The day is miserable, "we were supposed to have a summer this year" I think out loud as we skid around the sodden streets of the Concrete Jungle.
The tower block looms up at us from behind the trees. It beckons us forward to investigate what lies behind the pebble dashed delights of 1970's architecture.
Impressionist* and I arrive at the same time as Kanger* on the RRU. The call is for a young male with difficulty breathing. Its late on a Saturday afternoon and we're not hopeful about what we're going to find behind the battered doors of the flats inside.
We find the lift to the evens floor's is broken, we head up to the floor above and walk down, carrying this amount of kit gives us the right to be a little lax in our fitness efforts for the day.
The door is open and we can hear several voices inside. A net curtain covers the doorway to avoid people being nosey through the clear glass panels in the front door. A voice from within shouts us forward.
The living room is small and crammed with ill fitting furniture. The small kitchen leads through a doorway and the remains of several parties worth of alcohol visibly litter every surface. It seems to have spread into the living room by osmosis.
There are people everywhere. All young men and all have a can or bottle in one hand and cigarette in the other. Atmospheres don't become much more oppressive than this.
"Whose the patient?"
A hand rises from the back of an armchair facing away from us. As we move around the sofa a face bearing the marks of a recent beating looks up as us. He is clutching his right side and breathing steadily, if a little shallow.
"Could anyone who has a cigarette on the go either go outside or put it out for us? Cheers."
Most of the people in the flat are calm and nod at my request while heading for the door. One stays behind with the patient, he is jittery, hopping from one foot to other.
"Its my brother. I'm staying here"
"Ok, no problem" I put on my best 'calm and reassuring voice'. This guy is giving off bad vibes. The hairs start to prick up on the back of my neck. I make sure to keep him in eye line.
While I'm playing at crowd control, Kanger* and Impressionist are assessing the patient. His story is a familiar one. Having taken a kicking on Friday night our patient had attended The Holy Hospital and been informed he had some broken ribs. He was sent home and advised to rest for a few days with painkillers. Unfortunately there is no miracle cure for broken ribs.
"He's in that much pain he can't breath" His brother is obviously concerned, but I'm worried. Everything that comes out of his mouth has an aggressive tone. I don't think he is going like what will inevitably happen.
We explain to the patient the problem that broken ribs present. You use your ribs to help you breathe, therefore when some are broken it hurts when you breathe. There is absolutely nothing we can do for him other than take him back to the hospital, who will more than likely discharge him with more painkillers and the same advice.
"But he can't breath!" I calmly try to explain to his brother that our patient is managing to breath adequately, he is talking to us in complete sentences, he has a good colour (around the bruises) and his oxygen SATS are pretty good from someone sat in a smoke filled flat. Medically he can breathe fine. It just hurts.
I don't like the way this is going. His brother is very agitated and not happy with our assessment and advice. We turn back to the patient and ask him if he wants to attend hospital. He nods. We start to gather his things together to walk him down to the ambulance. Anything to get out of the flat.
His brother announces "I'm coming with you".
I turn to Impressionist, he's going to be in the back with this guy so I let him decide whether he wants to be an enclosed space with him. He nods. I know the next 20 minutes en route to hospital I'll be spending more time looking in the rear view mirror at our occupants than the side mirrors.
I don't often pick up on these feelings but get quite nervous when I do. Fight or flight changes slightly in a moving vehicle.
The journey occurs with no problems, I can see the patients brother jigging up and down in the chair like he has an itch he can't scratch but he doesn't interrupt as Impressionist asks questions to fill out the report form. I wonder to myself if he is on something and are we just bringing the A&E department a problem they really don't need on a Saturday afternoon. Too late now.
We leave the brothers in the waiting room after handing over to triage with an apologetic shrug.
We know the advice will be the same.
The question is whether they decide to take the advice.
________________________________________________________________
I hope everyone is ok and thanks for sticking with me! Its been bit of a mental 6 months and I've neglected the blog.
All will be revealed soon and I'm not going to make any promises of regular posting over Christmas as I may only break them!
Thank you!
Louise xx
The tower block looms up at us from behind the trees. It beckons us forward to investigate what lies behind the pebble dashed delights of 1970's architecture.
Impressionist* and I arrive at the same time as Kanger* on the RRU. The call is for a young male with difficulty breathing. Its late on a Saturday afternoon and we're not hopeful about what we're going to find behind the battered doors of the flats inside.
We find the lift to the evens floor's is broken, we head up to the floor above and walk down, carrying this amount of kit gives us the right to be a little lax in our fitness efforts for the day.
The door is open and we can hear several voices inside. A net curtain covers the doorway to avoid people being nosey through the clear glass panels in the front door. A voice from within shouts us forward.
The living room is small and crammed with ill fitting furniture. The small kitchen leads through a doorway and the remains of several parties worth of alcohol visibly litter every surface. It seems to have spread into the living room by osmosis.
There are people everywhere. All young men and all have a can or bottle in one hand and cigarette in the other. Atmospheres don't become much more oppressive than this.
"Whose the patient?"
A hand rises from the back of an armchair facing away from us. As we move around the sofa a face bearing the marks of a recent beating looks up as us. He is clutching his right side and breathing steadily, if a little shallow.
"Could anyone who has a cigarette on the go either go outside or put it out for us? Cheers."
Most of the people in the flat are calm and nod at my request while heading for the door. One stays behind with the patient, he is jittery, hopping from one foot to other.
"Its my brother. I'm staying here"
"Ok, no problem" I put on my best 'calm and reassuring voice'. This guy is giving off bad vibes. The hairs start to prick up on the back of my neck. I make sure to keep him in eye line.
While I'm playing at crowd control, Kanger* and Impressionist are assessing the patient. His story is a familiar one. Having taken a kicking on Friday night our patient had attended The Holy Hospital and been informed he had some broken ribs. He was sent home and advised to rest for a few days with painkillers. Unfortunately there is no miracle cure for broken ribs.
"He's in that much pain he can't breath" His brother is obviously concerned, but I'm worried. Everything that comes out of his mouth has an aggressive tone. I don't think he is going like what will inevitably happen.
We explain to the patient the problem that broken ribs present. You use your ribs to help you breathe, therefore when some are broken it hurts when you breathe. There is absolutely nothing we can do for him other than take him back to the hospital, who will more than likely discharge him with more painkillers and the same advice.
"But he can't breath!" I calmly try to explain to his brother that our patient is managing to breath adequately, he is talking to us in complete sentences, he has a good colour (around the bruises) and his oxygen SATS are pretty good from someone sat in a smoke filled flat. Medically he can breathe fine. It just hurts.
I don't like the way this is going. His brother is very agitated and not happy with our assessment and advice. We turn back to the patient and ask him if he wants to attend hospital. He nods. We start to gather his things together to walk him down to the ambulance. Anything to get out of the flat.
His brother announces "I'm coming with you".
I turn to Impressionist, he's going to be in the back with this guy so I let him decide whether he wants to be an enclosed space with him. He nods. I know the next 20 minutes en route to hospital I'll be spending more time looking in the rear view mirror at our occupants than the side mirrors.
I don't often pick up on these feelings but get quite nervous when I do. Fight or flight changes slightly in a moving vehicle.
The journey occurs with no problems, I can see the patients brother jigging up and down in the chair like he has an itch he can't scratch but he doesn't interrupt as Impressionist asks questions to fill out the report form. I wonder to myself if he is on something and are we just bringing the A&E department a problem they really don't need on a Saturday afternoon. Too late now.
We leave the brothers in the waiting room after handing over to triage with an apologetic shrug.
We know the advice will be the same.
The question is whether they decide to take the advice.
________________________________________________________________
I hope everyone is ok and thanks for sticking with me! Its been bit of a mental 6 months and I've neglected the blog.
All will be revealed soon and I'm not going to make any promises of regular posting over Christmas as I may only break them!
Thank you!
Louise xx