Monday, June 26, 2006

Bipolar Disorder

It’s been a pretty slow week at work really. The one job that sticks in my mind was a call to a care home for people suffering from mental illnesses. Lisa (not her real name) is young lady with Bipolar Disorder.

Every morning, the home has a “Morning Session” where residents meet and discuss with the group how they’re feeling and what issues are affecting them both positively and negatively. Lisa had woken up feeling more stressed than usual. She usually finds the Morning Session a positive thing, but today it had not been as structured as it normally is and had descended into chaos.

This had upset Lisa, and she was now having a depressive crisis to the point of feeling suicidal.

We couldn’t really do much for her other than take her to hospital who could arrange for a psychiatric assessment, but what struck me was although she was clearly depressive, she was able to hold a reasonable conversation calmly, and to state her needs clearly. What impressed me most was her recognition that she needed help and had to guts to ask for it.

I hope they are able to stabilise her moods, and that she goes on to lead as normal a life as possible.


After reading some of the comments on this post, I decided to write to Anna Raeburn on LBC radio and asked her if she'd consider doing a programme about Bipolar. She has replied, and the charity MIND have offered her a guest speaker on the subject, but the programme probably won't be broadcast until October. Anna's promised to keep me updated when a firm date is set so I can let you know.

You can listen to LBC in London on 97.3FM, and elsewhere online or on Sky channel 0177.

Friday, June 16, 2006

Night Shift part 2

Two more jobs - a search for a non-existant male passed out near an underground station, and the second to the sickest person of the night.

A 91 year old chap who has been unwell all day yesterday with a headache was sprawled across the bed when I entered his basement bedroom. He didn't give any reaction when I spoke to him, and only moved the right side of his body in response to pain.

Noting this, I pinched the back of his left leg, and there was no response. To be sure, I pinched the back of his right leg and he moved it away.

He was making a snoring sound, so I tried to put an oropharyngeal airway (a small curved tube) into his mouth to help him breathe, but as it goes down the back of the throat, it caused him to gag, so instead I put in a nasal airway, and gave him 100% oxygen.

The crew arrived, and we managed to get him onto the chair so the crew could carry him up the stairs. I followed behind weighed down with all my equipment as well as the crew's oxygen bag.

It's now 3.20am, and hopefully I'll be left alone now, but now I've said that I'll probably get another job soon...

Update: That was the last job, so it's nice to have been left alone for he last three hours of the shift. And to correct myself on the number of calls - it was just over 4,200, not just under.

Night Shift part 1

It's been a busy night so far - I was planning to do a multi-post tonight, but this is the first chance I've had to get near the computer. It's fairly easy to see the effect of the football match on the number of calls. Until the end of the match, the number of calls was ticking along at an average rate.

At the stroke of midnight, our Emergency Operations Centre had taken nearly 4,200 calls - a good 700 more than the average.

My first call was to a stabbing. After donning stab-vest, I made my way to the call, but held off round the corner as it was unclear where the assailant was and the police had nobody to send. I was just about to ask control to ask the police for an ETA when they rang me to tell me the police had updated them that it was a hoax call.

I then went to a bloke who'd fallen off one of those motorised scooters apparently called a "Goped", after losing control on a corner and hitting a parked car. He had a minor knee injury, and as it was what's known as a personal injury RTC, the police attended. Shame the bloke reeked of booze and admitted to having sunk 5 beers. Hope he doesn't have a driving licence - if he did, he doesn't now!

Then it was to a ?stroke. 65 year old man who seemed to fully enjoy the attention he was receiving, and although saying he had lost all movement in his left arm was able to stick his finger out so I could put a probe on his finger and take his blood sugar reading.

Then a woman with "difficulty in breathing". The only difficulty with her breathing was knowing when to stop talking to take a breath in!

And I've just been to a bloke who was assaulted four days ago and now has "pain all over". I'm sure he has, but telling us to "shove your pain-killers up your arse" is not going to help relieve the pain. We eventually got him into the ambulance. It wouldn't surprise me if he self-discharges before being seen.

I'm sure there'll be more - I'll try to update during the night.

Wednesday, June 14, 2006

Surgical Spirit

I’ve often thought that the activation phone on station is linked to the boiler in the kitchen.  I was just pouring a cup of coffee for me and my new crewmate, Graham, when it rang.

“We’ve got someone unconscious on a bus,” said the cheerful dispatcher.
It was just round the corner, and the police were on scene when we arrived.  

“We can’t rouse him – we’ve tried inflicting some pain but we’ve got no response.  We found these next to him,” said one of the officers.

“These” were two 200ml bottles of Surgical Spirit.
We strongly suspected him of having drunk them.  He was definitely unconscious – he scored 3 on the Glasgow Coma Scale (GCS).  None of the usual stimulus techniques worked.  We put in a nasal airway (a tube up his right nostril), started him on 100% oxygen and took a blood glucose level reading, which was normal.  We managed to get the bed onto the bus, as it had a wheelchair ramp on the exit doors.  With the help of the police and the bus driver, we got him onto the bed.

Back on the ambulance, I attached the blood pressure cuff, and took his temperature while Graham got IV access and took bloods ready for the hospital.  His blood pressure was low, so while Graham secured the cannula, I set up a bag of fluid.  The police looked through his belongings and found a card with his name on it.  He was still unconscious, so we put in a “blue call” to let the hospital know we were coming, and telling them that he had a GCS of 3.

The patient started to regain consciousness on the way in to hospital, and by the time we arrived, he was beginning to become slightly agitated.  We took him into the resuscitation room, and after handing over to the doctor and explaining that the patient had a GCS of 3 on scene and had started to regain consciousness on route to hospital, we transferred him to the hospital trolley.  Graham took the trolley out while I knelt down to plug the oxygen mask into the hospital supply (why it’s almost on the floor I have no idea.  It’s the only hospital I’ve noticed this in).  

It must’ve been a case of “Out of sight, out of mind”, but the doctor spoke to the patient and told him to open his eyes, and when he did (because his level of consciousness had started to improve as we’d just told him) he said “GCS of three, yeah right!”

I got up from attaching the oxygen and said to the doctor, “Actually, he did have a GCS of 3 while on scene, but as we’ve just told you, he started to come round on the way in to hospital.  Clearly our treatment was beginning to work!”

It bugs me that some hospital staff clearly think we are telling them rubbish simply because a patient’s condition has improved during transport to hospital.  Surely improving a patient’s condition is our goal isn’t it?

I’m doing overtime on the FRU tonight and tomorrow night.  I hope there’ll be some interesting calls I can write about, although England are playing again tomorrow – there’ll probably be a sudden increase in calls when the match ends….

Monday, June 05, 2006

Back On An Ambulance

So my first week back on an ambulance is over.  The station I now work out of used to be known as the “Olympic flame” because it supposedly never went out, but not anymore.  It has to be said that the vast majority of the jobs were genuine, although I did do three visits to the maternity wing at the local hospital.  One of the reasons for this is if we go to a woman who is more than 20 weeks pregnant, then we take them to their booked maternity unit regardless of what they’ve called us for.

The first one was a blatant maternataxi.  It was the girl’s second baby, she’d had a “show” (which is the plug of bloody mucus that seals the cervix closed during pregnancy coming away) a week before.  Now her waters had broken half an hour ago, but she wasn’t having any contractions. She still had hours if not longer before baby was to be born.  I asked if she had spoken to the hospital – thinking they may have asked her to come in, but no.
The look on her face was brilliant when I told her she’d more than likely be sent home – hopefully with a flea in her ear from the staff for calling an ambulance.

The other two were more genuine.  A lady had fallen downstairs and had pain in her bottom (I resisted the urge to say “Oh, so you’ve got a pain in the bum!”), but although she had no pain in her abdomen and there’d been no bleeding, she hadn’t felt baby move for longer than normal, so she’d rung her GP who’d told her to call an ambulance.

The third was a lady with back pain.  She’d had problems with kidney stones before, and this felt similar.  We did all the usual checks, and I had a listen to her breathing.  The breath sounds on the right were quieter than on the left.  At first, I thought it was just my hearing, so I got my crewmate to have a listen and he agreed.  The levels of oxygen in her blood were good, and she had no chest pain.  

So they were our three visits to maternity.  As well as those, we’ve had an old man having a serious stroke – ended up in ITU, a man who decided it would be fun to drink 2 bottles of surgical spirit and was unconscious, a man who was well liked in his community had been found passed away – he was terminally ill, and a woman who threatened to commit suicide because her bank wouldn’t give her any money.

There were a few others as well, but I can’t remember what they were.  So all in all, a reasonable mix of calls.

I’ve taken leave this week, and I’m going home to Lincolnshire to visit family and friends, so there’ll be a lack of posts this week and I may be a little slow approving any comments, but I’ll try to log in once a day.

Have a good week!