Saturday 2 June 2007

Shocking

Seven emergency calls. One assist-only, six required an ambulance.

This strange call took a colleague of mine onto the roof of a bus.

The rain is keeping people out of trouble and it's still relatively quiet for me. My ambulance colleagues are as busy as ever, I should point out - they have to deal with non-emergency transfers and assist-only calls on top of their emergency duties and although I am on a go-slow as a result of being on the FRU, I'm glad not to be doing that stuff to be honest.

The day started out with a couple of 'not required' calls: a faint at a hotel followed by another faint in Oxford street that was changed to choking (for some bizarre reason). In the first instance I didn't see the patient because the crew were on scene and dealing. The faint/choking job turned out to be nothing more than a simple collapse in the street. The woman was chatting to the crew when I arrived (as did the motorcycle solo). It was a lot of fuss for nothing really.

A 35 year-old male with chest pain had to wait longer than he should have because the address given was wrong and it sent me and the ambulance down the opposite end of the road in which the actual address existed. After two or three minutes of crawling along on blue lights looking for the building in question we got an update and raced off to the top of the road. Luckily, he wasn't having a cardiac event, he was panicking and hyperventilating. Again, I didn't have to do anything for him - the crew dealt with it and took him off to hospital.

Remember I said that my colleagues on the ambulances had assist-only jobs that I was glad I didn't have to do at the moment? I was asked to assist a gentleman who had become stuck in his bath. I was only around the corner and a crew were on their way and since this type of call is a non-emergency, they could be fifteen or twenty minutes away, so could I please go there and help him? I wondered what I was going to do with the man. I was told he weighed around 23 stone and was stuck fast. He had no injuries apparently, so I assumed my role would be to keep him company until the cavalry arrived.

When I got on scene a woman greeted me and introduced me to her husband in the bath. He was indeed a large man and he was indeed stuck fast. I had a go at de-wedging him but the bath was slippery and my back was beginning to groan at the attempt. I tried turning him and swinging his legs over the edge; the idea was to 'lever' him out but his weight kept him pinned to the wall and I was no match for it. So I gave up, waited for the crew and chatted at length to him.

His wife was in the front room doing the crossword and every now and then she would shout through an offer of a cup of tea. I declined the offer several times as I spoke to the man.

It turns out he was a career soldier - he was in his seventies now but had seen action in various parts of the world, including South Africa. He was a very interesting guy to talk to and although my military experience is minuscule in comparison, he was a fellow RAMC medic, so we had something in common. He had been a Regimental Sergeant Major and had obviously loved what he did. His wife had been with him throughout his army life and now she had to contend with his bath-bound problems. I discovered that he had been rescued before.

By the time the crew arrived I had been chatting with him for half an hour and had declined the offer of many cups of tea. We hatched a plan to lift him by degrees up on to a pile of cushions at his back, then swing him straight out but that failed because we couldn't get him to lift his own weight. So we went back to my plan, which was to swing his legs over the edge and lever him out. It worked this time - there were three of us pulling on him. He came out of the bath, albeit clumsily, popped his large feet onto the floor and waddled into the bedroom where his wife demanded he cover himself up immediately.

I said my goodbyes and left the crew to settle him back into his former enamel-free life. I walked to the car and thought about how interesting it was to have met him - maybe having more time with patients isn't a bad thing for solos. Maybe we should get one job a week like that just to keep ourselves in touch with people.

After a rest and my official break I was sent to a '13 year-old female, fainted'. I arrived at an iconic London tourist attraction to find a young French girl lying on the floor of the gift shop. She was surrounded by teachers and her school group. They had come over for a day visit from France and she had complained of being home-sick, apparently (her teacher told me) she hadn't wanted to come in the first place. She certainly didn't look happy to see me. She wasn't prepared to be friendly at all.

"Comment allez vous?" I asked in my best school French

Nothing.

Oh well I thought as she stared through me, teenagers with angst are the same all over the world. I explained this to the crew when they arrived - colleagues from my home station. They weren't impressed either. She was taken to the ambulance and then to hospital for no reason other than to find somewhere away from her friends where she could moan about her life.

Interestingly, I noticed that teachers from France behave the same as in the UK when faced with a moody, melodramatic child - they roll their eyes to heaven and regret the day they decided to join the profession.

Then on to a diabetic who had collapsed in the street. She had a BM of 2.1 and the crew, who had arrived on scene a minute before me, got to work on correcting the problem. As I assisted them, a man came up to me and complained that the hotel she had been staying in didn't have a first aider to help when she collapsed. I assumed that she had been staying in the hotel he was talking about but what he expected me to do about it, I didn't know. He was right though - it is a legal requirement for places like hotels to have a first aider on duty at all times. Then there's real life.

Finally, a man whose internal defibrillator was going off randomly, giving him shocks. This will happen if the device is faulty or it is actually stopping him from going into cardiac arrest. Either way, it was a unique and thoroughly interesting call for me. When I arrived he was lying on his bed, looking terrified. The first shock had prompted him to call 999 and while he was on the phone he got another one. He told me that it had happened before and that the battery was faulty and had to be replaced. He warned me not to touch him in case I got a shock when it went off again but I had obs to do and I was sure the energy wouldn't be enough to cause me harm. However, I did think about how tricky moving him was going to be when the crew arrived - he was a big man and must have weighed twenty stone or more. There were eight flights of stairs to go down (no lift) and if the device went off as we were lifting him in the chair he would jump and probably unbalance us, resulting in a fall and injuries to himself and (probably) us.

I called Control and asked them to relay the information I had so that the crew had a heads-up. I warned them about the man's weight, the stairs and lack of lift - oh and the unpredictable state of his defibrillator.

When the crew arrived, the paramedic (who had not been told about the man's size) took one look at him and requested another crew. We got one FRU paramedic. Still, with the four of us, we were able to get him down the stairs but it took a lot of careful balancing - we had a huge patient, a dodgy electrical device and two hands each on one of four corners of a little chair. We squeezed and angled our way down the world's narrowest stairwell. Luckily, during our descent, his maniac defibrillator behaved itself.

The man's ECG was all over the place and we weren't sure if we were looking at bogus electrical activity from the defib/pacemaker or he was having a cardiac event. He didn't have any chest pain and he had no other adverse signs or symptoms - except fear of the next shock.

He was taken to the specialist heart hospital just in case. The crew felt it was better safe than sorry, which is fair enough. I went ahead of them to give them a smooth journey and he was admitted - the consultant wasn't sure either apparently.

Be safe.

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