Wednesday 11 June 2008

The nearly-dead addict and the very dead crow

Thirteen calls; one hoax, one assisted-only and the rest by ambulance.


The gel-stealing alcoholics are working hard in my area. The first call of the shift was for a 35 year-old man who’d had the audacity to collapse in a doorway in trendy Piccadilly. Obviously, there was no way he was going to go unnoticed and we received a 999 call from passers-by to remove him as soon as possible. We are London's human rubbish street-clearing service.

He was a street alcoholic, laden with stolen hand-gel. I found two pump-bottles of spirit hand wash in his pockets (they were sticking out and I could see them from the car as I pulled up). He also had a Lucozade bottle containing a prepared mixture of water and gel for drinking.

I woke him from his slumped slumber as the crew pulled up on scene. I had already removed his contraband but he wasn’t happy.

‘Mine!’ he shouted in a heavy Lithuanian accent, as he tried to grab back the bottles.

‘Not yours. NHS property’, I informed him.


My next call to a 35 year-old male having an ‘asthma attack’ wasn’t; he had collapsed in a karaoke club after smoking weed (by his own admission) and while his female friends fawned over him, telling me how ‘amazing’ he was, I managed to glean most of what I needed to confirm that he was over-doing it a bit on the drama front. He settled down when I asked the ladies to leave the room.

Meanwhile, a cacophony of ‘singing’ rang out all around me as people attempted to murder some of the best songs in existence.


It’s unusual for me to be called to street-sleeping females but I found my next patient, a 22 year-old, lying on the pavement with her head on her bag as if it was a pillow. She was a visitor from the Czech Republic and she was adamant that slumbering in public after a few drinks was normal for her – she did this all the time at home apparently. Who was I to argue?

She was taken to hospital anyway – she didn’t have clear answers for anything, including where she came from and where she was going. Still, she was pleasant and smiled occasionally, which is a rare treat for me on a weekend night.


A long 3 mile trip into the East End next. The 23 year-old female had fainted in a Chinese restaurant and her family were concerned about her. By the time I arrived, she had fully recovered and didn’t want, or need, to go to hospital. I cancelled the ambulance and filled in the ‘get out of jail’ form.


A homeless shelter back in my own area and a 34 year-old man was feeling dizzy and had pain in his hands. He had a history of high blood pressure and psychosis and his anxious look and nervy attitude made me wonder which of the two conditions was most prominent.


As I sat in the car doing the paperwork for that call a young man approached the window and leaned in.

‘Excuse me, my woman’s stopped breathing’, he said.

Then he showed me a stuffed crow that he’d been carrying around (it was either stuffed or he’d picked it up from the street). He giggled and walked off as if the joke had actually worked. It would have been funnier if he’d said the right line, ‘excuse me, my bird’s stopped breathing.’ Silly fool.


Underage drinking is becoming much more of an issue today because it’s happening in the public domain. I was called to a 17 year-old who was drunk in the street. She slumped against a wall as her friends shouted and swore around her. They all looked about sixteen to me, no older than that.

Another girl, from the same pack, was sitting on the pavement semi-conscious but I concentrated on the one I’d been called to deal with. I spent the next ten minutes doing obs, keeping her awake and receiving abuse from these mouthy teens. I was no more than a servant and my opinion on their behaviour held no water with them. They must have star parents.

When the crew arrived, she was taken into the ambulance and IV fluids were started. Her less than awake friend was also taken aboard but managed to rise above unconsciousness and stay alert when she saw what was happening to her errant mate. If you get so drunk you can't stay conscious, then you are very likely to get a BIG needle in your arm and a bag of salt water connected to it. Tough love.

Outside the vehicle, her other friends were making demands. They demanded that she be taken to a specific hospital, demanded that they be allowed to go with her and basically demanded whatever they thought they’d get away with – nil respect was shown. None of their demands were met.

Speaking of respect, during the treatment of this young girl, a taxi driver had a go at me for parking ‘inconveniently’, causing a queue in the road. He ordered me to move my car, even though it was clear we were busy with a patient and our lights were flashing (this signifies that we are working on an emergency call and we use it to advise other road users of the hazard and possible obstruction we may cause temporarily).

I moved eventually but not at his request. I wondered if he’d be so quick to verbally attack a police officer in the same situation; probably not.


A 35 year-old Polish woman was found lying semi-conscious in a doorway in Regent Street. She had been drinking but not a lot and she was dressed immaculately, so it was unlikely she’d staggered into that place. All she could remember was going to the cashpoint across the road, after that she woke up where she was. It was all very strange and the police used the CCTV cameras to see if they could detect a crime (perhaps a mugging). Unfortunately, the camera nearest the scene was just too far away to catch much and the street was very busy, so a brazen attack would definitely have been witnessed. We had to conclude that she had just passed out or that she had a medical problem.


Another phantom shooting, this time at a club in Tottenham Court Road. I was cancelled by police when neither the victim (shot in chest) nor the shooter were located.


Staff at a Soho club decided to move an unconscious 22 year-old out into the street after she’d been found in the toilets. She was drunk and vomiting when I arrived and I wasn’t pleased to learn of her recent relocation in such a state. I think they thought it would be helpful if she was in a more open space, I don’t know for sure but I had a chat with them about liability in future.


Every now and then I am called to HQ to treat a member of LAS staff. Ironically, in the Control Centre, or elsewhere in the building, if someone becomes ill an ambulance must still be called. I attended a 24 year-old who had stress-related issues, resulting in chest pain and anxiety. It’s easy for us to forget, out on the road, that our colleagues in EOC can go through a shift filled with abuse, distress and blind panic, without the power to do much about it. I have listened in to 999 calls and some of the callers can make life hard for the innocent call-takers on the other end of the line, so I sympathise.


The police were driving behind me as I pulled into the alleyway that I’d been sent to next. A man had been spotted lying motionless at the end of the dark, quiet street. I went over to him and the cops followed me. It took a shake of his shoulders and a few seconds of looking at him before I realised he was in trouble. His breathing was depressed, he was totally unrousable and he had pinpoint pupils; he had overdosed, probably on heroin.

I grabbed my stuff as the two young officers stood over him and asked what they could do to help. I got him on oxygen and prepared what I’d need to give him narcan. His breathing was so shallow that it had to be supported. He tolerated an airway and was ‘bagged’ as soon as the crew arrived to help me.

Narcan was given IV and his condition suddenly changed after a few minutes. As we lifted him onto the trolley, he sat up, wide awake and quite agitated – the miracle of Naloxone!

I left the crew to it and got on with my shift but I learned later on that he stormed out of hospital without further treatment. This is typical; you save their lives but they hate you for it because they paid for a hit and had it stolen from them. I once met a cop who said ‘why do you bother?’ as I struggled to bring back a drug addict a few years ago in a park full of children. He looked around, looked down at my patient and shrugged his shoulders. We both knew he had a point but we also knew it was pointless.


A daft call for a 49 year-old woman who’d taken an ‘unexpectedly cold shower’ and was now complaining of an ‘aching side’. I’d gone up to her hotel room with a member of the hotel staff but couldn’t get an answer when I knocked repeatedly on the door. I must have disturbed a few of the other guests – it was very early in the morning. Then I was told she was waiting, bags packed, with her friend in the lobby downstairs. She’d seen me go past but hadn’t made any attempt to signal where she was.

When I got to her I found a perfectly lucid, virtually pain-free person sitting on a chair. Some people get anxious to the point of making things an emergency for themselves when the tiniest thing happens to them. I considered how secure this lady’s life must be that a simple cold shock to her muscles would develop into a request for ambulance assistance. Needless to say I left this one with the crew when they arrived.


I had five minutes of my shift to go when I received my last job. I went to see a 35 year-old woman who’d just had a gynae operation and had suffered all night with chest pain, probably as a result of the effects of her anaesthetic. I felt sorry for her because she was genuinely in pain and genuinely afraid. The crew were kind enough to arrive fairly quickly from a distance and they were happy to let me go home once I’d handed over…and so I got home late and very tired and with another shift to follow.

Be safe.

2 comments:

H said...

Stuart,

What happpens with regards to pay if you get a call say, 5 minutes before the end of your shift (as you did), meaning that you have to run over the end of your shift. Do you get paid over-time or something similar?

Xf said...

Henners

Yep...we get paid overtime. I would have signed off-duty late that day and thus would receive overtime for any period worked after my 12 hour shift.

But, I'd rather go home and get a proper sleep that earn an extra few quid (literally, after tax)