You aren’t called a Paramedic crew on the or the radio. Instead you are referred to as a “Hotel” crew. At the beginning of your shift Control want to know what skill level you are – so, I would give them the skill level of “Hotel”. Before hand it would have been skill level “Technician”.
Therefore, when a General Broadcast (GB) comes over the radio requesting specifically for a Hotel crew to attend a job you can almost guarantee its going to be something a little more serious than normal.
I’ve been registered as a paramenace for less than a month now and its safe to say that you tend to be a little nervous of any job that comes up on the . You almost believe everything that comes down is going to be a forty five stone patient lying upside down on a tight spiral staircase in cardiac arrest. So, when my crew mate pressed Green Mobile (ready to take the next job) straight after a GB came up requesting a Hotel crew for a job in the city, you can imagine the whimper of terror that emitted from my lips.
“WHAT THE FUCK DO YOU THINK YOU’RE DOING!!!!”
I didn’t actually say this out loud – I merely projected these thought waves at him. What I actually said was a lot more subdued . . .
“Right, ready to go?”
The job came down as Chest Pain. But if a Cycle Response Unit (CRU) had asked for a Hotel crew you could bet your bottom dollar it was proper chest pain and not the “broken finger nail” chest pain it usually turns out to be.
As we rushed to the job my mind raced with ideas of what illnesses the patient could be suffering from and subsequently what my treatment would be. But the more I tried to think of differential diagnosis’ the more the same ridiculous film scene would pop up in my head – Airplane II The Sequel, when Julie Hagerty informs everyone that “we’re also out of coffee” causing all the passengers to descend into panicking chaos . . . and if that wasn’t enough, my mind would then start playing the theme tune from the Magic Roundabout! Over and over.
I shook my head and whimpered.
My crew mate looked across, “You ok?”
“Yep . . . yes, just um . . . remembering a funny scene from er . . . Platoon” I winced – but luckily we had arrived.
We were quickly led to the patient who was currently writhing on the floor in agony. Oh, thank goodness he was still alive, I thought. The CRU gave me a handover – the patient had suffered central epi-gastric pain for the last few hours which had steadily got worse. The pain was always there but coming in strong waves and was described as gripping and burning. There seemed to be no radiation and no relevant history and he had vomited only once. The patient was in his fifties and looked like an Alien was about to burst from his chest – so I quickly deduced there was no need to ask him for a pain score!
After initial checks we thought we could narrow this down to one of three main complaints; Heart Attack, AAA (Abdominal Aortic Aneurysm) or a perforated stomach ulcer. I’m sure there could have been many other options but we weren’t about to break open the books and start looking. The poor man was in immense pain.
Once we got him onto the ambulance my crew mate and the CRU started doing monitoring and checks whist I gained I/V access. I think my time spent in hospitals butchering poor patients and draining them of their blood must of helped somewhat as I found cannulating the writhing patient strangely quite easy. Under the circumstances, I thought it best to withhold giving myself a secret “high-five” for getting the cannula in first time and instead, started readying Morphine.
Our checks left us with no improvement in terms of a diagnosis – the ECG showed a relatively good heart with no signs of infarctions. Bi-lateral blood pressures were also much the same and there didn’t seem to be any “pulsating masses” over the abdomen. All other observations were relatively ok albeit the patient was tachycardic with a heart rate of about 130. So after a brief discussion we decided to blue the patient into the nearest A&E. En route I would administer morphine and continue monitoring.
Once we’d handed over to the doctor in resuss, the patient motioned that he was going to be sick. I grabbed a sick bowl and thrust it under his face trying to keep good distance. But it was futile – his projectile vomiting matched with equal force and volume that of Mr Creosote from Monty Python’s Meaning of Life. His vast stomach contents splashed so hard off the sick bowl they sprayed the patient and my arm with generous dollops of brown yuk. He’d managed to fill two bowls before collapsing back in pain again.
We left him in the capable hands of the doctors and went back to the truck to “debrief” and complete the paper work. Afterwards I became acutely aware of a rancid smell coming from my shirt and promptly called Control on the radio.
“Hiya Red Base, is it possible you can show us off the road, returning to station for change of uniform?”
“Sure. Start heading back now. Red Base out.”
NB Sadly, we never got to find out exactly what was wrong with our patient. But I understand, after their checks, the Hospital were also going down the route of a perforated ulcer.