Double Trouble

The sixty-eight bus effect kicked in again today (cue X-Files theme) – spooky!

Did two jobs back-to-back which were almost identical and also quite unusual, at least from an ambulance point of view.

Two young ladies, one in her late teens and the other about ten years older had both been admitted to the medical assessment unit at the local hospital during the week suffering from symptoms which suggested possible meningitis; headache, neck stiffness, photophobia (sensitivity to bright lights), nausea, vomiting, and generally feeling unwell. One of them even had a rash, though it was non-blanching (didn’t pass the ‘glass test’). Down at good old MAU they’d been subjected to the usually battery of tests; bloods and stuff, and they both had a lumber puncture (Ooouch!! That hurts!). The results had been negative. Meningitis ruled out “probably just a viral infection”. Subsequently they’d been discharged home with some painkillers and told to “take it easy”.

Now the timings were different, they weren’t seen on the same day and they’d been home for different lengths of time but today, well today, things were just plain bad. Neck and shoulder pain had come on with a vengeance and every time they sat up or stood, they got shooting pains up into their heads which they both said felt “as if it’s going to explode.” One even had pains going down her back and into her legs. Their worlds were whirling around and they felt giddy and nauseous. Not much I or my colleagues could do really so back into MAU they went. Not a hint of dissent from MAU. The doctor I spoke to had seen one patient during her earlier attendance so already knew her history. The mother of the younger one arranged for her re-admittance so saved me a phone call and showed great initiative (for a relative!).

Be interesting to know what it’s all about. Is this some viral meningitis doing the rounds or something that’s occurred as a result of the lumber puncture? Or could it be (and this is sinister) a case of the lumber puncture results being wrong. If there are any medics out there reading this then I’d be interested in your views.

__________

The rest of the day was pretty boring (again). Spent nearly three hours of it on 'dynamic cover'. Now there is nothing 'dynamic' about being on cover. It means being holed up in the car, by some roundabout, waiting for something to happen. Only response cars have to do it. Ambulances get to stay on station. I thought we'd dispensed with all this some years ago when our new 'chief' arrived, but it's back again – "need to meet our response times." It really cheeses me off. It's not just boring, it's soul destroying. Guess that's why they pay us more money. Bit like the NHS ReDirect nurses – it's to compensate for the boredom.

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30 Responses to Double Trouble

  1. olivia says:

    This sounds exactly the same as the illness my nine-year-old daughter had last week. Ambulance up to the local hospital, tests (but not lumbar puncture), cleared for meningitis and then a few days later the symptoms returned with a vengeance. Not re-admitted, and symptoms cleared spontaneously after a further 48 hours. But very frightening for her and for me! It does sound as if there is a particularly nasty virus going around – it would be interesting to see whether your two patients had had their Hib B and Men C jags??? Could it be a mutated virus??

  2. Merys Jones says:

    I guess the boredom is why whenever I go observing the RRU guys are more than happy for me to go out with them – I guess it’s someone to talk to!

  3. EnZedGasMan says:

    At least some of the symptoms fit with Post-dural puncture headache – worse when you stand up certainly would suggest it. Most physician still use old fashion quinke point spinal needles which will almost certainly generate a headache especially in young patients.

  4. medic5 says:

    Could by post-dural puncture headache (PDPH) which can occur after spinal taps – usually treated conservatively (bed rest, hydration, acetominophen). If it doesn’t clear after conservative treatment, a blood patch may be done, where a small amount of blood is injected epidurally. I was told that my PDPH occurred because of continuing leakage of CSF after a tap.

  5. Jac says:

    Agree with Medic5 – when my ex-hubby had a lumbar puncture he had to lie face down for 24 hours to prevent similar symptoms (admittedly this was 10 years ago & things may have progressed).
    However in Feb my 8 month old son had a similar ‘viral??’ illness, non blanching rash etc. First Doc on Paed Resus thought meningitis, 2nd said not. Son went to GCS 10 in a couple of hours before I took him in at 23.30, had a rash covering even soles of feet by 02.00, was discharged at 04.30 and woke up next morning fit & well and went to nursery as I had to work!! 2nd Doc said it was the result of a heavy cold???!! No further incidents – thank heavens! Any ideas??

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  7. […] I’ve posted before about the six-eight bus effect – you know, where you don’t see one for ages and then two (or more) come along together. Last night the effect kicked in again. […]

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