Eleven emergency calls – two assisted-only, one treated on scene and eight taken by ambulance.
A 33 year-old who fainted at home was recovering on her sofa when I arrived. I carried out a few obs and the crew took over. She wouldn’t be going to hospital; she didn’t want to anyway.
Another fainting female, this time she was 65 years-old. A doctor was on scene attending to her when I arrived. She had fainted twice, according to witnesses and now seemed to be recovering well and she didn't seem to think a trip to hospital was necessary. The problem, however, was that her age and the fact that she had dropped more than once in quick succession merited further investigation. She was persuaded to go to hospital – it was probably nothing to worry about but better safe than sorry in this case.
A six foot tall drunken 21 year-old man required my attention as he lay in a pool of his own vomit on the platform of a busy tube station. He couldn’t be roused by the staff, so they called 999 and hoped for a swift end to this human obstruction. For some reason the tube staff asked a St. John Ambulance volunteer to help and he appeared at my side as if by magic. I don't mind a bit of assistance so I roped him in and started looking for a response from my dead-to-the-world drunk.
When I shook him hard enough and pinched his shoulder he woke up. He wasn’t pleased but neither was he aggressive – he was one of those smiling drunks who ‘understand the situation’. I managed to get him to sit up but he insisted on falling asleep at every opportunity, so I had to keep him company with a loud conversation until the crew arrived. He had already made it clear that he didn’t want to go to hospital, so we gave him the only choice he had left – leave the station or the police would remove him. He chose the former but we still had to assist him all the way up the escalators; he kept nodding off...even when standing up.
We got him to fresh air and he seemed a bit more alert. He was taken into the ambulance for a set of obs before he went on his merry way. As he approached the ambulance, he noticed the car parked with its lights flashing..
‘Aw, for f**k’s sake – is all that for me?’ he asked.
‘Yep, just for you’, I replied.
‘Aw, go and save someone who really needs it.’
Amen I thought. He was very embarrassed by this, so I think he may just have learned a lesson.
Our hoax caller made no less than six 999 calls tonight. I was sent to one in which he had asked for all three services but specifically wanted the London Fire Brigade to take him to Heathrow! I was still sent to deal with it. Apart from catching him red-handed, I had no idea what else I was supposed to do when I got on scene. Never mind the fact that I was being diverted from genuine calls, I was annoyed that, once again, the LAS had been despatched and not the police...or the LFB.
Immediately after my hike over to the hoax I received a call for a 4 month old baby with DIB. I was now three miles away from this one, all because of this timewasting madman. If the child was seriously ill, precious minutes would be lost and I rushed over there hoping that it was just another ‘hot baby’. Luckily, when I arrived a crew were on scene and they were happy to deal with it.
Back in my own area and a call to a club for a 26 year-old woman who was unconscious after allegedly popping a pill into her drink. Her cousin, who was distraught about this, denied the claim (which had been made by the doorman – apparently he witnessed her putting the pill in her own drink). I didn’t know what to believe and I didn’t really care because the girl was out of it, one way or the other, and my priority was her airway and breathing. The crew arrived and we took her to the ambulance on the trolley bed. She hadn’t responded throughout the entire drama. Her cousin joined her – he still looked shocked and kept apologising for the state of her.
If you are turning 18 soon, go out and enjoy yourself but don’t get so drunk that you can’t remember anything about it. Don’t wake up in hospital with vomit down your clothing and a gang of unknown faces looking at you and asking you questions. This is what happened to my next patient. She ended up unconscious on the floor of the ladies loos, while women were strolling in and out; practically walking over her to get to the cubicles (a bursting bladder negates good manners). It was all very undignified and not the kind of memory your friends should be taking home with them.
When I arrived her mates told me she had been this way once before. She had only turned 18 today, so that means she had drunk so much that she fell down when she was underage. I know parents should allow their kids to experiment and we all had a drink before we were ‘legal’ but getting this drunk in a public place when you are only 17 is not a good reflection on the mum and dad and here she was again...all legal and all unconscious. What a waste.
Outside this club, I notice a little group of teenagers; boys and girls. The boys were taking it in turns to fondle one of the girl’s breasts. I think it was a competition.
A diabetic with a BM of 2.1 was treated on scene with Glucagon and recovered in ten minutes. He was a 27 year-old who really didn’t want any help at first – his condition made him stubborn but not aggressive. His parents were with him and had found him in bed when he should have been at work. His father called us because he wasn’t sure how low his blood sugar level was.
Next, a call from the police for a 20 year-old man who had been assaulted and had a laceration to his head. It was a small wound and the bleeding was easily controlled, so I stuck a small dressing on it and waited for the ambulance to show up. Meanwhile the patient was strangely silent. He wouldn't talk to me; he wouldn't talk to the police. He wasn’t interested. The only reason he was allowing us to treat him at all was because the police were there and they insisted. I really didn’t mind if he wanted to sulk off, quite frankly.
When I greened up from the moody assault I was sent a few streets away to a 74 year-old male ‘collapsed in street, cold and shivering’. I arrived as the ambulance was pulling up and the crew and I went to see the patient together. He was homeless but he wasn’t drunk. He had been found in a doorway by a couple who were passing by. They had noticed how cold he seemed and became concerned about his condition. He certainly looked cold and was shivering violently.
We took him into the ambulance and he winced in pain a few times on the way. He complained about pain in his knee so I had a look at it when he was sitting down in the back. There was no obvious injury and he had no critical medical problems. His temperature was taken - it was 33.3c, so he was going to hospital for hypothermia anyway.
I was just about to leave the ambulance when one of the crew noticed something.
‘Your sleeve has blood on it’, she said, pointing to the right arm of my jacket.
I looked at it and saw a smear of blood. I had no idea where it had come from but it was wet, so it wasn’t from a previous call.
I looked at the old man and checked his hands. I found a deep cut to one of them. He couldn’t remember how he got it but it was likely as a result of falling. The bleeding was under control, so it was dressed and he was taken away to a warmer place.
Combining drugs with alcohol increases your chances of ending up in A&E. I went to an 18 year-old male who was vomiting uncontrollably after a night of cannabis and booze. His friends ‘didn’t know what to do’, so they passed the responsibility (and the cost) over to you, the taxpayer, via me and the NHS. There wasn’t much I could do for him to be honest and I waited for a crew to take him and his sorry mates away to hospital.
I ended this shift with a call that put all the others in perspective. It was for a 57 year-old man with severe chest pain. He has cancer of the liver, kidneys, spleen and spine and is so far down the line that his own morphine doesn’t ease the pain any more. His wife apologised for calling us out. He had been suffering for four hours before deciding to get an ambulance because he (and she) didn’t want to inconvenience us! I told him that he was precisely the reason we existed and that he should never allow himself to suffer for so long before calling us.
He was taken to hospital where, hopefully, they relieved his pain. I know the man is in his end days though. It’s frustrating to know that there are people like him out there, biting their lips and suffering instead of calling 999 while all around them the freeloaders and timewasters of society a racking up billions of pounds in wasted taxes to feed their addiction – the belief that a free service is available on tap just for them when they get a headache or fall down drunk.
Be safe.
Wednesday, 14 November 2007
Tuesday, 13 November 2007
Death's door
Six emergency calls – one refused and five required our attention.
Again, a relatively quiet night; the cold weather is probably responsible for the lack of people willing to go out and hurt themselves. The air is beginning to get a little ‘nippy’, as we say in the Homeland and the first frost is developing in the mornings when I come home from work. Of course, that means winter is here and the giant commercial beast that is Christmas is just around the shopping corner.
It all starts with a 55 year-old man who has ‘collapsed’ outside a pub in the City. Now, I know you will think I am a cynic but when I see the words ‘collapsed’ and ‘outside pub’ in the same sentence I usually expect to arrive at the scene to find a drunken male/female/shemale slumped against a puke-covered brick wall, surrounded by clucking friends who firmly believe that he/she/it has been ‘spiked’ or has ‘never been like this after just the one drink before’. Such is the inevitability of our descent into predicting calls of this nature – it creates singularly critical individuals of us all eventually.
I was wrong, however, but luckily I am armed with caution when I make presumptions – too many calls in the past have been genuine and I am always wary of making too quick a judgment.
I arrived to find a man standing at the door of a little pub. He looked unwell and two of his friends were on hand to help him. He was very pale and sweaty. He had suddenly felt unwell and looked like he was going to collapse, one of his mates told me, so they walked him outside and called an ambulance, such was their concern.
‘I had food poisoning over the weekend’, he told me.
That put it into perspective. He had no chest pain and he had no medical problems apart from a little hypertension and type two diabetes. I checked him for changes with either his blood glucose or blood pressure and found nothing untoward. I guess his food poisoning problems weren’t quite over.
A crew arrived within a few minutes and he was taken on board the good ship LAS for further checks (including an ECG).
I went on my merry way and found myself heading back to my own area for a 48 year-old female ‘fall, hit head, DIB’. Unless a head injury is significant, DIB is rarely a factor worth considering in these calls and it is a real problem for us because that single term determines the category of the job. It becomes much more urgent if those letters are added. I expected to find someone with a bump to their head and absolutely no problem breathing whatsoever and that’s exactly what I got when I arrived on scene.
The lady had slipped at work and cracked her head on the concrete floor. She had a nasty bump, a sore wrist and a painful rib. The rib injury was causing her to breathe cautiously, due to the pain but it didn’t impede her breathing and wasn’t in any way life threatening. Nevertheless, even though an injury like that should go by taxi to the nearest A&E, she was taken by ambulance to hospital.
Now that the weather is becoming colder, we tend to experience an increase in calls from the homeless as they attempt to secure warm lodgings and perhaps food in one of the local A&E departments, so I wasn’t at all surprised when I was dragged off to E1 for a 64 year-old man who claimed he had suffered three fits and was about to have another. He had managed to explain his medical emergency himself, lucidly and calmly, from payphone. When I arrived a crew were on scene and he was in the back of the ambulance chatting to them about his woes. Sometimes it’s hard to elicit sympathy from a crew who can feel the wool being pulled and so he wasn’t receiving the warmest of receptions but I guess we all have to put ourselves in their place. What would you do if you had nowhere to go on a bitterly cold night? Dialling 999 is still free (until the commercial animals get a hold of it) and generally speaking, the ambulance service aren’t going to say no to you.
I went south of the river for a 55 year-old lady who had collapsed on a tube train. I think she had mental health issues because she behaved erratically and refused to speak with any clarity or explain herself properly. Witnesses told us she was slumped in her chair and wouldn’t rouse when a member of staff attempted to wake her. The train had passengers on board and I don’t think any of them appreciated this delay in their journey as the crew and I attempted to get sense out of her. Some of them left to find other means of getting home. I was also wary of the fact that the entire line would be slowed or stopped as a result of this woman’s behaviour.
In the end, with exhaustion setting in on both sides, she stood up, refused any help and walked off the train. She crossed the floor to the other platform and stood there, petulantly, waiting for another train (going in the opposite direction). We had no choice but to leave her to it and the staff apologised to us for wasting our time.
After a good few hours of nothing, I went with a crew from my station to a 24 year-old who had fallen and sustained a head injury outside a gay club in the West End. It was freezing and rain had just fallen, so it was wet and freezing.
The man had fallen onto the ground and split his head open above the eye. In itself, the injury was innocuous but as he was too drunk to realise what he had done, it was safer to take him to hospital than it was to let him go home, which is what he wanted to do. Luckily his boyfriend persuaded him to take the sensible option. At this time in the morning and under these weather conditions options like this don’t hang around. I think he fancied one of the crew too.
My last call delayed me getting home but I didn’t mind because this patient needed us. It also reinforced my annoyance with people who insist on using the term DIB when they have nothing of the sort because this patient really was in trouble. He was a 48 year-old lung cancer patient who had developed severe DIB during the early hours and it had got worse as time went by. His frantic wife called us out because she had run out of options.
When you walk into the room of a person who is at death’s door, you know it immediately. There are no ifs or buts, a time-critical patient is an obvious sight. This man was at that door. His breathing was desperate, his eyes were pleading and he was using every muscle in his body to gather the strength to pull air in. If I could round up every caller who allowed the term DIB to be associated with their petty problems I’d shove them into this room, tell them to look at my patient and say ‘THAT is DIB’.
As soon as the crew arrived we took him to the ambulance. His lungs were filling with fluid, so I tried every drug at my disposal to resolve his immediate problem. His sats were in the low 60’s when I first checked them and even now, in the back of the ambulance, with a 100% oxygen mask on, GTN and Frusemide in his system, he wasn’t improving above 85%. He was diaphoretic, weak and scared. Every time I leaned over him I could smell that acrid, sticky aroma that hangs around the terminally ill; the smell of death. You can’t detect it during a resus and you don’t pick it up with acute emergencies – it’s associated mainly with long-suffering tissues and the ongoing breakdown of living stuff. I wasn’t fooling myself. I wasn’t going to save this man’s life. I was going to buy him enough time to say goodbye to his wife. I knew that, my colleagues knew that and he knew that. All I could do was try to make him comfortable, which in itself is an insult to the actual reality of the situation.
We got him to hospital in a reasonably stable condition and I handed him over to the doctor in Resus. His wife sat in the ‘family waiting room’ for news but her face was etched with despair and a fixed gaze developed in her eyes. I told her not to worry and that he was being taken care of now and she acknowledged everything I said without hearing a single word of it.
Be safe.
Again, a relatively quiet night; the cold weather is probably responsible for the lack of people willing to go out and hurt themselves. The air is beginning to get a little ‘nippy’, as we say in the Homeland and the first frost is developing in the mornings when I come home from work. Of course, that means winter is here and the giant commercial beast that is Christmas is just around the shopping corner.
It all starts with a 55 year-old man who has ‘collapsed’ outside a pub in the City. Now, I know you will think I am a cynic but when I see the words ‘collapsed’ and ‘outside pub’ in the same sentence I usually expect to arrive at the scene to find a drunken male/female/shemale slumped against a puke-covered brick wall, surrounded by clucking friends who firmly believe that he/she/it has been ‘spiked’ or has ‘never been like this after just the one drink before’. Such is the inevitability of our descent into predicting calls of this nature – it creates singularly critical individuals of us all eventually.
I was wrong, however, but luckily I am armed with caution when I make presumptions – too many calls in the past have been genuine and I am always wary of making too quick a judgment.
I arrived to find a man standing at the door of a little pub. He looked unwell and two of his friends were on hand to help him. He was very pale and sweaty. He had suddenly felt unwell and looked like he was going to collapse, one of his mates told me, so they walked him outside and called an ambulance, such was their concern.
‘I had food poisoning over the weekend’, he told me.
That put it into perspective. He had no chest pain and he had no medical problems apart from a little hypertension and type two diabetes. I checked him for changes with either his blood glucose or blood pressure and found nothing untoward. I guess his food poisoning problems weren’t quite over.
A crew arrived within a few minutes and he was taken on board the good ship LAS for further checks (including an ECG).
I went on my merry way and found myself heading back to my own area for a 48 year-old female ‘fall, hit head, DIB’. Unless a head injury is significant, DIB is rarely a factor worth considering in these calls and it is a real problem for us because that single term determines the category of the job. It becomes much more urgent if those letters are added. I expected to find someone with a bump to their head and absolutely no problem breathing whatsoever and that’s exactly what I got when I arrived on scene.
The lady had slipped at work and cracked her head on the concrete floor. She had a nasty bump, a sore wrist and a painful rib. The rib injury was causing her to breathe cautiously, due to the pain but it didn’t impede her breathing and wasn’t in any way life threatening. Nevertheless, even though an injury like that should go by taxi to the nearest A&E, she was taken by ambulance to hospital.
Now that the weather is becoming colder, we tend to experience an increase in calls from the homeless as they attempt to secure warm lodgings and perhaps food in one of the local A&E departments, so I wasn’t at all surprised when I was dragged off to E1 for a 64 year-old man who claimed he had suffered three fits and was about to have another. He had managed to explain his medical emergency himself, lucidly and calmly, from payphone. When I arrived a crew were on scene and he was in the back of the ambulance chatting to them about his woes. Sometimes it’s hard to elicit sympathy from a crew who can feel the wool being pulled and so he wasn’t receiving the warmest of receptions but I guess we all have to put ourselves in their place. What would you do if you had nowhere to go on a bitterly cold night? Dialling 999 is still free (until the commercial animals get a hold of it) and generally speaking, the ambulance service aren’t going to say no to you.
I went south of the river for a 55 year-old lady who had collapsed on a tube train. I think she had mental health issues because she behaved erratically and refused to speak with any clarity or explain herself properly. Witnesses told us she was slumped in her chair and wouldn’t rouse when a member of staff attempted to wake her. The train had passengers on board and I don’t think any of them appreciated this delay in their journey as the crew and I attempted to get sense out of her. Some of them left to find other means of getting home. I was also wary of the fact that the entire line would be slowed or stopped as a result of this woman’s behaviour.
In the end, with exhaustion setting in on both sides, she stood up, refused any help and walked off the train. She crossed the floor to the other platform and stood there, petulantly, waiting for another train (going in the opposite direction). We had no choice but to leave her to it and the staff apologised to us for wasting our time.
After a good few hours of nothing, I went with a crew from my station to a 24 year-old who had fallen and sustained a head injury outside a gay club in the West End. It was freezing and rain had just fallen, so it was wet and freezing.
The man had fallen onto the ground and split his head open above the eye. In itself, the injury was innocuous but as he was too drunk to realise what he had done, it was safer to take him to hospital than it was to let him go home, which is what he wanted to do. Luckily his boyfriend persuaded him to take the sensible option. At this time in the morning and under these weather conditions options like this don’t hang around. I think he fancied one of the crew too.
My last call delayed me getting home but I didn’t mind because this patient needed us. It also reinforced my annoyance with people who insist on using the term DIB when they have nothing of the sort because this patient really was in trouble. He was a 48 year-old lung cancer patient who had developed severe DIB during the early hours and it had got worse as time went by. His frantic wife called us out because she had run out of options.
When you walk into the room of a person who is at death’s door, you know it immediately. There are no ifs or buts, a time-critical patient is an obvious sight. This man was at that door. His breathing was desperate, his eyes were pleading and he was using every muscle in his body to gather the strength to pull air in. If I could round up every caller who allowed the term DIB to be associated with their petty problems I’d shove them into this room, tell them to look at my patient and say ‘THAT is DIB’.
As soon as the crew arrived we took him to the ambulance. His lungs were filling with fluid, so I tried every drug at my disposal to resolve his immediate problem. His sats were in the low 60’s when I first checked them and even now, in the back of the ambulance, with a 100% oxygen mask on, GTN and Frusemide in his system, he wasn’t improving above 85%. He was diaphoretic, weak and scared. Every time I leaned over him I could smell that acrid, sticky aroma that hangs around the terminally ill; the smell of death. You can’t detect it during a resus and you don’t pick it up with acute emergencies – it’s associated mainly with long-suffering tissues and the ongoing breakdown of living stuff. I wasn’t fooling myself. I wasn’t going to save this man’s life. I was going to buy him enough time to say goodbye to his wife. I knew that, my colleagues knew that and he knew that. All I could do was try to make him comfortable, which in itself is an insult to the actual reality of the situation.
We got him to hospital in a reasonably stable condition and I handed him over to the doctor in Resus. His wife sat in the ‘family waiting room’ for news but her face was etched with despair and a fixed gaze developed in her eyes. I told her not to worry and that he was being taken care of now and she acknowledged everything I said without hearing a single word of it.
Be safe.
Monday, 12 November 2007
Where have all the patients gone?
Two calls – Yep, two (2)! Both went by ambulance. I've recently started another six month secondment on the FRU and the new rota includes a nasty four night run over the weekend every five weeks. I wasn't looking forward to this first one but tonight surprised me. The usual drunken fools gave way to decent law-abiding veterans and their loved ones who had been out all day for Remembrance Sunday and now they were spending the night in London; drinking sensibly, going to the theatre and eating out. This produced one of the quietest nights I've known for years and it reflected what used to be the case on every night shift for the ambulance service years ago when the world wasn’t out to get as drunk as possible.
I don’t know if all of my colleagues had such a quiet one but there seemed to be more crews sticking around stations (I work between two) than usual. I’m not expecting to experience a night like this again for some time, if ever, but I was glad of the slow-down in pace. I felt a lot more relaxed when I went home.
So, my shortest posting of a shift ever begins with a 52 year-old man who was described as ‘not alert’. The police were on scene because the call came from the City and they are very good at responding to medical emergencies out there (they are specially trained and carry defibs). Unfortunately, when I arrived they had gone into the hotel mentioned on the address when the patient was actually outside in a black cab. This fact was made known to me by the cab driver, who, obviously confused, had not alerted the police when they arrived but had waited a few seconds until I got there and came to get me. The police followed when they saw I wasn’t going into the building.
The man in the back of the cab was collapsed on the floor and he was deathly pale. Sweating profusely, he could barely speak but his colleague told me what had happened. He had a history of kidney cancer and was on a cocktail of drugs. He had suddenly collapsed after making one of the most ominous (and often last) statements we hear second-hand; ‘I’m not feeling too good’. He then passed out onto the floor and remained unconscious for a few minutes.
I gave the man some oxygen, the universal waker-upper, and he began to recover slowly. He became more lucid and explained that this had happened to him twice before and the doctors could find no cause for it. It didn’t help that he was fully recovered by the time he arrived at hospital, so there was very little for doctors to go on. I suggested he should go back to hospital and try again and he agreed. He was a visitor from up North, so letting him get on with his evening would have been a mistake, I think.
When the crew arrived to take him away, he had completely recovered, just like he said he would. To be honest, I think his one remaining kidney (he had one removed because of a tumour) is being affected by the cancer he has and its function is becoming impaired. One of these functions is the regulation of blood pressure. But then, what do I know?
A few hours into the shift and I was sent to a lovely little ‘Christmassy’ crescent near King’s Cross. It was one of those streets that look as if it was designed by the Disney Corporation for one of their ‘this is how olde London looks’ films. Charming. Unfortunately, these handsome townhouses are now broken up into flats, one of which housed my patient. He had been smoking cannabis and was now suffering from chest pain.
When I got on scene, I was directed to him by his slightly embarrassed girlfriend. The man, a 30 year-old, had right-side chest pain which, as he described it to me, sounded pleuritic, not cardiac. We never rule heart problems out, however, so he was given the works, including an ECG to determine the possible cause of his discomfort. He had a few anomalies on the 12-lead but nothing that screamed imminent cardiac arrest, so he was taken to hospital for further investigation. Obviously, drugs can irritate the body systems and its possible he has just abused himself and was now being penalised.
Speaking of Christmas (is it still legal to say that word?) I can't believe the Oxford Street lights are up and ON already! Give us a break. It's barely gone Hallowe'en. How desperate are we to shove consumer tat down everyone's throats. No wonder the 'real' religions think we are hopeless. Leave it 'til December please!
Then I sat on stand-by for a while and watched the old men and women and the not so old men and women (and related children) go about their peaceful business in the West End. I saw no drunks, no fighting, no stupidity and no vomit on the pavement. All I saw were poppy-wearing heroes with chest fulls of medals. Maybe the youth of our Capital went home early because they couldn’t compete with men and women like these. Maybe they were intimidated by the presence of so many good people.
Whatever it was, I thank you all for allowing me and, I hope, many of my colleagues a bit of a break from the usual stress. For once in a long time I am able to sign off a posting with the same phrase I have used many times on calls. Not required.
Be safe.
I don’t know if all of my colleagues had such a quiet one but there seemed to be more crews sticking around stations (I work between two) than usual. I’m not expecting to experience a night like this again for some time, if ever, but I was glad of the slow-down in pace. I felt a lot more relaxed when I went home.
So, my shortest posting of a shift ever begins with a 52 year-old man who was described as ‘not alert’. The police were on scene because the call came from the City and they are very good at responding to medical emergencies out there (they are specially trained and carry defibs). Unfortunately, when I arrived they had gone into the hotel mentioned on the address when the patient was actually outside in a black cab. This fact was made known to me by the cab driver, who, obviously confused, had not alerted the police when they arrived but had waited a few seconds until I got there and came to get me. The police followed when they saw I wasn’t going into the building.
The man in the back of the cab was collapsed on the floor and he was deathly pale. Sweating profusely, he could barely speak but his colleague told me what had happened. He had a history of kidney cancer and was on a cocktail of drugs. He had suddenly collapsed after making one of the most ominous (and often last) statements we hear second-hand; ‘I’m not feeling too good’. He then passed out onto the floor and remained unconscious for a few minutes.
I gave the man some oxygen, the universal waker-upper, and he began to recover slowly. He became more lucid and explained that this had happened to him twice before and the doctors could find no cause for it. It didn’t help that he was fully recovered by the time he arrived at hospital, so there was very little for doctors to go on. I suggested he should go back to hospital and try again and he agreed. He was a visitor from up North, so letting him get on with his evening would have been a mistake, I think.
When the crew arrived to take him away, he had completely recovered, just like he said he would. To be honest, I think his one remaining kidney (he had one removed because of a tumour) is being affected by the cancer he has and its function is becoming impaired. One of these functions is the regulation of blood pressure. But then, what do I know?
A few hours into the shift and I was sent to a lovely little ‘Christmassy’ crescent near King’s Cross. It was one of those streets that look as if it was designed by the Disney Corporation for one of their ‘this is how olde London looks’ films. Charming. Unfortunately, these handsome townhouses are now broken up into flats, one of which housed my patient. He had been smoking cannabis and was now suffering from chest pain.
When I got on scene, I was directed to him by his slightly embarrassed girlfriend. The man, a 30 year-old, had right-side chest pain which, as he described it to me, sounded pleuritic, not cardiac. We never rule heart problems out, however, so he was given the works, including an ECG to determine the possible cause of his discomfort. He had a few anomalies on the 12-lead but nothing that screamed imminent cardiac arrest, so he was taken to hospital for further investigation. Obviously, drugs can irritate the body systems and its possible he has just abused himself and was now being penalised.
Speaking of Christmas (is it still legal to say that word?) I can't believe the Oxford Street lights are up and ON already! Give us a break. It's barely gone Hallowe'en. How desperate are we to shove consumer tat down everyone's throats. No wonder the 'real' religions think we are hopeless. Leave it 'til December please!
Then I sat on stand-by for a while and watched the old men and women and the not so old men and women (and related children) go about their peaceful business in the West End. I saw no drunks, no fighting, no stupidity and no vomit on the pavement. All I saw were poppy-wearing heroes with chest fulls of medals. Maybe the youth of our Capital went home early because they couldn’t compete with men and women like these. Maybe they were intimidated by the presence of so many good people.
Whatever it was, I thank you all for allowing me and, I hope, many of my colleagues a bit of a break from the usual stress. For once in a long time I am able to sign off a posting with the same phrase I have used many times on calls. Not required.
Be safe.
Sunday, 11 November 2007
Luck and fate
Seven calls; one assisted-only, one running call and the others needed an ambulance.
A chunk of concrete (it looks like a missing tooth) came away from the roof of the Selfridge building in Oxford Street. It fell over a hundred feet before exploding on the pavement, inches from a 17 year-old girl who was walking underneath at the time. This happened in daylight, when shoppers were out and about and it was only by sheer luck that she didn’t get seriously hurt. In fact, she escaped without a scratch.
This has happened before; last year a man was killed outright when one of these blocks came away and landed on him. Fate seems to have saved the lives of this girl (and many others if this had happened on a busy Saturday).
I got this call as a ‘please investigate’ after someone dialled 999 and said that a friend had called from Oxford Street to say that someone had been hit by a car. Control thought it might be a hoax, so sent me to check it out. I sped down there to find the police around the area, cordoning the pavement off and tending to this emotional wreck of a girl. Her friends were with her when it happened and they all looked a little shocked.
The police told me that they had received a call saying a bomb had gone off. Now it all made sense – the sound of that large brick shattering after its long and very fast journey to Earth must have been so loud that people in the distance had mistaken it for an explosion or the sound of a car hitting someone at speed – thus the calls.
I handed her over to the crew when they arrived and took this picture because I think something needs to be done about this urgently. Apparently work was carried out to check the integrity of these slabs after the man was killed but this has obviously failed to make things safe for people walking below, so maybe they should consider the design of this area of the roof. Maybe they should all be removed and replaced with something less hazardous or secured in some other, more permanent way.
I had started my shift with a call to a 50 year-old man who collided with a van whilst riding his motorcycle. The force of the impact ripped the number plate from the van and his ride was totalled. He was lucky enough to escape with a fairly minor leg injury and the only real hazard was the lake of petrol that was on the pavement. The LFB soon arrived to clear that up, however.
Then a 52 year-old woman with DIB but there was already a MRU and ambulance crew on scene, so I was not required and bowed out gracefully.
I witnesses an ugly little scene on my way back to the station. Again, in Oxford Street. A woman (a tourist in her 60’s I think) was crossing the street and didn’t notice a cyclist coming towards her as she walked into the road. I heard the cyclist shout something at her and then plough into her, knocking her down. She fell quite hard and the cyclist (and bike) tumbled after, entangling them in the road. I was going to see if I could help but they both struggled up. The cyclist had been underneath the woman, so he pushed her, quite aggressively, so that she rolled away from him. It was a very undignified thing to see. The poor woman stood up, dusted herself off and then was treated to a volley of verbal abuse from Mr Cycle man. Totally unnecessary in my book. I thought cyclists were calmer people because they got out more. Obviously I’m wrong.
A call to a 37 year-old with palpitations was a non-starter because, once again, the crew were ahead of me and I would have been a spare part.
Childbirth is a natural thing, we all know that but a first time mother with no family support needs reassurance. A 27 year-old, pregnant with her first child, single and without a family network, called the ambulance service because she felt faint and dizzy. She told me she had tried to get in touch with her midwife but couldn’t get an answer. In desperation she dialled 999. She was genuinely apologetic about it but didn’t know what else to do because she didn’t understand that the way she was feeling is part of the normal process of pregnancy for mothers. I helped her understand that everything was normal (all her vital signs were good) and the crew arrived to reinforce that. She went home much happier.
If you vomit once, it’s probably nothing. If you vomit twice then it’s probably worth resting and getting over what might be a stomach bug or food poisoning. If you vomit almost continuously for three hours, I suggest you have waited far too long to get it checked out.
A 40 year-old man was claiming this when he called us to a train station after slumping in a corner and telling staff he had been throwing up all over the place. I couldn’t understand why, if he was already out and about, he would wait so long and not take himself off to A&E. He waited three hours before doing anything about it, then decided an ambulance would be the right choice. Oh and he admitted eating lobster earlier in the day.
While I was at the station, doing my paperwork after the vomiting man, I was asked to take a look at a PCSO’s hand. He had been bitten by a drunkard as he tried to move him on.
He came out and showed me the injury; it was small and nasty and would certainly need to be cleaned but it also represented a potentially serious health risk to him. If the guy who had done this had HepB, Hiv or any other nasties, the cop could contract an infection through the wound. I arranged to take him to hospital myself while cops arrived by the van load to take care of the culprit.
I went into the station and spoke to the vagrant who was now lying, pinned down by the police, on the station concourse.
‘Do you have any medical issues. Any infections or diseases?’ I asked.
‘Yes’, he spat.
‘What?’
‘F**K off, I’m not telling you!’
Then he started kicking the police officers who were restraining him. I know one of these officers well – she is a friend of mine from Waterloo Train Station, where she is based. She is a big, strong woman and kicking her in the stomach, which is what our violent vagrant did, is a bad idea. She launched herself on top of him and he was flattened to the floor. He could breathe but he wasn’t going anywhere or kicking anyone again.
I took the PCSO to hospital and he waited to get checked out. He’ll probably need to give a sample of blood and the vagrant may have his taken so that any risk can be assessed and dealt with. Strangely, they call those who bite or inject us with their bodily fluids 'donors'.
After all that excitement, I got to go home...on time.
A chunk of concrete (it looks like a missing tooth) came away from the roof of the Selfridge building in Oxford Street. It fell over a hundred feet before exploding on the pavement, inches from a 17 year-old girl who was walking underneath at the time. This happened in daylight, when shoppers were out and about and it was only by sheer luck that she didn’t get seriously hurt. In fact, she escaped without a scratch.
This has happened before; last year a man was killed outright when one of these blocks came away and landed on him. Fate seems to have saved the lives of this girl (and many others if this had happened on a busy Saturday).
I got this call as a ‘please investigate’ after someone dialled 999 and said that a friend had called from Oxford Street to say that someone had been hit by a car. Control thought it might be a hoax, so sent me to check it out. I sped down there to find the police around the area, cordoning the pavement off and tending to this emotional wreck of a girl. Her friends were with her when it happened and they all looked a little shocked.
The police told me that they had received a call saying a bomb had gone off. Now it all made sense – the sound of that large brick shattering after its long and very fast journey to Earth must have been so loud that people in the distance had mistaken it for an explosion or the sound of a car hitting someone at speed – thus the calls.
I handed her over to the crew when they arrived and took this picture because I think something needs to be done about this urgently. Apparently work was carried out to check the integrity of these slabs after the man was killed but this has obviously failed to make things safe for people walking below, so maybe they should consider the design of this area of the roof. Maybe they should all be removed and replaced with something less hazardous or secured in some other, more permanent way.
I had started my shift with a call to a 50 year-old man who collided with a van whilst riding his motorcycle. The force of the impact ripped the number plate from the van and his ride was totalled. He was lucky enough to escape with a fairly minor leg injury and the only real hazard was the lake of petrol that was on the pavement. The LFB soon arrived to clear that up, however.
Then a 52 year-old woman with DIB but there was already a MRU and ambulance crew on scene, so I was not required and bowed out gracefully.
I witnesses an ugly little scene on my way back to the station. Again, in Oxford Street. A woman (a tourist in her 60’s I think) was crossing the street and didn’t notice a cyclist coming towards her as she walked into the road. I heard the cyclist shout something at her and then plough into her, knocking her down. She fell quite hard and the cyclist (and bike) tumbled after, entangling them in the road. I was going to see if I could help but they both struggled up. The cyclist had been underneath the woman, so he pushed her, quite aggressively, so that she rolled away from him. It was a very undignified thing to see. The poor woman stood up, dusted herself off and then was treated to a volley of verbal abuse from Mr Cycle man. Totally unnecessary in my book. I thought cyclists were calmer people because they got out more. Obviously I’m wrong.
A call to a 37 year-old with palpitations was a non-starter because, once again, the crew were ahead of me and I would have been a spare part.
Childbirth is a natural thing, we all know that but a first time mother with no family support needs reassurance. A 27 year-old, pregnant with her first child, single and without a family network, called the ambulance service because she felt faint and dizzy. She told me she had tried to get in touch with her midwife but couldn’t get an answer. In desperation she dialled 999. She was genuinely apologetic about it but didn’t know what else to do because she didn’t understand that the way she was feeling is part of the normal process of pregnancy for mothers. I helped her understand that everything was normal (all her vital signs were good) and the crew arrived to reinforce that. She went home much happier.
If you vomit once, it’s probably nothing. If you vomit twice then it’s probably worth resting and getting over what might be a stomach bug or food poisoning. If you vomit almost continuously for three hours, I suggest you have waited far too long to get it checked out.
A 40 year-old man was claiming this when he called us to a train station after slumping in a corner and telling staff he had been throwing up all over the place. I couldn’t understand why, if he was already out and about, he would wait so long and not take himself off to A&E. He waited three hours before doing anything about it, then decided an ambulance would be the right choice. Oh and he admitted eating lobster earlier in the day.
While I was at the station, doing my paperwork after the vomiting man, I was asked to take a look at a PCSO’s hand. He had been bitten by a drunkard as he tried to move him on.
He came out and showed me the injury; it was small and nasty and would certainly need to be cleaned but it also represented a potentially serious health risk to him. If the guy who had done this had HepB, Hiv or any other nasties, the cop could contract an infection through the wound. I arranged to take him to hospital myself while cops arrived by the van load to take care of the culprit.
I went into the station and spoke to the vagrant who was now lying, pinned down by the police, on the station concourse.
‘Do you have any medical issues. Any infections or diseases?’ I asked.
‘Yes’, he spat.
‘What?’
‘F**K off, I’m not telling you!’
Then he started kicking the police officers who were restraining him. I know one of these officers well – she is a friend of mine from Waterloo Train Station, where she is based. She is a big, strong woman and kicking her in the stomach, which is what our violent vagrant did, is a bad idea. She launched herself on top of him and he was flattened to the floor. He could breathe but he wasn’t going anywhere or kicking anyone again.
I took the PCSO to hospital and he waited to get checked out. He’ll probably need to give a sample of blood and the vagrant may have his taken so that any risk can be assessed and dealt with. Strangely, they call those who bite or inject us with their bodily fluids 'donors'.
After all that excitement, I got to go home...on time.
Be safe.
Friday, 9 November 2007
The weeble guard
Twelve calls today – two refused, on false alarm, one assist-only, two conveyed and the rest went by ambulance.
I scoot between Waterloo and the West End via Whitehall in the early mornings and this gives me an opportunity to flick a wave at the guard standing at the entrance to Horseguard’s. They start their shift early, just like me, but for the life of me I can’t work out what they are guarding against at that time in the morning. Anyway, one of them has been sneaking a nod in my direction when he sees me and it’s nice to be able to communicate, even if that’s as much of a conversation as we can achieve.
This morning, my friend was nowhere to be seen and another young lad was standing at the gate. Well, he was mostly wobbling at the gate. He must have been out the night before because he looked in imminent danger of falling flat on his face. He kept startling himself into a rigid posture, only to relax again and drift towards weeble-land and an inevitable drop. I had the opportunity to watch him for a minute or so as I waited at the traffic lights but I continued my journey and didn’t see what became of him. I don’t know what the drill is if one of these guys falls. Do they get disciplined?
We weren’t called for him so I’m guessing he sorted himself out in the end. Just as well because the horses come on duty later in the morning and they wouldn’t have approved.
My morning started off with a call to a 38 year-old male, ‘vomiting blood’. He claimed to have lost about two and half litres of the stuff and I was more than a little wary of his estimate. He was HIV positive and he told me he had never had trouble like this with his health before. It looked like trouble was catching up with him. His bathroom was spattered in blood and he had a recent history of passing tarry stools. Ominous though the signs were, he remained fully alert and was able to walk himself out to the ambulance when it arrived (he had initially walked out to greet me when I got on scene but I took him back into the house).
Then a 34 year-old pregnant woman who fell down stairs at a railway station, injuring her ankle. I had to reassure her that her baby was fine and that her ankle was a long way off her womb. When the crew arrived, the kind rail staff provided us with one of their electric buggies to convey her to the ambulance in. I hitched a free ride and watched my colleagues walk back. Well, I did offer.
I was cancelled on scene for my next call, to a 40 year-old male with lung cancer who was coughing up blood. A crew were already there and I would have been excess baggage.
A strange call to a 30 year-old woman after that. She worked in a posh(ish) hotel near Trafalgar Square and collapsed with a numb arm whilst going about her duties (cleaning rooms). She had no history of illness and hadn’t taken anything (drink or drugs) recently. A Motorcycle Response Unit (MRU) colleague was on scene when I arrived and we cancelled the ambulance; I would take her to hospital in the car because she didn’t seem to have any significant medical problems – just this numb arm.
When I got her to hospital, the nurse noticed that the affected arm was also slightly swollen. I hadn’t seen this to be honest and I don’t think the MRU medic had either. The swelling wasn’t massively obvious but when it was pointed out, it became noticeable.
I went back to check on her later in the day and was told that she had been diagnosed with Carpal Tunnel Syndrome.
I wasn’t required for the next call. The crew had already arrived and were dealing with a 20 year-old female who felt ‘dizzy and sick’ but I was required for the call after this one – a 19 year-old female who bumped her head and was emotional. I conveyed her myself because she really didn’t need an ambulance. She travelled with her friend and work colleague and as we chatted I got to know how fragile she was.
She had fallen after going to the loo and bumped her head on the tiled floor of her workplace (a dental hospital). She had no serious injuries; not even a bump on her head, but she was shaken up and a bit teary-eyed. She insisted on being taken to hospital and I sensed that she probably needed the reassurance.
I discovered during the trip that she didn’t drink, smoke or have any tattoos on her body (although quite how that detail got into the conversation I can’t recall). I found this unusual. It’s rare these days to find a female without a vice, or who hasn’t marked themselves. Maybe she was a nun, I thought. Still, she was a pleasant young lady and she was delivered to hospital in a much better frame of mind than when I first saw her.
Later in the shift, I was sent up into the north (of London) for a call to an 80 year-old man who had fallen out of bed. I found him slumped on the floor with a couple of nasty looking cuts to his head. He had fallen hard and it looked like this wasn’t the first time. His carers were on scene as well as a neighbour who had known him for decades. The neighbour was more concerned about his condition than the carers, I have to say.
The man had suffered a stroke before and was now unable to communicate properly. He’d shout ‘No!’ every now and again but that was the extent of it. He was also quite unable to fend for himself and couldn’t get off the floor without assistance, so I propped him up a little and tried to get to the bottom of what had happened.
Apparently, he had pressed a button on the control panel of his specialised bed which lowered a guard rail at the side. Then he had simply fallen over the edge when he got too close, landing heavily on the wooden floor.
‘Why is the button so near him?’ I asked the carers.
They both shrugged their shoulders. I rarely get any clear information from home carers and I have no idea why.
‘Don’t you think it’s unsafe for him to have any access to this panel?’ I suggested.
Again, blank looks. I wondered if they spoke English at all.
We had no idea how long he had been on the floor. He could have lain there all night. His neighbour was not impressed by the level of care he was receiving and when I asked for his diary ( a document which records the day-to-day activities of the carers) nobody seemed to know what I was talking about. It was produced eventually, when the penny dropped.
The crew arrived and he was carefully lifted onto a chair and then out to the ambulance. His head injuries needed attention and as I walked back to the car I wondered how long it would be before we were called again to the same address.
Even during daylight hours, calls to sleeping drunks can be generated by frantic members of the general public. A call for a 30 year-old female who ‘cannot be woken’ on a park bench had me racing a long way out of my area to find a woman slumped across the seat, which was out on the pavement at the park entrance. I walked up to her, shook her twice and woke her up.
‘Do you need an ambulance?’ I shouted.
‘Oi! F**k off!’ she replied.
Did I tell you I have a degree in waking drunks up? I walked back to the car and completed my paperwork. Then I made my way back to my own patch and my own drunks.
A 52 year-old woman with a history of internal bleeding (although we were never told why) called us for chest pain. When I got there I realised she was very depressed. She still complained of chest pain but she had a lost look about her and the crew got very little out of her when they arrived to take her away. She made me feel a little depressed in fact.
My next call was for a 21 year-old female with abdominal pain. She was writhing on the floor in agony when I arrived. She had a history of ovarian cyst and it looked to me as if she was suffering at the hands of an old enemy. The ambulance didn’t take long to arrive and she was quickly taken away. Pain relief was given but nothing seemed to be touching it. I felt sorry for her.
As the evening drew in I was called to a RTC in Camden where a moped had collided with a brand new Porche. Neither the moped rider nor the car driver were hurt but that expensive set of wheels (the Porche obviously) was badly damaged. Not because the moped had struck it but because the rider, a heavily built man, had been thrown onto the boonet before sliding off onto the road. His journey had left a major dent in the car as well as a long, deep scratch in the paint work.
With twenty minutes of my shift to go, Control sends me to a 25 year-old female who is unconscious in a tanning shop. The police were on scene for some reason and the staff were more than a little concerned about the woman's behaviour. She was conscious but looked stoned. She definitely looked as though she had taken something.
'Have you taken any drugs or medicines today?' I asked politely.
'No. I'm fine. Leave me alone', she said.
She was wobbly, disorientated and had slurred speech. I was concerned about her condition and she was adamantly refusing to go to hospital. Neither the police or myself could persuade her and her temper was beginning to fray but it spilled over when the maager of the salon explained to her that, because she had refused treatment, she could not be allowed to use the tanning machines again until an 'all-clear' had been given by a doctor.
I thought that was fair enough but the woman went ballistic and had to be told to calm down or else by the police.
After a twenty minute argument, she stormed out of the shop and I was left holding my bags in the air like a lemon.
I ended my shift by wandering back to my base station via Whitehall. I glanced across at the parade ground entrance. The guards were there but the horses were gone (they get taken away when the light fails) and the tourists were going back to their hotels. London was winding down and so was I. Time to go home.
Be safe.
I scoot between Waterloo and the West End via Whitehall in the early mornings and this gives me an opportunity to flick a wave at the guard standing at the entrance to Horseguard’s. They start their shift early, just like me, but for the life of me I can’t work out what they are guarding against at that time in the morning. Anyway, one of them has been sneaking a nod in my direction when he sees me and it’s nice to be able to communicate, even if that’s as much of a conversation as we can achieve.
This morning, my friend was nowhere to be seen and another young lad was standing at the gate. Well, he was mostly wobbling at the gate. He must have been out the night before because he looked in imminent danger of falling flat on his face. He kept startling himself into a rigid posture, only to relax again and drift towards weeble-land and an inevitable drop. I had the opportunity to watch him for a minute or so as I waited at the traffic lights but I continued my journey and didn’t see what became of him. I don’t know what the drill is if one of these guys falls. Do they get disciplined?
We weren’t called for him so I’m guessing he sorted himself out in the end. Just as well because the horses come on duty later in the morning and they wouldn’t have approved.
My morning started off with a call to a 38 year-old male, ‘vomiting blood’. He claimed to have lost about two and half litres of the stuff and I was more than a little wary of his estimate. He was HIV positive and he told me he had never had trouble like this with his health before. It looked like trouble was catching up with him. His bathroom was spattered in blood and he had a recent history of passing tarry stools. Ominous though the signs were, he remained fully alert and was able to walk himself out to the ambulance when it arrived (he had initially walked out to greet me when I got on scene but I took him back into the house).
Then a 34 year-old pregnant woman who fell down stairs at a railway station, injuring her ankle. I had to reassure her that her baby was fine and that her ankle was a long way off her womb. When the crew arrived, the kind rail staff provided us with one of their electric buggies to convey her to the ambulance in. I hitched a free ride and watched my colleagues walk back. Well, I did offer.
I was cancelled on scene for my next call, to a 40 year-old male with lung cancer who was coughing up blood. A crew were already there and I would have been excess baggage.
A strange call to a 30 year-old woman after that. She worked in a posh(ish) hotel near Trafalgar Square and collapsed with a numb arm whilst going about her duties (cleaning rooms). She had no history of illness and hadn’t taken anything (drink or drugs) recently. A Motorcycle Response Unit (MRU) colleague was on scene when I arrived and we cancelled the ambulance; I would take her to hospital in the car because she didn’t seem to have any significant medical problems – just this numb arm.
When I got her to hospital, the nurse noticed that the affected arm was also slightly swollen. I hadn’t seen this to be honest and I don’t think the MRU medic had either. The swelling wasn’t massively obvious but when it was pointed out, it became noticeable.
I went back to check on her later in the day and was told that she had been diagnosed with Carpal Tunnel Syndrome.
I wasn’t required for the next call. The crew had already arrived and were dealing with a 20 year-old female who felt ‘dizzy and sick’ but I was required for the call after this one – a 19 year-old female who bumped her head and was emotional. I conveyed her myself because she really didn’t need an ambulance. She travelled with her friend and work colleague and as we chatted I got to know how fragile she was.
She had fallen after going to the loo and bumped her head on the tiled floor of her workplace (a dental hospital). She had no serious injuries; not even a bump on her head, but she was shaken up and a bit teary-eyed. She insisted on being taken to hospital and I sensed that she probably needed the reassurance.
I discovered during the trip that she didn’t drink, smoke or have any tattoos on her body (although quite how that detail got into the conversation I can’t recall). I found this unusual. It’s rare these days to find a female without a vice, or who hasn’t marked themselves. Maybe she was a nun, I thought. Still, she was a pleasant young lady and she was delivered to hospital in a much better frame of mind than when I first saw her.
Later in the shift, I was sent up into the north (of London) for a call to an 80 year-old man who had fallen out of bed. I found him slumped on the floor with a couple of nasty looking cuts to his head. He had fallen hard and it looked like this wasn’t the first time. His carers were on scene as well as a neighbour who had known him for decades. The neighbour was more concerned about his condition than the carers, I have to say.
The man had suffered a stroke before and was now unable to communicate properly. He’d shout ‘No!’ every now and again but that was the extent of it. He was also quite unable to fend for himself and couldn’t get off the floor without assistance, so I propped him up a little and tried to get to the bottom of what had happened.
Apparently, he had pressed a button on the control panel of his specialised bed which lowered a guard rail at the side. Then he had simply fallen over the edge when he got too close, landing heavily on the wooden floor.
‘Why is the button so near him?’ I asked the carers.
They both shrugged their shoulders. I rarely get any clear information from home carers and I have no idea why.
‘Don’t you think it’s unsafe for him to have any access to this panel?’ I suggested.
Again, blank looks. I wondered if they spoke English at all.
We had no idea how long he had been on the floor. He could have lain there all night. His neighbour was not impressed by the level of care he was receiving and when I asked for his diary ( a document which records the day-to-day activities of the carers) nobody seemed to know what I was talking about. It was produced eventually, when the penny dropped.
The crew arrived and he was carefully lifted onto a chair and then out to the ambulance. His head injuries needed attention and as I walked back to the car I wondered how long it would be before we were called again to the same address.
Even during daylight hours, calls to sleeping drunks can be generated by frantic members of the general public. A call for a 30 year-old female who ‘cannot be woken’ on a park bench had me racing a long way out of my area to find a woman slumped across the seat, which was out on the pavement at the park entrance. I walked up to her, shook her twice and woke her up.
‘Do you need an ambulance?’ I shouted.
‘Oi! F**k off!’ she replied.
Did I tell you I have a degree in waking drunks up? I walked back to the car and completed my paperwork. Then I made my way back to my own patch and my own drunks.
A 52 year-old woman with a history of internal bleeding (although we were never told why) called us for chest pain. When I got there I realised she was very depressed. She still complained of chest pain but she had a lost look about her and the crew got very little out of her when they arrived to take her away. She made me feel a little depressed in fact.
My next call was for a 21 year-old female with abdominal pain. She was writhing on the floor in agony when I arrived. She had a history of ovarian cyst and it looked to me as if she was suffering at the hands of an old enemy. The ambulance didn’t take long to arrive and she was quickly taken away. Pain relief was given but nothing seemed to be touching it. I felt sorry for her.
As the evening drew in I was called to a RTC in Camden where a moped had collided with a brand new Porche. Neither the moped rider nor the car driver were hurt but that expensive set of wheels (the Porche obviously) was badly damaged. Not because the moped had struck it but because the rider, a heavily built man, had been thrown onto the boonet before sliding off onto the road. His journey had left a major dent in the car as well as a long, deep scratch in the paint work.
With twenty minutes of my shift to go, Control sends me to a 25 year-old female who is unconscious in a tanning shop. The police were on scene for some reason and the staff were more than a little concerned about the woman's behaviour. She was conscious but looked stoned. She definitely looked as though she had taken something.
'Have you taken any drugs or medicines today?' I asked politely.
'No. I'm fine. Leave me alone', she said.
She was wobbly, disorientated and had slurred speech. I was concerned about her condition and she was adamantly refusing to go to hospital. Neither the police or myself could persuade her and her temper was beginning to fray but it spilled over when the maager of the salon explained to her that, because she had refused treatment, she could not be allowed to use the tanning machines again until an 'all-clear' had been given by a doctor.
I thought that was fair enough but the woman went ballistic and had to be told to calm down or else by the police.
After a twenty minute argument, she stormed out of the shop and I was left holding my bags in the air like a lemon.
I ended my shift by wandering back to my base station via Whitehall. I glanced across at the parade ground entrance. The guards were there but the horses were gone (they get taken away when the light fails) and the tourists were going back to their hotels. London was winding down and so was I. Time to go home.
Be safe.
Wednesday, 7 November 2007
Two for one
Seven Emergencies: one treated on scene, one conveyed, one assisted-only and four taken by ambulance.
An early morning call to a 4 year-old girl with DIB and abdo pain took me to a small house in south London where I found a panicking mother and a rather calm little patient.
‘She has had this problem for weeks now and the doctor’s don’t seem to do anything about it’, mum said as I walked into the girl’s bedroom.
The girl was sitting up on her bed, looking right as rain. She beamed at me and I asked her mother some questions but my tiny patient decided she was going to answer them herself; it wasn’t the first time a minor had taken the role of lead during my interrogation – confident kids like to talk about their problems in their own way, that way mum (or dad) can’t ruin any planned embellishments or exaggerations.
I listened as she told me how she had woken up in the night with tummy ache and had felt a bit sick. She asked her mum to present me with the basin containing her latest expulsion, so that I could inspect it if I wanted to (it’s always nice to be made part of the family like that) and it was duly pushed under my nose. There was no vomit in it, just a little lump of sputum and a trickle of saliva – the vomit of the hopeful.
‘Ok, and have you been having breathing problems too?’ I asked.
‘Yes, but I’m better now.’
Mum was standing next to her with a concerned frown on her forehead. The little girl’s sister was supposed to be at school but obviously felt it necessary to be with her younger sibling during this time of crisis. That is until mum reminded her to get moving. She left the room reluctantly and headed off.
The crew arrived as I completed my obs, which revealed nothing really. The girl was a little ‘chesty’ but she had no temperature and there was nothing untoward with her vital signs. I began to wonder if she was avoiding pre-school. Nevertheless, she was taken with mum to hospital to be checked out and I left the scene shortly after completing my paperwork. I had started my shift with a little grin – not only had my patient been bold enough to try to pull the wool over my eyes as well as her mum’s, she had been confident enough to deliver a star performance. I couldn’t knock that.
A call to a 64 year-old female with back pain turned out to be a 64 year-old male with abdo pain. There’s nothing like getting a reverse product from a conversation, is there? He had recently been diagnosed with an infection of his testicles and had a history of diverticulitis, either of which might explain his current complaint. He was pale and quite obviously uncomfortable and he had waited for me longer than he needed to because, once again, I was wandering around his fortress estate looking for the correct door. It took me five or six minutes to get to him after I left the car.
There was nothing I could do for him immediately and when the crew arrived he was put into the chair and wheeled off to the ambulance (which was parked somewhere far away because they couldn’t gain access to the car park).
Hyperventilation is usually treated on scene. There is nothing emergent about this condition when it’s purely emotional (or psychological). My next call, for a 30 year-old female who was feeling faint took me to a hyperventilating woman. The crew were on scene at the same time, so I left them to work their magic on her. There’s no point in over-killing a perfectly straight-forward job.
A regular face next. He was inside the police office at Piccadilly Circus. He had gone in and collapsed dramatically and the call had been generated as '31 year-old male, fitting'. As I made my way there, it changed to ‘near faint’ and I knew I was going to meet someone I had dealt with before – especially in that location. I’ve yet to go to a genuine call there and I have been to that little office numerous times over the years – every faker in town goes there I think.
Sure enough, when I got inside a familiar face greeted me - well, he looked up in a sickly fashion and acknowledged my presence. You can see the physical change on someone’s face when you know they recognise you and they realise that their little game isn’t going to get them very far. He had that same disappointed look around his eyes when he caught sight of me.
I carried out my obs and asked him why he thought he needed an ambulance (this time). He changed his story over and over again. First he had a fit inside a theatre, then he was walking down the street when it happened. I pointed out that not many epileptics manage to walk into their local police office whilst having a seizure and he tried to change his story again. By now the crew had arrived and my ‘patient’ was already feeling much better. I explained the situation and they offered to check him out in the ambulance but he decided he was well enough to go home, so he declined, smiled and thanked us then wandered off into the crowd. I’ll see him again near Christmas I expect.
A combination call at an underground station in the late afternoon after that. I went to the aid of a 31 year-old woman who had fallen down steps at the station and twisted her ankle. It was swollen and discoloured and certainly looked sprained. During my chat with her an argument kicked off on the other side of the station office, where she had been brought after falling. A passenger was shouting and swearing at staff but I couldn’t catch what the theme was, so I asked them to keep it down while I was dealing with my patient.
The crew arrived to take her away and she seemed very upset about having to go to hospital. Lots of patients weep when they realise they have hurt themselves badly enough to warrant a trip to A&E.
I went out to my car and started on my paperwork but I didn’t complete it because a member of staff from the station knocked on my window and asked me to come back inside because he had an injured colleague. I went back down after calling this in as a ‘running call’ and was taken back into the station office. Another member of the underground staff sat in a chair with his leg elevated. There were a couple of police officers standing near him and a few of his colleagues were hovering.
It turns out the argument I had witnessed earlier was between this member of staff and a passenger who disagreed about the validity of his ticket to travel. A scuffle broke out, allegedly instigated by the passenger and my new patient ended up with a heavily bruised shin and cuts to his arm. On closer inspection the cuts looked like puncture wounds but I couldn’t work out what might have caused them. They were too round and small to be teeth marks, unless the passenger was a vampire (that might explain his desperate need to travel underground, even without a valid ticket – it was still daylight outside). It looked as though a small instrument had been used but the punctures were shallow, so a knife of some kind was unlikely.
There were no serious injuries and, as the patient swore his way through the explanation of what took place, I realised he wasn’t in any imminent danger of losing consciousness either, so I called Control and asked them to cancel the ambulance. They were more than happy for me to take the man to hospital myself because we had no ambulances to spare anyway.
On the way to hospital, he told me what he had done for a living before going underground. He was responsible for the upkeep of the clock in Big Ben’s tower. He used old pennies to weight the system precisely so that it wouldn’t go out of time. He also kept the works rust-free by cleaning and oiling them regularly. Fascinating.
If you have been ill for weeks and nothing has improved, you should really go and see your GP again. Calling an emergency ambulance for an on-going illness defeats the very purpose of our existence (acute emergency) and negates the purpose of a GP system. My last call, to a 33 year-old woman with a sore throat demonstrates this point. The call had been given as a DIB, which it was not, but once again a screening system that is just crying out to be abused had helped her get what she wanted – a blue light response for an ageing illness.
She had already been to her GP and been given antibiotics for a throat infection but they hadn’t cleared it. Her ‘DIB’ was panicky hyperventilation and nothing more. She had been suffering for three weeks but hadn’t bothered to go back to her doctor for another check and possibly some new antibiotics. Neither had she tried self-help. She had taken nothing to relieve her discomfort and simply lay there waiting for us to arrive and take her to an A&E department, where she could quite possibly spread her infection to vulnerable patients.
I know everyone is different but some real education is needed to stop this epidemic of ignorance about when an emergency response is needed.
One of the hospitals I frequently take patients to threatened to stop ambulances coming in because they had simply run out of beds and couldn’t cope with any more. This was on a busy week day but when I went in to look around at what they were dealing with, I found very few seriously ill or injured patients lying in cubicles. Most were drunk, drugged or had non-urgent problems. The reception area was full (standing room only) of minor problems that could have waited. Surely a crisis is coming?
Be safe.
An early morning call to a 4 year-old girl with DIB and abdo pain took me to a small house in south London where I found a panicking mother and a rather calm little patient.
‘She has had this problem for weeks now and the doctor’s don’t seem to do anything about it’, mum said as I walked into the girl’s bedroom.
The girl was sitting up on her bed, looking right as rain. She beamed at me and I asked her mother some questions but my tiny patient decided she was going to answer them herself; it wasn’t the first time a minor had taken the role of lead during my interrogation – confident kids like to talk about their problems in their own way, that way mum (or dad) can’t ruin any planned embellishments or exaggerations.
I listened as she told me how she had woken up in the night with tummy ache and had felt a bit sick. She asked her mum to present me with the basin containing her latest expulsion, so that I could inspect it if I wanted to (it’s always nice to be made part of the family like that) and it was duly pushed under my nose. There was no vomit in it, just a little lump of sputum and a trickle of saliva – the vomit of the hopeful.
‘Ok, and have you been having breathing problems too?’ I asked.
‘Yes, but I’m better now.’
Mum was standing next to her with a concerned frown on her forehead. The little girl’s sister was supposed to be at school but obviously felt it necessary to be with her younger sibling during this time of crisis. That is until mum reminded her to get moving. She left the room reluctantly and headed off.
The crew arrived as I completed my obs, which revealed nothing really. The girl was a little ‘chesty’ but she had no temperature and there was nothing untoward with her vital signs. I began to wonder if she was avoiding pre-school. Nevertheless, she was taken with mum to hospital to be checked out and I left the scene shortly after completing my paperwork. I had started my shift with a little grin – not only had my patient been bold enough to try to pull the wool over my eyes as well as her mum’s, she had been confident enough to deliver a star performance. I couldn’t knock that.
A call to a 64 year-old female with back pain turned out to be a 64 year-old male with abdo pain. There’s nothing like getting a reverse product from a conversation, is there? He had recently been diagnosed with an infection of his testicles and had a history of diverticulitis, either of which might explain his current complaint. He was pale and quite obviously uncomfortable and he had waited for me longer than he needed to because, once again, I was wandering around his fortress estate looking for the correct door. It took me five or six minutes to get to him after I left the car.
There was nothing I could do for him immediately and when the crew arrived he was put into the chair and wheeled off to the ambulance (which was parked somewhere far away because they couldn’t gain access to the car park).
Hyperventilation is usually treated on scene. There is nothing emergent about this condition when it’s purely emotional (or psychological). My next call, for a 30 year-old female who was feeling faint took me to a hyperventilating woman. The crew were on scene at the same time, so I left them to work their magic on her. There’s no point in over-killing a perfectly straight-forward job.
A regular face next. He was inside the police office at Piccadilly Circus. He had gone in and collapsed dramatically and the call had been generated as '31 year-old male, fitting'. As I made my way there, it changed to ‘near faint’ and I knew I was going to meet someone I had dealt with before – especially in that location. I’ve yet to go to a genuine call there and I have been to that little office numerous times over the years – every faker in town goes there I think.
Sure enough, when I got inside a familiar face greeted me - well, he looked up in a sickly fashion and acknowledged my presence. You can see the physical change on someone’s face when you know they recognise you and they realise that their little game isn’t going to get them very far. He had that same disappointed look around his eyes when he caught sight of me.
I carried out my obs and asked him why he thought he needed an ambulance (this time). He changed his story over and over again. First he had a fit inside a theatre, then he was walking down the street when it happened. I pointed out that not many epileptics manage to walk into their local police office whilst having a seizure and he tried to change his story again. By now the crew had arrived and my ‘patient’ was already feeling much better. I explained the situation and they offered to check him out in the ambulance but he decided he was well enough to go home, so he declined, smiled and thanked us then wandered off into the crowd. I’ll see him again near Christmas I expect.
A combination call at an underground station in the late afternoon after that. I went to the aid of a 31 year-old woman who had fallen down steps at the station and twisted her ankle. It was swollen and discoloured and certainly looked sprained. During my chat with her an argument kicked off on the other side of the station office, where she had been brought after falling. A passenger was shouting and swearing at staff but I couldn’t catch what the theme was, so I asked them to keep it down while I was dealing with my patient.
The crew arrived to take her away and she seemed very upset about having to go to hospital. Lots of patients weep when they realise they have hurt themselves badly enough to warrant a trip to A&E.
I went out to my car and started on my paperwork but I didn’t complete it because a member of staff from the station knocked on my window and asked me to come back inside because he had an injured colleague. I went back down after calling this in as a ‘running call’ and was taken back into the station office. Another member of the underground staff sat in a chair with his leg elevated. There were a couple of police officers standing near him and a few of his colleagues were hovering.
It turns out the argument I had witnessed earlier was between this member of staff and a passenger who disagreed about the validity of his ticket to travel. A scuffle broke out, allegedly instigated by the passenger and my new patient ended up with a heavily bruised shin and cuts to his arm. On closer inspection the cuts looked like puncture wounds but I couldn’t work out what might have caused them. They were too round and small to be teeth marks, unless the passenger was a vampire (that might explain his desperate need to travel underground, even without a valid ticket – it was still daylight outside). It looked as though a small instrument had been used but the punctures were shallow, so a knife of some kind was unlikely.
There were no serious injuries and, as the patient swore his way through the explanation of what took place, I realised he wasn’t in any imminent danger of losing consciousness either, so I called Control and asked them to cancel the ambulance. They were more than happy for me to take the man to hospital myself because we had no ambulances to spare anyway.
On the way to hospital, he told me what he had done for a living before going underground. He was responsible for the upkeep of the clock in Big Ben’s tower. He used old pennies to weight the system precisely so that it wouldn’t go out of time. He also kept the works rust-free by cleaning and oiling them regularly. Fascinating.
If you have been ill for weeks and nothing has improved, you should really go and see your GP again. Calling an emergency ambulance for an on-going illness defeats the very purpose of our existence (acute emergency) and negates the purpose of a GP system. My last call, to a 33 year-old woman with a sore throat demonstrates this point. The call had been given as a DIB, which it was not, but once again a screening system that is just crying out to be abused had helped her get what she wanted – a blue light response for an ageing illness.
She had already been to her GP and been given antibiotics for a throat infection but they hadn’t cleared it. Her ‘DIB’ was panicky hyperventilation and nothing more. She had been suffering for three weeks but hadn’t bothered to go back to her doctor for another check and possibly some new antibiotics. Neither had she tried self-help. She had taken nothing to relieve her discomfort and simply lay there waiting for us to arrive and take her to an A&E department, where she could quite possibly spread her infection to vulnerable patients.
I know everyone is different but some real education is needed to stop this epidemic of ignorance about when an emergency response is needed.
One of the hospitals I frequently take patients to threatened to stop ambulances coming in because they had simply run out of beds and couldn’t cope with any more. This was on a busy week day but when I went in to look around at what they were dealing with, I found very few seriously ill or injured patients lying in cubicles. Most were drunk, drugged or had non-urgent problems. The reception area was full (standing room only) of minor problems that could have waited. Surely a crisis is coming?
Be safe.
Friday, 2 November 2007
Dancing queen
Seven emergency calls – one assisted-only, one refused, one arrested and four taken by ambulance.
A 45 year-old homeless man who woke up in the street, covered in bruises and suffering chest pains called us out because he didn’t know how his injuries happened. It was a mystery to me and the crew too – his chest area looked as if someone had stamped all over it. He also had bruises to his legs and arms; he had clearly taken a beating at some point and I couldn’t believe he just slept through it.
‘How did you get these bruises?’ I asked him.
‘I don’t know. I can’t remember’. He replied.
Either he was knocked unconscious in the first few seconds of the assault or he just wasn’t prepared to tell anyone. The police were on scene too but they got nowhere fast. I understood this, however. Life on the street is rough and he was probably trying to protect himself from a worse beating in the future if he pointed the finger. Street people have their own territories, rules and unspoken agreements.
Although he was in a lot of pain, I couldn’t give him morphine because he had liver disease. He was given entonox instead but it didn’t seem to take the edge off it for him, so the crew got him to hospital quickly. He was conscious throughout and was able to walk but there was no way we could ignore the possibility of unseen injuries, so he was collared and put on a board for the trip.
The police, a motorbike responder (MRU) and myself were all called to a ‘20 year-old male, unconscious on a bus’. A hundred per cent of these calls, in my experience, have turned out to be nothing more than a sleeping drunk. In most cases, the bus driver is either too scared or simply not prepared to try and wake them up. It is bus company policy to dial 999 and get us on scene and I'm sure a few people will argue that the person may have a serious medical problem and I can’t dispute that but, statistically, the only real problem they have is alcohol.
I can go and investigate a call like this myself but when a little river of blue lights show up for one stubborn drunk it becomes a charade and I wonder what people think of us. The MRU paramedic sat on his bike shaking his head in disbelief – this is over-resourcing and will one day cost a genuinely ill or injured person dearly. Despite the flak I get for pointing this stuff out, I would remind everyone that WE pay for this and that it is time for common sense to be brought back in to the equation. Remove the decision-making computers and start taking responsibility for decisions in a human world. Rant over.
I walked onto the bus, shook the man a few times and he swung at me with his fist. That was my signal to let the police drag him onto the street, which they duly did. He was shoved into a corner and given a lecture about being abusive. We all left the scene and a major incident was averted. Twenty minutes, four professionals and a couple of hundred quid. He will do it again and again for years to come. It would be cheaper to buy this man as much alcohol as he wanted and give him his own personal bus to sleep on.
I know I have had my go at cyclists in London and I still feel angry at the way some of them behave – running red lights with impunity, speeding across pedestrian crossings when people are on them, being rude to drivers who let them know how annoying they are - but sometimes I get called to a cyclist who has suffered at the hands of a motorist, like the 35 year-old man who was knocked off his bicycle on a busy road by a driver who wasn’t looking or didn’t care to see him. The car swerved in front of him, clipping his wheel and throwing him over the handle bars.
When I got on scene the police were already dealing with the driver, a middle-aged woman dressed in a smart suit. She looked badly shaken up by the experience and didn’t know where to look when one of the police officers produced a breathalyser. I think her world had just come crashing in.
The cyclist had gotten away with a fractured collar bone and dislocated shoulder. I noticed a long scar as I treated him.
‘Is this scar from an operation in the past?’ I enquired.
‘Yes’, he replied, ‘I've broken this collar bone before and had to have it operated on’.
‘How did that happen?’
‘I was knocked off my bike by a car’.
The man hadn’t been wearing a helmet and this was not his first encounter with other vehicles on the road. I was beginning to wonder if he had any common sense.
The crew arrived shortly after I put him in a sling and he was taken to hospital.
I went back to Leicester Square after that job and had a few minutes to myself until a call came through for an 80 year-old man who had collapsed at one of the casinos in the area. I didn’t need to drive, so I grabbed my stuff and walked across the gardens to the address. The location I was given was inaccurate, however, and I found myself on a building site. The builders inside became concerned when I told them a call had been made from their location and, thinking that there was only one place in the building where anyone in trouble could be, they took me to the cellar area where a locked door barred us from getting any further. I thought we might be breaking this down to get to a dying man underneath.
That drama didn’t happen – one of the builders pointed out that there was another casino next door which shared the building’s address, so I made my way there and asked the girl at the reception desk if they had called an ambulance. She didn’t know but one of the security guys did and he led me downstairs to the patient.
Among the little crowd of gamblers in the lounge bar, a pale and sweaty Chinese man sat. He was known to the casino staff but had no friends with him. He had collapsed and fallen onto the floor whilst playing roulette. As I assessed him and translated my concerns through an interpreter (getting Chinese interpreted in this part of London is easy – China Town is behind the Square), I discovered that this had happened before but he didn’t want to go to hospital. He seemed to be recovering and was clearly only interested in continuing his day’s fun and games, so I waited with him for ten minutes, carried out more obs and asked him a few more times if he was sure. He was adamant. He signed my form and I left him in peace. The casino manager said he would keep an eye on him and I walked out wondering how much money the Chinese man loses every day.
On a shift where it seemed every patient was going to be male, I headed to an address to deal with a 63 year-old man with chest pain and SOB. He had a history of MI and was currently on GTN and aspirin – a standard combination for cardiac histories. He had taken his GTN and this had brought some relief from the chest pain he had originally called about. It’s useful to us to establish what a person was doing just prior to the onset of chest pain as this can help to eliminate a possible MI from simple angina. This patient had not been exerting himself when the pain started, so it was best if he went to hospital, especially as he had experienced some shortness of breath during the episode. The crew arrived as I completed my obs and I put a precautionary cannula in just before we set off for hospital. He arrived in a stable condition with diminishing pain and no SOB.
Another expensive call – this time involving a cycle responder (CRU), the police, an ambulance and myself – for a 20 year-old male who was ‘fitting’ in a large department store in Oxford Street. The descriptor included the words ‘been caught shoplifting’ and I knew I was heading to a faker.
Sure enough, when I got on scene, I joined the police officer and my CRU colleague to witness the worst parody of epilepsy I have ever seen. The young man was flopping around on the floor, clearly conscious, with a co-ordination that can only be brought about by an alert and fully functional brain. He was asked repeatedly to stop the charade but refused to play ball for twenty minutes until he grew so tired of it himself, he simply gave up and lay on the floor staring up at one of the funniest cops I have worked with. The officer had no sympathy for the boy on the floor (it transpired he was only 15 years old) and verbally berated him until he behaved himself and sat up to be questioned. His stony face and no-nonsense attitude was just what was required for this delinquent and it was refreshing to see that it still existed. None of this ‘yes sir, no sir’ rubbish that the police are forced into – he was an old school cop and was having none of this lad’s stupidity. It struck me that the policeman’s approach was probably good for this young thief – he probably needed a father-figure, if only for a few hours.
The ambulance crew arrived soon after the boy began to ‘recover’ and we all waited on scene just in case he decided to do anything stupid but he behaved and began to talk to the police, who were now three-strong and included a very attractive WPC...not that I was looking.
At first the boy lied to the officers about his details, then he told them everything they wanted to know but he included a detail that they hadn’t asked for; the name of an accomplice who was waiting for him across the street! They had been on a shoplifting spree, stealing mainly clothes from shops up and down Oxford Street. Now his mate was standing outside one of these stores waiting to meet up. Little did he know the police were on their way to arrest him, thanks to his loyal friend. I think the lad was bitter about being caught. Maybe he should consider an honest life.
The only female patient of the shift was a 27 year-old woman who fell during a dance class and twisted her ankle. She was lying on the floor at the back of the room as dancers continued their lesson around her. She had a badly sprained ankle and was in a lot of pain. I gave her entonox for that.
The crew didn’t arrive for fifteen minutes, so I had plenty of time to assess her and discover what had happened. She was quite a big girl and I looked around the class wondering how she fitted in – all the other dancers were slim, light and looked like ballet professionals. I didn’t want to be rude but I had to ask.
‘So, you were dancing with this group when you twisted your ankle?’
‘No, I jumped up and fell awkwardly on it’.
I had been there long enough to notice that none of these dancers were jumping around. They were doing stretching exercises.
‘Why were you jumping up?’
‘We were jiving’.
‘Jiving? What, this lot?’
‘No. This is the other class. My class left half an hour ago’.
So, she had been with a jive class and fallen badly. They had left when the class ended and the next dance class had come in while she was lying in agony on the floor with nothing but a few ice packs and a member of staff for company. It seemed comically ironic and the cruellest part of my humour smiled at the thought. The poor girl had been on this floor for almost an hour waiting for an ambulance. She probably had to wait because we were busy with an ‘emergency’ shoplifter.
When the crew took her away, I had one last look at the graceful things dancing in front of me. I don’t see much beauty in this job, so my last few minutes on duty were spent in this pleasant world. I think I can be forgiven for the indulgence.
Be safe.
A 45 year-old homeless man who woke up in the street, covered in bruises and suffering chest pains called us out because he didn’t know how his injuries happened. It was a mystery to me and the crew too – his chest area looked as if someone had stamped all over it. He also had bruises to his legs and arms; he had clearly taken a beating at some point and I couldn’t believe he just slept through it.
‘How did you get these bruises?’ I asked him.
‘I don’t know. I can’t remember’. He replied.
Either he was knocked unconscious in the first few seconds of the assault or he just wasn’t prepared to tell anyone. The police were on scene too but they got nowhere fast. I understood this, however. Life on the street is rough and he was probably trying to protect himself from a worse beating in the future if he pointed the finger. Street people have their own territories, rules and unspoken agreements.
Although he was in a lot of pain, I couldn’t give him morphine because he had liver disease. He was given entonox instead but it didn’t seem to take the edge off it for him, so the crew got him to hospital quickly. He was conscious throughout and was able to walk but there was no way we could ignore the possibility of unseen injuries, so he was collared and put on a board for the trip.
The police, a motorbike responder (MRU) and myself were all called to a ‘20 year-old male, unconscious on a bus’. A hundred per cent of these calls, in my experience, have turned out to be nothing more than a sleeping drunk. In most cases, the bus driver is either too scared or simply not prepared to try and wake them up. It is bus company policy to dial 999 and get us on scene and I'm sure a few people will argue that the person may have a serious medical problem and I can’t dispute that but, statistically, the only real problem they have is alcohol.
I can go and investigate a call like this myself but when a little river of blue lights show up for one stubborn drunk it becomes a charade and I wonder what people think of us. The MRU paramedic sat on his bike shaking his head in disbelief – this is over-resourcing and will one day cost a genuinely ill or injured person dearly. Despite the flak I get for pointing this stuff out, I would remind everyone that WE pay for this and that it is time for common sense to be brought back in to the equation. Remove the decision-making computers and start taking responsibility for decisions in a human world. Rant over.
I walked onto the bus, shook the man a few times and he swung at me with his fist. That was my signal to let the police drag him onto the street, which they duly did. He was shoved into a corner and given a lecture about being abusive. We all left the scene and a major incident was averted. Twenty minutes, four professionals and a couple of hundred quid. He will do it again and again for years to come. It would be cheaper to buy this man as much alcohol as he wanted and give him his own personal bus to sleep on.
I know I have had my go at cyclists in London and I still feel angry at the way some of them behave – running red lights with impunity, speeding across pedestrian crossings when people are on them, being rude to drivers who let them know how annoying they are - but sometimes I get called to a cyclist who has suffered at the hands of a motorist, like the 35 year-old man who was knocked off his bicycle on a busy road by a driver who wasn’t looking or didn’t care to see him. The car swerved in front of him, clipping his wheel and throwing him over the handle bars.
When I got on scene the police were already dealing with the driver, a middle-aged woman dressed in a smart suit. She looked badly shaken up by the experience and didn’t know where to look when one of the police officers produced a breathalyser. I think her world had just come crashing in.
The cyclist had gotten away with a fractured collar bone and dislocated shoulder. I noticed a long scar as I treated him.
‘Is this scar from an operation in the past?’ I enquired.
‘Yes’, he replied, ‘I've broken this collar bone before and had to have it operated on’.
‘How did that happen?’
‘I was knocked off my bike by a car’.
The man hadn’t been wearing a helmet and this was not his first encounter with other vehicles on the road. I was beginning to wonder if he had any common sense.
The crew arrived shortly after I put him in a sling and he was taken to hospital.
I went back to Leicester Square after that job and had a few minutes to myself until a call came through for an 80 year-old man who had collapsed at one of the casinos in the area. I didn’t need to drive, so I grabbed my stuff and walked across the gardens to the address. The location I was given was inaccurate, however, and I found myself on a building site. The builders inside became concerned when I told them a call had been made from their location and, thinking that there was only one place in the building where anyone in trouble could be, they took me to the cellar area where a locked door barred us from getting any further. I thought we might be breaking this down to get to a dying man underneath.
That drama didn’t happen – one of the builders pointed out that there was another casino next door which shared the building’s address, so I made my way there and asked the girl at the reception desk if they had called an ambulance. She didn’t know but one of the security guys did and he led me downstairs to the patient.
Among the little crowd of gamblers in the lounge bar, a pale and sweaty Chinese man sat. He was known to the casino staff but had no friends with him. He had collapsed and fallen onto the floor whilst playing roulette. As I assessed him and translated my concerns through an interpreter (getting Chinese interpreted in this part of London is easy – China Town is behind the Square), I discovered that this had happened before but he didn’t want to go to hospital. He seemed to be recovering and was clearly only interested in continuing his day’s fun and games, so I waited with him for ten minutes, carried out more obs and asked him a few more times if he was sure. He was adamant. He signed my form and I left him in peace. The casino manager said he would keep an eye on him and I walked out wondering how much money the Chinese man loses every day.
On a shift where it seemed every patient was going to be male, I headed to an address to deal with a 63 year-old man with chest pain and SOB. He had a history of MI and was currently on GTN and aspirin – a standard combination for cardiac histories. He had taken his GTN and this had brought some relief from the chest pain he had originally called about. It’s useful to us to establish what a person was doing just prior to the onset of chest pain as this can help to eliminate a possible MI from simple angina. This patient had not been exerting himself when the pain started, so it was best if he went to hospital, especially as he had experienced some shortness of breath during the episode. The crew arrived as I completed my obs and I put a precautionary cannula in just before we set off for hospital. He arrived in a stable condition with diminishing pain and no SOB.
Another expensive call – this time involving a cycle responder (CRU), the police, an ambulance and myself – for a 20 year-old male who was ‘fitting’ in a large department store in Oxford Street. The descriptor included the words ‘been caught shoplifting’ and I knew I was heading to a faker.
Sure enough, when I got on scene, I joined the police officer and my CRU colleague to witness the worst parody of epilepsy I have ever seen. The young man was flopping around on the floor, clearly conscious, with a co-ordination that can only be brought about by an alert and fully functional brain. He was asked repeatedly to stop the charade but refused to play ball for twenty minutes until he grew so tired of it himself, he simply gave up and lay on the floor staring up at one of the funniest cops I have worked with. The officer had no sympathy for the boy on the floor (it transpired he was only 15 years old) and verbally berated him until he behaved himself and sat up to be questioned. His stony face and no-nonsense attitude was just what was required for this delinquent and it was refreshing to see that it still existed. None of this ‘yes sir, no sir’ rubbish that the police are forced into – he was an old school cop and was having none of this lad’s stupidity. It struck me that the policeman’s approach was probably good for this young thief – he probably needed a father-figure, if only for a few hours.
The ambulance crew arrived soon after the boy began to ‘recover’ and we all waited on scene just in case he decided to do anything stupid but he behaved and began to talk to the police, who were now three-strong and included a very attractive WPC...not that I was looking.
At first the boy lied to the officers about his details, then he told them everything they wanted to know but he included a detail that they hadn’t asked for; the name of an accomplice who was waiting for him across the street! They had been on a shoplifting spree, stealing mainly clothes from shops up and down Oxford Street. Now his mate was standing outside one of these stores waiting to meet up. Little did he know the police were on their way to arrest him, thanks to his loyal friend. I think the lad was bitter about being caught. Maybe he should consider an honest life.
The only female patient of the shift was a 27 year-old woman who fell during a dance class and twisted her ankle. She was lying on the floor at the back of the room as dancers continued their lesson around her. She had a badly sprained ankle and was in a lot of pain. I gave her entonox for that.
The crew didn’t arrive for fifteen minutes, so I had plenty of time to assess her and discover what had happened. She was quite a big girl and I looked around the class wondering how she fitted in – all the other dancers were slim, light and looked like ballet professionals. I didn’t want to be rude but I had to ask.
‘So, you were dancing with this group when you twisted your ankle?’
‘No, I jumped up and fell awkwardly on it’.
I had been there long enough to notice that none of these dancers were jumping around. They were doing stretching exercises.
‘Why were you jumping up?’
‘We were jiving’.
‘Jiving? What, this lot?’
‘No. This is the other class. My class left half an hour ago’.
So, she had been with a jive class and fallen badly. They had left when the class ended and the next dance class had come in while she was lying in agony on the floor with nothing but a few ice packs and a member of staff for company. It seemed comically ironic and the cruellest part of my humour smiled at the thought. The poor girl had been on this floor for almost an hour waiting for an ambulance. She probably had to wait because we were busy with an ‘emergency’ shoplifter.
When the crew took her away, I had one last look at the graceful things dancing in front of me. I don’t see much beauty in this job, so my last few minutes on duty were spent in this pleasant world. I think I can be forgiven for the indulgence.
Be safe.
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