Threatening staff

None of us join this job to have the pleasure of being threatened or attacked.  But it does happen.  And too much on a regular basis.  Most of the time you shrug it off and rarely bat an eye lid as a drunken foul mouthed lout tries to land a slow motion swinging ape arm at you – a) because you know he’s most likely going to miss and pass out in a puddle of his own vomit/urine/faeces and b) the police will promptly step in and protect you with as much force as is necessary.

However, sometimes they are not there and we have to deal with the situation as best we can.

The other week a good friend of mine, who works way down in South London, had someone pull a gun on him.  Now, by all accounts this is a very rare thing to have to suffer and not something any of us would wish to happen to them.  But the tiniest portion of sympathy had to go out to this happless individual pointing a gun at my colleague as they couldn’t have picked the worse opponent to do this to . . . for the gun was pulled on an ex-kick boxing champion . . . two times champion . . . of Europe.

So, it should be of no surprise that my friend was able to “disarm” his oponent before the police were able to arrive and section the man.

Don’t get me wrong, it wasn’t an easy position to be in and my friend admits to being terrified in that moment – and who wouldn’t be if presented with the same situation.  I’m pretty sure if someone pointed a gun at me my chronic bowel obstruction would be instantly cured, my prostate would cease its grip on my bladder and my voice would probably rise by four octaves – and that’s all before fainting.

The closest I’ve come to such stouthearted gallantry was when a Mental Health woman pulled a butter knife on me after we woke her from a drunken sleep at a bus stop.  She held it close to her so as not to attract too much attention (in the same way old gangsters used to hold a revolver in black and white films) and her eyes flashed from me to the knife and to me again – so as to ‘remind’ me that it was there!

I remember smiling patronisingly and scratching the back of my head before speaking.

Binder:   What you intend to do with that Sally*?  Spread some butter over me?

My crew mate and the FRU sniggered . . . as did some members of public who were waiting for their bus.

Binder:   For goodness sake Sally, give me that here and come along with us.

Deflated she handed it over and followed us onto the Ambulance.

So here’s to the likes of my friend in South London who succeeded in facing up to his adversary.  But also, here’s to those who havn’t been quite so successful – and sadly there’s plenty out there.  None of us deserve it but it happens every day.

Binder

*Not her real name of course

Two different days – Part 2

This day was, in all aspects of our job, a normal day.

Day 2 – fun filled day of not so proper jobs

Job 1)  Two year old with a high temperature.  No Calpol in the house and the young child was wrapped up for winter.  The family lived 500m away from the hospital and unsurprisingly, Dad chose to follow on in their car.

Job 2)  The job came down as 57 year old with chest pain.  But on arrival we were presented with a ‘drunk’ 57 year old with no chest pain – outside a betting shop . . . 500m from the same hospital in the opposite direction.  He said his walking stick had been stolen and was kicking up a fuss.  We don’t know where the “chest pain” had come from but had a sneaking suspicion that the betting shop used it to get us there quickly!
He demanded to go to hospital to get another stick.

Job 3)  A 40 year old man who had a car knock the back of their legs.  Basically, they were cleaning the rear window of their car when another gentleman went to start his car behind them.  Forgetting it was still in gear the car jolted forward hitting the man’s legs.
There was no loss of consciousness, no bones broken, no cuts and no bruising.  In fact there wasn’t a mark on the man – but he was insisting that we massage his leg better.  After politely refusing we left him in the community with “good advice”.

Job 4)  3 year old slipped whilst dancing in the living room.  They glanced their face on a cabinet on the way down just ever so grazing the skin on their forehead.  The kid had burst into tears immediately.
Checking the patient over we could see that the graze was about a quarter of a centimetre long and hadn’t shed any blood.  After calming both the child and parent we left them at home – with “good advice”.

Job 5)  18 year old having a subtle anxiety attack after smoking cannabis.  Calmed and left with sister –  with “good advice”.

Job 6)  A 33 year teacher with a gradual onset of a headache.  No vomiting, no dizziness, no joint pains, no fever – just a headache . . . and a desire to go to hospital.

Job 7)  35 year old woman unresponsive in the back of a taxi . . . outside her house.  On arrival the woman was indeed unresponsive – or rather drunk and asleep in the back of the taxi . . . outside her house.  So, after a few shakes and shouts the patient awoke, was apologetic and was helped to their front door where and even more apologetic husband was waiting.  Bless.

Job 8 )  30 year old woman unresponsive in street.  Upon arrival the said woman was awake and drunk, also admitting to taking cocaine – however, a long time earlier.  She was within 100 yards of a well known night club and had come out for some fresh air.
After all our checks she agreed she wanted to go home to South London and insisted we take her, saying that we had nothing better to do in our job.  After informing her politely that we were not in fact, a taxi service and would not be escorting her home at the cost of the British tax payer she started to sulk.  I did however, talk with the night club bouncers who arranged a taxi for her and we waved goodbye as she was driven off.

This rounded off our day as a perfectly timed off-job.  Pretty standard day as most would agree.  But as stated in the previous post we had some interesting news delivered to us by a night turn crew.  They stepped up to us when we were dropping off our teacher with the headache.

Crew:     “Was it you guys on that job yesterday with that chap who was refusing to go to hospital?”
Binder:  “The old chap in the nursing home?”
Crew:     “Aye, that’s him.  We went to him in the early hours of this morning”
Binder:  “How was he?”
Crew:     “Dead.  We found him kneeling beside his bed, just starting to stiffen up”
Binder:  “Oh”

There was less than eight hours from when we’d seen him to when this crew had found him and he had already started to go into rigormortis.

The sly old bugger – I thought – he knew!  He bloody knew.

Binder

 

Two different days – Part 1

It has been a while since writing . . . well, in fact a long while.  “Why is this?”  I hear everyone cry.

**listens for crys . . . nothing but gentle winds, a tumble weed drifts past and a distant church bell**

Well anyway, I reckon its writers block – or whatever the hell people call it.  Its not for the lack of interesting things to write about that’s for sure.  I have a long list of anecdotes from colleagues that I desperately want to put up – and I will, honest.  But for now, lets break back into it gently . . .

Shortly after the previous post I had two completely different days from each other.  And its for these reasons I like working for the Ambulance Service so much.  You really don’t know what you’re going to get each job and anything can spring up.  Admittedly, a high percentage of what we go to doesn’t end up being life threatening (and that’s a good thing for the patients) but trying to predict what sort of job you’re going to get next is really a pointless task.

Therefore, I have split the two days into two separate entries.  This one has the fun filled day of proper jobs and the next one has the fun filled day of not so proper jobs.

Day 1 – fun filled day of “proper jobs”

Job 1) Started day with an RTC close to station.  Motorcyclist vs van.  Van pulled across motorbike’s path who “T-boned” it at about 30mph.  Side of van caved in, including the B pillar (supporting strut).  Front of bike destroyed and visor and chin guard ripped off patient’s helmet.
Collared, boarded and conveyed to Royal London.  Got off lightly with a broken arm, dislocated shoulder and a broken zygoma (cheek bone).

Job 2)  A 50 year old woman with very low  of 70.  She was gasping slowly and deeply for air and looked pale and ‘big sick’.
This was a load and go – and think and do en route.

Job 3)  A 70 year old with exacerbation of .  In classic form to this condition the patient was sat in a tripod position fighting to force air in and out of their lungs.
This was another load and go and think and do en route.  But, at least by the time we’d arrived at hospital and after administering all the indicated drugs the patient was able to talk – albeit in short breaths.

Job 4)  Another Mental Capacity case.  This time a 78 year old man in a nursing home who was refusing all food and fluids.  An ambulance had been called out to him the day before for the same thing but he’d refused everything and they’d had to leave him be.  So, here we were presented with the same problem.  The man was thin, pale and looked malnourished but by all accounts had all his faculties about him.  He was polite enough to co-operate with everything we asked of him and we were able to do all our ‘obs’ and paperwork.  But, none the less, he did not want any help and didn’t want hospital.  He’d simply “given up”.  And after all his sentences he’d politely finish with a gentle whispering smile, “I’m ok, it’ll be alright”.
Again, there was nothing we could do for him other than tie things up.  We contacted family and did all the necessary paperwork and bid our goodbyes.  He held our hands and thanked us, smiling, and then just lay there staring at the ceiling.

Job 5 and our Off-Job)  A 56 year old in cardiac arrest -i.e. their heart had stopped beating.  Within a minute of the call there were five of us paramenaces working on the patient.  Whilst CPR was in progress we hooked the patient up to our Lifepak machine to monitor her heart rhythm.  She was in  which meant we couldn’t ‘shock’ her but it did mean we could give her adrenaline.  And within a minute of giving adrenaline the patient had a return of spontaneous circulation (ROSC) – i.e. her heart was beating again . . . we’d got her back!!  I’d never been part of a ressuss that had had this outcome before so understandably I was a little surprised, and sat there staring.  But after a few seconds I snapped back into gear and continued helping to get the patient ready to go to hospital.
As this was our off job, the other crew stepped up and offered to convey the patient for us and do the bulk of the paper work.  We followed them to the hospital and then were able to go home only forty minutes over due.

Days like this don’t happen that often but when they do you can’t help leaving work buzzing.  And needless to say, as soon as I got home I had a nice cup of tea and promptly fell asleep . . . on the toilet – much to the amusement of my wife.

The next day was to be in stark contrast to this one – all apart from one small piece of news we were to receive about our mental capacity patient from this day . . .

Binder

 

Saturation – ie the amount of oxygen saturating in their blood each breath.  A normal level in a normal patient would be between 94-100%.  COPD patients can be expected to be between 88-93%.  If your sats are low, you generally look ill! 
COPD – “Chronic Obstructive Pulmonary Disease”.  A generic term used for a long term illness associated with the lungs – eg, Asthma, Emphysema, Bronchitis etc.  Patients with COPD usually present with difficulty in breathing (DIB) and are a high percentage of our call-outs.  Smoking is a massive influence to this condition – I reckon if we could take the general public round with us sometimes to visit the folk who are COPD due to smoking, it would probably turn things around. 
 PEA – “Pulseless Electrical Activity”.  This is a rhythm seen on the FR2 or Lifepak machine which resembles the heart beating.  And to an on-looker would look like the person is alive.  Sadly they aren’t at that stage as there is no pulse.  The electrical circuits are firing fine, but the heart isn’t beating.