Back on the bus tonight (attending, so back in the back) and I actually enjoyed being on it. I have a new partner (temporarily) and he has been working my line whilst I have been on the car, so this is the first time he has worked with me since he transfered a few months ago!
Admittedly I get to spend lots more time with patients when on the ambulance as opposed to the car but the pace is a little slower. I used a few skills tonight, including giving narcan to a drugged up man who was taken to a police station because he was wandering aimlessly around the road. When we got there he was barely with it but able to talk sense but when we got him into the ambulance he started to go downhill; his breathing became depressed and he was much more difficult to rouse. I couldn't ascertain from anyone what he may have taken and so, on the basis of his condition and his pin-point pupils (oh and the fact that he looked a likely character) I 'narced' him - nice and slow, IV.
We were about to leave on a blue call to hospital when he suddenly (and miraculously :-)) recovered. He wandered up from his slum of narcotic sleep to a world in which he realised he had been robbed of his £20 hit (or whatever today's going rate is). Now he wanted out of the ambulance. He wasn't violent and we reached an understanding, kind of. I monitored him for a few more minutes and all his vitals were back to normal so, at his insistence and him being of 'sound' mind, I got him to sign my form and I let him go. I disconnected him from everything and removed his IV obviously!
He will probably relapse in a corner somewhere and someone else will have him as a problem for the rest of the night. He declined. What can I say?
We also dealt with a middle aged lady who collapsed and passed out in a theatre. When I did her obs. her BP was a very low 84/53 and her pulse rate was in the low 50's consistently. She had no relevant medical history for this and her ECG was unremarkable. She had no chest pain and no current illnesses. Her BP didn't improve a lot when she was laid flat but she felt a little better. I put IV fluids up for her and this improved her BP to 102/87 with a relative increase in her pulse rate. She looked a hell of a lot less pale when she arrived at hospital. She began to complain of abdominal and back pain (around the kidney area) just before she got to resus., so I wonder if the problem lies within her.
It was nice to talk to someone whilst on duty tonight. I didn't realise how lonely the job on the car was until now. Maybe a combination of car and ambulance work during the year is best. This is the suggestion being made when they roll out all the new cars and I think it may be healthier to do both.
I've changed the background colour (not much I can do about the dots as they are part of the template). Is this better?