It's bad enough being called animal names but to be made to look like Punch & Judy is pushing it...a policeman's lot as they watch crowds during the New Year festivities (photo taken in on 1st January).
Thirteen emergency calls – two conveyed in the car, one cancelled on scene, one not required, one no trace and the rest required an ambulance.
Friday nights are killers, especially when they herald my long weekend of nights (I do four 12 hour stints in one tour of duty). At least this time I had company – I was asked to take someone out with me for the shift.
As usual, it didn’t take long for the first job to come in and I was off to help an unconscious 20 year-old who was lying somewhere in a small park. I left my alien torch in my other stab vest cover pocket, so I had no light to see by, apart from my pen torch, when we arrived and started looking for him. Luckily, his street mates were taking care of him and they waved me over. The patient was now conscious and I knew him; a young alcoholic from East Europe who had needed our attention several times in the past year.
He had been found unconscious and very cold – he was hypothermic when I checked. We walked him to the car and I decided to take him to hospital myself, rather than tie an ambulance up. To get to the car we had to jump down a three foot wall, so I warned my charge that it was coming but he didn’t jump – he fell. The landing, short as it was, twisted his knee, so now he had another problem and another reason to go to hospital. There wasn’t much I could have done to prevent him falling, he had been warned and I wasn’t going to carry him down. In his drunken, hypothermic state, he had completely misjudged the drop.
We got him to hospital and I booked him in – at least he would be warm and closer to pain relief for his injured limb.
Sometimes you look at someone and you completely miss the obvious because your judgment is obscured by a preconception. A 19 year-old female who collapsed suddenly at work and whose manager was very concerned but also very helpful, had me and the crew on scene, treating her as an innocent young woman with an unknown problem. But she had that look about her and we all recognised it. She claimed that she felt ill and became unconscious without any explanation or cause. She denied drugs or alcohol and she said she had been eating properly. She didn’t have a virus and there was no food poisoning suspected. She was taken to hospital and supported as she walked to the ambulance. Every one of us displayed professional caring and sympathy.
What we didn’t know, but nevertheless suspected, was that she was a heroin addict and she had injected herself at work. She had collapsed in a quiet alley outside the bar that she worked in, which was suspicious, but her pinpoint pupils were the biggest clue and I asked her for confirmation that she hadn’t taken any drugs. She was a plausible liar. They all are but I think we were fooled by her innocent demeanour - more so than with the others.
Chronic Pain Disorder is a strange ‘disease’. My next patient, a 60 year-old man, collapsed in a tube station and the staff thought he was having a fit. When I examined him, however, he displayed signs and symptoms more akin to a stroke than epilepsy, although a seizure can go hand-in-hand with a neurological insult.
His behaviour was bizarre and it took me and the crew a little while to get him upstairs and into the ambulance because he claimed to be a CPD sufferer and that he had pain down one side of his body. When we got into the vehicle, I offered him pain relief and he initially refused but then he asked what I would give him. I told him morphine could be administered and suddenly his mind was changed; he would have some analgesia after all. I found this suspicious.
I cannulated him but he didn’t get any morphine – he got a flush of saline instead. He had already taken pain relief earlier on and, to be honest, I couldn’t work out his state of mind. None of us were quite sure if he was actually in pain (he only referenced it when asked about it) or had suffered a stroke (our FAST test was negative and his speech was fine) or was a mental health candidate. I suspected the latter.
I told him that he wasn’t getting any morphine and he was fine with that. His pain wasn’t so bad now anyway, apparently. Off he went to hospital and I returned to my car with my new friend Scott – my rideout companion for the shift.
One drunk on a bus is one drunk on a bus too many, right? The next call was for FOUR non-responsive men on a bus, all sitting separately. When one person is out, I’ll go and deal with it, when two are out, things are looking tricky but when three or more are out, we go into a state of alert. I was told to stand-by at an RV, as was the ambulance. The bus was parked around a corner and all I was allowed to do was stand outside the car and look at it.
The HART team were sent for this, as they always are for a 1,2,3 type call and they cautiously entered the street where the bus was sitting. They didn’t have their space suits on – that would have been more over the top than this was.
The police arrived a few minutes after we did and they entered the street and got on the bus. A few seconds later I received an update that the police had immediately been attacked by the men who were currently being arrested. I was then told to go round and see if there were any casualties. Luckily, there weren’t. All of the men, bar one, were arrested for assault. This is why over-the-top precautions. Apparently, they were off their heads on crack cocaine.
A quick call to assist a crew with a heavy, drug overdosed patient next. He was on the fourth floor of a building with a narrow, winding staircase, which made for a very awkward lift and carry in the chair. He was unconscious, so it was no picnic, even for three of us.
I travelled a long way out of my area for a drunk on a bus, only to find the police walking her off when I got on scene. A completely unnecessary journey.
A very worried 69 year-old woman with chest pain which radiated to her left arm may have been suffering a heart attack. She had no definitive cardiac history but that didn’t rule it out and she was taken to hospital quickly.
Then a ride in my car for a 20 year-old female who had been hit over the head after an argument with a random guy in Soho. Her very drunk friend came with us and she began to suffer the full effects of her earlier binge. So much so, in fact, that she collapsed in front of her now bedbound mate in hospital. The girl in bed looked on as we struggled to lift her up while she thrashed and vomited onto the cubicle floor. Funny and sad at the same time.
Our next run was for a 27 year-old man who’d walked straight into a moving bus and sustained a fairly serious head injury. HEMS were activated and I was sent to assist the FRU on scene. The man was conscious but he had a large open wound on his forehead and because he was drunk, it was difficult to accurately assess his GCS.
As we packed him into the ambulance, the HEMS team (all six of them!) arrived but they didn’t stay long because the man wasn’t injured seriously enough to justify the need. They went instead to my next call; a man who’d just been stabbed in the chest at Trafalgar Square. When I arrived, he was already being worked on by the team, several crews and another FRU who’d also been brought in.
He lay on the street in a large pool of his own blood as his girlfriend (I presumed) screamed and yelled nearby. For Scott, this was a first – he hadn’t yet seen anything so traumatic and certainly not in such circumstances. He was quite rightly shocked at the violence (and result of it) we see. Welcome to the ambulance service.
I worked with the teams around me (all I needed to do was get some fluids up and running) and we got the teenager into the ambulance and rapidly to hospital. There’s no doubt that the efforts of the first arriving crew, who just happened to be in the right place at the right time and got this one as a running call, helped. Their actions would have made a huge difference until HEMS arrived.
Initially, I was sure the young man wouldn’t survive and it’s only now, as I write this, that I have discovered he is still hanging on to life. He shouldn’t be because his heart must have been penetrated by the knife that punctured his chest. He will probably never thank the crew who started saving his life, so I’ll do it here...thanks and well done!
There was no trace of the 19 year-old girl who was supposedly unconscious (? cause), so I called it a no-trace and went to my next call for a 78 year-old man with chest pain, a history of PE and a swollen ankle. He has had three bypasses, so I wasn’t surprised to see a less than healthy picture on his ECG. Another trip to hospital then but sooner or later, his body will give up the fight.
I must have been particularly wicked recently because there was no rest at all tonight. My last job took me to LAS HQ where a man had collapsed in front of the entrance. He was surrounded by police and ambulance officers and a crew joined me as I tried to make sense of what was wrong with him. We spent more than half an hour listening to him rant about his hatred of all things Irish and Scottish (which offended me, of course) and his love of all things English. He spun and twisted and thrashed on the ground. He was clearly out of his mind; either on MDMA, or something else...or he had just had a psychotic breakdown. How else could I explain his irrational loathing of the Celts?
In any case, cruel as it sounds, he was highly amusing at times. One of the cops tried to restrain his legs because he was very strong and seemed to have endless energy. At one point I felt he was going to dislocate my thumb after he grabbed it and held on during my second attempt at getting a BM (I really shouldn’t have bothered). I heard it click and there was a sharp pain as it popped back into place.
He looked down at the cop restraining him by the legs and said ‘F*ck off, you f**king hamster!’
This brought us all to tears because the police officer did look a bit like a hamster when you caught a certain angle of his head. Nobody would have noticed that about him without the aid of drugs or madness.
Eventually, he was cuffed and fully bound with tape. Then he was transfered to a trolley bed and into the ambulance with a police escort. He will spend the rest of the day...or his life, in a padded room wearing a restraining jacket I should think.