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Medical mole

Posted Nov 21 2008 4:26pm
Eight calls – one refused, the others went by ambulance.

A fairly routine sort of shift which started off with a 37 year-old male who had a near faint in E1. The crew were already on scene and dealing, so I confirmed my ‘not required’ status, turned around and headed back to my own area.

A 50 year-old pedestrian who had a physical argument with a lorry came off worst with a fractured ankle – but he’ll live. As soon as the crew arrived I handed him over to them and he was taken to hospital for an x-ray and possibly a few pins.

For some reason, there are shifts that are coincidental in nature. I mean, most of the time when I am writing a post I run a theme through it. That's usually only possible because of the nature of my work. One day I might get more chest pain patients than another, for example. Most of my patients (or all of them) were 80 year-old men...or I find myself working near railway tracks, mostly underground for almost the entire shift.

If you have chest pain – I mean proper chest pain – don’t ignore it for days before calling an ambulance. A 55 year-old female collapsed at Kings Cross station because she couldn’t cope with her chest pain any longer – she had suffered it for three days. Her husband was anxious and annoyed because he had been kept out of the loop. A Motorcycle Response Unit (MRU) was already on scene when I arrived, so I helped guide the crew to where she was. She was quickly loaded onto a bed and wheeled out to the ambulance. Her ECG was abnormal but not, thankfully, immediately worrying.

Reactions to food can affect people quite suddenly. My next call was to a 35 year-old woman who collapsed and passed out on the floor of the toilet at her workplace. She had just eaten lunch and was now covered in an erythemic rash. She was conscious when I arrived and denied having any allergies. She confirmed that she had eaten a sandwich and it’s possible that something in it caused her sudden collapse. The rash is insignificant but the sudden collapse isn't, so she went to hospital for further checks.

A 79 year-old with a cardiac history and who really should know better, nursed his chest pain for 2 months on and off before finally giving in and calling an ambulance, or so he claimed. When it became too uncomfortable to bear he tried his GTN and this brought about an immediate drop in blood pressure and collapse. His family, tired of his stubborn nature, decided enough was enough and called us out.

He lived on the millionth floor of a tower block that was in mid-renovation. Scaffolding covered the building and workmen were sawing, hammering and generally being noisy all around me when I arrived. The lift, although working, had to be the slowest in Europe. It seemed to take forever to get to the floor I needed. Thank God he wasn’t having a heart attack.

He was very pale and looked uncomfortable. His collapse was probably solely due to the GTN and his ongoing chest pain was probably unstable angina, so he was taken to hospital as soon as the crew arrived.

I went to the newly opened St. Pancras station for a 76 year-old man who had fallen and sustained a head injury on the station platform. He had a nasty cut to his scalp but the bleeding was under control and an off-duty paramedic from another service was on scene to lend a hand before I arrived.

I chatted with the patient and looked at his injury. He hadn’t been knocked out, he had no medical problems and he certainly hadn’t been drinking alcohol. It wasn’t until I looked down at his feet that I realised what had happened to him.

He was running along the platform edge (well, shuffling fast – his gait was quite unstable) when he clipped the cobbled part of the platform edge, spilling over onto the concrete as a result. He was wearing flip-flops; loose sandals. Hardly practical and his toes must have been freezing.

He refused to go to hospital, so I cancelled the ambulance. That didn’t stop two crews showing up on scene, however.

Still on a railway theme, I found myself at Victoria underground station next. I was there for a 30 year-old female who had collapsed on the platform. The place was heaving with commuters and I was being edged out towards the rail – it was quite dangerous trying to get through them. When I got to my patient she was sitting on a bench with a member of the underground staff and an off-duty doctor. She was hyperventilating. She told me that she had nearly fainted on the train after experiencing stomach pains. I reassured her and began the process of slowing her breathing down as we waited for the ambulance crew to fight their way towards us.

Finally, a 31 year-old male with chest pain at yet another underground station. This time, however, he claimed his chest pain wasn’t actually a pain but more of a ‘weird feeling’ in his stomach. So neither chest nor pain, in fact. He went to hospital for the reassurance he needed, if nothing else.

I was glad to be back in fresh air (sort of) after all that.

Be safe.
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