to base, we passed another one of these old vehicles. It had broken down and the men driving it were frantically trying to get it started again. They weren’t cranking a handle and they weren’t push-starting a motor... they were setting fire to its underbelly in order to get a boiler heated so that steam could power it up the hill! Flames were belching out from below and tourists were stopping to film and photograph the sight.

I don’t care what they say about London in some places; this is one of the funniest cities in the world.

Be safe.

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