Day shift: Four calls; one by car; one assisted-only; one declined; one gone before arrival.
Stats: 1 eTOH; 1 Panic attack; 1Headache.
They put me on a ‘truck’ for the morning to help a trainee who was being assessed. I was his bitch for a few hours as he impressed the Training Officer with his skills and knowledge. We used to call this rideout a ‘Millar’ (or the clinical part of it) and it qualified you as a fully-fledged Ambulance Technician. I left them to it when I had to go to my regular(ish) FRU meeting – I’m sure he will do well.
When I returned from my free lunch and discussions, I was tasked to a one-after-the-other treat of low-grade calls, starting with a 40 year-old female who was ‘almost falling over’ and ‘drunk’ outside a cafe. She had hip problems in fact, and her balance was all over the place because of it but she had a stick to compensate. Yes, she’d had a drink or three as well but she always did, she told me. She wasn’t happy that people had called an ambulance for her but I offered to drive her to her flat because I was sure she wouldn’t get too far down the street before she toppled over. Her home was a few streets away and it wasn’t a problem.
She chatted to me (or at me) all of the way in the car and to the top of her stairs, where her flat, shrouded in dust and debris from ongoing building works, greeted us with open door. The workmen were inside – she’d given them the key.
As soon as I stepped out of the flat (the woman offered me a pair of shoes from the hallway because she thought they’d suit me) I was sent literally across the street to a pub where a 21 year-old Italian tourist had collapsed. Her friends thought she was having an asthma attack but she was panicking. Her bag had been snatched while she sat with the group she was with and now she was upset. Not really a 999 call.
I reassured her and she declined medical help or a trip to hospital – the only sensible choice.
Straight away, I was off to a surveillance store, where a 50 year-old man had called us and the police. He’d stated that he had a headache (thus an ambulance was required)and that the store staff were ‘keeping him in there’. The police were on scene when I arrived but the man, who insisted I took his blood pressure and then promptly asked me to write it down for him, as well as my own details (he got my call sign), was erratic and nervy – he refused to go to hospital, then said he wanted to, then refused again. I asked him over and over if he wanted me to take him but in the end he told us he’d make his own way ‘immediately’ and that was that.
The patient with back pain who’d suffered for a week and now wanted an ambulance got one – me. Unfortunately, even after a week, he had no patience to wait and went up the road to the Walk-in Centre in a taxi. Apparently, according to his colleague who met me when I arrived on scene, he had to be carried.
Be safe.
Friday, 12 March 2010
Thursday, 11 March 2010
The man in the Watergel mask
Day shift: Eight calls; two by car; one treated on scene; five by ambulance.
Stats: 1 Hypothermic; 1 Viral infection; 1 Cyst in foot; 2 Head injuries; 1 Burns; 1 RTA with leg & neck pain; 1 Cut hand.
As I drove across Waterloo Bridge this morning I saw a large drift of black smoke, somewhere in the east of London, where a fire was, or had been burning. I wondered if any of our crews had been sent to it.
Almost immediately into the shift we were tasked with recovering a drunken male who’d been found asleep outside a tube station. He had been waiting for it to open so that he could go home but I think he’d been there all night because when his temperature was checked it read 33c. He was with the police and was refusing any help but underground staff wouldn’t let him travel in his current condition, so the only thing for it was to take him to hospital and after a bit of a debate, he agreed. He was quiet and good natured, so it was a routine trip and another life saved with no effort
Same again later on when we were sent to a 19 year-old supposedly ‘fitting’ at a hostel for foreign visitors. He wasn’t fitting and never had been – he had a viral infection and a sore throat. His raised temperature could go with him to the local GP or walk-in centre because, if we could possibly avoid it, he wasn’t going to a busy hospital with ill people in it. An ambulance arrived obviously (before I could cancel it), so I left the ultimate decision with the crew.
A special assignment next for a high-ranking foreign diplomat who had a cyst on his foot. All he needed was a dressing on it – it had already been partially drained by a doctor. We were ushered into a posh hotel and up to the Presidential Suite floor by a Diplomatic Protection Officer. The treatment process took no more than a few minutes to complete but the security surrounding him was such that it took almost 30 minutes to get to him and be shown back out via back lifts and cellar areas. We were, for the time we were on scene, the secret agents of the ambulance service.
The next job was interesting too – an employee of the Inland Revenue fell down concrete steps and cracked her head open. She’d been laying on the cold floor, bleeding into a dressing applied by the first aider for 20 minutes before we arrived (ambulance shortage at the time). She hadn’t been knocked unconscious but as soon as I lifted the dressing to peer at the wound a line of arterial blood squirted across my glove. She had severed her Temporal Artery. I immediately applied pressure and placed another dressing on to the site as quickly as possible – this was tricky considering she was a potential neck injury and her fine, long hair (matted in blood) made the task awkward. When it was done, we moved her (with the help of lots of hands) carefully into a better position for a collar and awaited the ambulance crew – then she was immobilised and lifted out to the ambulance.
Before I could get anything to eat (but luckily managed to go to the loo) we got a call for a 17 year-old chef at a high-brow restaurant who’d burned his face with hot oil. The stuff reaches 200c I was told and as soon as I saw him I realised how lucky he’d been. His entire face was scalded – he had partial thickness burns from his scalp to his chin. He’d also burned his hands and shoulder and one of his ears but these were less severe and only superficial - like a bad sunburn without blisters. In total he had around 20 – 25% burns to his body. He’d been smart enough to douse his face in cold water for almost ten minutes before we arrived and I applied a Watergel mask (which had to be made on the spot). His hands could be dealt with simply enough and I acquired a couple of plastic bags to be tied over the Watergel dressings we’d put on them.
He sucked on Entonox and this helped ease the pain considerably. The crew arrived shortly after we’d settled him down and done all we could to stop the burning process but he will still need specialist treatment at hospital to prevent any permanent scarring to his face.
A RTC that presented us with nothing more than a young man sitting on a wall, waving at us as if we were his taxi, started out as a simple covey in the car to a collar and immobilisation job. His car had been shunted from behind and his leg had been injured (a minor muscle pain) when his seat slid forward. The police weren’t too happy with him because he let the driver who’d hit him go after supplying details. You only do that if you are in a minor vehicle accident with no injuries – otherwise all parties must stay on scene.
He complained of C4 neck pain after fifteen minutes and as I was just about to set off for hospital with him in the car and this, of course, changed the rules. Now we had to have an ambulance and another twenty minutes passed by as we collared him and got him onto a scoop and stretcher for the journey.
A fairly drunken 72 year-old fell off his bar stool and smashed his head on a metal carpet strip, cutting it open above his eye. His friends told us he’d just ‘blacked out’ when he fell, so after his wound had been dressed, his pulse and blood pressure measurements were taken – one was slow and one was low – a combination often seen in heart blocks.
An ambulance arrived and his ECG was taken (I couldn’t do it in the pub now that it was filling with regulars). There was evidence of an AV block – a long P-R interval. This accounted for his bradycardia (averaging at 48bpm) and thus, the low blood pressure... and ultimately his syncope and head injury. Off he went then, for treatment to his head injury and some advice from a doctor about his heart.
We still get 999 calls from people who have fairly minor injuries that could and should walk into A&E for treatment... or a Minor Injuries Unit. I might open up a little treatment centre in the future. It would deal with all those little cuts, bumps and grazes that some individuals believe, hand-on-heart are emergencies. So, the 22 year restaurant worker who sliced open the palm of her hand when a wine glass she was handling shattered, was given an expensive run in the car to hospital, after basic first aid; dressing and elevation sling, was applied. Prior to that, she’d been given a blue plaster and a gauze sheet to wrap her poorly hand up in.
Be safe.
Stats: 1 Hypothermic; 1 Viral infection; 1 Cyst in foot; 2 Head injuries; 1 Burns; 1 RTA with leg & neck pain; 1 Cut hand.
As I drove across Waterloo Bridge this morning I saw a large drift of black smoke, somewhere in the east of London, where a fire was, or had been burning. I wondered if any of our crews had been sent to it.
Almost immediately into the shift we were tasked with recovering a drunken male who’d been found asleep outside a tube station. He had been waiting for it to open so that he could go home but I think he’d been there all night because when his temperature was checked it read 33c. He was with the police and was refusing any help but underground staff wouldn’t let him travel in his current condition, so the only thing for it was to take him to hospital and after a bit of a debate, he agreed. He was quiet and good natured, so it was a routine trip and another life saved with no effort
Same again later on when we were sent to a 19 year-old supposedly ‘fitting’ at a hostel for foreign visitors. He wasn’t fitting and never had been – he had a viral infection and a sore throat. His raised temperature could go with him to the local GP or walk-in centre because, if we could possibly avoid it, he wasn’t going to a busy hospital with ill people in it. An ambulance arrived obviously (before I could cancel it), so I left the ultimate decision with the crew.
A special assignment next for a high-ranking foreign diplomat who had a cyst on his foot. All he needed was a dressing on it – it had already been partially drained by a doctor. We were ushered into a posh hotel and up to the Presidential Suite floor by a Diplomatic Protection Officer. The treatment process took no more than a few minutes to complete but the security surrounding him was such that it took almost 30 minutes to get to him and be shown back out via back lifts and cellar areas. We were, for the time we were on scene, the secret agents of the ambulance service.
The next job was interesting too – an employee of the Inland Revenue fell down concrete steps and cracked her head open. She’d been laying on the cold floor, bleeding into a dressing applied by the first aider for 20 minutes before we arrived (ambulance shortage at the time). She hadn’t been knocked unconscious but as soon as I lifted the dressing to peer at the wound a line of arterial blood squirted across my glove. She had severed her Temporal Artery. I immediately applied pressure and placed another dressing on to the site as quickly as possible – this was tricky considering she was a potential neck injury and her fine, long hair (matted in blood) made the task awkward. When it was done, we moved her (with the help of lots of hands) carefully into a better position for a collar and awaited the ambulance crew – then she was immobilised and lifted out to the ambulance.
Before I could get anything to eat (but luckily managed to go to the loo) we got a call for a 17 year-old chef at a high-brow restaurant who’d burned his face with hot oil. The stuff reaches 200c I was told and as soon as I saw him I realised how lucky he’d been. His entire face was scalded – he had partial thickness burns from his scalp to his chin. He’d also burned his hands and shoulder and one of his ears but these were less severe and only superficial - like a bad sunburn without blisters. In total he had around 20 – 25% burns to his body. He’d been smart enough to douse his face in cold water for almost ten minutes before we arrived and I applied a Watergel mask (which had to be made on the spot). His hands could be dealt with simply enough and I acquired a couple of plastic bags to be tied over the Watergel dressings we’d put on them.
He sucked on Entonox and this helped ease the pain considerably. The crew arrived shortly after we’d settled him down and done all we could to stop the burning process but he will still need specialist treatment at hospital to prevent any permanent scarring to his face.
A RTC that presented us with nothing more than a young man sitting on a wall, waving at us as if we were his taxi, started out as a simple covey in the car to a collar and immobilisation job. His car had been shunted from behind and his leg had been injured (a minor muscle pain) when his seat slid forward. The police weren’t too happy with him because he let the driver who’d hit him go after supplying details. You only do that if you are in a minor vehicle accident with no injuries – otherwise all parties must stay on scene.
He complained of C4 neck pain after fifteen minutes and as I was just about to set off for hospital with him in the car and this, of course, changed the rules. Now we had to have an ambulance and another twenty minutes passed by as we collared him and got him onto a scoop and stretcher for the journey.
A fairly drunken 72 year-old fell off his bar stool and smashed his head on a metal carpet strip, cutting it open above his eye. His friends told us he’d just ‘blacked out’ when he fell, so after his wound had been dressed, his pulse and blood pressure measurements were taken – one was slow and one was low – a combination often seen in heart blocks.
An ambulance arrived and his ECG was taken (I couldn’t do it in the pub now that it was filling with regulars). There was evidence of an AV block – a long P-R interval. This accounted for his bradycardia (averaging at 48bpm) and thus, the low blood pressure... and ultimately his syncope and head injury. Off he went then, for treatment to his head injury and some advice from a doctor about his heart.
We still get 999 calls from people who have fairly minor injuries that could and should walk into A&E for treatment... or a Minor Injuries Unit. I might open up a little treatment centre in the future. It would deal with all those little cuts, bumps and grazes that some individuals believe, hand-on-heart are emergencies. So, the 22 year restaurant worker who sliced open the palm of her hand when a wine glass she was handling shattered, was given an expensive run in the car to hospital, after basic first aid; dressing and elevation sling, was applied. Prior to that, she’d been given a blue plaster and a gauze sheet to wrap her poorly hand up in.
Be safe.
Wednesday, 10 March 2010
Poor little heart
Day shift: Four calls; two by car; two by ambulance.
Stats: 1 Abdo pain; 1 Chest pain; 1 RTC with fracture; 1 Earache.
My Uni Student is out with me for the next few shifts and so I’m observing more than doing for a change. The shift started with a straight-forward car transfer from an underground station, where a 28 year-old woman was suffering abdo pain (period pain).
Then a call came in for an 11 year-old girl at school who had chest pain. Normally a young-person-chest-pain call is actually nothing of the kind but when it’s a child there are implications. We took the call seriously and the update informed us that she had a heart condition and was waiting for a pacemaker to be fitted. I’d already sussed the possibility of her having this kind of problem because I’ve been called to a few in the past and, in my time teaching in schools, I’ve heard of other cases.
The girl was floppy, quiet and looked very frightened. She had that particular look on her face - you normally see it on adults when they are genuinely in trouble and they know it. I couldn’t detect a radial pulse and her pulse rate was very slow – around 45bpm via my sats probe. Typically for a child, her oxygen saturation was high despite her condition.
The ambulance arrived quickly and we moved her by chair into the back of it for an ECG. I’d expected to see a profoundly bradycardic rhythm and, sure enough, she had a slow rate (41bpm) with few P waves and escape complexes randomly spaced in couplets and triplets. Her natural pacemaker wasn’t functioning and her heart was firing slow compensatory impulses from the upper ventricles to stay alive. I think if she’d been older, she’d have had a very short time before her heart gave up. Even at her age, this could be a potentially life-threatening condition.
We got her to hospital rapidly and she was taken into Resus with her worried teachers in tow. She may have to be given an artificial pacemaker to resolve this issue. The poor little girl never uttered a complaint throughout.
A RTC in which a motorcyclist hit a U-turning car (all too common) next and we found him in the middle of the road with police officers trying to control the traffic, although buses and other vehicles were still passing quite close to his feet. I asked for the traffic to be stopped completely to safeguard the patient and ourselves while we assessed him. He was conscious and alert and the only pain he had was in his shoulder. He had a badly fractured collar bone and I discovered later that he’d landed on this when he came off his bike at around 20mph.
He was very reluctant to allow us to examine him properly – this meant cutting away clothing and his biggest fear was that we would cut into his leather jacket. Now, I completely understand how motorcyclists feel about this item of protective clothing because it is very expensive but we can hardly sit a potential spinal patient up and remove it manually. He was more worried about his jacket than his broken bone.
In the end, and with a crew on scene to help, we managed to get the jacket off without butchering it. He could have claimed compensation for it anyway.
The last job of the day was to a 6 year-old girl with earache, neck pain and a sore throat. When we got to her flat she was lying in bed feeling very sorry for herself and I could see why immediately. She had an advanced infection and we were told this was recurrent; ongoing for the past year or so. This recent bout had been treated with antibiotics but they weren’t working and, although the family had asked for more, they had been told the girl was ‘okay’ and didn’t need anything else. This, in my opinion, was nonsense because she had a hugely swollen Submandibular gland, an almost closed pharyngeal space, a high temperature and severe earache. She had all the signs of Chronic Recurrent Otitis Media, a disease that could ultimately destroy her middle ear bones and lead to deafness.
She was awaiting an operation but the family couldn’t specify what she was going to have done – it could be an adenoidectomy, a typanoplasty, myringoplasty or to have a grommet fitted. If she didn’t get help with this, it could develop into a more severe infection – spreading into the bones and causing Mastoiditis or Meningitis, which can be fatal.
We took her and her family in the car to hospital where, hopefully, they will see how urgently she needs treatment to resolve her acute condition.
Be safe.
Stats: 1 Abdo pain; 1 Chest pain; 1 RTC with fracture; 1 Earache.
My Uni Student is out with me for the next few shifts and so I’m observing more than doing for a change. The shift started with a straight-forward car transfer from an underground station, where a 28 year-old woman was suffering abdo pain (period pain).
Then a call came in for an 11 year-old girl at school who had chest pain. Normally a young-person-chest-pain call is actually nothing of the kind but when it’s a child there are implications. We took the call seriously and the update informed us that she had a heart condition and was waiting for a pacemaker to be fitted. I’d already sussed the possibility of her having this kind of problem because I’ve been called to a few in the past and, in my time teaching in schools, I’ve heard of other cases.
The girl was floppy, quiet and looked very frightened. She had that particular look on her face - you normally see it on adults when they are genuinely in trouble and they know it. I couldn’t detect a radial pulse and her pulse rate was very slow – around 45bpm via my sats probe. Typically for a child, her oxygen saturation was high despite her condition.
The ambulance arrived quickly and we moved her by chair into the back of it for an ECG. I’d expected to see a profoundly bradycardic rhythm and, sure enough, she had a slow rate (41bpm) with few P waves and escape complexes randomly spaced in couplets and triplets. Her natural pacemaker wasn’t functioning and her heart was firing slow compensatory impulses from the upper ventricles to stay alive. I think if she’d been older, she’d have had a very short time before her heart gave up. Even at her age, this could be a potentially life-threatening condition.
We got her to hospital rapidly and she was taken into Resus with her worried teachers in tow. She may have to be given an artificial pacemaker to resolve this issue. The poor little girl never uttered a complaint throughout.
A RTC in which a motorcyclist hit a U-turning car (all too common) next and we found him in the middle of the road with police officers trying to control the traffic, although buses and other vehicles were still passing quite close to his feet. I asked for the traffic to be stopped completely to safeguard the patient and ourselves while we assessed him. He was conscious and alert and the only pain he had was in his shoulder. He had a badly fractured collar bone and I discovered later that he’d landed on this when he came off his bike at around 20mph.
He was very reluctant to allow us to examine him properly – this meant cutting away clothing and his biggest fear was that we would cut into his leather jacket. Now, I completely understand how motorcyclists feel about this item of protective clothing because it is very expensive but we can hardly sit a potential spinal patient up and remove it manually. He was more worried about his jacket than his broken bone.
In the end, and with a crew on scene to help, we managed to get the jacket off without butchering it. He could have claimed compensation for it anyway.
The last job of the day was to a 6 year-old girl with earache, neck pain and a sore throat. When we got to her flat she was lying in bed feeling very sorry for herself and I could see why immediately. She had an advanced infection and we were told this was recurrent; ongoing for the past year or so. This recent bout had been treated with antibiotics but they weren’t working and, although the family had asked for more, they had been told the girl was ‘okay’ and didn’t need anything else. This, in my opinion, was nonsense because she had a hugely swollen Submandibular gland, an almost closed pharyngeal space, a high temperature and severe earache. She had all the signs of Chronic Recurrent Otitis Media, a disease that could ultimately destroy her middle ear bones and lead to deafness.
She was awaiting an operation but the family couldn’t specify what she was going to have done – it could be an adenoidectomy, a typanoplasty, myringoplasty or to have a grommet fitted. If she didn’t get help with this, it could develop into a more severe infection – spreading into the bones and causing Mastoiditis or Meningitis, which can be fatal.
We took her and her family in the car to hospital where, hopefully, they will see how urgently she needs treatment to resolve her acute condition.
Be safe.
Earache
Day shift: Four calls; two by car; two by ambulance.
Stats: 1 Abdo pain; 1 Chest pain; 1 RTC with fracture; 1 Earache.
My Uni Student is out with me for the next few shifts and so I’m observing more than doing for a change. The shift started with a straight-forward car transfer from an underground station, where a 28 year-old woman was suffering abdo pain (period pain).
Then a call came in for an 11 year-old girl at school who had chest pain. Normally a young-person chest pain call is actually nothing of the kind but when it’s a child there are implications. We took the call seriously and the update informed us that she had a heart condition and was waiting for a pacemaker to be fitted. I’d already sussed the possibility of her having this kind of problem because I’ve been called to a few in the past and, in my time teaching in schools, I’ve heard of many other cases.
The girl was floppy, quiet and looked very frightened. She had that particular look on her face that you normally see on adults when they are genuinely in trouble and they know it. I couldn’t detect a radial pulse and her pulse rate was very slow – around 45bpm via my sats probe. Typically for a child, her oxygen saturation was high despite her condition.
The ambulance arrived quickly and we moved her by chair into the back of it for an ECG. I’d expected to see a profoundly bradycardic rhythm and, sure enough, she had a slow rate (41bpm) with few P waves and escape complexes randomly spaced in couplets and triplets. Her natural pacemaker wasn’t functioning and her heart was firing slow compensatory impulses from the upper ventricles to stay alive. I think if she’d been older, she’d have had a very short time before her heart gave up. Even at her age, this could be a potentially life-threatening condition.
We got her to hospital rapidly and she was taken into Resus with her worried teachers in tow. She may have to be given an artificial pacemaker to resolve this issue. The poor little girl never uttered a complaint throughout.
A RTC in which a motorcyclist hit a U-turning car (all too common) next and we found him in the middle of the road with police officers trying to control the traffic, although buses and other vehicles were still passing quite close to his feet. I asked for the traffic to be stopped completely to safeguard the patient and ourselves while we assessed him. He was conscious and alert and the only pain he had was in his shoulder. He had a badly fractured collar bone and I discovered later that he’d landed on this when he came off his bike at around 20mph.
He was very reluctant to allow us to examine him properly – this meant cutting away clothing and his biggest fear was that we would cut into his leather jacket. Now, I completely understand how motorcyclists feel about this item of protective clothing because it is very expensive but we can hardly sit a potential spinal patient up and remove it manually. He was more worried about his jacket than his broken bone.
In the end, and with a crew on scene to help, we managed to get the jacket off without butchering it. He could have claimed compensation for it anyway.
The last job of the day was to a 6 year-old girl with earache, neck pain and a sore throat. When we got to her flat she was lying in bed feeling very sorry for herself and I could see why immediately. She had an advanced infection and we were told this was recurrent; ongoing for the past year or so. This recent bout had been treated with antibiotics but they weren’t working and, although the family had asked for more, they had been told the girl was ‘okay’ and didn’t need anything else. This, in my opinion, was rubbish because she had a hugely swollen parotid gland, an almost closed pharyngeal space, a high temperature and severe earache. She had all the signs of Chronic Recurrent Otitis Media, a disease that could ultimately destroy her middle ear bones and lead to deafness.
She was awaiting an operation but the family couldn’t specify what she was going to have done – it could be an adenoidectomy, a typanoplasty, myringoplasty or to have a grommet fitted. If she didn’t get help with this, it could develop into a more severe infection – spreading into the bones and causing Mastoiditis or Meningitis, which can be fatal.
We took her and her family in the car to hospital where, hopefully, they will see how urgently she needs treatment to resolve her acute condition.
Be safe.
Stats: 1 Abdo pain; 1 Chest pain; 1 RTC with fracture; 1 Earache.
My Uni Student is out with me for the next few shifts and so I’m observing more than doing for a change. The shift started with a straight-forward car transfer from an underground station, where a 28 year-old woman was suffering abdo pain (period pain).
Then a call came in for an 11 year-old girl at school who had chest pain. Normally a young-person chest pain call is actually nothing of the kind but when it’s a child there are implications. We took the call seriously and the update informed us that she had a heart condition and was waiting for a pacemaker to be fitted. I’d already sussed the possibility of her having this kind of problem because I’ve been called to a few in the past and, in my time teaching in schools, I’ve heard of many other cases.
The girl was floppy, quiet and looked very frightened. She had that particular look on her face that you normally see on adults when they are genuinely in trouble and they know it. I couldn’t detect a radial pulse and her pulse rate was very slow – around 45bpm via my sats probe. Typically for a child, her oxygen saturation was high despite her condition.
The ambulance arrived quickly and we moved her by chair into the back of it for an ECG. I’d expected to see a profoundly bradycardic rhythm and, sure enough, she had a slow rate (41bpm) with few P waves and escape complexes randomly spaced in couplets and triplets. Her natural pacemaker wasn’t functioning and her heart was firing slow compensatory impulses from the upper ventricles to stay alive. I think if she’d been older, she’d have had a very short time before her heart gave up. Even at her age, this could be a potentially life-threatening condition.
We got her to hospital rapidly and she was taken into Resus with her worried teachers in tow. She may have to be given an artificial pacemaker to resolve this issue. The poor little girl never uttered a complaint throughout.
A RTC in which a motorcyclist hit a U-turning car (all too common) next and we found him in the middle of the road with police officers trying to control the traffic, although buses and other vehicles were still passing quite close to his feet. I asked for the traffic to be stopped completely to safeguard the patient and ourselves while we assessed him. He was conscious and alert and the only pain he had was in his shoulder. He had a badly fractured collar bone and I discovered later that he’d landed on this when he came off his bike at around 20mph.
He was very reluctant to allow us to examine him properly – this meant cutting away clothing and his biggest fear was that we would cut into his leather jacket. Now, I completely understand how motorcyclists feel about this item of protective clothing because it is very expensive but we can hardly sit a potential spinal patient up and remove it manually. He was more worried about his jacket than his broken bone.
In the end, and with a crew on scene to help, we managed to get the jacket off without butchering it. He could have claimed compensation for it anyway.
The last job of the day was to a 6 year-old girl with earache, neck pain and a sore throat. When we got to her flat she was lying in bed feeling very sorry for herself and I could see why immediately. She had an advanced infection and we were told this was recurrent; ongoing for the past year or so. This recent bout had been treated with antibiotics but they weren’t working and, although the family had asked for more, they had been told the girl was ‘okay’ and didn’t need anything else. This, in my opinion, was rubbish because she had a hugely swollen parotid gland, an almost closed pharyngeal space, a high temperature and severe earache. She had all the signs of Chronic Recurrent Otitis Media, a disease that could ultimately destroy her middle ear bones and lead to deafness.
She was awaiting an operation but the family couldn’t specify what she was going to have done – it could be an adenoidectomy, a typanoplasty, myringoplasty or to have a grommet fitted. If she didn’t get help with this, it could develop into a more severe infection – spreading into the bones and causing Mastoiditis or Meningitis, which can be fatal.
We took her and her family in the car to hospital where, hopefully, they will see how urgently she needs treatment to resolve her acute condition.
Be safe.
Sunday, 7 March 2010
HEMS aboard
Day shift: Four calls; one dealt with by police; one treated on scene; one by car; one by ambulance.
Stats: 1 Bite; 1 Bacterial infection; 1 EP fit; 1 ? Sprained ankle.
There’s nothing quite like the stupidity of petty brawling between a boyfriend and girlfriend first thing in the morning – especially when it culminates in the boyfriend being bitten and the police being called. The girl was behaving wildly and he was holding her down, trying to control her. A passing motorcyclist had stopped to help and was on the phone to us when I saw them on the bridge. I called it in, got confirmation that it was coming in ‘on the nines’ and attended to stop it getting any uglier than it was.
A crew joined me very soon after and by that time she was making claims of assault against the young lad whilst he sported a very fetching ‘whole set of teeth embedded in forearm’ look. Luckily the skin wasn’t broken because her temperament bore a striking resemblance to someone affected by Rabies.
The cops arrived, talked to them sternly and sent them packing.
I picked up an observer later in the morning – a HEMS doctor was joining me for a few hours to see what us grunts get up to on the line. He chose a Sunday morning, so I was hoping he’d get something out of his free time. Luckily, we didn’t have too long a hiatus before things kicked off.
A 25 year-old man walked into a doctor’s surgery and asked for help with his breathing problems and an ambulance was called for him, so myself and my observer went to help and found him sitting in the waiting area, GP letter to hand and in some distress. He had a raging throat and mouth infection, tonsillitis and pharyngitis, the combination of which was giving him a lot of difficulty when it came to breathing properly, although he was in no immediate danger. The bacterial matter had spread to his tongue, such was the state of his health and I wondered why he had let himself become so run down. Then I read the letter and it detailed his personal circumstances. This young man and his partner had recently lost one of their twin children to meningitis and of course they were at rock bottom. He’d been smoking cannabis constantly and hadn’t eaten for days. His health was suffering and it wasn’t long before he was crying in deep emotional pain. I felt very, very sorry for him.
A crew arrived to take him to hospital and I advised them of the circumstances and the risk to his kidneys – he had been complaining of lower back pain just above each kidney too. He was taken to hospital where, I hope, someone will talk this through with him, as well as treating his physical illness.
Another call came in just as I was offering to pay for coffee at Frith Street for my Doctor guest (a happy coincidence for a Scot you might say), so we went to Park Lane, where a 17 year-old Italian student had fitted. She was recovering when we arrived and a motorcycle colleague was already on scene. He was the one who requested the car instead of an ambulance because the girl was stable.
She was with her tutor and a large group of other visiting students and seemed tired but otherwise okay after her 2-3 minute seizure. She had a single history of fitting but was not on any meds. She had this one four years on from the last and I think it may have been triggered by the change in light (she was in a dark underpass and walked out into the strong sunlight when it happened). She lost bladder control in the car and vomited when she arrived at hospital. In between, the trip was uneventful and she was booked in.
A mum and her two teenage daughters set off for an evening of entertainment – JLS style – but had to pause when one of the daughters, a 13 year-old, took a bit of a tumble down steps (actually as the result of her mother tumbling first). I suggested compensation may be in order if her mother confessed to attempting to throw her child down the stairs but for some reason that bait wasn’t taken. It was all in good humour I have to say.
The girl’s ankle was slightly swollen and if she had a sprain it looked no more than a grade I anyway. Her night out was important and they’d travelled a distance, so mum asked me to ‘strap up’ the ankle and I got the girl to take paracetamol for the pain, which wasn’t too bad. That way they could avoid 4 hours of waiting in hospital and having to return home empty-handed and bereft of the JLS experience. I did advise accordingly but I also understood and the young lady was perfectly able to walk on her injured ankle – always a positive sign. I left them in the care of themselves and the kind and helpful London Underground staff.
It wasn’t long after this that I went home – the sight of a bald man walking around Trafalgar Square with a little black ball balanced on his head made me think it was probably time to leave.
Be safe.
Stats: 1 Bite; 1 Bacterial infection; 1 EP fit; 1 ? Sprained ankle.
There’s nothing quite like the stupidity of petty brawling between a boyfriend and girlfriend first thing in the morning – especially when it culminates in the boyfriend being bitten and the police being called. The girl was behaving wildly and he was holding her down, trying to control her. A passing motorcyclist had stopped to help and was on the phone to us when I saw them on the bridge. I called it in, got confirmation that it was coming in ‘on the nines’ and attended to stop it getting any uglier than it was.
A crew joined me very soon after and by that time she was making claims of assault against the young lad whilst he sported a very fetching ‘whole set of teeth embedded in forearm’ look. Luckily the skin wasn’t broken because her temperament bore a striking resemblance to someone affected by Rabies.
The cops arrived, talked to them sternly and sent them packing.
I picked up an observer later in the morning – a HEMS doctor was joining me for a few hours to see what us grunts get up to on the line. He chose a Sunday morning, so I was hoping he’d get something out of his free time. Luckily, we didn’t have too long a hiatus before things kicked off.
A 25 year-old man walked into a doctor’s surgery and asked for help with his breathing problems and an ambulance was called for him, so myself and my observer went to help and found him sitting in the waiting area, GP letter to hand and in some distress. He had a raging throat and mouth infection, tonsillitis and pharyngitis, the combination of which was giving him a lot of difficulty when it came to breathing properly, although he was in no immediate danger. The bacterial matter had spread to his tongue, such was the state of his health and I wondered why he had let himself become so run down. Then I read the letter and it detailed his personal circumstances. This young man and his partner had recently lost one of their twin children to meningitis and of course they were at rock bottom. He’d been smoking cannabis constantly and hadn’t eaten for days. His health was suffering and it wasn’t long before he was crying in deep emotional pain. I felt very, very sorry for him.
A crew arrived to take him to hospital and I advised them of the circumstances and the risk to his kidneys – he had been complaining of lower back pain just above each kidney too. He was taken to hospital where, I hope, someone will talk this through with him, as well as treating his physical illness.
Another call came in just as I was offering to pay for coffee at Frith Street for my Doctor guest (a happy coincidence for a Scot you might say), so we went to Park Lane, where a 17 year-old Italian student had fitted. She was recovering when we arrived and a motorcycle colleague was already on scene. He was the one who requested the car instead of an ambulance because the girl was stable.
She was with her tutor and a large group of other visiting students and seemed tired but otherwise okay after her 2-3 minute seizure. She had a single history of fitting but was not on any meds. She had this one four years on from the last and I think it may have been triggered by the change in light (she was in a dark underpass and walked out into the strong sunlight when it happened). She lost bladder control in the car and vomited when she arrived at hospital. In between, the trip was uneventful and she was booked in.
A mum and her two teenage daughters set off for an evening of entertainment – JLS style – but had to pause when one of the daughters, a 13 year-old, took a bit of a tumble down steps (actually as the result of her mother tumbling first). I suggested compensation may be in order if her mother confessed to attempting to throw her child down the stairs but for some reason that bait wasn’t taken. It was all in good humour I have to say.
The girl’s ankle was slightly swollen and if she had a sprain it looked no more than a grade I anyway. Her night out was important and they’d travelled a distance, so mum asked me to ‘strap up’ the ankle and I got the girl to take paracetamol for the pain, which wasn’t too bad. That way they could avoid 4 hours of waiting in hospital and having to return home empty-handed and bereft of the JLS experience. I did advise accordingly but I also understood and the young lady was perfectly able to walk on her injured ankle – always a positive sign. I left them in the care of themselves and the kind and helpful London Underground staff.
It wasn’t long after this that I went home – the sight of a bald man walking around Trafalgar Square with a little black ball balanced on his head made me think it was probably time to leave.
Be safe.
Saturday, 6 March 2010
The Lion man
Day shift: Six calls; one assisted-only; two by car; three by ambulance.Stats: 3 Head injuries; 1 asleep; 1 Period pain.
I’m still not feeling 100% but I’m back on a weekend tour and hoping to keep myself fit and well enough to stay the course until my next rest day. Luckily nothing happened for a few hours and I didn’t get my first call, which was a ‘no patient contact’ because the crew was on scene, for a few hours.
Later on an 89 year-old lady stumbled on a rough, sloping pedestrian ramp and hit her head on landing. She was with a motorcycle colleague and had already been checked and cleared as fit for the car. She had a large bump on her head but had sustained no other injury and wasn’t knocked out. This was her second fall on this type of pedestrian crossing ramp and I suggested that she asked for assistance next time but her face told me she wasn’t sure about asking strangers for help. It’s a shame we’ve arrived at this point in society because, despite her fears, I’m sure she’d still find plenty of people willing to hold her in balance as she negotiated the pavement.
The lions on Trafalgar Square are slippery at the best of times but sitting on them whilst wearing a sleek lycra costume is not advised unless you want to fall off. A Facebook gathering of costumed characters gathered in the Square and one of them, a 24 year-old man, slipped and fell fifteen feet onto his head, landing hard on the ground below. When I got there he had the attention of plenty of police officers and a lot of bystanders, including bemused tourists. He had a small cut to his head but I suspect that hid bone damage underneath. He had no neck pain but he was treated to the full immobilisation required for a fall like that.
Interestingly, as I treated him and waited for the arrival of the crew, none of the lions were occupied. Only after he’d been scooped up and taken into the ambulance did people, including children, start to clamber over them again.
A sleepy-headed man triggered a Red1 call because he chose to go to sleep on a bus. This, as you know, is very, very common and, as yet, nothing is being done about it except that we run around with cars, cycles and ambulances just to wake them up and send them on their way. I was with a cycle responder on this one and initially couldn’t get to it because the roads were being closed down due to yet another demonstration being held in Central London. Typically, none of us out and about knew anything about it – there was no warning. We must get together with the council one day and chat about this stuff. Oh, and the bus-slimbering man eventually got the hint and walked off.
In an underground station a 19 year-old female suffering from abdominal pain asked for an ambulance. She was starting her period today and, although she had been through this higher level of pain several times before, she hadn’t taken anything for it. She had vomited several times and so she felt this additional problem warranted an emergency response.
I took her to A&E in the car and she felt sick as soon as she sat down in the department. I scrabbled around looking for a vomit bowl, knowing that time was running out (it’s a familiar look – that imminent-vomit blanch) but didn’t find one and so she got off the chair, ran around the corner - where the porters usually sit and chat - squatted down and threw up copiously onto the floor - several times. Luckily the porters weren’t in position or there would have been tears (mine probably).
And just to prove that London’s visitors get along just dandy I was called to a 24 year-old male who’d been allegedly assaulted by his erstwhile friend. He was literally chucked onto the ground after a headlock in which he stretched out his arms in submission – nice touch I think. For his trouble he ended up with a 5cm incision in the back of his head that will probably need stitches. His blood-soaked clothing gave away the nature of this short but obviously nasty little encounter – caused primarily by alcohol-induced rage. He was flanked by other, less violent mates and a lone police officer when I arrived and an ambulance turned up just as I finished off the knot on his second head dressing.
Be safe.
Monday, 1 March 2010
Sick
Night shift: Six calls; one cancelled on scene; one left at home; two by car; two by ambulance.
Stats: 1 abdominal pain; 2 back injuries; 1 eTOH; 1 Hyperglycaemic.
I was asked to run to a chest pain but got cancelled on scene as the ambulance arrived, so that I could go in the opposite direction for three miles to attend a woman with abdominal pain. The 34 year-old was with staff when I arrived and she had been suffering an acute ‘sharp’ pain for two hours prior to asking for help. I gave her entonox and got her into the car after checking her medical history (or lack of it) and observations. When I got to A&E it was packed. Every bed was taken up and people queued outside the Majors Department to be seen. In Reception it was just a bad, with a 4-hour wait to see a doctor, if you were lucky.
Then off to see a 5 year-old boy and tell his parents that he didn’t need an ambulance. He’d slipped between a sofa and the wall and landed (not very hard) on the metal end of a set of barbells. He had an insignificant scratch on his lower back and when tested, could flex, bend and move his body properly without pain or guarding. This was a typical example of over-reactive parenting. The tests I did were simple and proved a point – anyone can do them and they are obvious. Look at what happened. Consider what kind of injury could be caused, or not. Test for dysfunction, extreme pain or immobility. In doubt? Call us out. Seemple... as the Meerkat says.
Another soldier call and this time he’d fallen down steps at an underground station. The 19 year-old tripped and toppled, landing hard on his back. He was with police and staff when I arrived and it took 10mg of morphine to deal with the pain before I could move him, with the help of a crew. He was in an awkward position but the move was done slowly and carefully without the need of a scoop or board, which would have added to the nightmare. His injury was mostly muscular and he probably jarred the Sciatic nerve when he hit the hard steps, so I’m sure he will be on his feet and soldiering again very soon.
The drunks of the town have yet to leave us alone, even on a Monday morning they are turning up in police stations. A 22 year-old man sat in the caged entrance to custody with police officers propping him up on a chair as he vomited almost continuously and lolled around muttering stupidity to nobody in particular. He was a large man and I’m told he had to be carried from the police van to this spot. He wasn’t being arrested but he needed to go to hospital because his drinking binge had poisoned him. He got a yellow bag around his neck to vomit in (a Booze Bus invention) and an ambulance to transport him – there was no way he was getting in the car.
I got a break and the system was shut down as calls went ‘manual’ for a few hours. During that time it seemed reasonably quiet but I began to feel quite unwell as the hours passed by and when my next call came in I was feeling very ill. This is not the job to have when you are sick yourself, so my 39 year-old diabetic who’d asked a gang of builders on an early-morning renovation to call an ambulance for him because he was ‘feeling cold’ and had ‘diabetic problems’ got the best of the professional attention I could summon, considering that I probably felt worse than he did.
I had two hours to go and was prepared to see the shift through, as long as I wasn’t exposed to anything that could set my delicate system off (like my earlier vomiting drunk). I took the patient to hospital in the car – he had a BM of 23. By the time I booked him in the nurses were asking if I’d like to book myself in too because I was looking very pale. Needless to say I got myself off home as soon as possible before I dragged the profession into the gutter.
Be safe.
Stats: 1 abdominal pain; 2 back injuries; 1 eTOH; 1 Hyperglycaemic.
I was asked to run to a chest pain but got cancelled on scene as the ambulance arrived, so that I could go in the opposite direction for three miles to attend a woman with abdominal pain. The 34 year-old was with staff when I arrived and she had been suffering an acute ‘sharp’ pain for two hours prior to asking for help. I gave her entonox and got her into the car after checking her medical history (or lack of it) and observations. When I got to A&E it was packed. Every bed was taken up and people queued outside the Majors Department to be seen. In Reception it was just a bad, with a 4-hour wait to see a doctor, if you were lucky.
Then off to see a 5 year-old boy and tell his parents that he didn’t need an ambulance. He’d slipped between a sofa and the wall and landed (not very hard) on the metal end of a set of barbells. He had an insignificant scratch on his lower back and when tested, could flex, bend and move his body properly without pain or guarding. This was a typical example of over-reactive parenting. The tests I did were simple and proved a point – anyone can do them and they are obvious. Look at what happened. Consider what kind of injury could be caused, or not. Test for dysfunction, extreme pain or immobility. In doubt? Call us out. Seemple... as the Meerkat says.
Another soldier call and this time he’d fallen down steps at an underground station. The 19 year-old tripped and toppled, landing hard on his back. He was with police and staff when I arrived and it took 10mg of morphine to deal with the pain before I could move him, with the help of a crew. He was in an awkward position but the move was done slowly and carefully without the need of a scoop or board, which would have added to the nightmare. His injury was mostly muscular and he probably jarred the Sciatic nerve when he hit the hard steps, so I’m sure he will be on his feet and soldiering again very soon.
The drunks of the town have yet to leave us alone, even on a Monday morning they are turning up in police stations. A 22 year-old man sat in the caged entrance to custody with police officers propping him up on a chair as he vomited almost continuously and lolled around muttering stupidity to nobody in particular. He was a large man and I’m told he had to be carried from the police van to this spot. He wasn’t being arrested but he needed to go to hospital because his drinking binge had poisoned him. He got a yellow bag around his neck to vomit in (a Booze Bus invention) and an ambulance to transport him – there was no way he was getting in the car.
I got a break and the system was shut down as calls went ‘manual’ for a few hours. During that time it seemed reasonably quiet but I began to feel quite unwell as the hours passed by and when my next call came in I was feeling very ill. This is not the job to have when you are sick yourself, so my 39 year-old diabetic who’d asked a gang of builders on an early-morning renovation to call an ambulance for him because he was ‘feeling cold’ and had ‘diabetic problems’ got the best of the professional attention I could summon, considering that I probably felt worse than he did.
I had two hours to go and was prepared to see the shift through, as long as I wasn’t exposed to anything that could set my delicate system off (like my earlier vomiting drunk). I took the patient to hospital in the car – he had a BM of 23. By the time I booked him in the nurses were asking if I’d like to book myself in too because I was looking very pale. Needless to say I got myself off home as soon as possible before I dragged the profession into the gutter.
Be safe.
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