Stroke day

Apparently this is how my name is written in Arabic.

Day shift: Five calls; one not required; one by car and three by ambulance.

Stats: 1 Haunted fire; 1 Near faint; 1 ?TIA; 1 ?CVA; 1 High BP.


I decided to do a bit of people-watching this morning as I sat idling on Trafalgar Square. At 8am, as commuters passed me by on their way to whatever they do for a living, I noticed that they all had a similar expression on their faces – neutral. I know they’d hardly be bouncing around with grins on their faces without reason and if they did, it would look mad but it made me think of the predicament of the human condition. Most of the time we look unhappy. There are probably a few cultures where the general population wake up and are smiley, happy people from the start but it isn’t here; it’s not us Brits.

Then I thought about myself and how I look from a patient’s perspective. It’s difficult to paint a smile on when don’t feel like it but every now and then my patients just light me up. Something they say or do – the fact that they smiled first... something triggers it and I feel better for it. What I try to do but find so difficult, is approach a routine call with a pre-set happy demeanour. I wonder how many of my patients would begin to feel better if I did that or are we so abused and down-trodden as a profession that it isn’t worth the effort?

Nobody smiled at me until a PCSO passed by; she beamed in at me as she walked on her patrol. A single smile acknowledging one uniform with another.


Smoke coming from a disused part of Holborn Underground Station – a haunted part I’m told by the member of staff leading me and the crew down to the platform – triggered a fire alarm and the Fire Brigade went in with breathing apparatus to locate the source. We stood on the platform as train after train crawled past and onward without stopping, unhappy commuters staring out balnkly at us. The station was closed and the acrid stench reaching our nostrils confirmed that something was indeed on fire behind the area inside the tunnel.

We were stood down eventually by a Duty Officer – nobody was dead or dying and the fire was being tackled by the Fire Brigade. HART was on scene now anyway and we became surplus.

The Underground has a reputation for being haunted and some very interesting stories have been told about things that happen, especially at night, inside the miles of meandering darkness. A self-ignited fire in a disused part (where an old station line used to run) will probably figure among those tales now. Maybe one or two of my readers work or have worked in these places – I’d like to hear any tales you have. We all would I’m sure.


A pregnant lady felt a little faint with blurred vision at work and called an ambulance, so I was sent, as is my remit, to assess and convey if necessary. AT 24 weeks into her pregnancy, she was bound to start feeling the physical effects and I reassured her about the experience, which she was recovering from when I arrived on scene but she still wanted to go to hospital and I obliged by driving her in the car and walking her to the ante-natal assessment unit.


After a quick cup of tea I was off to an hotel for a 47 year-old man who was experiencing right-sided numbness. He had no medical history of significance but had been panicking recently after attending a ‘life coaching’ seminar in which his entire human fabric was unravelled so that it could be re-built. This alone will cause psychological problems in people with lots to unravel, I would imagine (I attended one of these things in the ‘80s – two very expensive days of soul demolition and not a lot of benefit afterwards).

However, the numbness didn’t go away after ten minutes of chatting to him. His FAST check was negative and he could move and feel the affected side. His BP was normal, as were his other vitals, so I still think he was in the midst of a psychological crisis with physical manifestations. Or I could be wrong and he has had a TIA. A crew arrived to take him to hospital in case the latter spat out the former.


Another call in which the diagnosis could be flawed was to a 34 year-old pharmacist who suddenly complained of a swollen face and neck, which she attributed to a possible allergic reaction because she had a history of shellfish allergy. She hadn’t actually eaten anything with fish in it and it did indeed look and sound like a mild allergic reaction – itchy, puffy skin, nausea and that feeling of constriction in the throat. Her breathing was a little fast but she had plenty of oxygen getting in and could talk in full sentences. She felt ‘strange’ but was able to walk towards the ambulance, which turned up just before I was able to complete my obs.

The one element that I still hadn’t checked was her blood pressure. When it was taken in the ambulance it was very high – the high 160’s over the high 120’s. The reading was repeated just in case but it was correct. She had been suffering from blood pressure problems, according to her doctor, she informed us but she had been given nothing for it. Now she was sitting there with a significant indicator for stroke. Her neck pain (and now she had a headache that was getting worse) may have pointed to SAH, so she was ‘blued’ in immediately.

This call would have been taken in the car on the basis of a mild allergic reaction but her blood pressure changed the picture entirely and it was fortunate that an ambulance had been despatched anyway rather than wait for me to ask for one. Sometimes the odds we play are evens for one thing or the other.


A 40 year-old man working for the Government felt dizzy as he walked out of his workplace. He had no history of significance but was being seen by his doctor for high cholesterol, so when the crew arrived and we got him into the ambulance, we took his blood pressure, which was consistently high. He felt nauseous and looked stressed as he called his wife on his mobile to let her know he was going to hospital. He didn’t seem like the complaining type and so the way he felt was to be considered serious enough for him to worry about it and have an ambulance called. He may well be on his way to his first stroke.

Be safe.

Is that all you've done all day?

Day shift: Two calls: Two by car.

Stats: 1 ?O/D; 1 Epistaxis.


I’ve been going through one of those periods in life where an aspect of communication seems to be going wrong at every turn. Perspective is a funny thing and every one of us has a singular sensitivity to the way information is received – that means ALL information; spoken, written, visual... this is why I don’t particularly like texting when a complex situation needs to be resolved and it’s also why I tend to over-explain things when I am trying to get a point across. No amount of text, with or without so-called 'emoticons', can relay the real emotions that are being felt with the words - so anger, denial, impartiality and so on are often confused, misunderstood or simply not picked up at all in the sentence.

What is seen can also be misunderstood because all of the facts aren’t known, so something is perceived without true perception – this is a major cause of conflict with people and I have been at the sharp end of it recently without the means to defend myself because it’s impossible to agree a middle point with individuals who, for reasons known only to themselves, have a rigid set of rules over who they decide is right and who is wrong. It’s a form of prejudice and we can all suffer from it unless we open our minds and accept that we all can be victims of it. I’m just throwing this out there for debate. It's not a rant. :-)


Another slow day and a false start cancellation for a young woman with neck pain. This was followed a few hours later by a call to a 25 year-old man who’d wandered into a hostel and behaved ‘strangely’ after taking one (by his own admission) Risperidone tablet which he claimed he’d been prescribed by a GP, although he couldn’t tell me which GP and there was no packaging with the pills. He was very reluctant to even let me see the tablets and I was suspicious about the possibility that they didn’t actually belong to him but he insisted all he wanted to do was sleep and that he’d only taken one but the staff members I spoke to were worried that he’d taken a lot more than that. Obviously, if he is schitzophrenic, all of this is to be expected but his physical demeanor changed and this made it all a bit more complex. Had he taken something else? Had he taken lots of those pills?

His pulse was very irregular and his BP was on the low side, so the crew (who’d arrived on scene just before me) took him to the ambulance for an ECG. On the way he decided to have a smoke but I told him to wait. He argued a little but eventually gave in. He was a very cagey individual and I didn’t trust him instinctively. His ECG had minor anomalies that could be explained by his youth and stature but his BP was dipping and we had to elevate his feet to stabilise it. Strangely, his pulse became regular again and his ECG showed no slip in rhythm at all. If I was the only one who’d checked his pulse I would put that down to my dumb fingers but I had asked my colleague to check it too and she confirmed that it was very irregular – three beats then a long pause before the next one and so one. The change in his position may have rectified something or the single drag on the cigarette he’d just had might have some bearing (possibly not tobacco in it), I’m not really sure. Answers on a post card if you care.

He went into Resus just in case he’d swallowed a load of those tablets and not come clean but he was stable as a fish in water as we gave the handover to the doctor. Better safe than sorry I say.


Later on and I was back into the same hospital as overdose guy with a 22 year-old girl with learning difficulties who’d had a ten minute nosebleed and headache. Her support worker came along with her because she was in a basic skills class at a college when the epistaxis struck. She’d had a recent ear infection and it’s not unknown for nosebleeds to be associated with this – same tube structures and all.

In a packed A&E she was sent to the front to sit it out and I noticed my overdose man sitting on a chair with no life-threatening signs and no desire to sleep. I still don’t know what I was looking at with his whole pulse and BP thing but I believe I acted appropriately for the possibility of overdose. I’ll remember his face for future calls though.


The shift ended as it had begun, with a cancellation and I was happy about that. These slim-picking days are very long and tiring, strangely enough, so my run south for a last-minute possible minor cut to face, called in and subsequently cancelled by the police, was a relief.

Be safe.

Emergency chin

Icebergs in the water on Trafalgar Square.

Day shift: Three calls: Two by car and one by ambulance.

Stats: 1 ?TIA; 1 Deep cut; 1 Assault.


Back on the car to watch the rain melt any remaining snow as the weather became a little less cold, giving us a respite from the fall-fracture and associated calls that have plagued the service over the past week.

It was a long time before I received my first call of the shift – it was lunch time in fact. I went to check on a 66 year-old man who’d developed left-sided numbness in his arm and leg. He had no medical history of any significance and he was able to walk, talk and complain about the number of times he had to repeat the story of his current problem. I apologised for being the one asking him for the fourth time and explained that I didn’t know it, so needed to hear it for myself. I thought about the earful the poor doctor was about to get for being the fifth person in line.

He lived with a disabled woman he called his 'friend' in a cluttered flat with the largest portable commode I’ve ever seen. She, to be fair, was a wide lady and the device was required because she was unable to move much – still the size of it had me staring for a few seconds. At times I was tempted to place bits and pieces on it, like my BP cuff and BM kit but remembered what it was used for and resisted to the point where I would be looking around the room for a tidy space that didn’t receive human waste on a daily basis. I settled for the floor.

The man rode quietly in the back of the car and was deposited in a cubicle to await irritating person number five, who would no doubt find something minor wrong with him – or he had suffered a TIA and would recover fully.


Later in the afternoon, after I’d been watching the ice melt on the Trafalgar Square fountains, a call came in for a 35 year-old man in a police cell who had a cut to his chin but was ‘bleeding seriously’. Now, I wasn’t sure how to take this one and I let my imagination run wild in supposition (maybe he’d impaled himself on something nasty) as I drove to the police station. Once in the Custody Suite (the police hotel), the nurse explained that the man, who was being guarded by five large cops as he sat in his cell, had been bleeding for four hours because he simply refused to have anyone dress it. He’d been to hospital and a doctor had stopped the bleeding for a short time but as soon as he was being returned to his cell he tore off the dressing and the cut bled even more aggressively. When I finally got to meet the patient I was shocked to see just how much he’d bled from what turned out to be a 4cm laceration under his chin. Drip, drip, drip it went onto his white clothing (worn as his religion demanded), soaking through and making it heavy. It was covered in large clots which had been created by the sheer accumulation of blood. His head, face, hands and feet were crimson. Nothing had escaped the staining – the cell door was smeared with it and the toilet bowl contained a pool of it. It was like walking into an abattoir.

I managed to make the man see sense after his initial resistance to go anywhere but home. ‘This is nothing’, he said unconvincingly. Only when I got him to really look at the amount of blood he’d lost (and don’t forget he’d been bleeding elsewhere for hours before this) did his face register the possibility that he might need urgent hospital attention. I haven’t yet seen someone die of shock as a result of bleeding from their chin and it would be another hour at least before he’d lost enough to make hypovolaemia an issue but he had seemed adamant about leaving it to leak all over the place. Now, at last, I’d gotten through to him and he was pressing a large dressing onto the wound – the pad soaked through in minutes and had to be replaced several times before the ambulance crew arrived to take him, escorted by four police officers, to A&E for stitches.

I watched as the five foot nothing man was taken out of the cell and into the ambulance and I noticed that he was more responsive to the male crew member than the female attendant – this may have been cultural because he’d also been a pain with the female nurse at the station. Of course, male or female, he didn’t like any of the cops.


I’d had a quiet day and was due to go home early anyway because I’d had no break (ironically) but the most irritating thing happened just as my last hour of work elapsed – I got an awkward, time-consuming call – Sod and his law.

A 30ish-year old man had been found wandering into the main road by police and when questioned had not responded – he seemed confused and edgy and had bruising to his face, cuts to his ear and an obviously fractured hand. A cycle responder colleague was already on scene and had requested me to have a look and take him to hospital – if they could catch him again, that is. By the time I showed up he’d legged it and the police were tracking him down, so I stood at a busy junction and chatted with my colleague about the patient.

Nothing was known about him except that he had been injured, possibly assaulted and that he was homeless. After ten minutes, he was brought back to us with three police officers (two plain clothed). He was a six foot plus dark-skinned man with a vacant stare. I asked him over and over again if he wanted to go to hospital and examined his hugely puffed up hand. He didn’t respond to me and he had a passive interest in his injury, so I asked the officers to get him into the car for the trip to A&E.

At first he was compliant but then he wanted out of the car and refused to go to hospital. I asked him a few pertinent questions to establish capacity but he either couldn’t or didn’t want to answer, so I had only two options – let him go and he might wander into the road and be killed or fall down dead because his head injury was severe... or ask the officers to section him under the Mental Health Act to enable me to take him against his will but for his own protection. Now this decision is always tricky and I waited until I’d driven him and the officers to hospital before I asked for the Act to be invoked. Until then he was convinced to stay in the car by the police with the capacity argument in our favour.

When we got to A&E he tried to walk away and repeatedly refused to go into the department. I asked a nurse to come out and see if she could sweet-talk him inside but that didn’t work too well and there was no choice but to use Section 136 to enforce his protection. So, the cops gently but firmly walked the man into A&E and the first available cubicle. Only then did the facts of his situation start to come out as the officers received new information over their radios. Allegedly the man had attempted to steal someone’s mobile phone and had gotten himself beaten up for his trouble. His reluctance to accept medical help was probably down to his guilt rather than a lack of ability to understand the consequences of his refusals and the time and energy that had been wasted trying to persuade him to get treatment for his injuries could have been spent on me and the cops driving to our respective homes, so I was a little annoyed with him.

Be safe.

Snow joke

Twinkle, twinkle.

Day shift: Three calls: One assisted-only; two by ambulance.

Stats: 1 Nosebleed; 1 Back pain; 1 ? Flu.


An ambulance shift for me today and the reason we only managed to get three calls covered was that I had an afternoon meeting to attend and that consumed the rest of my day. Oh, and sick Londoners were fewer and further between today as the snow floated onto their pavements yet again.


Epistaxis, or nosebleed, is usually of no consequence and there is no need for concern when it occurs, especially in young people and children (for whom the most likely reason is nose-picking) but when it occurs in the elderly or in anyone where the bleeding is significant, there may be an underlying problem. Posterior expistaxis can be serious and the 39 year-old woman we attended to at work had a familial history of brain haemorrhage; her young sister (in her twenties) died of one and now she was in the ladies toilets with colleagues, nursing a nosebleed that had gone on for more than 30 minutes and which had produced tissue upon tissue of crimson distress. She had lost no more than 100mls of blood but she was clearly worried about what was happening.


We took her to A&E – her vital signs were normal, although her blood pressure could have been a little lower for her age and the bleeding had stopped by the time she reached the hospital. As I said, most nosebleeds are inconsequential and do not require an ambulance but some can’t be ignored.


An 88 year-old man with back pain called us and we climbed five floors, past offices in a narrow building to reach his flat, which was one of five on the roof of the premises. The long-ago fire station had residences at the top and commercial units from then on down so it was very unusual. It also meant that come 5 or 6 o’clock and at weekends, the residents were completely isolated at the top of the building. Our patient was one of them. His flat was tiny, a little untidy and cold. His front room looked like a depot of some kind rather than a living space and although we had climbed a lot of stairs to reach him, he told us he used a lift to get out and about when he could. We used that lift when we left with him – it was a large goods lift, full of junk and bits of rubbish strewn around the floor. To get to it we had to make our way down a flight of stone steps and when we exited we had to snake along a darkened corridor to a fire exit leading into the street. This is how the old man got in and out of his home. We also learned from a worker on the premises that the patient’s own toilet had long since become unusable and that he had to use a facility two floors down from his little hovel.

He had severe back pain and hadn’t been able to get out for weeks to collect his prescription medicines, so his blood pressure (for which he had meds) was high and his general health was not good. This frail old man had finally lost his independence and by his own admission needed support. I spoke to a very kind ‘neighbour’ from one of the companies inside the building and he offered to run daily errands for the man and to ask everyone else to keep an eye out for him. We also completed a vulnerable adult form in the hope that he will get much needed care in the future – he simply can’t continue to live like that.


Our last job took us to a fashion clothing outlet with more security than Buckingham Palace. The place was staffed by well-dressed young people and the goods on sale were spread around as if they needed their own space to breathe. Designer handbags, jeans and shoes were presented without price tickets for the most obvious of reasons and it smelled as if the rich frequented the place more often than the not-so. The 21 year-old member of staff who’d almost fainted and had reportedly suffered chest pain had been panicking because she felt unwell. All our checks were normal and after a long chat and deliberation, she was left to the care of her colleagues and advised to go home and rest. She probably had ‘Flu and that meant a day or so off work. The possibility of those handbag and clutch prices making her sick existed too.

On the way out I suggested that my hi-vis jacket could be ‘souped up’ with designer flair and sold off as something kitsch but current. I got sympathetic looks and nods but no takers.

Be safe.

Bloody weather

I've been unable to get into work because I am virtually trapped at home by local untreated roads, so nothing new to report. I hope my colleagues have been safe and well out there though because we aren't as well off as the Red Cross and don't have 4x4's trucking around for our patients, so the tyre condoms will be on when things get tough...

Oh, thank you to the people who have pressed the 'donate' button and given a little to support this blog. One of you even paid for my next coffee and pannini! If you have no objections I will use the money to buy Harry and Scruffs stuff since their images have kept you all amused over the years (or months, in the case of little H).

I'll be back next week.

Xf

The start of it

Night shift: Five calls: One assisted-only; one false alarm; one by car and a two by ambulance.

Stats: 1 DOAB; 1 EP Fit; 1 Depressed actress (running call); 1 RTC; 1 Abdo pain


A female DOAB to start the busiest night of the year (6000+ calls) and a few minutes into my arrival on scene, she was off the bus but it took a few more minutes to get her to move on. This Scottish sleeper wanted to assert her right to kip wherever she liked.


The call number was heading into the mid-6000’s, mainly as a result of the spill-over from New Year’s Eve, when I was sent with a crew to an epileptic 11 year-old who was fitting. On arrival he was resting on the sofa with his foster carer on scene. He’d had a seizure but had recovered, so I left the crew with him because I simply added to the little crowd in the front room. As I stepped out into the freezing night, I was greeted by the sight of someone lying sprawled on the road in front of the ambulance and two women looking over her.

‘She’s cut her wrists very badly and she is suicidal’ said spokeswoman number one, who lived on the street and had witnessed this person ‘collapse’ conveniently two feet from the emergency vehicle. I looked at her wrists but the scars were old and she was a habitual self-harmer from the look of it, so I thanked the concerned MOPs, who had called another ambulance and the police for good measure, and attempted to get sense from the very drunken, unwilling-to-cooperate female on the ground. She slurred at me several times but I was unable to translate. Luckily the police knew her and when they turned up, they got down to the business of making her see sense.

The other crew arrived and I left it to them. Meanwhile, upstairs in the epileptic boy’s house, the first crew were completely unaware that a dramatic attention-seeking act had played out for their benefit.


It started to snow just after midnight and the first RTC casualty was an 84 year-old man who lost control of his car and crashed nearside into a lamp post, damaging the car on that side, bursting the tyre and deploying the airbags. I found him unscathed and sitting in the back of a police car – the patrol had been passing and were bemused to see him standing by the vehicle looking confused. It took less than a minute to establish that he remembered the entire collision (he’d seen a shadow on the road and swerved to avoid it) and that he was diabetic. A BM test revealed a low blood sugar level; not critical, just low enough to cause concentration problems, so I suggested he went to hospital for a proper check and to ensure that he’d come to no hidden physical harm as a result of what he describe as a '20 mph' impact.

This man told me of his wartime life and it cheered me to know that he was still independent and willing to take life’s knocks without blaming everyone else. ‘I’m an old soldier – I’ll survive’ he told me as he tried to convince me he could just go home. The police took care of his car and I drove him to A&E, where he tied his gown on around his neck instead of across the back of his shoulders – he looked as if he had a thin bow tie on. ‘I’m feeling better every minute’ he said as he trotted around his cubicle waiting impatiently for medical attention. I could tell he had other plans – his dinner date at the casino for example.


A late early-hours call for a French man with abdominal pain was a wasted journey because he was fit enough to walk over with his friends and be given directions to the nearest drink of water. He’d been drinking and thought something may have been put in it by someone else - but they all say that.

Be safe.

Trojan horses

Night shift: Eleven calls: Three no trace; one by FRU; everyone else by ambulance.

Stats: 4 eTOH; 1 Croup; 1 Fractured legs; 1 DIB; 1 EP Fit.


New Year’s Eve is our busiest night of the year and tonight was going to prove no exception as thousands of people flooded into Central London for the fireworks, booze and violence that comes with the territory these days. But it was a night of disguised problems too – I was working on an ambulance all night and a few of the calls were not as they seemed, catching me out on one occasion. I was working on an ambulance tonight.


But it started with a drunken 43 year-old woman who was found in the street by police after they’d been called to a possible mugging. She told me she’d been attacked as she spoke on the phone and she was very drunk – not that this had any bearing on the truth of her claim but it turned out she had no phone, nor any valuables and not because she was mugged but because her angry boyfriend, who was fed up with her constant drunken stumbling, took them away from her and left her in the street to fend for herself.

On the way to hospital, where she had to go just for safety, she told me she used to be a cardiologist. Someone, clearly, should have known better.


A 10-month old baby with croup next and it took us a while to find the address, so we were late getting there but a car was already on scene and the paramedic brought the patient and his mother down to us. The child had been diagnosed with a chest infection and given antibiotics, which he’d completed but the problem persisted. Now he was barking and crying in the ambulance all the way to paediatric A&E.


The first serious call of the night came in as party-people started to fill the West End and Soho. Two people had apparently fallen from a first floor window and we were asked to check on injuries. Then the call changed and we were asked to report on arrival because now it was a fifth floor window they'd fallen from. I knew the street well and I knew the injuries would be significant if this call was genuine because there is only pavement to land on. There are also people and this part of town would be very busy with them.

We arrived after struggling through crowds and closed roads (which were opened for us by the police) to find an ambulance and two FRUs already on scene. There was someone lying on the pavement and the first crew was dealing with her so I was instructed by the Duty officer to go and check on a child who had fallen from a window. I was sent upstairs into a block of flats with the police leading the way. This stumped me – hadn’t I been told that the child had fallen from a window? What was he doing upstairs in the flat?

When we got to the door it was opened by a very frightened looking man. ‘Where’s the child?’ I asked. He pointed at a bedroom and said ‘in there’, then his face crumbled.

I walked into the room and a woman was standing by a bed, so I asked her where the child was – she didn’t hear me the first time because she had started to speak the moment she saw us and the police inside the flat. ‘I just turned away for a second and he was gone’, she kept repeating. ‘Where’s the child?’ I insisted again. She pointed to the bed and there was a lump on it, completely covered by a blanket. At first I thought I was about to see a dead kid but when she pulled the blanket away from his head, the little boy cried and screamed. The shock of seeing us probably brought that on because it wasn’t the sound of pain.

It took a while to get the facts of this incident but when I did, after a long time trying to console the four year-old and attempting to find out what, if any injuries, he had, I discovered that he had been looking out of the fifth floor window, which had a sheer drop to the pavement below and had simply toppled out of it when his mother turned her back. All she and her older son (the one who answered the door) knew about it was the sound of crying from the street soon after he vanished from the ledge. I looked over that ledge and there was a glass jar or bottle on the little plinth below; I think he was trying to reach that or had dropped it. Whatever the case, the jar will have to be recovered or the first decent wind to come along will whip it off and onto someone’s head in the future.

The boy fell almost 50 feet by my reckoning and that was enough to get him to hospital, even though he showed no visible signs of injury and was very vague about pain or immobility. He would not weight-bear on his legs and that was significant.

He had landed onto an awning that stuck out from a shop below (the only awning for a long way on that street). He must have bounced off it, reducing the energy of his flight by a great deal, then he landed on a passing woman – striking her across the back and flattening her onto the pavement. After that he simply rolled off her. This woman told me how it had happened and she was very lucky to be alive, just like the little boy. If that awning hadn’t broken his fall, there would probably have been two dead people on the pavement. Ironically, the woman he struck across the back was already suffering from a back problem.

His brother had run down stairs and out to the street, finding him crying there next to the woman. He’d grabbed him and taken him back upstairs before calling an ambulance. His mother was now talking about letting us know if anything got worse – she was considering leaving him at home. I explained that the fall was enough to warrant going to hospital. That sort of mechanism for injury cannot be ignored and even though I thought he was the luckiest kid alive on New Year’s Eve, I would be surprised if nothing was found wrong with him.

We blued him in but he was so feisty and inconsolable that boarding, collaring and restraining him in any way, except on the stretcher, was impossible to do. He went in and I had to explain why he wasn’t tied up. We later found out that he had two broken legs. He was still a very lucky little chap.


The drunk calls started in earnest as we went through the night and a 21 year-old girl who fell onto her chin at an underground station was our next catch of the day. Her male friend stuck with her all the way to hospital. He was sober but she was so far gone she had to be given fluids.


We were north of the river now and at one minute to midnight we were asked to go south for another call, which wasn’t even an emergency. This was not a wise thing to ask of us because when the New Year arrived the crowds blocked every possible route and we soon found ourselves locked-in tight with an ocean of bodies around us. Not all of them were friendly – we got the odd ‘Happy New Year’ but we also got a bottle or two thrown at the ambulance and more than one fist slammed against it as we attempted to move through the crowd to our call. In the end and after warning Control that we wouldn’t make it, I called in to inform them that we were stuck and going nowhere. The fireworks were going off overhead but we saw nothing of them – it was the flattest start to the New Year I’ve had in years (since the last time I worked on this night in fact).

As the fireworks died down a roar came up from the crowd but it wasn’t appreciation; it was awe. A lot of people were looking skyward and I followed their gazes – it had started to snow.


The warm fuzzy feeling of seeing the first snow of the new decade dissipated (as did the snow) with the next call – to a 23 year-old female who was lying, blind drunk, outside a club. Her friends abandoned her as soon as we got her into the ambulance, so she was alone and out of it most of the time. But she wasn’t so bad that she couldn’t make some sense and when another drunken person came to the window of the ambulance and asked if we could attend his even more inebriated friend, she repeated my answers from the back as she lay on the stretcher. ‘Has your friend been drinking?’ I asked. ‘Yes!’ came the enthusiastic response from behind me. Both her hearing and her attitude were sharp.


The next proper call of the shift was for an 88 year-old woman with constipation and abdominal pain. At first I thought it was cut and dry but she had a noisy rasp to her breathing and her sats were very poor. So poor in fact that I didn’t believe the probe – she was cold and the figures tend to be low as a result. I put her on oxygen anyway and there was no real change in her condition. In fact, she tore the mask off her face several times because she didn’t like it.

Apart from her abdo pain and a history of a recent pacemaker fitting, she had no other immediate problems – no chest pain, no true DIB, although that soon changed. She had type II diabetes and hadn’t been able to control it very well – her BM was high but not critical and her GP had taken her off Metformin for some reason. She was very distressed but her daughter told me she was always like that and the raspy sound was being made by her vocal cords as she panicked. What was hard to pick up was any probable cause for her distress, apart from the pain of constipation. She’d had a chest infection and that had been treated with antibiotics and she’d been constipated before and it was treated, so we proceeded on that basis.

When we got to A&E, however, I noticed that five minutes after arriving and during my handover, her breathing rate had doubled and she was getting more and more restless with it. They took her into Resus and found that her sats were indeed low and that she needed to have oxygen forced into her lungs because her blood gases were so bad. I wonder if her high blood glucose had been in status for a while. If so, that could have a detrimental affect on her health.


The next drunken person was a 17 year-old who was in the street with his mates. His temperature was 34.1c and that was reason enough to take him into hospital, which was becoming busier by the minute.

After that we were being sent to calls that had been held for two or three hours at a time. Of course, every time we arrived, like to the epileptic who’d been fitting in a club, we found that they’d gone – in this case the FRU pilot had got fed up waiting and had driven the patient to hospital himself. The other calls were for drunks who’d long gone home or slithered into some other place for the night. It was an exercise in clearing up.

Well, that’s another year gone. More of the same to come I guess unless something changes for me. Happy New Year.

Be safe.