Day shift: Five calls; all by ambulance.
Stats: 1 eTOH fall with head injury; 1 EP fit; 1 RTC with minor injuries; 2 Faints.
Sometimes we make judgments based on very little; it’s a human characteristic and I am much more careful these days about unilateral thinking, especially as I am naturally inclined to dislike anything that is disproportionate or done at the expense of others (even though I have been guilty of that myself). That’s why, despite saying I would, I decided not to record anything about my feelings on the Gaza conflict and why today I was reminded, yet again, that my opinion means nothing until I get the whole picture.
Jade Goody has never been my favourite ‘personality’, mainly because I believe she has none. She got her fame on the back of one of the worst television programmes ever thought up for the bored masses and she rose through to so-called stardom without having to do anything special at all. But she did have mass appeal, if you like that sort of thing and the recent publicity of her cancer diagnosis and its progression made me think that she wanted to be pitied in return for compensation, as if people were duty bound to learn about every detail of her agony.
I sympathised with every cancer sufferer in the world who didn’t get such attention and who died respectfully with their loved ones close by…or alone and broke. It wasn’t until now, when I learned that the coverage of her illness had boosted the number of women being screened for cervical cancer that I softened my attitude. She also said, through her publicist, that she wanted to make every penny she could for her children before she died and that, after some thought, made perfect sense to me. After all, what parent wouldn’t want that? She has no other talent, other than her name and face, so without the fees from newspaper and television articles, she would have nothing much to leave them – I guess even the money she has in the bank would soon dry up when she’s gone and the publicity machine would quickly forget the Goody family.
It’s interesting for me to realise that Jade may never have achieved anything more in her life than being another nonsense celebrity but that now, through terribly tragic circumstances, she will probably be responsible for saving a lot of women’s lives. Maybe her destiny was shaped like that.
All of this reflection on my part helps me to carry out my job in as neutral a way as possible and, apart from those blatantly wasteful and selfish people we deal with out there, the vast majority of our patients need a non-judgmental approach. Even with my dislike for what Jade stood for, I still wouldn’t have put her on the same level as some of the nasty people I have met in my career. I hope she makes enough money for her kids to live a decent life because, clearly, that’s all she wants. And I sincerely hope, as I would with every terminal patient, that she slips away in her sleep when the time comes.
Sunday is all about picking up the pieces of Saturday night and so off I went to a night club at chucking out time to help a crew with a gay punk man who had fallen and knocked himself out, due to alcohol. His equally gay-punk friends were there to help him and regardless of my initial apprehension about going near them (I used to dislike punks when I was a teenager but I didn’t know them, so I was wrong) I ventured in with the crew to assist.
These guys wore the biggest boots in the world, so they all towered above us (well, not the crew paramedic because he’s already over 6 feet tall in his socks), making the scene a bit sinister if you aren’t clued up on the culture. They were also the nicest bunch of people I’ve encountered for a while and cared no less for their friend and for the need for us to do our job than the best of the lot we get on a daily basis. I have to point out, before you go on the boil with me, that I have no phobia at all with gay people or punks…or gay-punks – I just never realised they existed in combination. That has everything to do with the image I’ve always had of them since they first appeared in the 1970’s and my ignorance of the whole scene, since I was far too soft to become one.
My first revelation of this group of people was the discovery that spitting at each other was regarded as a compliment, not an insult. In my post from a few years ago, ‘Spitting Punks’, I mentioned one who ran at the ambulance and gobbed deliberately at us as we passed by. I had to do a bit of research to learn what that was all about…until then I was most offended. I always believed that a gang of punks would tear your head off if they approached you. The frightening garb, hair and makeup give the wrong impression – they are good people…just a bit taller these days.
Prior to that call I’d wasted my time getting on scene behind an ambulance from the same station for a 30 year-old man who was having a panic attack. He got a Red status for his breathing and a CRU was already on scene dealing with him. It was a blue light circus for nothing more than hyperventilation.
A couple of miles out of my area and I was communicating with an elderly lady who’d fitted in a large store. She fell down in an aisle and had a 20-minute seizure, which was unusual for her, even though she was a known epileptic. She was still stiff (tonic) when I reached her and could only answer my questions with her eyes (once for yes, two for no). People were busily shopping around her and there was no respect or courtesy given to her dignity and privacy, so I asked the staff to close down the aisle – this is perfectly valid in case she has another fit.
The woman recovered rapidly on oxygen and attempted to stand up. She didn’t want to go to hospital, that was clear and when the crew arrived - she struggled with them as they tried to relax her and put her on the bed. We can’t force anyone to go to hospital, except in certain circumstances but I think she was eventually persuaded by her husband. Unforgivably, I was told that a selfish customer actually complained to the manager for the aisle closure. Some people.
A two-car RTC caused some road chaos and had an ambulance, MRU and myself on scene with the police to assist but nobody was badly hurt – one woman sat crying on the kerb and a child in the front seat of the second vehicle was talking to the crew. It was all under control and I headed back to the station when my paperwork was done.
It was a few hours before I got my next call for a 65 year-old man who had collapsed in a theatre. He had a pacemaker fitted and he told me that it had malfunctioned before, so it’s possible he was having difficulties with it again. He’d fainted and now looked very pale and sweaty. He was also a bit nauseous but held himself together well as the crew wheeled him to the ambulance for an ECG (which is not of great value because of the pacemaker). The device seemed to be working properly but he’d need to see an expert, so off he went.
I ended the shift at Marble Arch, where an Islamic march had ended and hundreds of people, dressed in traditional black attire, were gathered. A 70 year-old woman had collapsed and fainted but she was recovering now. The ambulance couldn’t get near her because nobody was willing to give way, so she had to be wheeled through the tightly-crowded mass with a police officer shouting for space at the front.
As the crew got on with their obs, I stood chatting to one of the cops and we both watched in horror as a man attempted to run his family, including small children, across the busy road. Cars were flying past and the little ones would never have made it in one piece. He did this right in front of the cop, which elicited an angry response from him of course. He ordered the man to stop and use the crossing and all he got for his concern was a deep glare. I remember a time when, if a police officer raised his voice, you did as you were told. It’s not as if there wasn’t a very good reason for it.
Be safe.
Sunday, 15 February 2009
Saturday, 14 February 2009
Punch your Valentine
Day shift: Five calls; one assisted-only and four by ambulance.
Stats: 1 RTC with back injury; 1 Assault with eye injury; 1 Faint with chest pain; 1 Asthma attack; 1 RTC with pelvic injury.
Valentine’s day is supposed to be the most romantic day of the year and it certainly promotes the romantic inclinations of the drunken few, so the night was destined to be busy and I was glad I wasn’t working it. Instead I was out attending to a young female jogger who got hit by a car at a very busy and very dangerous part of town for traffic. I don’t know if she ran into the path of the vehicle or a red light was run but she was lying in the middle of the road, surrounded by police officers, blue lights and onlookers when I arrived.
She had put a good sized ‘bulls-eye’ in the windscreen and I found out that most of her back had done that, rather than her head, which is a good thing. She was very emotional and that didn’t surprise me. She cried as she lay there waiting to be collared when the crew arrived and it took us less than five minutes to get her off the ground and into the warmth and privacy of the ambulance.
Twenty minutes after arriving on scene, I skulked off with my MRU colleague for a coffee until the next call came in.
Any illusion of the day being romantic was quickly dispelled when I pulled up on scene for a 20 year-old woman who’d allegedly been assaulted by her husband. She had been punched in the face and the police were with them – he was in the police van and she was sitting in the back seat of their car with a baby in her arms. It was a minor facial injury and I would like to think that she’d be reconsidering the type of man she’d married but, as experience has shown, they will probably make up over a nice Valentine’s meal tonight whilst he awaits his court date.
On Trafalgar Square a couple of elderly men preached over a loudspeaker from the base of Nelson’s Column. I listened to them because nobody else was and hundreds of tourists clambered around the plinth where they sat talking about God, Jesus and all the usual stuff we never hear properly. I’m not particularly into this kind of bible-bashing but I did catch something that interested me – a quote from the bible in which Jesus had said something about Prophets being listened to anywhere except in their own country and among their own families (I’m sure one or two of you will know the exact quote – I forgot to write it down). This had me thinking because, whether you believe or not, Jesus had a lot of things to say that make prefect sense even now.
People with anything to say of relevance will find enemies among their own; it’s a given and that’s why we are so fragmented as a society. Some of you may have a talent that is overlooked by those close to you but admired and understood by strangers. Large companies and organisations have the same problem – many of them cannot see the value of the people who work for them, even though everybody else can. Governments pay more attention to the outside world than the very people who elected them.
I had a salient point to make but in the midst of time between then and writing this now, I have mislaid it somewhere in my memory that I no longer have access to – I’ve forgotten the password. I probably lost track of my thoughts when I watched a young girl clamber up onto one of the lions with a peace flag in her hand. She waved it around at everybody and nobody, then slipped off and crashed to the ground in a heap with the flag flapping around her face – that’ll learn ya! (as Mrs G would say).
A stoical 78 year-old woman who fainted at a museum just after experiencing chest pain told me that she had suffered a few ‘twinges’ before but had ignored them. She wasn’t much for making a fuss, you see.
She lay on the first aid couch, pain-free and recovering from her collapse while I carried out a full set of obs and found nothing untoward. Her ECG could have been taken from a teenager and so, despite the strongest advice, she declined to go to hospital and decided to continue her day out with a friend to look after her.
A call to the underground next, for an asthmatic female who, on close inspection, didn’t appear to be having too much trouble breathing at all. Her sats were high and she was capable of speaking in full sentences but I continued down the route I must take if there is any chance of a clinical condition being present. Obviously I couldn’t hear her lung sounds because the tube traffic was relentless and noisy. With the help of the crew she was able to walk up the escalators and into the ambulance.
The shift ended with another RTC in which a motorcyclist was removed from his ride by a naughty car driver who’d stopped dead in the middle of a very busy lane just as Mr. M/C ran up behind him at 30mph or more. The damage to his fuel tank was severe, indicating that his lower parts had made significant contact with it as he flew from the bike onto the road. I found him lying there with police around him and I began to do what’s necessary – C-spine control.
Only after a few seconds did I realise there was another person on the road – he was lying flat on his face as if dead and I asked the cops around me who he was. ‘We think he was the passenger’, one of them told me. The second helmet on the road confirmed this and I left one police officer in charge of the first patient, who was conscious but in pain, to attend to the second one – just in case he was dead…or dying.
Thankfully, the second man was conscious and seemingly unhurt, although he was instructed to stay still until I assessed my first patient properly.
I spent a few minutes with the bike rider until a crew arrived and I asked them to split tasks between one patient and the other. The rider was collared and scooped whilst the passenger remained where he was during a secondary survey but as we were now tied up with the rider, who had a suspected fractured pubis symphysis, it wasn’t until the second ambulance arrived some minutes later that I was able to get back to him. During that time, he lay there like a drunk man, drumming his fingers as if bored (he probably was).
I sat the passenger up once I was sure that there was no need to worry about him (he hadn’t been propelled through the air like his mate) and he was taken off to ambulance number two.
The bike rider was blued into hospital and his passenger was trundled in behind him - as I left the scene the police asked me if I could check the driver of the car that had been rear-ended. I’d forgotten about him to be honest; I had my hands full. I looked at the small bruise on his head and advised him that I would arrange for another vehicle to come and collect him (I had to travel with the biker). I checked back later and was told that a FRU had arrived to an empty scene – even the police had gone. I guess he wasn’t too badly hurt then.
I hope you all had a happy Valentine’s day.
Be safe.
Stats: 1 RTC with back injury; 1 Assault with eye injury; 1 Faint with chest pain; 1 Asthma attack; 1 RTC with pelvic injury.
Valentine’s day is supposed to be the most romantic day of the year and it certainly promotes the romantic inclinations of the drunken few, so the night was destined to be busy and I was glad I wasn’t working it. Instead I was out attending to a young female jogger who got hit by a car at a very busy and very dangerous part of town for traffic. I don’t know if she ran into the path of the vehicle or a red light was run but she was lying in the middle of the road, surrounded by police officers, blue lights and onlookers when I arrived.
She had put a good sized ‘bulls-eye’ in the windscreen and I found out that most of her back had done that, rather than her head, which is a good thing. She was very emotional and that didn’t surprise me. She cried as she lay there waiting to be collared when the crew arrived and it took us less than five minutes to get her off the ground and into the warmth and privacy of the ambulance.
Twenty minutes after arriving on scene, I skulked off with my MRU colleague for a coffee until the next call came in.
Any illusion of the day being romantic was quickly dispelled when I pulled up on scene for a 20 year-old woman who’d allegedly been assaulted by her husband. She had been punched in the face and the police were with them – he was in the police van and she was sitting in the back seat of their car with a baby in her arms. It was a minor facial injury and I would like to think that she’d be reconsidering the type of man she’d married but, as experience has shown, they will probably make up over a nice Valentine’s meal tonight whilst he awaits his court date.
On Trafalgar Square a couple of elderly men preached over a loudspeaker from the base of Nelson’s Column. I listened to them because nobody else was and hundreds of tourists clambered around the plinth where they sat talking about God, Jesus and all the usual stuff we never hear properly. I’m not particularly into this kind of bible-bashing but I did catch something that interested me – a quote from the bible in which Jesus had said something about Prophets being listened to anywhere except in their own country and among their own families (I’m sure one or two of you will know the exact quote – I forgot to write it down). This had me thinking because, whether you believe or not, Jesus had a lot of things to say that make prefect sense even now.
People with anything to say of relevance will find enemies among their own; it’s a given and that’s why we are so fragmented as a society. Some of you may have a talent that is overlooked by those close to you but admired and understood by strangers. Large companies and organisations have the same problem – many of them cannot see the value of the people who work for them, even though everybody else can. Governments pay more attention to the outside world than the very people who elected them.
I had a salient point to make but in the midst of time between then and writing this now, I have mislaid it somewhere in my memory that I no longer have access to – I’ve forgotten the password. I probably lost track of my thoughts when I watched a young girl clamber up onto one of the lions with a peace flag in her hand. She waved it around at everybody and nobody, then slipped off and crashed to the ground in a heap with the flag flapping around her face – that’ll learn ya! (as Mrs G would say).
A stoical 78 year-old woman who fainted at a museum just after experiencing chest pain told me that she had suffered a few ‘twinges’ before but had ignored them. She wasn’t much for making a fuss, you see.
She lay on the first aid couch, pain-free and recovering from her collapse while I carried out a full set of obs and found nothing untoward. Her ECG could have been taken from a teenager and so, despite the strongest advice, she declined to go to hospital and decided to continue her day out with a friend to look after her.
A call to the underground next, for an asthmatic female who, on close inspection, didn’t appear to be having too much trouble breathing at all. Her sats were high and she was capable of speaking in full sentences but I continued down the route I must take if there is any chance of a clinical condition being present. Obviously I couldn’t hear her lung sounds because the tube traffic was relentless and noisy. With the help of the crew she was able to walk up the escalators and into the ambulance.
The shift ended with another RTC in which a motorcyclist was removed from his ride by a naughty car driver who’d stopped dead in the middle of a very busy lane just as Mr. M/C ran up behind him at 30mph or more. The damage to his fuel tank was severe, indicating that his lower parts had made significant contact with it as he flew from the bike onto the road. I found him lying there with police around him and I began to do what’s necessary – C-spine control.
Only after a few seconds did I realise there was another person on the road – he was lying flat on his face as if dead and I asked the cops around me who he was. ‘We think he was the passenger’, one of them told me. The second helmet on the road confirmed this and I left one police officer in charge of the first patient, who was conscious but in pain, to attend to the second one – just in case he was dead…or dying.
Thankfully, the second man was conscious and seemingly unhurt, although he was instructed to stay still until I assessed my first patient properly.
I spent a few minutes with the bike rider until a crew arrived and I asked them to split tasks between one patient and the other. The rider was collared and scooped whilst the passenger remained where he was during a secondary survey but as we were now tied up with the rider, who had a suspected fractured pubis symphysis, it wasn’t until the second ambulance arrived some minutes later that I was able to get back to him. During that time, he lay there like a drunk man, drumming his fingers as if bored (he probably was).
I sat the passenger up once I was sure that there was no need to worry about him (he hadn’t been propelled through the air like his mate) and he was taken off to ambulance number two.
The bike rider was blued into hospital and his passenger was trundled in behind him - as I left the scene the police asked me if I could check the driver of the car that had been rear-ended. I’d forgotten about him to be honest; I had my hands full. I looked at the small bruise on his head and advised him that I would arrange for another vehicle to come and collect him (I had to travel with the biker). I checked back later and was told that a FRU had arrived to an empty scene – even the police had gone. I guess he wasn’t too badly hurt then.
I hope you all had a happy Valentine’s day.
Be safe.
Monday, 9 February 2009
Gawping
Day shift: Three calls; one assisted-only and two by ambulance.
Stats: 1 Faint; 1 Near-faint; 1 RTC with arm injury.
So, my night shifts were interrupted so that I could attend court – I wasn’t upset about this at all!
I waited for over an hour before being called as a witness for the Coroner and I was ‘on stage’ for less than ten minutes giving my evidence. It was strange to hear the entire life story of a person I’d seen dead the first and only time I’d encountered them. More often than not we get very little detail about the human being whose body we are resuscitating or calling time on. It defuses the emotion you’d feel; the sadness of knowing the person as a living being, not as a corpse. In that respect not knowing their history is probably for the best.
By the time I got back to my station, the afternoon was upon us and I took the car out for a mere three-call shift, which was fine because the weather wasn’t (fine, that is). It poured freezing rain relentlessly.
My first call was to a female who’d fainted inside the reception area of a school. She was one of the parents and had been complaining of abdominal pain for a while before she passed out, according to the staff on scene.
I crawled to a halt outside the place as kids and parents were pouring out (great timing) and I had to wait until a stupid woman with her small children, including one in a pram, got out of my way. She was in the middle of the road with not a care about the traffic…or me and my blue-lights. I bet she’d be the first to shout at anyone driving too fast or too close to her precious cargo – it’s a shame her horse was higher than the pavement she should have been using because I would have spent time chatting to her about the stupidity of her actions.
Inside the school, little kids were bustling past with parents dragging behind and the patient lay in the recovery position, looking, for the world, like she was unconscious, as I attempted to get a story above the din.
The woman’s eyelids were fluttering and I asked her to open them because I knew she could. The crew arrived as I was getting a name and some details from her, so I asked for a chair to make life easier and she was taken out to the ambulance where it was child-free. Her own kid, incidentally, had been taken home by a neighbour.
I caught the obs and decided to leave the crew alone. She wasn’t in trouble and her faint had probably never been an actual event (more likely a near-faint), so I made my way back to the station, from where I launched myself for the rest of the day, given the unpleasant weather.
RTC’s are the last type of call you want to get on a day like this. Your uniform is going to get soaked and you’ll spend the rest of the shift damp and cold, unless Control allow you to change it and even then, how many trouser-changes are you going to get if the day turns out to be a RTC frenzy?
This one, thank goodness, for a 47 year-old male with a minor arm injury, required only an ambulance crew and there was one already on scene when I turned up. The man had been clipped by the car’s wing mirror and had been bruised as a result – no big deal. The hospital was a spit away, so I expect the crew simply walked him over to A&E. I wonder why he didn’t try that himself?
My last call of the day was to a 36 year-old who’d almost fainted at work and whose request not to have an ambulance called was ignored. When I got to her, she was sitting on her chair in an open plan office, smiling and looking sheepish about the whole thing. Thank God, she must have thought, only one yellow jacket. Unfortunately, she was in for a treat because I knew the crew had arrived on scene a few seconds behind me and were probably on their way up.
She told me that she had swooned off her chair after hearing the gory details of her friend’s recently fractured leg over the phone. I thought this was quite funny. She said that this was normal for her; she always faints or nearly faints when she sees or hears unpleasant things. I had two thoughts at this point: why did she listen to the gory details if she knew she’d pass out? And how long would she last in the ambulance service?
She was a nice person with a sense of humour about the whole thing - being in an open-plan space, there were plenty of people watching and I think she felt a little self-conscious. I didn’t, therefore, point out the fact that across the mezzanine, through large glass-windowed offices full of men in suits, an even bigger audience was considering buying tickets. I’ve never seen so many full-grown adults with better things to do, gawping at the possibility of something serious happening. Oh no, wait…yes I have…every weekend in Leicester Square.
Be safe.
Stats: 1 Faint; 1 Near-faint; 1 RTC with arm injury.
So, my night shifts were interrupted so that I could attend court – I wasn’t upset about this at all!
I waited for over an hour before being called as a witness for the Coroner and I was ‘on stage’ for less than ten minutes giving my evidence. It was strange to hear the entire life story of a person I’d seen dead the first and only time I’d encountered them. More often than not we get very little detail about the human being whose body we are resuscitating or calling time on. It defuses the emotion you’d feel; the sadness of knowing the person as a living being, not as a corpse. In that respect not knowing their history is probably for the best.
By the time I got back to my station, the afternoon was upon us and I took the car out for a mere three-call shift, which was fine because the weather wasn’t (fine, that is). It poured freezing rain relentlessly.
My first call was to a female who’d fainted inside the reception area of a school. She was one of the parents and had been complaining of abdominal pain for a while before she passed out, according to the staff on scene.
I crawled to a halt outside the place as kids and parents were pouring out (great timing) and I had to wait until a stupid woman with her small children, including one in a pram, got out of my way. She was in the middle of the road with not a care about the traffic…or me and my blue-lights. I bet she’d be the first to shout at anyone driving too fast or too close to her precious cargo – it’s a shame her horse was higher than the pavement she should have been using because I would have spent time chatting to her about the stupidity of her actions.
Inside the school, little kids were bustling past with parents dragging behind and the patient lay in the recovery position, looking, for the world, like she was unconscious, as I attempted to get a story above the din.
The woman’s eyelids were fluttering and I asked her to open them because I knew she could. The crew arrived as I was getting a name and some details from her, so I asked for a chair to make life easier and she was taken out to the ambulance where it was child-free. Her own kid, incidentally, had been taken home by a neighbour.
I caught the obs and decided to leave the crew alone. She wasn’t in trouble and her faint had probably never been an actual event (more likely a near-faint), so I made my way back to the station, from where I launched myself for the rest of the day, given the unpleasant weather.
RTC’s are the last type of call you want to get on a day like this. Your uniform is going to get soaked and you’ll spend the rest of the shift damp and cold, unless Control allow you to change it and even then, how many trouser-changes are you going to get if the day turns out to be a RTC frenzy?
This one, thank goodness, for a 47 year-old male with a minor arm injury, required only an ambulance crew and there was one already on scene when I turned up. The man had been clipped by the car’s wing mirror and had been bruised as a result – no big deal. The hospital was a spit away, so I expect the crew simply walked him over to A&E. I wonder why he didn’t try that himself?
My last call of the day was to a 36 year-old who’d almost fainted at work and whose request not to have an ambulance called was ignored. When I got to her, she was sitting on her chair in an open plan office, smiling and looking sheepish about the whole thing. Thank God, she must have thought, only one yellow jacket. Unfortunately, she was in for a treat because I knew the crew had arrived on scene a few seconds behind me and were probably on their way up.
She told me that she had swooned off her chair after hearing the gory details of her friend’s recently fractured leg over the phone. I thought this was quite funny. She said that this was normal for her; she always faints or nearly faints when she sees or hears unpleasant things. I had two thoughts at this point: why did she listen to the gory details if she knew she’d pass out? And how long would she last in the ambulance service?
She was a nice person with a sense of humour about the whole thing - being in an open-plan space, there were plenty of people watching and I think she felt a little self-conscious. I didn’t, therefore, point out the fact that across the mezzanine, through large glass-windowed offices full of men in suits, an even bigger audience was considering buying tickets. I’ve never seen so many full-grown adults with better things to do, gawping at the possibility of something serious happening. Oh no, wait…yes I have…every weekend in Leicester Square.
Be safe.
Sunday, 8 February 2009
Depressed
Night shift: Eight calls; two false alarms; two assisted-only and four by ambulance.
Stats: 3 eTOH; 1 Chest pain; 1 Asthma; 1 Anxiety attack
It’s still cold enough to make you wonder why people go out and get drunk when all they have to look forward to is a slow, frozen journey home…if they make it home at all.
My colleague was two hours late for the shift changeover because he was tied up on a call in which a 13 year-old boy drowned in a canal. I used the time I had by delivering a vehicle to a crew and then got stuck on the way back when they received a call for a pregnant woman who simply walked out into the LAS taxi she’d demanded.
I got back and took over the car later and my first call was to a 25 year-old who was ‘unconscious’ outside a club. She was drunk, of course and no more unconscious than me but she had to go to hospital because she wasn’t fit to walk. Her annoying, fag-smoking friend kept yelling out for her as the crew tried to do their job and I had to usher her away from the back of the vehicle. The police were on hand to remind her that she wasn’t – definitely wasn’t – going with her mate to hospital in the ambulance. There’s nothing more irritating and potentially dangerous than carrying a full cargo of drunken people.
The chest pain call was for a 43 year-old man with no cardiac history and a recent chest infection. His pain came on only when he breathed, so it was unlikely to be related to his heart. He felt as cold as ice, even though his bed-sit was relatively warm but his core temperature was normal. I suspect he’d been outside too long.
The next drunken patient of the night fell asleep at an underground station, prompting a Red3 call for an ‘unconscious’ person. Try to remember that, according to our computer system, that patient is more important than you if you have broken an arm. The crew was ahead of me and woke him up. He left the scene and I was advised not to bother. So I didn’t.
Two false alarms; the first of which was to a 17 year-old who was ‘fitting’. I was cancelled on an earlier call for this as it was a higher priority. The trouble was that she wasn’t fitting, nor had she ever been fitting. Apparently – and this was from the patient’s relatives – they had been advised to let an ambulance come to her even though they’d said they didn’t need one.
The girl was lying across her bed when I got there with the crew. She had been out with friends and had suffered a mild panic attack which included shaking. This movement had been blown way out of proportion when the call was taken and so an emergency response kicked in. Meanwhile, the call I’d been cancelled on (palpitations) was probably still waiting for attention miles away. I hope I’m never in an accident on the way to one of these spurious calls. I do not want to be injured or killed on duty because some over-zealous person pressed the panic button for a call like this.
The next false alarm was a RTC involving a car and a pedestrian. The car had hit this person deliberately, allegedly, then an argument broke out between the driver and the victim. The police had removed one of them from the scene to their station and when I turned up it had all blown over with nobody actually hurt.
A regular caller made his way into a hotel lobby and announced that he was having an asthma attack. He does this every time and is in and out of hospital on an almost weekly basis. He’s so well known to us all that we nod and say hello to him whenever we see him out and about. Soon enough we’ll be swapping Christmas cards.
His condition was stable but he tried hard to push a wheeze or two through his windpipe to convince me that all was not well with him. It didn’t matter because he was going to hospital – he always goes to hospital. That said, he demonstrated his understanding of our willingness to comply by specifying which A&E unit he’d prefer to visit.
Another drunken female was being propped up outside a club by one of the security people. A nearby woman waved her cigarette in my face and generally got in the way. She’d obstructed the car on the way by blocking my path as I tried to park in the tight little street. I let her know I wasn’t pleased with her behaviour and she swore at me to let me know she didn’t care.
The drunken girl was completely out of it and had vomited a few times on the pavement. Nobody was with her initially and when the crew arrived she was lifted onto the trolley bed with no-one to worry about her. She woke up and became startled by what was happening, as if oblivious to her state and the reason we had been called.
Then, as if by magic, people started to appear around us with concerned faces and claims of knowing her. One of them pulled open the back door as she was being treated and I had to push him back from the vehicle as he tried to get in. ‘Read the sign’, I told him, ‘knock and wait’. I closed the door and a second later, there was a knock. I asked for that really, didn't I?
The cigarette-smoking rude girl eventually calmed and apologised. ‘I know you hate me’, she said, ‘but I was the one who found her’.‘I don’t hate anyone’, I replied, ‘I just don’t like being treated rudely when I’m trying to help someone’. I think she understood. We were best mates now. Another Christmas card on the way I expect.
I spent my rest break at the station and an hour or so after I’d put my feet up a call came in for a patient having a panic attack in the flats across the road. I definitely met ORCON with that one – it took me ten seconds to get on scene. I could have walked but the law of Sod would probably have given me a cardiac arrest to deal with and no kit to my name.
The woman was in her toilet and was very edgy. She had psychiatric problems that were ongoing and depression was one of them. I sat and spoke with her for a while as she calmed down and then the crew arrived to help me talk her back to reality. Her husband lay in bed sleeping – he’d lived with this for so long that he didn’t get up til later when we were taking her to the ambulance for a long chat and more obs.
The lady remembered me from a call I attended at the same building a few years ago and even more surprisingly, to me anyway, she still knew my name.
She was very nice but very scared and it took a good hour to settle her and convince her that she could go back home with her husband and sleep. We all got a thank-you kiss on the cheek. I think that’s allowed.
Be safe.
Stats: 3 eTOH; 1 Chest pain; 1 Asthma; 1 Anxiety attack
It’s still cold enough to make you wonder why people go out and get drunk when all they have to look forward to is a slow, frozen journey home…if they make it home at all.
My colleague was two hours late for the shift changeover because he was tied up on a call in which a 13 year-old boy drowned in a canal. I used the time I had by delivering a vehicle to a crew and then got stuck on the way back when they received a call for a pregnant woman who simply walked out into the LAS taxi she’d demanded.
I got back and took over the car later and my first call was to a 25 year-old who was ‘unconscious’ outside a club. She was drunk, of course and no more unconscious than me but she had to go to hospital because she wasn’t fit to walk. Her annoying, fag-smoking friend kept yelling out for her as the crew tried to do their job and I had to usher her away from the back of the vehicle. The police were on hand to remind her that she wasn’t – definitely wasn’t – going with her mate to hospital in the ambulance. There’s nothing more irritating and potentially dangerous than carrying a full cargo of drunken people.
The chest pain call was for a 43 year-old man with no cardiac history and a recent chest infection. His pain came on only when he breathed, so it was unlikely to be related to his heart. He felt as cold as ice, even though his bed-sit was relatively warm but his core temperature was normal. I suspect he’d been outside too long.
The next drunken patient of the night fell asleep at an underground station, prompting a Red3 call for an ‘unconscious’ person. Try to remember that, according to our computer system, that patient is more important than you if you have broken an arm. The crew was ahead of me and woke him up. He left the scene and I was advised not to bother. So I didn’t.
Two false alarms; the first of which was to a 17 year-old who was ‘fitting’. I was cancelled on an earlier call for this as it was a higher priority. The trouble was that she wasn’t fitting, nor had she ever been fitting. Apparently – and this was from the patient’s relatives – they had been advised to let an ambulance come to her even though they’d said they didn’t need one.
The girl was lying across her bed when I got there with the crew. She had been out with friends and had suffered a mild panic attack which included shaking. This movement had been blown way out of proportion when the call was taken and so an emergency response kicked in. Meanwhile, the call I’d been cancelled on (palpitations) was probably still waiting for attention miles away. I hope I’m never in an accident on the way to one of these spurious calls. I do not want to be injured or killed on duty because some over-zealous person pressed the panic button for a call like this.
The next false alarm was a RTC involving a car and a pedestrian. The car had hit this person deliberately, allegedly, then an argument broke out between the driver and the victim. The police had removed one of them from the scene to their station and when I turned up it had all blown over with nobody actually hurt.
A regular caller made his way into a hotel lobby and announced that he was having an asthma attack. He does this every time and is in and out of hospital on an almost weekly basis. He’s so well known to us all that we nod and say hello to him whenever we see him out and about. Soon enough we’ll be swapping Christmas cards.
His condition was stable but he tried hard to push a wheeze or two through his windpipe to convince me that all was not well with him. It didn’t matter because he was going to hospital – he always goes to hospital. That said, he demonstrated his understanding of our willingness to comply by specifying which A&E unit he’d prefer to visit.
Another drunken female was being propped up outside a club by one of the security people. A nearby woman waved her cigarette in my face and generally got in the way. She’d obstructed the car on the way by blocking my path as I tried to park in the tight little street. I let her know I wasn’t pleased with her behaviour and she swore at me to let me know she didn’t care.
The drunken girl was completely out of it and had vomited a few times on the pavement. Nobody was with her initially and when the crew arrived she was lifted onto the trolley bed with no-one to worry about her. She woke up and became startled by what was happening, as if oblivious to her state and the reason we had been called.
Then, as if by magic, people started to appear around us with concerned faces and claims of knowing her. One of them pulled open the back door as she was being treated and I had to push him back from the vehicle as he tried to get in. ‘Read the sign’, I told him, ‘knock and wait’. I closed the door and a second later, there was a knock. I asked for that really, didn't I?
The cigarette-smoking rude girl eventually calmed and apologised. ‘I know you hate me’, she said, ‘but I was the one who found her’.‘I don’t hate anyone’, I replied, ‘I just don’t like being treated rudely when I’m trying to help someone’. I think she understood. We were best mates now. Another Christmas card on the way I expect.
I spent my rest break at the station and an hour or so after I’d put my feet up a call came in for a patient having a panic attack in the flats across the road. I definitely met ORCON with that one – it took me ten seconds to get on scene. I could have walked but the law of Sod would probably have given me a cardiac arrest to deal with and no kit to my name.
The woman was in her toilet and was very edgy. She had psychiatric problems that were ongoing and depression was one of them. I sat and spoke with her for a while as she calmed down and then the crew arrived to help me talk her back to reality. Her husband lay in bed sleeping – he’d lived with this for so long that he didn’t get up til later when we were taking her to the ambulance for a long chat and more obs.
The lady remembered me from a call I attended at the same building a few years ago and even more surprisingly, to me anyway, she still knew my name.
She was very nice but very scared and it took a good hour to settle her and convince her that she could go back home with her husband and sleep. We all got a thank-you kiss on the cheek. I think that’s allowed.
Be safe.
Saturday, 7 February 2009
Too cold for work
Night shift: Six calls; one sent packing; one assisted-only and four by ambulance.
Stats: 1 Chest pain; 1 Abdominal pain; 1 EP fit; 1 RTS with shoulder injury; 2 eTOH.
Back on the dark ones and its freezing out there, so I was hoping for as many ‘inside’ jobs as possible but Friday night being what it is, that was going to be unlikely. I only have two to do instead of my usual four because I’m a Coroner’s Court witness next week and so I’ve been stood down for that.
A 51 year-old Albanian man suffering chest pain decided to do nothing about it when he first experienced it last week. He continued to suffer the pain for almost three hours tonight again before his worried family called an ambulance. He wasn’t the type to make a fuss, they said.
He took a paracetamol but it didn’t help, so now he was getting GTN and an aspirin, courtesy of the NHS before being taken into the ambulance for an ECG when the crew arrived. His Q-T intervals were prolonged and that can mean something or nothing, since a small percentage of us have the anomaly without necessarily suffering any ill-effects. I would also have expected him to feel faint if this was his problem. There was no ST elevation to indicate a heart attack but, again, who knows until a thorough check has been done, so off he went.
DIB for an abdominal pain next and the 42 year-old Indian lady, who spoke no English and had to have everything I said (and she said) translated by a younger member of the family, stood in her bedroom clutching the offending belly part. She had no DIB and had never had DIB but when asked on the phone, the 999 caller is bound to say YES to the question and so it goes red.
She had a history of ulcer and that was probably causing her more misery now and yes, ulcers can be life-threatening, so yes, she went to hospital.
Unconsciousness cannot be faked by amateur street drunkards and so I asked the 23 year-old fool lying in the street to sit up because I knew he was pretending. The police were on scene and the two officers had been trying to get him to respond ever since he was seen lying there by a passing driver who called 999. A couple of his mates were there too but I don’t know how long this little charade had been going on.
It took me 30 seconds to convince him that the game was up and as he fluttered to life, the cops gave him an ear-bashing. ‘Sit up or you’ll be arrested for wasting police time’, the taller officer said.
‘You can’t nick me’, said the moaning man as he sat upright.
‘You want a bet sunshine?’ the cop replied.
I like it when police officers adopt a no-nonsense approach; it reminds me that there are still disciplines between people that can be reinforced. Of course, a 'right-minded' person would probably think it unprofessional for a cop to shout at someone like that, but I don't. I think its necessary and effective.
This prompted the young drunk to request the officer's shoulder number so that he could make a complaint. A complaint about what exactly, I don’t know but me, the cops and the crew that had just arrived for nothing, were very cold and not in the mood for this tonight. His parents may have taught him that 'they can't touch you' and so he has lived his life like an ill-behaved child as a result BUT he wasn't spending any more of my hard-earned tax money and that was that.
He saw sense and walked off with his friends, who must have been more than a little embarrassed by his behaviour.
Immediately after that call, when I pressed the green button on my screen, I got another one. I was going a short distance south and when I arrived on scene I was windmilled to a spot on the pavement where an 18 year-old lad was fitting violently. He’d managed to call his friend out to help him on his mobile phone and was still clutching it as he writhed and jerked on the pavement. It took most of my strength to keep his head off the ground – he would have bashed it open otherwise.
Although he was seemingly fitting, he could talk every now and then and could answer questions with a nod and by the time he was taken into the ambulance, his behaviour had become very odd. Now, he may well have been having a partial-seizure – his legs and arms were certainly busy all the time or he could have taken something earlier.
I asked his now growing gang of friends (they were all arriving at the back doors of the ambulance) if he took drugs and they all, to a man, denied that he did. I believed them because they didn’t hesitate and they looked genuinely concerned for him.
The crew fought to get a line in as he flapped about on the stretcher but eventually it was done. He was blued in, still convulsing and with no explanation for it – he had absolutely no medical conditions as far as we could ascertain from him (when he spoke) and his friends (who never stopped).
On the way back to the station I was asked to assist an EMT who was attending a 30 year-old woman who’d been knocked off her bike by a car, which had then sped off, leaving her lying in the road with a shoulder injury. I was told that she needed stronger pain relief than entonox and I went there to give her morphine.
The woman was sitting in my colleague’s FRU, screaming in pain. Her shoulder had either been fractured, dislocated or both…probably both and she was 10 out of 10 for pain. I prepared her for the morphine as she sat in the car and when the ambulance crew arrived, they helped me to complete my task. Again, there were a few friends hanging about – all girls and all cyclists who’d been with her when she was hit.
After a long battle to calm her and relieve her pain, she was taken to hospital with 10mg of the good stuff in her system. She was actually quite chirpy when she arrived at A&E, so it must have been effective. Her constant sucking on the entonox mouthpiece may also have contributed. I think she emptied the cylinder. By the time I left she and her mate, who'd travelled with her, were eyeing up the young men in the department.
Whilst in hospital a ‘blue call’ was received and in came a young man who’d been involved in a fight. He was taken straight to Resus with a deeply cut throat. I went in to see him (being nosey as we all are) and I couldn’t believe how lucky he’d been – his throat had been opened all the way around almost to the back of his head. Someone had used a broken bottle or glass to do it. He also had a head injury which, my colleagues reliably tell me, bled more than the potentially fatal neck wound. The slash had missed all of the vital structures, including his carotid artery, which could be clearly seen through the gaping hole.
I honestly think someone had tried to behead this man. No amount of alcohol or aggression is worth it. Now someone out there may be charged with attempted murder but he will more than likely be done for ABH or less, such is our legal system and the difficulties of proof. To my mind an act so violent as to almost kill someone, regardless of whether it is planned or not, should be sentenced accordingly.
A DOAB at 4.30am when all was just getting quiet and all I had to do was wake him up. He was unsteady on his feet and completely lost, so I directed him to the nearest bus stop. ‘I don’t want to sleep, I just want to go home’, he bleated as I held him still on the pavement. Don’t we all, I thought.
Luckily he didn’t fall down and managed to stagger off in time-honoured fashion.
Be safe.
Stats: 1 Chest pain; 1 Abdominal pain; 1 EP fit; 1 RTS with shoulder injury; 2 eTOH.
Back on the dark ones and its freezing out there, so I was hoping for as many ‘inside’ jobs as possible but Friday night being what it is, that was going to be unlikely. I only have two to do instead of my usual four because I’m a Coroner’s Court witness next week and so I’ve been stood down for that.
A 51 year-old Albanian man suffering chest pain decided to do nothing about it when he first experienced it last week. He continued to suffer the pain for almost three hours tonight again before his worried family called an ambulance. He wasn’t the type to make a fuss, they said.
He took a paracetamol but it didn’t help, so now he was getting GTN and an aspirin, courtesy of the NHS before being taken into the ambulance for an ECG when the crew arrived. His Q-T intervals were prolonged and that can mean something or nothing, since a small percentage of us have the anomaly without necessarily suffering any ill-effects. I would also have expected him to feel faint if this was his problem. There was no ST elevation to indicate a heart attack but, again, who knows until a thorough check has been done, so off he went.
DIB for an abdominal pain next and the 42 year-old Indian lady, who spoke no English and had to have everything I said (and she said) translated by a younger member of the family, stood in her bedroom clutching the offending belly part. She had no DIB and had never had DIB but when asked on the phone, the 999 caller is bound to say YES to the question and so it goes red.
She had a history of ulcer and that was probably causing her more misery now and yes, ulcers can be life-threatening, so yes, she went to hospital.
Unconsciousness cannot be faked by amateur street drunkards and so I asked the 23 year-old fool lying in the street to sit up because I knew he was pretending. The police were on scene and the two officers had been trying to get him to respond ever since he was seen lying there by a passing driver who called 999. A couple of his mates were there too but I don’t know how long this little charade had been going on.
It took me 30 seconds to convince him that the game was up and as he fluttered to life, the cops gave him an ear-bashing. ‘Sit up or you’ll be arrested for wasting police time’, the taller officer said.
‘You can’t nick me’, said the moaning man as he sat upright.
‘You want a bet sunshine?’ the cop replied.
I like it when police officers adopt a no-nonsense approach; it reminds me that there are still disciplines between people that can be reinforced. Of course, a 'right-minded' person would probably think it unprofessional for a cop to shout at someone like that, but I don't. I think its necessary and effective.
This prompted the young drunk to request the officer's shoulder number so that he could make a complaint. A complaint about what exactly, I don’t know but me, the cops and the crew that had just arrived for nothing, were very cold and not in the mood for this tonight. His parents may have taught him that 'they can't touch you' and so he has lived his life like an ill-behaved child as a result BUT he wasn't spending any more of my hard-earned tax money and that was that.
He saw sense and walked off with his friends, who must have been more than a little embarrassed by his behaviour.
Immediately after that call, when I pressed the green button on my screen, I got another one. I was going a short distance south and when I arrived on scene I was windmilled to a spot on the pavement where an 18 year-old lad was fitting violently. He’d managed to call his friend out to help him on his mobile phone and was still clutching it as he writhed and jerked on the pavement. It took most of my strength to keep his head off the ground – he would have bashed it open otherwise.
Although he was seemingly fitting, he could talk every now and then and could answer questions with a nod and by the time he was taken into the ambulance, his behaviour had become very odd. Now, he may well have been having a partial-seizure – his legs and arms were certainly busy all the time or he could have taken something earlier.
I asked his now growing gang of friends (they were all arriving at the back doors of the ambulance) if he took drugs and they all, to a man, denied that he did. I believed them because they didn’t hesitate and they looked genuinely concerned for him.
The crew fought to get a line in as he flapped about on the stretcher but eventually it was done. He was blued in, still convulsing and with no explanation for it – he had absolutely no medical conditions as far as we could ascertain from him (when he spoke) and his friends (who never stopped).
On the way back to the station I was asked to assist an EMT who was attending a 30 year-old woman who’d been knocked off her bike by a car, which had then sped off, leaving her lying in the road with a shoulder injury. I was told that she needed stronger pain relief than entonox and I went there to give her morphine.
The woman was sitting in my colleague’s FRU, screaming in pain. Her shoulder had either been fractured, dislocated or both…probably both and she was 10 out of 10 for pain. I prepared her for the morphine as she sat in the car and when the ambulance crew arrived, they helped me to complete my task. Again, there were a few friends hanging about – all girls and all cyclists who’d been with her when she was hit.
After a long battle to calm her and relieve her pain, she was taken to hospital with 10mg of the good stuff in her system. She was actually quite chirpy when she arrived at A&E, so it must have been effective. Her constant sucking on the entonox mouthpiece may also have contributed. I think she emptied the cylinder. By the time I left she and her mate, who'd travelled with her, were eyeing up the young men in the department.
Whilst in hospital a ‘blue call’ was received and in came a young man who’d been involved in a fight. He was taken straight to Resus with a deeply cut throat. I went in to see him (being nosey as we all are) and I couldn’t believe how lucky he’d been – his throat had been opened all the way around almost to the back of his head. Someone had used a broken bottle or glass to do it. He also had a head injury which, my colleagues reliably tell me, bled more than the potentially fatal neck wound. The slash had missed all of the vital structures, including his carotid artery, which could be clearly seen through the gaping hole.
I honestly think someone had tried to behead this man. No amount of alcohol or aggression is worth it. Now someone out there may be charged with attempted murder but he will more than likely be done for ABH or less, such is our legal system and the difficulties of proof. To my mind an act so violent as to almost kill someone, regardless of whether it is planned or not, should be sentenced accordingly.
A DOAB at 4.30am when all was just getting quiet and all I had to do was wake him up. He was unsteady on his feet and completely lost, so I directed him to the nearest bus stop. ‘I don’t want to sleep, I just want to go home’, he bleated as I held him still on the pavement. Don’t we all, I thought.
Luckily he didn’t fall down and managed to stagger off in time-honoured fashion.
Be safe.
Tuesday, 3 February 2009
Slush
These boots are made for gripping...Day shift: Eight calls; all by ambulance.
Stats: 2 Faint; 1 Chest pain; 1 Hypoglycaemic; 1 Asthma attack; 1 EP fit; 1 RTC with Spinal injury; 1 Hypothermia.
Back to normal and I use slush to describe the weather as well as the working calls – not with disrespect of course but as the best descriptive comparison of the last two shifts. With snow, you know what you are getting but slush is a mixture of all kinds of stuff...including contaminants and rubbish.
The snow covers were removed from my car and I slid about a bit but not so much that I couldn’t keep control under 30mph on those icy side streets that still hadn’t been touched by grit or salt.
The fainters are back on line. The first call I received was for a 27 year-old who’d almost passed out in his University Halls of Residence. He’d also claimed chest pain but this was easing as his emotional state relaxed. As I approached the rooms where he lived I noticed various signs that were posted on the walls. One of them pointed in the direction I was heading. It read ‘rubbish’. I hadn’t made a personal judgement yet but I had to smile at the irony of it.
The second call of the morning was also a faint but a crew was on scene for the 20 year-old female who’d passed out in an underground station.
Another chest pain call for a young person turned out to be a bit more interesting than usual. The 24 year-old woman suffered from Wolfe-Parkinson-White Syndrome. She had palpitations and was breathless as she lay on the floor of her boyfriend’s room (again in a Halls of Residence). This condition can quickly convert to a life-threatening VF if not treated but that only happens in rare cases (less than 1%), although at her age she was at higher risk, so it was all taken seriously.
She’d had an ablation treatment for it a few months ago and had seemed fine until today. Her ECG had all the expected waves and forms and there was no evidence of a new problem (no shortened P-R or Delta waves, for those of you inclined to care for the technical stuff) but it would be down to a cardiologist to determine that, so off she went to hospital and straight into Resus.
I felt sorry for her; she’s too young for that kind of problem and it may or may not resolve itself in later life. I could only hope that the former was true in her case.
A 51 year-old lady fell out of her bed and I was sent to her on an assist-only mission. She was a large woman with MS and weakness of the legs as a result. This made my valiant attempt at lifting her on my own rather useless, so I requested another FRU to help me. At this point an ambulance wasn’t really necessary and she wasn’t interested in going to hospital but when I checked her BM as part of my basic obs, I found it to be very low (2.2). I tested her again because she wasn’t diabetic and had no other issues apart from a recurring UTI. The reading was still low. I had to change my mind about the ambulance. Either my properly-calibrated meter was faulty or there was a new problem that needed checking.
When the crew arrived the woman was munching on a chocolate biscuit that I’d given her from her personal stash in the kitchen. I noticed that she also had tubs of sweets and chocolate bars at her bedside. She was obviously a sweetie monster, as we say in the Homeland. I can be one too, I must admit.
This in itself did not make her a candidate for hypoglycaemia because with a high intake of sugar I’d expect to see the opposite if she was developing diabetes but her condition was clearly serious, if taken on face value, and a trip to hospital was now required to sort it out, one way or the other.
Before leaving her flat, I carried out another BM test using my colleague’s meter and the reading was normal (4.4), so there could have been a problem with mine or giving her the biscuit may have been a mistake as it may have skewed the reading, although I’m sure one biscuit wouldn’t cause her glucose level to rise by so much so quickly (within ten minutes of the second check). I was torn between allowing her blood glucose to remain low, thus disallowing any aberrant influence and treating her condition. Clinically, I had to treat her, so the biscuit was given. Oh and the finger I tested on had been cleaned prior to lancing (just in case you leap to any conclusions).
Asthma and hyperventilation can sometimes go hand-in-hand and sorting one out from the other is usually clear-cut but my next patient, a 25 year-old asthmatic who was at work when she suffered an attack, had me making a choice for the benefit of the patient. She was obviously upset and there was a slight wheeze in her chest but I wasn’t entirely convinced that she was having a full-blown attack. Nevertheless, I gave her Salbutamol by nebuliser as a substitute for her non-effective inhaler and this took care of the wheeze and calmed her down. I have seen the psychological effect of this drug many times before and would never advocate its use in an absolutely clear case of over-breathing but there is sometimes a fine line and, again, a clinical decision has to be made on the spot. Peak flow and sats help to make that a simpler task.
The epileptic fit call was to an 18 year-old girl who had a witnessed 2-3 minute seizure at an underground station. A South African paramedic gave me a sterling handover and then promptly disappeared, which is the done thing, when I took over.
The young girl was recovering but told me that she often had more than one fit, so as soon as the crew arrived, she was taken on board. She’d also hurt her ankle, most likely during her fall to the floor, which was seen by one of the station staff members.
Stats: 2 Faint; 1 Chest pain; 1 Hypoglycaemic; 1 Asthma attack; 1 EP fit; 1 RTC with Spinal injury; 1 Hypothermia.
Back to normal and I use slush to describe the weather as well as the working calls – not with disrespect of course but as the best descriptive comparison of the last two shifts. With snow, you know what you are getting but slush is a mixture of all kinds of stuff...including contaminants and rubbish.
The snow covers were removed from my car and I slid about a bit but not so much that I couldn’t keep control under 30mph on those icy side streets that still hadn’t been touched by grit or salt.
The fainters are back on line. The first call I received was for a 27 year-old who’d almost passed out in his University Halls of Residence. He’d also claimed chest pain but this was easing as his emotional state relaxed. As I approached the rooms where he lived I noticed various signs that were posted on the walls. One of them pointed in the direction I was heading. It read ‘rubbish’. I hadn’t made a personal judgement yet but I had to smile at the irony of it.
The second call of the morning was also a faint but a crew was on scene for the 20 year-old female who’d passed out in an underground station.
Another chest pain call for a young person turned out to be a bit more interesting than usual. The 24 year-old woman suffered from Wolfe-Parkinson-White Syndrome. She had palpitations and was breathless as she lay on the floor of her boyfriend’s room (again in a Halls of Residence). This condition can quickly convert to a life-threatening VF if not treated but that only happens in rare cases (less than 1%), although at her age she was at higher risk, so it was all taken seriously.
She’d had an ablation treatment for it a few months ago and had seemed fine until today. Her ECG had all the expected waves and forms and there was no evidence of a new problem (no shortened P-R or Delta waves, for those of you inclined to care for the technical stuff) but it would be down to a cardiologist to determine that, so off she went to hospital and straight into Resus.
I felt sorry for her; she’s too young for that kind of problem and it may or may not resolve itself in later life. I could only hope that the former was true in her case.
A 51 year-old lady fell out of her bed and I was sent to her on an assist-only mission. She was a large woman with MS and weakness of the legs as a result. This made my valiant attempt at lifting her on my own rather useless, so I requested another FRU to help me. At this point an ambulance wasn’t really necessary and she wasn’t interested in going to hospital but when I checked her BM as part of my basic obs, I found it to be very low (2.2). I tested her again because she wasn’t diabetic and had no other issues apart from a recurring UTI. The reading was still low. I had to change my mind about the ambulance. Either my properly-calibrated meter was faulty or there was a new problem that needed checking.
When the crew arrived the woman was munching on a chocolate biscuit that I’d given her from her personal stash in the kitchen. I noticed that she also had tubs of sweets and chocolate bars at her bedside. She was obviously a sweetie monster, as we say in the Homeland. I can be one too, I must admit.
This in itself did not make her a candidate for hypoglycaemia because with a high intake of sugar I’d expect to see the opposite if she was developing diabetes but her condition was clearly serious, if taken on face value, and a trip to hospital was now required to sort it out, one way or the other.
Before leaving her flat, I carried out another BM test using my colleague’s meter and the reading was normal (4.4), so there could have been a problem with mine or giving her the biscuit may have been a mistake as it may have skewed the reading, although I’m sure one biscuit wouldn’t cause her glucose level to rise by so much so quickly (within ten minutes of the second check). I was torn between allowing her blood glucose to remain low, thus disallowing any aberrant influence and treating her condition. Clinically, I had to treat her, so the biscuit was given. Oh and the finger I tested on had been cleaned prior to lancing (just in case you leap to any conclusions).
Asthma and hyperventilation can sometimes go hand-in-hand and sorting one out from the other is usually clear-cut but my next patient, a 25 year-old asthmatic who was at work when she suffered an attack, had me making a choice for the benefit of the patient. She was obviously upset and there was a slight wheeze in her chest but I wasn’t entirely convinced that she was having a full-blown attack. Nevertheless, I gave her Salbutamol by nebuliser as a substitute for her non-effective inhaler and this took care of the wheeze and calmed her down. I have seen the psychological effect of this drug many times before and would never advocate its use in an absolutely clear case of over-breathing but there is sometimes a fine line and, again, a clinical decision has to be made on the spot. Peak flow and sats help to make that a simpler task.
The epileptic fit call was to an 18 year-old girl who had a witnessed 2-3 minute seizure at an underground station. A South African paramedic gave me a sterling handover and then promptly disappeared, which is the done thing, when I took over.
The young girl was recovering but told me that she often had more than one fit, so as soon as the crew arrived, she was taken on board. She’d also hurt her ankle, most likely during her fall to the floor, which was seen by one of the station staff members.
I asked her what she did for a living because she'd mentioned going into work tonight. In the din of the station my ears heard her say 'restaurant' and I assumed she was a waitress, being so young, so I said 'you'll be on your feet a lot then', referring to the association between her job and her injured ankle.
I got a peculiar look - nothing more than a bemused glance from her. It was only later, when I asked her to confirm what she did for a living that I realised what I'd done. She worked for an escort agency...
My next call took me back to a road junction I had been to a few days earlier. I'd helped a motorcyclist who'd been knocked off his bike at the exact spot where a man now lay on his back in the filthy slush. He'd been seen to stagger or slip backwards into the road and his head hit a van as it drove past. The van driver didn't know what had happened so continued and disappeared, according to a taxi driver who'd witnessed the whole thing. Now the man was concussed and complaining of severe neck pain; even the slightest touch set him off.
As usual in this area, there was a lot of traffic moving past. I am particularly careful in this area because the vehicles get very close. Once again I found myself on my knees in the middle of the road, holding someone's neck still until backup arrived.
I'd asked for the police but a Camden Guardian was helping out with the traffic for me until they arrived. In the meantime, I spent fifteen minutes with the man, unable to do much else but monitor him until a crew pulled up. By the time he was moved into the ambulance, he had become very cold, despite the blanket I'd put over him. Most of the cold you will feel when lying on the ground will be from below.
I was on scene for an hour and accompanied the ambulance to the hospital, where I sat inside my car doing the necessary paperwork. That's when I was approached by two women who told me that someone had collapsed around the corner and that an ambulance had just gone past him. They thought the crew may not have seen him, so could I do something to help.
I called it in and offered to go and check it out. This would be my last call of the shift.
Around the corner a man was leaning against a railing and swinging his arm in and out as if punching the air. He was fairly young and looked out of his head. A newspaper vendor had called us because she'd been watching him behave bizarrely for the past half hour.
I went up to the man and spoke but he didn't communicate. Instead he swung his arm out towards me several times. At first I thought he was being deliberate but the more he did this, the more convinced I was that it was a repetitive action. He may have taken drugs or there may be another reason for his behaviour.
I waited for five minutes, attempting to get him to speak but his railing-clinging, arm-swinging continued without rest or interruption.
When the crew arrived (three of them - a paramedic and two trainees), we managed to get him into the ambulance and when I jumped aboard a few minutes later he was sitting up and talking. It was a miraculous change in his demeanour but he still wasn't quite right.
'Can I go now', he said, moving towards me at the door.
There was no way to stop him. Our duty of care doesn't extend to the forceful restraint of a person who wants to be left alone but he wasn't 100% and we watched him as he staggered down the road, at one point stalling in the middle of the pavement like a short-circuited robot.
None of us believed he was drunk but drugs were still a possibility. It wasn't until he collapsed in a doorway and became unconscious that we discovered what might be wrong. The crew took the opportunity of getting obs while he was sparked out. I had called the police because we needed to get him into hospital for his own good and while we waited for them, I was told that his temperature was reading below 30 degrees Celsius. In fact, I recall the number 28.7 or thereabouts being used.
Severe hypothermia can bring about odd behaviour, unconsciousness and death. It all fitted with what had been happening and I found it unbelievable that someone like that had become so cold. He may have been on the streets but he didn't look like he was (which is generalising but they do have a certain distinction).
When the police arrived, he was off again and wandering down a busy street, the crew on his tail trying to persuade him to get into the warm. The police officers had to struggle with him when he became aggressive on seeing them. He was eventually cuffed and brought back to the ambulance.
It's all a bit brutal, I know, because the poor man had done nothing illegal but leaving him to wander the streets until he finally died was not an option for any of us.
Be safe.
Monday, 2 February 2009
Snow
All snowed-in with nowhere to go.Day shift: Four calls; one left on scene; three by ambulance.
Stats: 1 Cardiac arrest; 2 EP fits; 1 Febrile convulsion.
Stats: 1 Cardiac arrest; 2 EP fits; 1 Febrile convulsion.
The phrase ‘extreme weather event’ had been used by the media to describe what was coming but still we were ill-prepared for it. A snow storm, lasting all day and laying down up to 40cm in places, left us with very few ambulances and an ORCON nightmare.
I started out at 5.30am and slid, crawled and slithered my way to work on virgin snow and untreated main roads. I saw cars that had been abandoned and some that had simply crashed to a halt before their drivers left them where they rested. Although there was traffic on the road – more than I had expected – the going was very, very slow and I eventually got to my station a little late for my shift.
A handful of my colleagues were there. The usual early morning buzz of people, motorbikes and ambulances was missing. All was relatively quiet and a single on-duty officer busied himself with the task of trying to put crews together. The whole day reminded me of 7/7; not since then have we been forced to tell the public that we would only answer life or death calls, so only Red1 and Red2 emergencies were being passed to us. Everything else was being carefully screened by clinical desks and patients were being told to deal with their own ailments or make their way to the G.P. or hospital. Why we can't do this all the time is beyond belief.
I’ve never seen so many people walking about in such quiet conditions. Even cyclists were attempting to brave the weather, to the cost of many of them as they fell off their rides. I saw no motorcycles today at all. You’d have been a fool to consider it. Neither were there any buses - for the first time in their history, every London bus was out of service.
My first call was a cardiac arrest with no ambulance available to run on it. My FRU colleague, who’d just finished his night shift, offered to stay and help out until we got our manning levels up. He came with me and we ran the four miles on blue lights at no more than 30mph. Even with the snow covers on my tyres, traction was unreliable and the car slid more than once on the way.
When we got on scene we found that no-one at the Nursing Home had attempted CPR on the woman. She wasn’t very old and had no terminal conditions, so something should have been done. Twenty minutes or so had passed without a single one of the ‘registered nurses’ putting their hands to the task of saving her. It meant my hopes of reversing her suspended state were virtually nil.
My colleague and I set to work and the crew arrived soon after we’d started but it was hopeless and I called it after a decent attempt. In my opinion, nobody deserves to use the title ‘nurse’ if they refsue to carry out this basic duty of care. That said, there is much more to this story but I can't get into it here I'm afraid.
I started out at 5.30am and slid, crawled and slithered my way to work on virgin snow and untreated main roads. I saw cars that had been abandoned and some that had simply crashed to a halt before their drivers left them where they rested. Although there was traffic on the road – more than I had expected – the going was very, very slow and I eventually got to my station a little late for my shift.
A handful of my colleagues were there. The usual early morning buzz of people, motorbikes and ambulances was missing. All was relatively quiet and a single on-duty officer busied himself with the task of trying to put crews together. The whole day reminded me of 7/7; not since then have we been forced to tell the public that we would only answer life or death calls, so only Red1 and Red2 emergencies were being passed to us. Everything else was being carefully screened by clinical desks and patients were being told to deal with their own ailments or make their way to the G.P. or hospital. Why we can't do this all the time is beyond belief.
I’ve never seen so many people walking about in such quiet conditions. Even cyclists were attempting to brave the weather, to the cost of many of them as they fell off their rides. I saw no motorcycles today at all. You’d have been a fool to consider it. Neither were there any buses - for the first time in their history, every London bus was out of service.
My first call was a cardiac arrest with no ambulance available to run on it. My FRU colleague, who’d just finished his night shift, offered to stay and help out until we got our manning levels up. He came with me and we ran the four miles on blue lights at no more than 30mph. Even with the snow covers on my tyres, traction was unreliable and the car slid more than once on the way.
When we got on scene we found that no-one at the Nursing Home had attempted CPR on the woman. She wasn’t very old and had no terminal conditions, so something should have been done. Twenty minutes or so had passed without a single one of the ‘registered nurses’ putting their hands to the task of saving her. It meant my hopes of reversing her suspended state were virtually nil.
My colleague and I set to work and the crew arrived soon after we’d started but it was hopeless and I called it after a decent attempt. In my opinion, nobody deserves to use the title ‘nurse’ if they refsue to carry out this basic duty of care. That said, there is much more to this story but I can't get into it here I'm afraid.
What I will say is that the nurses I know and work with are true professionals and not one of them would shy from their responsibilities at work. It is disgusting that we have so-called nurses and carers out there who neither nurse nor care for anyone. It is wrong and has to stop.
A 7 month-old baby having an epileptic fit was attended by a crew as I pulled up at the address, so I wasn’t required. The trip had taken me four minutes but the location was only a few hundred metres away from where I’d set off. The roads were still treacherous to drive on.
A 7 month-old baby having an epileptic fit was attended by a crew as I pulled up at the address, so I wasn’t required. The trip had taken me four minutes but the location was only a few hundred metres away from where I’d set off. The roads were still treacherous to drive on.
Another EP fit, this time a 3 year-old that I’d attended before, was called in as a Red1 ‘cardiac arrest’ but the mother’s screaming and the father’s panic had created confusion. This little girl fits regularly and often eight or nine times in a day, so it was understandable. For a few minutes though I considered that my day might consist of suspended patients of all ages. We really were being used as a genuine emergency service for once.
When I got on scene, a crew was with me and another FRU had already arrived ahead of us. Before that the call had been downgraded to a Red2; the patient was fitting but not in cardiac arrest, thank God.
It took a while to find the address, even though I’d been there before the estate had many access design flaws and reaching the pertinent block proved stupidly difficult. We had to ask a group of teenagers where it was and that delay (if this had been a Red1) may have cost the little girl her life. It’s all very well building security into these places but it makes emergency access slow.
The child was recovering and we swept her up and got her into the ambulance quickly. As I said before, I knew her and I knew that she could fit again at any moment. She has a big-eyed amile for everyone and shows no fear. It's heart-breaking to think that sooner or later her condition may prove too much for her young body. I really don't want to be the one who arrives first when she truly suspends.
She had another seizure in the ambulance, despite being given Diazepam and it took a few minutes before she settled again. The crew blued her into hospital for the nth time in a short period.
Some smart Alex decided to sculpt this onto the roof of my car while I was inside the station. It was a shame to knock it off when I got a call.Finally, as the snow began to fall again for the evening’s rush hour, I was sent to a 20 month-old girl with a fever who’d just had a convulsion. Febrile convulsions are common and perfectly normal – usually without hazard – but all children suffering them should go to hospital just in case.
The Grandmother was well aware of this and had called because she was concerned that the Calpol she’d given hadn’t worked to reduce the baby’s temperature. I had no way of knowing, apart from palpating the back of her neck (the baby, not the Grandmother) because my thermometer wasn’t working as a result of the cold weather.
There was no big fuss and no screaming relatives; the Grandparents had seen this all before and it made life a lot easier for me and the crew when they arrived to take the child away.
Then off home and into a mini-blizzard. Luckily the traffic was light and most of the main roads had been gritted so, apart from one near-miss when I skidded toward the pavement (containing two nervous pedestrians), I got back in one piece.
Be safe.
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