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Day shift: Seven emergency calls; one assisted-only, one taken by car, five by ambulance.

Stats: 1 Fall (no injuries); 1 EP fit; 1 ?TIA; 1 Toe injury; 1 Broken nose; 1 Stomach ulcer; 1 ?CVA.

A lovely lady with brain cancer fell out of her bed and slid under it somehow – I found myself crawling underneath to untangle her head and body from the cables that had wrapped themselves around her as she struggled to escape (the bed was motorised). Then I carefully pulled her out of the darkness as her husband and carer looked on. Her body was permanently stiff because the muscles are in a state of constant tone, so she was difficult to manage and her inflexible frame, slight as it was, made sitting her up a bigger task than it should have been.

Apparently this was the second time she’d slipped from the mattress and gone under the bed. I suggested to her that she was hiding deliberately and that brought a smile to her face. She was in no pain, apart from an ongoing hip problem that, given her medical history, couldn’t be fixed, so I waited for the crew to arrive and we lifted her back onto the bed where she wanted to stay. I was to see this lady again soon.


In a posh flat overlooking the river, a teenager had a fit in his bedroom and his worried parents called an ambulance. He hadn’t fitted since he was 7 years-old, so a trip to hospital was definitely on the cards and his mum and dad explained that they were all due to fly out on holiday later on that day. I couldn’t promise them a delay-free flight and I left it to the crew to complete the obs and take them away.


Then a 40 year-old woman who’d had a near-faint and recovered with right-sided weakness and was ‘not alert’ became my next patient later on in the morning. Her work colleagues had called us because she didn’t seem right to them. I had to agree; she was vague and a little confused. The FAST test I carried out was negative but when the crew arrived and did another one, she failed the arm-drift test – patients sometimes do this to me…I say one thing and they prove me wrong. She was taken to hospital on the suspicion that she’d suffered a TIA.


Those plastic shoes that little girls wear – the ones that you can stick colourful studs into – are dangerous on escalators I think. My next call was the second that I’d experienced where a child’s foot had been gripped by the teeth of an escalator step as it reached the top. The toe is usually pulled in towards the edge and becomes trapped (and crushed) inside the shoe. Now obviously I don’t want the manufacturer of these shoes to get all legal with me but, in my opinion and having seen a couple of identical injuries involving this particular type of footwear, I can only assume there is a connection. Blame the shoe or blame the escalator, feel free to choose.

The 6 year-old was crying her eyes out as her mother nursed a badly torn big toe. The damage was severe and it looked like a partial amputation. It had bled a lot before clotting and the suspect shoe was lying on the floor with a chunk of the front missing and those tell-tale teeth marks across it. I’m sure the child’s toe can be repaired but I would ask parents to be vigilant when accompanying their kids on escalators, especially if they are wearing this type of shoe; keep them well away from the inner edge of the step and get them to walk off as soon as possible when the stairs have reached the top. On each occasion the child has been able to free themselves from the step as it crushed their toe but I dread to think of how much pain they would endure if they became trapped in the moving mechanism properly.


Remember the advertising board that flew off in the wind and killed the young woman who was walking past? Another incident occurred in the West End and the similarity struck me immediately when I got on scene. So much so that I had the LFB shut the road down for a while.

A motorcyclist was hit by a board that came away from scaffolding as he pulled away from the traffic lights. The heavy card slammed into his helmet and part of it intruded through his partly-open visor, breaking his nose and throwing him from his bike. Luckily, I found him standing at the scene with witnesses, including the building safety manager. I looked up at the other boards and at least one other was ready to come off in the strong wind, so I suggested we get the Fire Brigade down to secure or remove it. There were people walking underneath all the time because it was a busy pavement, so the risk of injury or death was high enough to warrant such a drastic step I think.

The police closed off the road and the LFB arrived with two vehicles, including a ladder, to remove some of the boards (see pics). The 26 year-old patient was taken by ambulance to hospital to have his injury treated. He was badly shaken by the experience, as you can imagine.


A 30 year-old man complaining of abdominal pain probably had a stomach ulcer, I decided. He had a history of ulcer and the pain was similar, he told me. His obs were normal and he was stable, so I took him to hospital myself in the car, rather than use up an ambulance. This call had come in as a ‘chest pain’ but you’d be surprised at the number of people who can’t tell the difference between their chest and their abdomen. We have another saying in Scotland and it describes such confusion in a more general sense…


In a busy McDonald’s ‘restaurant’ a 14 year-old girl suddenly developed speech problems and a facial droop. This is very young for a CVA but it doesn’t rule it out. The crew was on scene at the same time as me, so I stood and watched as they spoke to the parents about their fears. I’m hoping the staff of this particular McD’s didn’t know what was going on because if they did, I wondered where their first aider was…or their caring Manager. One thing’s for sure, the crowds from the street cared not one bit for this suffering teenager and continued to bustle past her as the crew attempted to make sense of the situation. The least people could have done was make a bit of space for them. Clearly the pain of a human being is second to the joy of an imminent burger. Humanity’s in the bin.

Be safe.

Questionable

Lovely view, isn't it?

Day shift: Seven calls; One taken by police; one taken in the car; the rest by ambulance.

Stats: 1 Faint; 1 RTC with rib injuries; 2 Abdo pain; 1 EP fit; 2 ETOH.


A 24 year-old man fainted at work. The crew was on scene and I wasn’t required after initial obs and a speedy recovery (the patient, not me).


Then I was on my way to a 24 female who’d been hit by a reversing car in the garage in which she worked. The East European woman was sitting on a chair, crying to herself with nobody helping her when I arrived. She’d been badly shaken by her experience and had rib pain. The driver left the garage after hitting her and was only tracked down when the police arrived and chased him up. So, a caring employer and a guilty employee – nice combination of reassurance for one of our foreign workers.


A man with abdo pain walked down, with assistance, to meet me at his office building. Despite the insistence of the first aiders on site, he’d decided not to stay and wait for me. He was incredibly uncomfortable and had a history of kidney stones – he told me this pain was very similar and I believed him. The ambulance arrived during my initial obs and he was taken inside for some much needed pain relief.


Another abdo pain and another working man. This time, a builder and his brother walked into the local medical centre and an ambulance was called after the nurse judged him to have a potentially serious problem. He was in a lot of pain and morphine didn’t seem to touch it, even after the crew arrived and ten minutes had elapsed. He’d had a sip of beer at lunchtime and his stomach had retaliated, so he may have an ulcer. He certainly had the history for one; stress, stress and more stress from what his brother told me.


I waited 30 minutes for an ambulance when I arrived at the home of an epileptic 29 year-old man who’d fitted and was now recovering. He didn’t really need to go to hospital; they rarely do but his worried brother, who’d found him having a seizure on the floor, was adamant. So, I waited for transport until I decided he was fit enough to go in the car and I took him there myself. He only every fitted once, he told me (just in case the pedants out there believe I took an unwarranted clinical risk) and he didn’t usually need to go at all after an episode. Ironically, his brother declined to join him.


There were two drunken women lying in the street in broad daylight (it wasn’t even 6pm yet), hugging each other and ‘not responding’...no, it’s not a fairy tale from Olde London Towne, it’s my reality, unfortunately. The two were found by a passer-by, of which there were many in this busy part of town, apparently out of it on the pavement. I arrived to find a security man from a nearby office block trying to prise them apart. They must be very good friends, I thought.

When I approached one of the women said ‘I don’t know her, get her off me please’. She said it in one of those drunken, not-telling-the-truth voices and although I tried, I couldn’t get the other woman to loosen her grip – she must have been a wrestler or something in sobriety. Eventually we got her to let go and the first woman was taken away by a work colleague too embarrassed to talk to me much. ‘I’ll take her home, don’t worry’, he said without eye contact. That suited me fine but it left me with the other woman, who was now going mental at the thought of being separated from her inebriated surrogate twin. I still wonder why women seem to have much louder voices than men when they are drunk. Did God build this in for a laugh? It's not funny, it's annoying. I danced with her for a while on the street, to the amusement of the local builders and office workers. She wouldn't let go of me now and she was very strong (or I am becoming very weak).

Even when the crew arrived the battle for supremacy continued on the street as she clawed at us, moaned about losing her friend and generally misbehaved (she was in her 40’s at least). I had struggled to keep control of her on my own for a bit and she very nearly dragged me into the oncoming traffic a few times in her desperate bid for freedom. Normally, I’d let her go but she was far too drunk to make it across the road safely.

The police were called because this was beyond medical help but they didn’t arrive for another twenty minutes, during which time I was dragged across the road successfully – with one Mercedes driver (there, to shame you I’ve named your car) refusing to stop and almost running into me as I stretched my arm out and showed him my gloved hand in an attempt to manipulate his brakes with mind power. One of these days...

Then she tried to drag me down an alley to ‘show me something’. I told her I’d seen everything I needed to see and she pawed my face and told me I had lovely eyes. I didn’t mind that, even from a drunken person because we don’t get enough praise quite frankly. The last time I’d been told my eyes were lovely it was a 20 year-old drunken male and he’d leaned over from the seat in the ambulance to kiss me (I think), so I won’t count that one if you don’t mind, especially as later on it took four police men with drawn batons to get him out of the vehicle.

When the police turned up the crew had joined me to gently but firmly restrain the woman (for her own safety of course). The officers thought it was all highly amusing and I could see the funny side when she was being bundled into the back of their car after refusing to be nice. Her head simply did not want to follow her body into the vehicle. The cop had to push it in manually. She’ll be very proud of herself in the morning, if she remembers anything. Her friend has probably cut all ties with her now. Ah, the cost of alcohol keeps rising.


A Red1 ‘life status questionable’ for a male who was clutching his chest had me all confused. Surely, I reasoned, if he was clutching, he was breathing? Who am I to judge such things when on high, better knowledge is held? Off I went then, only to find that my patient was a drunken Polish man who claimed a security man at the local Tesco’s had hit him, thus he was clutching his chest. You see, it all makes sense now, doesn’t it? Clearly he was a Red1.

Anyway, I didn’t believe for one minute that a respectable place like Tesco would employ a thug for security, so I assumed that he was either lying (which might seem harsh but he was drunk and very vague, even in translation) or he had done something to provoke the security man...like shoplifting and not allowing himself to be caught. I’m a hard judge of human nature but I’m biased towards sober people these days, sorry.

Be safe.

Injured queens

Day shift: Six calls; one false alarm; five by ambulance.

Stats: 2 Head injury; 1 Angina; 1 Allergic reaction; 1 Emergency transfer; 1 Cut chin.


This was my second shift on an ambulance and it started early on with a ‘one under’ at a busy train station. We were almost on top of it and could see the fire engines, police cars and other ambulance vehicles ahead when we were cancelled. Since we were passing the scene, we stopped and asked a crew what had happened – there was certainly enough fuss.

Apparently a man had jumped but the train had just gone passed him, so he fell into the pit on the track. He had minor injuries and a crew were dealing with him. He hadn’t tripped; he’d allegedly leaped with the intention of going under the train – strangely the entire length of the train had already passed him by before he acted on his impulse. He literally missed his train.


Later on we were standing over an unconscious 24 year-old Colombian man who’d collapsed in front of his friends after a night out drinking. He wasn’t drunk, they suggested and he definitely hadn’t taken any drugs...they suggested. Nobody’s is ever really sure about the drink and drugs habits of their close friends. He had a head injury – the result of falling and meeting the ground, so his condition may have been caused by this, although I had to bear in mind that he fell first, so he was probably losing consciousness before his head hit the ground...bringing me back to the possibility of drink, drugs or both.

His vital signs were abnormal - his pulse rate was slow (35 bpm) and irregular and his blood pressure was consequently low. He didn’t respond at all throughout our time with him and we were on scene long enough for him to have woken up if he’d wanted to. I’d given him narcan and that hadn’t helped, so now he was on fluids and I’d lifted his pulse rate with atropine. His vitals were stable enough after twenty minutes on scene and it should have taken us less than ten minutes to sort him out and get going except for a bus driver who clipped the ambulance as we worked on the patient inside. He’d tried to take a turn around our vehicle and misjudged it badly. Then he spent the next ten minutes shouting at me and my crew mate because I’d stopped him from driving off after the accident!

We got the young man to hospital and he was poked and prodded by even more people in an attempt to find the solution to his state.


A 68 year-old man had an angina attack at a police station, where he was being held on suspicion of alleged fraud. He was the perfect Essex type bloke from the old days...a gentleman. He’d sorted his pain out with his own spray and the police doctor had attended to him but because the police get a bit paranoid when it comes to people potentially dying in their custody, he went to hospital for checks.


It’s been a long time since I gave an injection to a small child but my next call, for a 2 year-old girl who was having an allergic reaction, forced me to make a quick decision about whether to leave it to the hospital staff or to do it myself. At first she’d been fine – swollen lips, rash...the usual stuff but she quickly became more lethargic and floppy and her airway was becoming swollen. I gave her a shot of adrenaline on the way to hospital and by the time she arrived (literally two minutes), she was beginning to look much better. The medical team worked around her for a short time and I watched her bounce out of the hospital with her parents fifteen minutes later. A miracle.


Some of the saddest jobs I do involve children and our next call was an emergency transfer. We had to take a 4 year-old boy from one hospital to another for specialist treatment. It was a long trip on blue lights and took up a lot of our afternoon.

The child had complained of earache, which his G.P. diagnosed as an infection but it got worse over the course of a few days and his face began to swell on one side. He was taken back to his doctor, who repeated the diagnosis of infection. The parents weren’t convinced and when he complained of great pain and his face became even more swollen a few days later, he was taken to hospital, where a scan revealed a massive, intrusive tumour.

He sat on the trolley bed with a smile on his face and a large family gathered around him as we left the hospital. On the way he began to feel pain again and was crying his eyes out by the time we got there. I could do nothing to relieve his discomfort because the doctor had already dealt with his meds before he left. We took him up to his new bed and left him with his doting mother and weeping father. My crewmate and I stood in the corridor and discussed the non-existence of God.


The shift ended with a farcical call in a park. A gang of gay men were playing rounders when two of them collided head-on at speed. One had a head injury and had been knocked out and the other had a deep cut to his chin. The MRU was on scene and had attended the man on the ground (the head injury) as it started to rain. From the very start, this man was a bit obstructive. He didn’t want his head and neck held still – he didn’t like the collar and he refused the continuance of his care twice before we were able to talk any sense into him. The other guy – the one with the cut chin – behaved like an adult.

We took them both to hospital at the same time and on the way, our chin-injury patient said ‘I’ll bet you didn’t think you’d be coming to the aid of forty queens playing rounders’. Funnily enough, it hadn’t crossed my mind.

Be safe.

Truck work

Day shift: Nine calls; all by ambulance (funnily enough).

Stats: 1 Anal pain (no jokes please); 2 Unconscious, ?O/D; 2 Abdo pain; 1 CVA; 1 Fracture; 1 Fit and 1 Generally unwell.


The powers that be have decided to pull all of the FRU’s off the road. The motorcycles will be replacing us on the basis that they are faster and better looking – leather has always been more popular than cotton. I will be back on my old line and back on an ambulance with a new crew mate for a stint until something changes again (and it will). I’ve been running around Central London in that little yellow car for three years now and I will miss it (I think). I’ve been on a couple of ambulance shifts, one of which I write about here and have two more shifts on the FRU before I hang up my badge and gun, either for the last time or for a hiatus – who knows?


So, a 61 year-old bowel cancer patient with a painful anus requires our attention and we discover she hasn’t been taking her pain killers properly – she’s been taking four a day instead of two, four times a day. No surprise then that she had a bit of discomfort. She walks out to the ambulance with us and we chat all the way to hospital. She’s Italian and quite funny, considering her predicament.


The first of two unconscious drug overdoses next. The 24 year-old man is inside a popular gay club and he’s not responding to anything, so he gets ‘Narc’d’ and I give him fluids too but still nothing. Of course Narcan won’t help a GHB overdose, if that’s what he’s had but we have to cover all the bases. By the time we get to hospital, he’s stable but still unconscious, so we leave him in the hands of the Resus team, who intubate him and cart him off to Critical Care for his own good.


A regular caller with abdominal pain (of which he complains a lot) and I’m chatting to a fellow Glaswegian who doesn’t care about anything and tells us which hospital he’d prefer to go to because the other one ‘doesn’t understand my problem’, he claims. They are probably just fed up with him. He’s known to be abusive but I forgave him on the basis that a) he might have genuine pain and b) he’s a Glaswegian alcoholic from the good old days.


‘I thought I was going to die’, said my next patient as she described her abdominal pain and near-faint experience. The 40 year-old had obviously never been exposed to anything more lethal than cotton wool in her life. Her crying Italian mum was making things worse by demonstrating how serious she thought her daughter’s condition was. Both had to be consoled. Both were very lovely people but neither had a sense of the real world.


An 89 year-old woman who fell earlier in the day and was now ‘making no sense’, according to her daughter, was probably suffering the effects of a UTI. The smell was powerfully strong and she had all the classic signs.


A short trip down to The London Eye for a 14 year-old boy with a broken collar bone next. We arrived to find him among hundreds of youngsters who were jumping from heights and somersaulting to the ground – urban free-running it’s called. He’d done a forward jump with a backward flip and landed awkwardly and heavily onto his shoulder, breaking the thin collar bone in the process. The fracture was immediately obvious and it looked serious enough to warrant a couple of stabilising pins in surgery but the x-ray would confirm the severity of it when he got to hospital.

His father and brother were with him; the boy had been wearing absolutely no protective gear when he came crashing down and I could see his father squirming uncomfortably in his seat in the back of the ambulance as I lectured the young lad about how ‘lucky’ he had been considering he’d only damaged his shoulder and not his head or neck. Dad would have to explain this to estranged mum and I didn’t fancy his chances at all.


The last time I dealt with a patient in a taxi he was the driver. He’d had a stroke and was slumped at the wheel on Parliament Square, right outside the House of Commons. Nervous armed cops had approached in case he was a terrorist. He was a Cockney but I don’t think a couple of cops with guns was going to change that. Anyway, my next patient was the passenger of a cab and he had his two young sons with him. He had just been discharged from hospital after having an epileptic fit and had another in the taxi on the way home. His very switched on and amazingly calm sons took care of him and waited for the ambulance to arrive. A FRU was on scene and we took over when the details of his fit were given. He was post ictal and it took another twenty minutes for him to realise what had happened. He was bitterly disappointed to be heading straight back to hospital.


Cirrhosis of the liver is common in alcoholics and my 52 year-old patient had a long history of alcoholism. Now he was suffering generally as his liver began the road to self-destruction. He was unwell – Hep C was exacerbating his malaise.


A strange unconscious call next. A 20 year-old man had been found slumped on Oxford Street. He was completely unrousable, even to deep pain. A solo cyclist was waiting for us when we arrived (although the road works down almost the entire length of one side of the road didn’t help to speed our journey - I had to keep jumping out to chuck cones away) and he explained that the man had been found in this condition by a passer-by who’d bothered to check on him. The patient’s pupils were pinpoint and his blood glucose level was low, so he was given Glucagon and Narcan (for good measure). There was no sensory evidence of alcohol but his possessions gave us something to ponder. He had a bag on him and inside the bag was another bag...a feminine looking bag. Inside that was a store card with a name on it. We presumed that it was his name, of course and proceeded to call him by it all the way to hospital. It was a foreign name and although I didn’t recognise it for gender my brain was telling me it wasn’t a male name. I even asked the attending doctor what he thought of it while the patient was examined in Resus. Everyone was a bit confused about the man’s name and his bag...and the cheap make-up that was inside it.

Now, before you all say ‘it’s obvious’, nothing is in London these days. It could easily have been his make-up and he may well have taken GHB (a popular recreational drug for the gay community) and he may have been on his way home but collapsed as a result of taking the drug. Contrarily, and I began to suspect this and suggest it after looking through more of his possessions – he could have been a bag thief.

Inside the outer bag was another form of ID – a travel pass. This bore a completely different name and a photo, which matched our unconscious patient. Now it was fairly obvious. He had stolen this bag from some unsuspecting lady with bad taste in make-up and had probably intended to get rid of it but had become unconscious in the street – for what reason we still don’t know, unless he had taken heroin earlier on.

If there’s one thing about this city that never ceases to amaze me, it’s the possibility of coming across the most bizarre jobs on a regular basis. I would miss that if everyone became normal.

Oh and the decision to take the FRU's off the road was suddenly reversed soon after I wrote this. Nobody knows why.

Be safe.

Lifeless

What goes up...this wonderful piece of grafitti art was pasted onto the wall of the building across from my station but in less than a month, vandals had torn a lot of it away at the bottom and so, down it all came again. I think this photo says a lot about society.

Day shift: Nine calls; four assisted-only, one false alarm, one conveyed in the car and the others went by ambulance.

Stats: 2 ETOH; 1 EP fit; 1 Fall with no injuries; 1 RTC with no injuries; 1 Unwell adult; 1 Muscular chest pain and 1 Suspended.

The day started routinely and ended badly.


My first call was to a 25 year-old male ‘unconscious on a bus’ and we all know what that means. He was drunk and asleep and at 7am when I hadn’t even had breakfast yet, he told me to ‘f**k off’. Still, mustn’t grumble, I had annoyed him into submission and he promptly left the bus. The bus driver looked in with admiration and then said:

‘I couldn’t have done that. You guys are trained for this sort of thing’

I knew what he meant to say but I was crushed at the thought that I’d become nothing more than a specialist drunk waker-upper. I thought I’d achieved a higher goal. I was to find out later on that not everything I do will go according to plan.


Then a 51 year-old epileptic man decided to have a fit in his police cell. He was found lying on the floor by the police officer charged with checking in on him every so often, as they do. ‘Are you alright?’ she’d shouted to him. ‘Yes, I’m just having a fit, don’t worry’, he’d respectfully replied.

His obs were normal and he wasn’t post ictal but he did have a history and I couldn’t ignore the giant, softly-spoken man when he confirmed that he had indeed suffered a small seizure. Who was I to judge? At over six feet tall and just as wide, I wasn’t going to argue with him. My MRU colleague was with me on this call and the crew showed up to take him away.


A call to a 49 year-old epileptic man whose Careline alarm had gone off explained to me that he was absolutely fine and that his power had gone down, thus the alarm was triggered and we were called out automatically. We stood on his doorstep; me fully clothed in uniform – him almost naked and not too fussed about the daylight or the neighbours…or me.


I didn’t do anything at all for the 85 year-old lady who’d fallen and got herself trapped between a wardrobe and her bed. The crew was on scene and they didn’t need a third pair of hands.


A report of a ‘bus vs ped’ meant I was racing towards Charing Cross Road thinking that I may do some good today after all. The bus had clipped a man as he walked across its path (yeah, they tend to do that) but he wasn’t badly hurt and just needed checked out by the crew who arrived before me. The additional MRU wasn’t required either. The man had lost all his beer, however because his plastic bag of booze had been hit, rather than him. You’d think he’d be grateful for small mercies. Still, what a waste.


Off to an hotel (got to say 'an', otherwise the pedants will have a go about the grammar) for a 75 year-old male with DIB ‘? Heart attack’. The staff probably felt it necessary to put that last bit in but when I arrived he didn’t have any chest pain, although he was as white as a sheet. He was with his wife and he denied ever having any DIB but his face was off-colour and sweaty, so he was going through some kind of crisis. He told me he had dizziness and visual disturbances when he exerted himself (this started when he lifted his case from the car to the room). I’ve seen something very similar to this and it rang a little alarm bell. The last case of this kind was a few years ago and I posted on it; the guy had lost some vision in one eye and was very off-colour but had nothing much else to report. He was later found to have suffered a neurological insult.

The man and his wife were quickly packed off to hospital, while the hotel staff helped by carrying one of my bags – it’s like instinct. No tip was offered; I was busy.


The call that ruined my day came next. After initial reports that a 15 year-old was fitting in a playing field, I was sent running on a Red1 ‘CPR being carried out’. I had to call in to confirm this because the call description was confusing – apparently he was still fitting…but that couldn’t be. Either one thing or the other applied and I had a gut feeling that it was the other.

I arrived to find another FRU colleague on scene (by seconds). There was a crowd of about a hundred people gathered around the perimeter of a playing area and I was ushered inside through the chain fence gate. I could see someone compressing a young man’s chest. The closer I got the more I could see that the young man was actually a boy.

I can’t go into specific detail on this call but before long there were three cars and two ambulances on scene and I had taken the reins of the job, so I was trying to co-ordinate airway management, CPR, defibrillation and drugs in an environment filled with people. Obviously, it’s not the first time I’ve done this but when it comes to young people the effort just seems that much more important…much more charged.

He was shocked three times during the attempt and he converted from VF to an agonal rhythm with a very weak pulse – but that didn’t last and try as we could, he slipped back into a pulseless non-shockable rhythm, which lasted all the way to hospital.

I had gone with him and had another paramedic and an EMT with me in the back of the ambulance. Together we struggled to keep him stable but he wasn’t responding to the drugs given or the continual CPR. We had already established that he had no medical history, didn’t take illicit substances and was normally fit and well – he was playing football when he suddenly collapsed, looked like he was fitting, then went into cardiac arrest. After that the story is vague and confusing because I wasn’t listening after the main facts were given by the police officers on scene.

At some point a medical student began CPR with the help of a police officer and a pocket mask. This continued until the first FRU arrived and then we all descended within minutes. None of it made any difference. He was pronounced at hospital after an extended attempt to recover him.

The call knocked the stuffing out of my day because the patient was so young (he was actually 18 years old) and because there looked like a chance in hell at one point but it slipped away.


After that I had to persuade an unconscious drunken Pole to get to his feet and wander off to a less public place than the middle of the pavement to sleep. This was followed swiftly by a 37 year-old French man who said he had chest pain but it soon became clear that he had nothing more than a muscular problem, so I took him to hospital myself. I loathed the idea of an ambulance being tied up on this one while another teenager possibly lay lifeless on a playing field.




Be safe.

Too late for some

Day shift: Three calls; one hoax, two by ambulance, including a running call

Stats: 1 Neck injury (fall); one ETOH

Interesting to see that the media are now getting all excited about the fact that alcoholics are using Spirigel to feed their habit. Not only do they use the word 'anecdotal' to describe the evidence but they still seem to believe it hasn't yet been experienced by many of us out there. If only they'd read what I wrote more carefully, eh? I haven't seen my Polish frequent-flyer for some time - I suspect he may have succumbed as a result of his gel-stealing. I warned him many, many times.


Trafalgar Square is my stand-by point and it’s usually a pleasant place to be, especially when the weather is nice and there are lots of interesting people around. Today, however, the tourists, Londoners and myself were treated to some light entertainment when one of the local alcoholics started threatening someone with a broken bottle. When the cops arrived I watched as he aggressively abused one of them too. The cops were PCSO’s and so when the real thing arrived (no offence to the PCSO’s) en-masse (three vehicles and a van turned up), he was eventually subdued with handcuffs and a quick drag to the lock-up. Too right.


I was cancelled on the first call of the day for a 35 year-old man with a neck injury who had fallen from scaffolding, according to the call details. I phoned in to see if I could be useful because I was only a minute or two from the scene and it takes at least two people to deal with a proper neck injury, if that’s what it was. I was told that a bike had already been despatched but I was still concerned about the nature of the call and the fact that only one person had been sent.

I was re-sent the job (apparently I was closer after all) and sped to the scene. I found myself in a construction site and was led up three flights of half-built stairs and along what seemed like endless corridors to a first aid room. This surprised me because I had expected to be taken to the bottom of scaffolding on site – I had my hard hat on and everything.

The patient sat on a chair with a collar on. This was my second surprise. The duty nurse had placed it after the man had been brought to him – he had walked down stairs to get here and complained of neck pain – well, no wonder, I thought. Apparently he’d just smacked his head on the scaffold as he climbed down. This sort of accident had happened before, I was reliably told by the nurse, and the last patient had to be lowered down to ground level using a Neil Robertson stretcher.

My MRU colleague arrived after a few minutes and I explained what was going on. Soon the crew was with us too and we planned his route out - over a period of time, I can tell you. The place was a bit of a maze. Nevertheless, the clever crew managed to get the trolley bed up in the goods lift, despite the fact that this 'couldn’t be done', according to the nurse. The patient’s neck was immobilised properly and he was put on a board using our rapid take-down technique, which involves lowering him from a standing position until he is flat, without him having to make a move himself. We don’t have to do it much but short of putting him in a KED and taking him down on a chair, this worked just fine.

There is always a risk of compression of the spine when you stand up and smash your head on some unyielding object, like a scaffold cross-bar, so we weren’t taking any risks; neither were we taking him down on a Neil Robertson (there was one laid out on the floor for us).

It took us almost an hour to complete our mission but it was managed and he wasn’t in too much pain. He had all his necessary sensations and movements, as per our ritual checks and he was very calm…and why not, he’d walked himself to the first aid room, hadn’t he?

When I got out and had to park up elsewhere and complete my paperwork, the friendly, helpful workmen did this to my car...for protection they said.

My hoax call was for an unconscious female on Trafalgar Square. I think someone must have seen me in the car and decided to dial 999 for a laugh. The call had been made from a local box, so whoever it was must have sloped away and watched as I searched the area with a bewildered look on my face.


A Polish nurse friend of mine was chatting to me when I got my last call and ironically not only was it a few yards from where I was but the ‘unconscious’ male just happened to be Polish. She hadn’t believed me when I told her that we see a lot of her countrymen drunk on the street but I think this took her by surprise. I asked her to help with translation and she went on to have a full conversation with him until he lumbered onto the ambulance for further checks. He’d been seen lying sparked out on the pavement near the Portrait Gallery – he was only nineteen but already he knew how to mimic his elders.

I have to say that I have great respect for the Poles and I mean no harm when I talk about individual nationals like this. I have been just as scathing of the drunken behaviour of my own countrymen but there are fewer of them around these days. They’re probably all lying in the streets of Poland.

Be safe.

Teen trouble

Day shift: Five calls; one assisted-only, four by ambulance.

Stats: 1 TIA; 1 HepB; 2 Faint; 1 Frequent flyer with odd excuses


Transient Ischaemic Attacks (TIAs) are calling cards for stroke – they are ‘little strokes’ if you wish, caused by a sudden decrease in blood-oxygen supply to a small part of the brain. Multiple TIAs are fairly common in people prior to the big one.

My first patient of the day was a 53 year-old man who woke up in his hotel room bed, unable to move his right side properly. He had lost power and some feeling in the limbs and had speech problems caused by a cranial nerve dysfunction. He noticed his speech was slurring when he made the emergency call.

We carry out a FAST test on suspected neurological patients and this basically involves checking for power, sensation and co-ordination. This man’s test was positive for ‘arm drift’ and ‘crooked smile’. He knew himself that things weren’t right. He was a stoical German type and kept repeating solemnly ‘this isn’t good’. I put him into a more positive frame of mind by reminding him that he could recover fully from his predicament.


Drug addicts are more prone to Hepatitis B than most of the population because they are in a higher risk category for exposure. My next patient, a 41 year-old ex-heroin addict (he’d been using since he was 16 years old) rolled about in agony on a chair at the hostel he lived in. He clutched his abdomen (this call was given as ‘chest pain’ incidentally) and moaned about the pain he was in. He was a very skinny and very sweaty individual with a history of HepB and a recent inoculation of the C variety. He didn’t look very well and it was obvious that his illness was giving him problems. He’d dined on a concoction of Methodone, Valium and Cocaine the night before, so he left a little room for differential diagnosis.

His BM was low, so a liver-related problem was more likely and off he went to hospital, although he dithered and stopped a few times along the way to drink something, grab ciggies and chat to mates about how miserable he was – funny, they all seem to do that.


Pain causes some individuals to faint and I guess that until I have experienced truly agonising pain, I won’t know for sure if I am one of those people but I doubt it. I tend to stomp around smashing things instead – it doesn’t relieve the pain but I get my own back on inanimate objects that have always annoyed me. The last time I did that was when I had a nasty tooth abcess.

So it was with my usual smiley, happy-to-see-you face that I greeted the 32 year-old female who’d fainted because she had back pain. Another German person determined to play it down. She was fully recovered by the time I arrived and, after the crew gave her a quick on-the-spot check, she was left at work to continue her day. She asked for my phone number. I smiled but didn't give her it - I'd be in trouble if I did :-)


My second faint of the day was a 40 year-old man who collapsed inside the toilets of his workplace. He lay there feeling ill as I tried to get to the root of his problem. He was pale and shaky but he seemed to be recovering well enough. He had no medical history of significance and had fainted once before, so he knew the score. He told me he was dealing with a lot of stress at work (who isn’t these days?) and that he hadn’t been able to cope very well with it – evident from his current situation.

He was taken to hospital and actually started to look even more ill as he was trundled through his workplace by the crew.


I spent a short time in Wells Street, W1 after that doing my paperwork and I noticed a little pub called Ben Crouch’s Tavern sporting a sign claiming that it had a ‘spooky atmosphere’. I’d like to visit it one night when I’m off duty but if any of you guys get a chance before me, send me a report. Also, let me know what the prices are like.


Just as my day looked routine, I got a call to attend a 15 year-old boy who’d ‘passed out’ several times in the street. I got on scene and he was waving at me from a call box, looking well enough to walk. I couldn’t understand a thing he told me and there was nobody else with him. He didn’t know his age or his date of birth and was vague about where he lived. This concerned me and I was relieved when the crew arrived because I didn’t want to be on my own with this kid. His behaviour was strange and he made no eye contact whatsoever. I don’t trust anyone who doesn’t make eye contact.

While the crew chatted to him (gaining no new ground) I called for the police to attend because I suspected something wasn’t right with this boy but the cops were busy dealing with a firearms incident and couldn’t get there ‘til much later. Great.

I didn’t want the crew going off on their own with him because that would mean the attendant would be alone in the back of the vehicle with him and God knows what he’d come out with (the boy, not the attendant). I agreed to travel in the back as well, so there were two of us. He’d already said something spurious about a man talking to him and suggesting things to him and that made me nervous about his state of mind.

I managed to get his mother’s contact number, one of only two that he stored in his mobile ‘phone (who has only two numbers in their phone?). Ironically, the other number was his.

I called and called but there was no reply. Then, as we were preparing to set off after twenty minutes of getting nowhere with the boy, his mum called me back but she was evasive and gave very little information. She asked which hospital he would be going to and that was pretty much that, despite my enquiry as to his mental health or if he had learning or behavioural difficulties.

We got him to hospital whilst he repeatedly reminded us that he wasn’t mad, not that any of us had even suggested it and I found out through a colleague who just happened to call me that he was a known frequent flyer from her sector and that this was exactly his M.O. – he loves the lights and sirens apparently and calls the police and ambulance services out to appease his desire. Someone’s mum needs to have a really long chat with someone I think.

We left him in a cubicle, after having to catch him several times as he wandered off at random in the hospital. The nurses could take care of him now and I hoped never to see him again. I hoped he’d return to his usual stamping ground…we’ve got enough of our own down this way, thanks very much.

Be safe.