Saturday Night ‘Piss-Heads’

Just finished another fun Saturday night. It had reached 1 a.m. Been a steady shift so far; usual run of medical stuff and minor trauma. Got a call to run on an unconscious female in one of our more ‘smarter’ towns; though it has more than it’s fair share of pubs and wine bars. Patient had collapsed outside a restaurant in the high street, possibly as a result of alcohol. It’s about a 10 mile run from my base.
“No back-up available at present. All ambulances busy on other calls”
“Great. Here we go. Usual Saturday night ‘piss-heads’ turning out of the pubs.”

The local response car was already tied up on another pub brawl in the town. He phoned me while I was en-route to see if I fancied suturing a face wound. He had a young gentleman who’d had a bottle in the face, now had a small gash to his cheek. I explained that I was already on another call and that our protocol doesn’t allow me to do faces and hands so he’d better ‘send him in’ and let the ‘max-fax’ boys (and girls) do their stuff. It was a shame really ’cause suturing jobs don’t come along that often.
“So that guy had had a fun night out then!”

I got to the high street in question. Usual crowds of late night revelers falling all over the street, some pretending to ‘be ill’ as I passed, others just waving away. Makes it very difficult sometimes to identify the ‘real’ patient. Anyway, no sign of my patient or the restaurant in question. I called up on the ‘bat phone’. Surprisingly someone answered. They would “get back to the caller for a better location”. I headed back up the high street to the accompaniment of jeers from all the revelers I’d passed on the way down. The bat phone rang.
“Caller doesn’t know where he is. Thinks he’s near the bus station.”
“Oh good, that’s only about a quarter of a mile away on the other side of town.”
Off I shoot down the high street again. Now twice is having a laugh but three times is really ‘taking the piss’. The revelers had a field day!

I finally found the crowd I was looking for. As I approached they all got up off the pavement, including the ‘unconscious’ patient who staggered over to the car. I could tell she was the one ‘in trouble’. Possibly it was the vomit matted in her hair and dripping off her face that gave it away; or it could have been the shit smeared all over her skirt and spattered down her legs.
“Lovely. Just the sort of girl you want to take home and meet Mum!”
They all tried climbing into the car.
“Whoa. Hold on here. I’m not taking anyone in the car. What’s the problem?”
“She’s dying man. Can’t you see, she dying!”
“No she’s not, she’s just had a bit too much to drink.”
“No she’s dying, you gotta take us to the hospital now!”
There followed a spate of highly charged questions but I managed to discover that, “no she hadn’t fallen over and hit her head”. “No she hadn’t taken any ‘recreational’ drugs”. “Yes she had had a bit too much to drink and now she’d shit herself so she must be dying”. The girl, herself, was quite ‘with it’. She could string a coherent sentence together. She could walk; a bit wobbly mind, but she could still walk. I explained that she didn’t really require an ambulance and that if they were concerned they could get a taxi.
“I just wanna go home.” the girl said.
“No babe, you need to see a doctor, you’re dying.”
“No I don’t. Just piss off, I wanna go home.”
“Why don’t you just take her home,” I helpfully suggested.
“Fuck you man, you’re fucking useless!!”
Then they all launched into a cavalcade of abuse about the state of the ambulance service and that ‘old chestnut’ of how I have to take them ” ‘coz our taxes pay your wages”.
“Yeah right!”
I was reaching for the bat phone, thinking it might be time to request the help of the ‘old bill’ when, luckily, the girl decided she’d had enough and was going home with or without her ‘mates’. She staggered off up the road and her friends decided to follow her hurling off the occasional passing shot about my birthright and other obscenities.
“Three cheers for alcohol”

Meanwhile, a call had come in for an unconscious male at one of the local pubs nearby. An ambulance was already on its way. When I called up Control gave me the details and off I shot. I’m pleased to say that we all arrived at the same time. The crew weren’t in the happiest of moods though, they’d just done a ‘drowning’.

Seems a middle aged lady had supped a glass of wine too many. Decided to take a bath. Vomited. Choked and aspirated on the vomit and drowned in the bath. Hubby had found her not long after and a couple of ‘first responders’ were carrying out CPR when the crew turned up. They ran it as a working cardiac arrest. They had an output (sort of) at A&E but her pupils were fixed and dilated. Prognosis? Probably brain dead.
Another happy celebration then!

Meanwhile our man was lying on the pavement with a large gentleman of the proverbial ‘brick shit house’ variety kneeling on his arm.
“It’s bad mate. It’s a real bleeder. He’s sliced his arm punching a window.”
“Can we take a look?”
“You sure you want to, it’s a real spurter?”
“Think we better. Just to see what we’re dealing with”.
He removed the bandage he was pressing against the guy’s arm. We only had a short look, that’s all we needed. Enough to see a large hole at the elbow where he’d managed to severe his arm through the joint. Lots of blood, muscle, bone and general mess but it was the fountain of ‘claret’ spurting up that clinched it. We were dealing with something a little nasty here! An arterial bleed!
“Better get him on the back, hang some fluids and go.”
With the aid of all and sundry we unceremoniously dumped him on the trolley. One of my colleagues got ‘a line’ in, the other applied copious large dressings over the wound while I ran up a saline drip. We managed to get about 50 mls in him before he started ‘kicking off’. Arms thrashing everywhere, blood flying, obscenities raining down and then, before we could make the cannula secure, wham, out came the line.
“Shit! Damn! Bugger!”
“We’re never going to get another one in with him like this. Let’s just go!”
The large gentleman stuck his head in the door.
“Thought you guys better know, he’s had a right skin full. Loads of beer, double spirits and he’s snorted about a gram of coke.”
“Brilliant. Wonderful. This just gets better by the minute!”
So, with one colleague trying to staunch the blood flow and me vainly trying to keep one of the patient’s arms still long enough to try and get another line in, we roared off to hospital.

Full trauma team was waiting. All hands to the deck. Lines in. Fluids up. Then off to theatres to see what the surgeons could do to stop the fountain. He’s going to end up with the plastic surgeons eventually – if they can save his arm that is! No pulse at the wrist. No sensation to the hand and fingers. No movement. Sadly it’s his dominant hand too. First task is for the vascular surgeons to stitch up the artery and graft together a couple of veins so they can make a circuit and hopefully restore a blood supply to the arm. Plastics can sort out the nerves. They’ll take months to heal (if they ever do) and he’s a smoker too, so the odds are stacked against him right there. They’ll probably have to complete a skin graft to cover that hulking great hole.

And, to top it all, it’s his birthday today. That’s why he was out celebrating.

“Many happy returns mate!!”

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10 Responses to Saturday Night ‘Piss-Heads’

  1. NIKKI says:

    Hi

    Really enjoying your blog. Im a first responder or community responders as we are called here im just starting to come across ECP’s on some calls

    Theres nothing more irritating than calls to drunks where the mates are there, they are always full of advice about what you should be doing half the time there is nothing you can do they just need to go and sleep it off! Ive had the ” ive seen casualty they dont do it like that” the “hes dying help him ” – the chap was snoring loudly but i was given it as a cardiac arrest in the street! I certainly recognise the sort of situation you talk about – alchohol is a great leveller given enough everyone will behave like a pratt!

    I can see the value of ECPS for some patients and also how it could encourage the bone idle to abuse the system! As a group we’ve had an offer from 2 ECPs to go out second manning with them on thier respective cars they seem to do a bit of everything the ECP visits and response work im sure it would be valuable experience.

    looking forward to reading your next entry.

  2. John B says:

    > alchohol is a great leveller given enough everyone will behave like a pratt!

    I was in for a broken leg four years ago, around the World Cup. On the morning after, two wallpunchers werre brought in to have their hands rebuilt, and that night the ward got a machete attack. Patient, his “mate” and mate’s girlfriend had drunk a bottle of rum, bottle of whisky and a slab of Stella. The girlfriend had got frisky with the patient, whereupon his mate hit him from behind with the machete. Over 700 stitches, arm broken in three places, six missing teeth and the blade was sticking in his head when the ambulance arrived.

    amazingly, he was conscious and chatty in 12 hours: “There’s wuss off than me, but Ah doan’t envy ’em”

  3. Greg says:

    Just saying I love your blog, and have added it to my daily bookmarks. Keep up the good work 🙂

  4. Cos says:

    The “our taxes pay your wages line” makes me so annoyed each time I hear it. I always want to ask people who say it “Do you think I don’t pay taxes, or what ?”. I’d love to see the people who come out with this line put up with what public sector workers deal with.

    I wonder if the friends of the man with the severed artery will change their drinking habits as a result of this. Or will it just be another tale trotted out each time they get hammered. ?

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  6. Sho29 Arch says:

    Sho29 Arch

    I have enjoyed reading your article, thanks.

  7. Very amazing site! I wish I could do something as nice as you did…mary

  8. rachel says:

    iam 1 of lifes piss heads,and i love it wwwwwwwwwwooooooooooooooooooooooooowwwwwwwwwwwwwwwwwwwwwww and at 1 stage a have xshit my pantsx but ya just turn over an 4get bowt it oh yes yes yes yes the more a drink the more i wana drink give me a bottel ov vodka, a crate ov fosters an a cupel ov wkds an iam ya bezze m8

  9. rachel says:

    ssssssssssooooooooooooooo wat u think bowt thTY THEN AN I AV WOKEN UP IN A BBYS COTT DONT THINK IT MINDID THO

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