Monday 30 April 2007

All quiet on the Central front

An altogether strange weekend. The sun was out, it was warm and there were plenty of people around - in fact, Central London was extremely busy and yet I probably had the quietest couple of shifts I have experienced for at least four years. My usual callsign (the 'amber' car) had been suspended, for reasons not explained to me and I was on a 'CS' callsign, which means I dealt only with Red and Amber calls - no green calls.

I was the only FRU on duty out of my station but I still wasn't as busy as expected, especially on a weekend. I will probably regret bringing this up at some point in the near future!

On Saturday I melted into the Trafalgar Square crowds at a food festival (I think it was at any rate) called 'Eat London'. I stood by the car and waited for a call. I only got TWO all day. One of these emergency calls was to a male who had fainted in a bookshop. He had gone down quite hard and hit his head on the edge of a shelf, splitting his scalp open. There is always plenty of initial bleeding when that part of the body gets opened up, so his head was matted with blood when I arrived but the bleeding had stopped.

The gentleman refused to go to hospital and continued to refuse throughout my treatment and obs. He had a significant cardiac history and I suspected his BP was quite low, not that my wrist monitor was any good at the moment (its going through a moody phase). He was very pale and diaphoretic, although he tried to put that down to the weather. I wasn't convinced and neither were my colleagues when they arrived. At first I thought there was no point in having the ambulance crew here - the patient was adamant that he wasn't going anywhere. I had given him three opportunities to change his mind and was prepared to get my paperwork and let him sign it so that he could continue his day out with his friend. The problem, however, was that I couldn't convince myself that it was the right thing to do considering his condition and past medical history. There was a possibility of cardiac origin for his present status, chest pain or no chest pain but in a situation like this, where a grown man is refusing, you can only hang around trying to persuade him for so long - you can't harrass people into going to hospital and my gentle coaxing wasn't working.

Between us, the crew and I persuaded him to go to the ambulance for further checks. His BP was indeed low, which explained his faint but he hadn't recovered fully and that was of concern to all of us. Still he refused to go. I took the details I required and left it to the crew. I sat in the car and completed my paperwork. The attending paramedic came up to the car five minutes later and told me that the patient had finally agreed to go to hospital.

I guess it was difficult for him to make the decision to go because of the circumstances in which he found himself - a public place, people all around and a lot of pride to tackle. Or the fact that my colleague was female. Who knows?

As a 'CS' unit I am on the same radio channel as the HEMS team so I can listen in to the chatter between the helicopter pilot, the medics on board and the Control desk that activates and directs them to their jobs. They seemed to be busy today, unlike some.

My last call was to a very posh apartment (too posh to call a flat) in Mayfair. The lady who lived there had been experiencing a fast heart beat for over five hours. She had a history of PSVT and had gone through these episodes many times but this was lasting longer than normal and had not resolved when she used her usual techniques. It was giving her and her husband cause for concern. It is common for chest pain to be present during these episodes and she reported this to me when I arrived.

I had almost completed my obs. when the crew turned up. I explained the lady's history and gave them her pulse rate reading - 196 bpm. The heart is a strong muscular organ and can work very hard for long periods of time but this patient's heart will eventually tire and things could get complicated. She needed to go to hospital now. The crew wasted no time and she was in the ambulance and on her way in a few minutes.

I wrapped up my day on stand-by then made my way back to base, where I almost copped a call at five minutes to going home time! It was cancelled before I started rolling on it - maybe Control had only just noticed me and I had been invisible on the radar prior to that.

Be safe.

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