Enough to blow your mind
The first was ‘legitimate’:
Middle aged female with a 24 hour history of intense headache – and not a known headache or migraine sufferer.
Photophobic but with no concomitant rash. She had some neck stiffness but was still able to flex her neck.
No nausea or vomiting but felt extremely cold initially and now feeling hot.
Both her pupils were dilated (not surprising as she was lying in a darkened room) but both reacted to light.
She had been seen by a GP earlier in the day; no diagnosis provided but he left a prescription for amoxycillin.
We got called because she had deteriorated over the last couple of hours. She refused, or was unable, to talk; couldn’t stand up, and hubby and sister were now at their wits end. She did manage to ‘grunt’ a confirmation that the headache had come on suddenly. “She was fine yesterday evening and then, all of a sudden, she said she had a blinding headache”, pitched in her sister, helpfully. Not a lot we could do really, so it was a trip up to A&E; trying to be as gentle as possible.
I checked up on her a few hours later: confirmed sub-arachnoid haemorrhage (apparently).
The second was the sort of waste-of-space job that gives you a headache.
A young man with abdominal pain; lying by the shops about a quarter of a mile from the hospital.
“How long have you had this pain?”
“Since I walked down from Tesco.” He pointed back down the road in the direction of the hospital; in fact you can see that particular Tesco from the hospital.
I couldn’t resist a sarcastic comment. “If you were that close to the hospital, why didn’t you pop across to casualty?”
He looked extremely sheepish, and muttered something incoherent to his feet.
“What do you want to do then?”
“I guess I should go to the hospital.”
The options seemed to consist of shaking him warmly by the throat, telling him to piss off and walk back to the hospital, or take him down the road myself. In the early hours of the morning, with a light drizzle starting, I really couldn’t be arsed with either of the first two so I suggested he “hop in”.
“I better call my Mum and Dad and tell them where I’m going.”
Aarrgghh! What’s the matter with this idiot? He walks away from A&E and now decides he needs to go there but can’t be bothered to walk. Has a workable phone (i.e. actually has some credit on it unlike half the local population) but can’t/won’t phone his parents for a lift or call for a taxi; instead he dials 999 for an emergency response.
It only took a couple of minutes to get back to the hospital. I didn’t do a thing for him – didn’t even do any ‘obs’. Couldn’t be bothered to complete yet another ‘totally pointless‘ patient report form so I just dropped him of at the entrance to A&E and told Control it was a ‘not required‘.
I know I wasn’t as professional as I could have been but everyone ended up a winner and I got to head back to station for a cuppa.
Welcome to 2007. Same sh*t – different year.
Picture by Matt Mills