Tensions Rising

Sometimes prejudice comes into play when attending a call, not intentionally perhaps, but through ignorance or previous experience. Sometimes though, prejudices can be shattered.

I attended a call last night to a young girl supposedly fitting. It was to an area in my 'patch' that I've often been through but never been to. It all seemed rather odd as I approached. It was a dark, overcast night, clouds scudding across the sky and threatening rain at any moment. The road was partially rural but in an urban area; initially industrialised but then giving way to small, cold looking houses set back from the road, each barricaded behind imposing brick walls. There was no street lighting, no pavement and just rough verges. The address was given as a 'yard' and I had no idea what this was supposed to mean. About a quarter of a mile in, a man stood motionless by some high metal gates just starring at me. "Is it? Isn't it?" went through my mind "Why don't people make it a bit more obvious that they're waiting for an ambulance".
I let down the window, "Are you waiting for an ambulance sir?"
"Yeah, down that drive mate", he whispered. It seemed strange that he appeared so detached. It was all very spooky and in such an odd area too.
I punched 'quick dial' on the bat phone. "Not really comfortable with the location", I said, "is the ambulance far behind?"
"They're about a minute away. Don't go in if you're not happy".
Sensible advice, but now that I'd made contact with the caller or one of their family/friends it's extremely difficult to explain why you're not getting out of the vehicle, particularly as the situation wasn't hostile, just odd, and my gut was a little uneasy.

As it turned out this was a 'permanent' traveler site (bit of a contradiction in terms really). I delayed as best I could, driving slowly down the drive and stalling as I punched 'at scene' and gathered various bits and bobs. I was also conscious that there was a young girl fitting close by and, depending on the medical history, this could be potentially serious. My other concern was the new 'rules' concerning our drug storage. For epileptic fits we carry rectal diazepam (ooh nice!) and i.v. diazemuls. For years we've been happily carrying these around in the 'drug bag', but now, under new guidelines, they have to be stored away in the locked safe where we keep our morphine (a class A drug). I was very conscious of how vulnerable I was leaning into the back of the vehicle, parked down a dark drive in an isolated area, while I 'faffed' about trying to get the safe open.

With the drugs stuffed in my pocket and carrying the usual 3 tons of kit, I was escorted through a rabbit warren of paths into the house. Inside was warm and cozy and with a large number of people. On the floor, lying in the corner, was a 15 year old girl. Her fit seemed to have ended and I assumed that she was in a postictal state. I knelt down beside her and, while I readied some oxygen, I attempted to obtain some history from her father. He seemed a charming, caring dad; the sort that seems so vulnerable because they find themselves in a situation where they're unable to help those that depend upon them most. Mum seemed somewhat detached but I put this down to her being upset. During our conversation the ambulance crew turned up and almost immediately the girl started shaking again. Now some crews seem to me to be far more aggressive than others. While I still engaged dad, trying to get a better picture of the circumstances, the crew were straight in with a cannula and diazemuls. Out the corner of my eye I noticed another lady seemingly getting very agitated about this turn of events.

The history we obtained suggested that perhaps this was, in fact, a pseudo-fit; a cry for help or attention. The crew certainly,seemed to decide that the girl was now 'playing up' "Come on, open your eyes!". "Don't mess us about!". I could feel the tension in the house rising. Ms Agitation was edging forward. "Oi! Don't talk to her like that! Show a bit of respect!" We agreed that a short trip 'down the road' was probably in order so one colleague disappeared off for the carry chair. Meanwhile the family started quizzing me about fits, and "what could they do" "was there any way to get a scan?" "how did the drug we just gave work?" and other concerns that rose to mind. I found them very attentive to my replies, they excepted what limited information I could provide and seemed genuinely interested and concerned. They were, above all, still very courteous as I explained what we proposed to do.

With the carry chair putting in an appearance the girl was lifted aboard but then started shaking again."Stay still. Stop fidgeting" one colleague commanded, in a tone that made we wince, just a touch. Sure enough Ms Agitation 'kicked-off' again. Tensions were once again on the rise and I was beginning to fear the worst. While the crew got the girl away, I cleared up my kit and tried to delay the family by engaging them in more discussion. I'm pleased to say it worked. The girl was safely onboard and I was able to obtain a bit more information about her from Mr Whisper who'd met me at the entrance. He was her uncle as it happens. Seems she's been having a difficult time of it lately so perhaps a pseudo-fit was the correct diagnosis. It was his birthday yesterday, that's why there were so many family members about and it appears that Ms Agitation had perhaps had more than enough to drink; plus, like the rest of them, she was very concerned.

As I stowed my kit away, they all came out and thanked me for what we'd been able to do. My heart really went out to them. I've been involved with travelers before, usually for stabbings and other assaults and never found them particularly amenable. This family were certainly the polar opposite. I like to think that I 'treat as I find' and I hope in future I won't let prejudices dictate how I deal with a situation. I also don't want to be too naive either. It's a fine balance.

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8 Responses to Tensions Rising

  1. Merys Jones says:

    Out of curiosity, was the girl given the diazemul, and what effect does this have on someone who hasn’t actually had a fit – I presume just drowsiness??

  2. magwitch says:

    Yes, the girl was given 2 doses of 10mg of diazemuls i.v. by the ambulance crew. It always gets very difficult when there are 2 (or more) paramedics on the same job as to who is in charge. Personally, I wasn’t going to give her anything as I was sure she was post fit when I first got there. Even though she started ‘shaking’ again I’m not that agressive in my treatment and I’d have waited a minute or two just to see how things progressed. Whether she was pseudo-fitting or not she was certainly awake by the time she was on the back of the ambulance.

    I had a short, quiet chat with her there while the crew busied themselves with blood pressure, blood sugar and all that stuff, and before we let her father on. She admitted that she’d felt very panicy before the attack as she’d had a ‘bit of a row’ with her Mum; something her mother had denied earlier, so it’s possible/probable this was just a cry for help. After an earlier attendence at A&E for a similar episode, she had been discharged with a diagnosis of ‘panic attacks’. Draw your own conclusions 🙂

    The major side-effect of diazemuls is respiratory depression (i.e. the patient may stop breathing). I’ve only ever had this happen once (very unnerving to say the least). You’re quite correct though, the usual effect is to make the patient drowsy. Although we carry diazepam/diazemuls for epileptic fits it’s primarily found in the community for anxiety attacks. Consequently overdoses involving diazepam are not that uncommon with the only real effect being that the patient is very sleepy.

    P.S. thanks for adding a link to this blog from yours

  3. Merys Jones says:

    You’re welcome. The link serves a couple of purposes actually – I can’t use these subscription malarkey thingabijigs, so the links remind me of the stuff I like too!

  4. Craig D says:

    Did you manage to have a chat to the crew about having a caring bedside manner?

    Or even just “how to read a scene” so they don’t end up assaulted by a patient/family?

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    are you sure about that?

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