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Sick doctors

Posted Nov 21 2008 4:27pm
Nine emergencies, 1 green, 1 assist-only, 3 conveyed and 6 ambulances required.

Now I'm tired!

Before I completed my VDI (vehicle daily inspection) I was asked to attend a 'male, collapsed in street'. I suspected a drunk and arrived on scene to find...a drunk. There was a MOP (member of the public - no disrespect intended, it justs works well) waving frantically at me, mobile phone in hand. He pointed to the figure slumped in the corner of a doorway and I pointed to the can of extra strength lager that was sitting beside him. I may or may not have politely mentioned the fact that the gentleman was probably drunk and what, exactly, did he want me to do about this?But I can't remember. All I could think of was that I was still fifteen minutes away from officially being on duty and that I hadn't even had a chance to fuel up with a cup of coffee for the morning.

So I sat with this drunk (Polish) man who spoke very little English and whose vocabulary could only string the words " take me home please" together in a slurred, spit-filled shower. He kept grabbing at me and trying to hold on to my arm. That is a no-no. Don't even attempt that.

I had no choice but to request an ambulance. I don't like bringing in crews for this stuff but I couldn't take him in the car and he was certainly going to generate calls all day long if he wasn't removed from the street to a place of safety. He was quite big, so I wasn't going to grapple with him to control him. Instead, I lodged him against a corner to keep him upright.

The crew arrrived and I explained what we had. They removed him to hospital, after a little exchange in which the drunken Pole attempted to grab my colleague's arms. The empty lager can was left behind in the doorway. I was going to remove it and bin it but I forgot.

I heard the crew from that job reporting that they had been called to this guy again, outside the hospital. He had walked out and made a nuisance of himself in the street. This time, the police were requested and he was taken away to a better place.

I returned to the same area on my next call to attend a cyclist and a pedestrian who had been punching and kicking each other in a cycle/pedestrian-rage incident. It's the first one I have attended and I know there will be more. I'm sorry if you are a cyclist but drivers and pedestrians are absolutely fed up with the way a lot of them behave on the road. They buzz through red lights and pedestrian crossings like they are immune to the highway code. I have seen a number of near-misses involving cyclists who have hammered across red lights, almost hitting people who were, rightfully, crossing the road. It's high time they were made to put ID plates on their bikes so that they can be photographed breaking the law and brought to book. I believe they can get points on their driving licences if they are caught. Personally, since they are using the same roads drivers have to pay for, I think they should have a little tax disc on their bikes. Just my opinion.

This particular cyclist had annoyed a pedestrian by almost hitting him, so he lashed out. They had a very public punch-up and the cyclist (18 years old) ended up with a bruised cheek, whilst the pedestrian (in his 50's) got a black eye. Nice start to the day. Dignified.

Soon after this job (both got arrested) I was called to a female 'sitting on wall feeling dizzy'. I saw her, sitting on the wall as described, her head in her hands. She didn't even look up when I got out of the car and said good morning in my professional voice. Its one of my pet hates - people who call ambulances and then ignore you when you speak to them. I believe they think it will make them look genuinely ill if they don't look up or react when you speak. To me its just plain bad manners. Eventually, she looked up and answered my questions. She answered them slowly and in as quiet a voice as possible. This is another annoying addition to the 'I am very ill' act. It turns out she was on her way to work and felt dizzy and tired. I feel like that every morning. She fell asleep in the back of my car, only waking momentarily to ask me a question.

"Can you people call my work for me?", she said.

"No. My people can't. You have to do that yourself." I replied.

I was hurt. No, really.

An emergency call to a pregnant female whose waters have gone and who is now in labour but has collapsed twice. I race to the scene, requesting a midwife, considering the call description and another ambulance but when I arrive I find a woman, in her twenties, who is having a normal labour. Her pains are about 3 minutes apart and she is stable. Even the attendant from the crew who arrived shortly after me asked why this was an Amber call. She walked to the ambulance and went to hospital like anyone else in her condition. This was a maternitaxi and nothing more.

A Red1 for a ? suspended sent me into the posh side of London. The man was sitting up in the street when I arrived, so I called Control and advised them that it was not as given. The crew were a still few minutes away because they were delayed in traffic. The man had collapsed sudddenly and he certainly looked unwell. He was a doctor and, ironically, another doctor who was passing helped him. He also gave me an excellent handover before he left the scene. The patient's brother was also there.

The patient had a long history of heart problems and had undergone a CABG (pronounced Cabbage by all who use it) a few years ago. Now he was diaphoretic, confused, had an extremely low BP and had lost bowel and bladder control. I also noticed that his pulse was racing and felt very weak, even though my pulse oximeter recorded a heart rate of just over 100, it was likely to be much faster. He was also a diabetic and his BM was high. I watched him carefully and his level of consciousness slipped a few times. I called Control and asked for an ETA for the ambulance. I didn't think this man was going to remain conscious for much longer.

Thye crew arrived soon after and we transfered the patient to the ambulance. An ECG revealed his problem - he was in VT. This could convert to a life-threatening arrhythmia so it was now critical to get him to hospital quickly. His blood pressure was low because his heart was not pumping effectively and it needed cardioversion as soon as possible. IV access was gained, his feet were elevated to help his BP and he was blued in to the nearest hospital. I followed the ambulance in the car (well, I went in front to clear and stop the traffic - this ensures a smoother drive for the ambulance crew).

When we got him to hospital, we watched as he was put to sleep, intubated and then shocked to convert his VT to sinus rhythm. It worked perfectly and his heart behaved normally for about 5 minutes. Then it converted back to VT and he was in trouble again. I think it caught the hospital team out as they were just about to wake him. They shocked him again and his heart stabilized once more. I had to leave after that and get back on duty, so I don't know how many times they had to do that or even if he survived.

All through this, the man's brother sat outside the resus room, quietly awaiting news. He still didn't realise how serious things were.

Later on I was called to a man who had 'poured boiling water on his feet', the description had the word 'accidentally' stuck on the end of it. I had to smile at the thought of such a self-inflicted deliberate act. The ambulance was already on scene when I arrived. The man's injuries were minor so I was not required.

I went into the West End to attend a French man who had become ill overnight in his hotel room. He had chronic diarrhoea and didn't look well at all. Whilst in the toilet he had stumbled and fallen, bursting his nose open on the floor. The bleeding had stopped but it looked like it might be broken. His wife was with him and he insisted on going to the toilet just before I walked him out to the car. He insisted on going to the toilet with the door wide open and his wife standing in the doorway watching. I was also invited to watch, just in case something happened to him during the event. I declined the offer and waited at the front door. I still had to listen though.

I had just put a teaspoon full of coffee into my cup at the station when my 'phone rang. I was going to a female who was fitting. I arrived to find a woman and her friend sitting on the floor. Although the patient wasn't epileptic, her friend confirmed that she had just had a seizure. Since it was a witnessed event and her first, I advised her to go to hospital. She was a doctor and she knew what I was saying but I noticed that she was a little vague with details, although I assumed she was just confused about what had happened.

The crew arrived to take her away and she became more confused and stopped answering questions. I looked at her as we wheeled her out on the chair and she was staring into the corner. She was absent. I told my colleague and she was wheeled out with more urgency but a few seconds later she began to have another seizure. We got her into the ambulance, with some difficulty, and my colleague immediately sorted out her airway. I placed a cannula but she pulled it out, so there was no further attempt to give her diazepam - we took her straight to hospital. By the time she got there, she was post ictal again.

This lady had told me she had SLE and I completely forgot what that stood for. Only when the word Lupus was used did I remember - SLE; Systemic Lupus Erythematosus. I had only ever used the term 'Lupus' for this disease but there are different kinds, so SLE is more specific. It can cause inflammation of the brain that may lead to seizures.

I saw her again later on and she was fully recovered. She didn't remember pulling the cannula out of her arm though.

Then a RTC for a 'car vs ped - bleeding from ears'. This sounded serious and I was asked to report for HEMS on arrival. When I arrived, I could see HEMS wasn't required, so I reported back. The woman hadn't been hit by a car at all. She had attempted to get into a taxi but the taxi driver had locked the doors (she was drunk) and allegedly driven off. Unfortunately, she was still holding onto the door handle and got pulled onto the road, where she hit her head. The bleeding was coming from a wound just above her ear. She was taken to hospital by ambulance and I saw her wandering around the A&E department, barely dressed, later on.

My final call of the day was to a lovely 87-year-old lady who had fallen off the kerb and hit her head on the road. She also had a little knee pain. She was being cared for by two kind MOPs who had witnessed the fall. Interestingly, this old lady remembered and used my name 20 minutes after I had introduced myself to her. Its unusual because very few people bother to keep a mental record of your name when they are ill or injured. It is especially unusual when they are in their 80's. I found it heart-warming.

I took her to hospital in the car and she started singing to herself in the back seat. This lady has nobody else in the World, she has no relatives but what a happy soul she was.

Be safe.
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