Tuesday 22 May 2007

Fun with drunks

Eight emergency calls, one non-convey. Seven required an ambulance.

First call of the night was to a RTC on a busy one-way street. When I arrived the casualty was sitting against a post with bystanders helping him out. He had a head injury which had bled quite a bit but was now under control. The witnesses (and there were a lot of them) had seen him attempt to cross the road, step into the path of a car and get hit, throwing him into the air. He landed, head first, on the road. Then he got up and staggered over to the pavement, where his helping hands gathered around him.

This little collision was his own fault - he had walked in front of the car and it should have been as clear cut as that but, of course, it wasn't. The driver and passenger of the vehicle carried on, went round a corner, parked up and legged it. Why on Earth would they do that? It was now a hit and run and they both faced criminal charges as a result.

The ambulance arrived and took care of the patient, who was suffering concussion and not much else and I went to look at the car so that I could get an idea of the force of the collision. I walked to the street where it was parked and a number of witnesses, including taxi drivers who had tried to stop the pair running away, were milling around. The car involved was one of those smart car things - you know, park anywhere; put it in your pocket when you're done.

There was slight damage to the front of the vehicle but nothing significant, which is always good from the patient's point of view.

I wondered why the driver and passenger had run. Was the car stolen? Would anybody steal a smart car? No offence if you own one. Did they have drugs on them? Had they been drinking? Now they are in serious trouble. Before they ran, they had nothing to fear.

My next emergency call was for a 49 year-old male who was 'not alert'. I located him in a couple of minutes because he was in the next street. He had a couple of concerned looking people with him. I walked up to him and decided he had been asleep.

"Do you need an ambulance?", I asked

"No. I'm just really tired", he replied

Meanwhile, 999-caller man is looking rather sheepish and apologising.

The man was basically on the street, had been up all day and evening selling The Big Issue and was waiting for his usual pitch to clear so that he could get a sleep. Unfortunately, his usual pitch was the doorway of a busy theatre, so he had to wait until they had shut, probably another three hours off. All he wanted to do in the meantime was sleep on the pavement. However, the good people of London town will simply not permit this and will, in good conscience, call us out every two minutes until we realise that they just can't deal with the sight of sleeping people in public places. The term 'not alert' usually means they have called out softly to the sleeping/drunk person from the other side of the street and (strangely enough) he or she has not responded.

"Can't you get in to the hostel at St. Martin's?" I ask

"Have you ever been in there?", he says with a glare

"Yes I have. Enough said. Have a good rest", I concede

I had intended to visit this man later in the shift and check on him but I never got a chance.

During my stand-by on Leicester Square I noticed two rather large women walking behind their pedi-cab (a taxi bicycle), from one end of the Square to the other, just to climb back on at the other end. These vehicles are not allowed to cycle across you see, so fare-paying passengers have to get out, walk alongside their taxi and then get back in. They probably had only a few hundred yards left of their journey to go. They could've walked the lot and had a few quid left for more alcohol. You see, I'm always thinking of others.

My next call shook me out of that daze and I went to the aid of an abusive, vomiting drunk who, as luck would have it, was already in the back of the ambulance when I arrived. I copped out by asking the crew if they needed me and go the much expected reply, "no". So I left with my uniform still clean. However, I wasn't to be let off that easily and my next call, immediately after this one, was for a 'male, lying in street, unresponsive'. Here we go, I thought.

I hunted for this man for a few minutes. I did an area search. I called it in and thought about a 'no trace'. The ambulance arrived and the crew couldn't find him either. Then I spotted him on the other side of the road. There were a number of people in their cars pointing him out to us. We looked sharp and on-the-ball at that instant, I can tell you.

I went over to him and gave him the customary shake and shout. He responded but wasn't pleased. He was drunk and, surprise, surprise - Scottish. The crew joined me and we stood him up but I could tell he wasn't going to stay that way (up that is). We asked him to move on because he was just drunk but he refused. My colleague very kindly offered him the opportunity of going to hospital to 'sleep it off' but he became abusive and swore at her. So that was the end of the NHS-nice act, I can tell you.

He stood (wobbled) his ground and said the strangest thing.

"I need to go to hospital"

"Why?", we asked

"I'm Scottish", he said

He went on to shout that we didn't understand Scottish people and that he was a true Scot. I pointed out that I was standing right next to him, was Scottish and that he did not represent me or my nation. So he went in a huff (as we say).

We started him on his way and he took three steps before wobbling and falling on his face against a corrugated iron shutter. He slid down this in a most undignified manner and lay there feeling sorry for himself and rubbing his sore head. I had a pang of sympathy. I really did.

My colleague had called the police for him and they arrived to send him on his way. The ambulance left and I drove a few metres down the road to complete my paperwork. I should have driven further. One of the police officers came up to my window and asked if we could take him. He was drunk and incapable (we knew that) but the police don't deal with that any more. I had to call the ambulance back and elicit a promise from Mr True Scot that he would behave and apologise to my colleague for the abuse he had given her.

The ambulance returned, he apologised and he behaved. Off he went to bed.

After a rest and a coffee I was off to a job in the City, where an 18 year-old was so 'ethanoic' he couldn't move. He was on the deck (literally) of a boat Quay, where he had fallen down stone drunk. He was a guest at a party for a girls' school and there were a number of 'supervising' teachers there too. The teachers were all sober. The pupils were mostly drunk. One of the girls had bumped her head and was bleeding and crying when I got there. I dealt only with the drunk lad though - she was fine.

The ambulance crew arrived to help me get him off the Quay. It was a tricky, bumpy ride in the chair for and became more alert as the short journey progressed. He was wide awake by the time I left the scene.

A call to a male who was lying in the street turned out to be a bit of a mystery. The caller had stated he may have a neck injury. I arrived at the same time as the ambulance, crewed by two officers, so they started the assessment of this patient. He was lying flat on the pavement, complaining of neck pain. There was a bit of blood around him and I looked to see where it had come from. There were deep scratches down his left arm - they looked like fingernail scratches in fact. The blood had come from them and because there was no blood anywhere else around him, it was clear he had sustained this injury on the spot.

The crew collared him and put him on a 'scoop'. Personally, I didn't think he needed it. He had good movement, sensation and his story made no sense. He claimed that he had just been walking down the street and then woke up like this. There were lots of people around and none of them knew what he was talking about. The crew were being cautious.

When we got him into the back of the ambulance I asked him if he was a self-harmer. He was vague with his answer, stating that he "used to be". This gave me a profile already and I have to say I didn't believe anything he was telling me. I asked him if he had been fighting with a woman tonight. He took offence but his scratches had been caused by strong nails and not many men have nails long enough or strong enough to cause an injury like the one he had.

The police were now on scene and the whole thing was going nowhere. His story was inconsistent and he was absolutely miles away from home. I think he has been in a lot of ambulances.

Later on, I was called to a 62 year-old male with chest pain and DIB. When I arrived the crew were behind me and so we all went in together. The man was standing at the door waiting for us and he did indeed have DIB. His sats were very low and he had a cardiac history. He was quickly nebulised (this cleared the wheeze) and blued in to hospital.

My last job of the night shift was for an 18 year-old female who was 'not responding'. The call came in at about 5.30am and originated from an estate in south London. When I arrived in the area, I noticed a police car passing by - the officers were looking at me and they seemed puzzled. I got on scene and the police car drove up and parked next to me. The officer asked me if I had been cancelled for this call (they had been dispatched to the same address) and I told them I hadn't. I thought it was strange that they had been called at all and I asked them to stick around. I had a feeling about this one.

Together we went up to the flat and were met by an agitated elderly man who spoke no English. He led us to a bedroom where a young girl was lying - looking dead. Her mother was shaking her and crying. The girl was completely lifeless. The flat seemed full of people; the brother was there (he spoke English) and the father and an Aunt were all in the front room. The brother had come in and told us that she was sleeping and she suddenly coughed then became unconscious. He tried to wake her but she did not respond. The brother, I should point out, sleeps in the same room.

I asked the mother to let me near the girl and she relented. I tried for a response and got nothing, she was floppy, her mouth was open and she looked gone. Then I manually opened her airway and she moved her head because it was uncomfortable. She was faking.

I told everyone to clear the room and I was left with the police officers. I told the girl that her family were no longer in the room and she opened her eyes but she still refused to speak. She closed her eyes again and ignored me. She had wet the bed and I asked the family about this. Her mother said she did it all the time and that it was normal. Then her brother said that she had never done this. It was all becoming a bit strange.

I started checking the girl's vital signs and blood sugar level. Everything was normal. I asked her again what had happened and she refused to speak. She opened her eyes properly now and I convinced her that I was there to help. I looked at her and I felt something was very wrong. I asked her some pertinent questions.

"Do you need an ambulance?"

She shook her head.

"Do you need the police?"

She shook her head.

"Do you want us to leave?"

She shook her head vigorously.

That was it. I asked the police officers to stay with her and chat while I left the room. Something was wrong here.

The crew arrived and I explained the situation to them. Then, after five minutes, one of the police officers came out of the room and stated that she had told them she had eaten grass earlier that day and he asked me if that was likely to cause this problem. I looked at him and wondered what was going on. I told him that I found the idea ridiculous (as did he) but that, yes, if the grass had been treated with something, like weedkiller, she could have respiratory problems but it didn't make sense in this case. She hadn't vomited and she had no other physical problems.

I went back into the room with the crew and I examined her mouth. Her tongue was red and damaged. It looked to me as if she had bitten it or something had caused trauma to it. For the record, I had my suspicions but they can't be printed here.

The girl was eventually taken to hospital with the crew and a police officer. More police were asked to attend and they stayed with the family. Interestingly, the girl refused to have anyone in her family accompany her and later denied the whole 'grass eating' story.

Be safe.

8 comments:

Anonymous said...

Why are your archive months in Italian?

Anonymous said...

Not difficult to venture a guess into what happened to the poor girl. Hope she gets the help she needs and the family gets looked into too.

Anonymous said...

Hello,

I'm interested from a psychology point of view (with a social psychology exam coming up next week). Why did the fact that the guy said he used to self-harm ring alarm bells for you and make you doubt his word?

Part of the exam is on reading body language and facial expression combined with a tone of voice and we've been taught the theory but not really the practice.

Thanks :)
Rosie

Xf said...

carmelo

They aren't. At least not at my end. Anyone else having this problem?

Maybe your Italian blood is playing games with your eyes?

:-)

Xf said...

rosie

A self-harmer is looking for help/attention. An additional diagnosis is Munchausen's. He seemed to know the game and he was vague and defensive. This made me suspicious of him. His story was full of holes. He hadn't been mugged - nothing had been taken and he hadn't been seen fighting with anyone (although that is always a possibility).

I believe he harmed himself (I checked his nails - long and tough) and feigned his collapse.

The injury was on his left arm. He was right-handed and could have scratched his left arm easily. If someone else, who was right-handed, had assaulted him, they would most likely have scratched his right arm, not his left. Conjecture, I know but its how I reasoned it out at the time.

His neck injury was, in fact, an old one - he said he did it whilst skiing and I have to tell you I didn't believe that either. I don't think he has ever been near a piste in his life. All of this, as ever, is my own opinion.

Anonymous said...

Ok then, that was weird. Must be then. Apologies :-(

Anonymous said...

I'm confused! What happened to the grass-eating girl??? I'm a bit slow!

Xf said...

anonymous

a bit slow and very late with comments :-)

I don't know is the answer. I left the scene and she was taken to hospital. I never followed it up - no medical need to.