A Mixed Bag

Another shift on the response car

Today was the first in a run of 12 hour shifts back on the response/ECP car; and a right mixed bag it was too.

First job of the day was to a young girl who’d fainted whilst drying her hair. Was it the heat from the hair dryer? We’ll probably never know. The good news was that by the time I pitched up she was as ‘right as rain’. Mum was all in a ‘2 & 8’ mind but settled down once she realised that all would be well. I did all the usual checks, ably assisted by ‘Teddy’ who was perched on the arm of the chair. There was nothing out of the ordinary. No reason at all why she shouldn’t head off to school; in fact she was rearing to go! Mum was going to let the school office know – just in case.

Next up was a visit to Stan who’d taken a little tumble getting out of bed. A crew was there just ahead of me and they’d got Stan up and back sitting on the bed. It was all a bit of an anti-climax. Non-injury. Just the usual paperwork and a bit of re-assurance, mostly for his wife who was finding him a bit of a handfull. Not surprising really as he was nearly twice her height (at least it seemed that way) and he suffered from Alzheimer’s and pernicious anaemia. I agreed to stay and do the necessary checks and fill out the paperwork. After the crew had disappeared I helped Stan downstairs to the lounge and we got going on with the observations. Whilst I was writing things up a friend of the family, who was also Stan’s carer, turned up. As so often with these cases things were not as clear cut as first appeared. Stan had become a lot more confused lately – thinking UTI. He was now doubly incontinent, had increased urinary frequency, had lost a substantial amount of weight over the last 3 weeks and was on all sorts of dietary supplements because his stomach couldn’t cope with ‘normal’ food.

I dipped his urine – traces of blood plus nitrites and leukocytes. I had a quick glance at my GP Handbook just to check up on pernicious anaemia. Interestingly it says “Long term, patients have an increased risk of stomach cancer”. Now I’m no doctor but I just wondered; recent weight loss plus ‘delicate’ stomach? Was it possible? Using the UTI and trace of haematuria as an excuse, plus Stan’s increasing acopia, I gave the med reg a call. Yep, he was happy to see Stan at the medical assessment unit. If nothing else it might give his wife a break.

Call three was to a lady I’d seen the previous week and sent in to A&E. A known DVT patient, her leg was now swollen and red and she was unable to walk or straighten her leg. She’d already spoken to her GP who suggested a return to casualty was probably in order, hence the 999 call. As luck would have it, the DVT nurse, who she’d been referred to last week, had already arranged for a scan in the afternoon. Nothing for me to do here really except get the paperwork started. The crew were close behind and off she went to hospital.

The next patient was a little trickier. He’s a regular caller; at least 3-4 times a week. He’s a known schizophrenic but a highly manipulative and ‘dangerous’ individual. He’s been known to lay little ‘booby-traps’ for us and the police; razor blades in his pockets, broken glass hidden under bed clothes when we try and do assessments. His favourite scheme at the moment is to claim an overdose. This case was no different: an alleged overdose on paracetamol 3 hours earlier but, as with all our previous visits, he could produce no evidence. No boxes, no blister packs no evidence at all of any drugs in the house. He was asymptomatic and could give no valid reason as to why he calls 999 – just says he “sees peoples eyes falling out.” Would he like to go to A&E?” “No thanks.” We all believe he just gets very lonely: no job, never goes out, only sees his mother once a week and now excluded from the local mental health unit; in other words totally isolated. Again not too much to do. A bit of reassurance and leave the paperwork. No doubt we’ll be back again before the end of the week.

The afternoon saw things liven up a bit. A long run for an RTA on the local motorway. By ‘long’ I mean that the crash is just before the local exit so to get to it means heading up the motorway to the next junction and coming back down again. Unfortunately (or fortunately for the patient) it was a non-injury and I got cancelled by the police before I’d even headed on to the slip road.

It was then all charge round to a chap who’d “amputated his arm with a circular saw”. With the inevitable blood lust at the thought of a bit of trauma I raced the crew round to the address. Sadly (for us at least) it was a case of overkill on the part of Control. The chap had only ‘nicked’ his arm with the saw. He had a nice 4 inch laceration across his forearm but it had barely gone through the fatty tissue; it had missed muscle and major vessels. Just the sort of thing for an ECP to suture. Great! Except there was no suture kit on this car (boy, it gets frustrating sometimes). So it was a quick bandage around the wound and the crew took him off down to A&E for someone else to get all the fun.

After a brief lull another RTA came up. Off I charged again. This one was more traumatic. A young chap had left the road at about 60 mph, flown over a small bank, flipped the car end to end then rolled it sideways a couple of times. The roof on the driver’s side was flattened level to the steering wheel. Amazingly the driver got out without major mishap. He had some lacerations to his head and was certainly suffering concussion but how he managed not to get crushed or sustain any major head or neck trauma is beyond me. Nevertheless, a roll over is a roll over, and with a speed of 60 mph plus, we weren’t taking chances; collar and longboard were the order of the day and another patient trundled over the hill for A&E. The hospital confirmed later that there were no other injuries. That was certainly a lucky young man.

That was it for the day. I stayed on station for the last hour until my colleague came on duty.

I wonder what tomorrow will hold.