Another Regular

I've mentioned regular callers on here before....but we've started going to one of them more and more recently.

Joe is a lovely old man, but he is becoming a bit of a pain in the proverbial, because he has now had an ambulance every night this week while I have been at work. His list of previous attendances at the hospital shows he has been there every night for the last month.

I've been to him twice this week - two nights running. He always calls for chest pain, but the reality is that he's quite lonely, and just isn't looking after himself properly, wearing the same clothes every day. He doesn't have a carer to help him - he refuses to accept that he needs some help. Instead, he calls us every night to go to hospital, saying he has chest pain. It should annoy both us and the hospital, but for some reason, many staff feel sorry for him.

When we go, we always do the usual things for chest pain patients - but we're more reluctant to "blue" him in, because as soon as we get him to hospital, he gets up and walks around the department, chatting to staff, and getting himself a cup of tea from the machine. He also seems to "forget" his chest pain when he thinks nobody is watching him, only clutching his chest and groaning when he spots us looking.

This shows us that he wants the company more than him having chest pain. So after we've done the 12-lead ECG which invariably shows us he isn't having a heart attack, we trundle in to hospital, where all the staff greet him with "Hello Joe, back again eh?"

Unfortunately, we're at the stage where we're having to start doing something about the number of calls he is making. I discovered the other night when we took him in that this was is fourth visit of the day to A&E. It seems he is being assessed, then after a few hours observation (because he has called for chest pain) he's discharged. The once home, he simply calls another ambulance.

Because of his apparent self-neglect and the continuing calls for the ambulance, I filled out one of our Vulnerable Adult forms for him the other night. This should highlight him to social services who should go and assess Joe and see what help they can give. It should also cause our Patient Advice and liaison service (PALS) to monitor the number of calls we get from him. Doing something about it will be somewhat problematic because he always calls for chest pain, generating a category A response.

Until an alternative form of care can be implemented for Joe, we'll just have to keep going to him, doing the ECG, and taking him to hospital.

Firsts

We've spent the last couple of weeks going to "silly" calls - including a job to a 17 year old girl actually given as "Bleeding PV, on period."

But my crewmate (who's asked me to call him Barry on my blog) was on his block leave at the beginning of the month. We've found whenever one of us is off, the other gets interesting jobs.

While Barry was on his hols, I went to a woman about to give birth to twins. My crewmate for the day and I decided we just had enough time to "blue" her through the traffic and get her into hospital before she gave birth. Normally, I moan as loudly as anyone about doing "Maternataxis" but in this case it was justified....the woman and her husband had been trying to get to hospital in the car, and had got stuck in gridlocked traffic. We had some difficulty getting to her because of it all, but we managed to get her in with a little time to spare.

The next job the same day was a young woman in her twenties who'd died sitting on her sofa. She'd been found by her brother who'd broken in when he got no reply at the door. There was no sign of self harm, and the brother told us that she suffered from asthma. We can only guess that she had an asthma attack and died.

Then later, again the same day, we went to a call given as a "Collapse Behind Locked Doors."
These usually turn out to be people who've gone out and not told anyone, so we get called by concerned family or neighbours who can't get a reply and think something must be wrong. I've lost count of the number of times we've done one of these calls and had the police break the door down only to find the occupier has gone shopping, or popped out for a pint of milk.
This one seemed genuine though. We'd been called by the district nurse, who'd called to check on the patient as he had just recently had an operation on his heart, and wanted to see if he needed anything to help him. We knocked very loudly, in case he was deaf and simply hadn't heard the door, then we pushed the letterbox open and looked through to see if we could see anything. All we could see were stairs leading up to a first floor flat. And there was a pungent smell.
The police kicked the door in, and we told the nurse to stay outside. We went upstairs, where the smell was almost overpowering. He wasn't in the bedroom or the lounge, so we made our way down the hallway. The kitchen door was open - he wasn't in there.
"He's in here," called one of the police officers, holding his nose.
We peered round into the bathroom. There he was, laid in the bath, which was empty of water, and he was in an advanced state of decomposition.
It was the first advanced decomp I've been to, and I had often wondered how I would react when I finally went to one. I've been to plenty of people who've passed away, but none had been much more than the very early stages of decomp but never anything like this. Apart from having the smell up my nose for a week afterwards, I was pleased to realise that it didn't really bother me that much.

At the end of the shift, after a few more calls, we considered the days jobs. We thought we'd just had a day where we were somehow involved in the balancing forces of nature. We'd been to a woman who'd been just about to give birth to twins, then later been to two people who'd passed away.

Two days later, another first for me - a shooting. I was working with a relatively new trainee when we got the call which had come from the police. "Male has committed suicide using a firearm" read the screen. I had to smile when control sent a message to the screen telling us "A rifle is involved." No, really?! I knew what they meant though. It was a message for our safety, which is always very much appreciated.
It reminded me of a scene from CSI - a man sitting in an office chair in the middle of the room, back to the door, still clutching the gun. A small exit wound to the back of his head, and blood spatter mixed with brain on the ceiling.
We made the formal declaration that the gentleman was beyond saving - the reason we'd been called because the police aren't allowed to officially recognise death - even when it's obvious, then we left. We'd been careful where we'd walked and made sure not to touch anything so we didn't get any of our uniform or equipment taken from us for evidence, so we were allowed to leave after completing the paperwork.

The next week, Barry came back....and we've been doing rubbish calls since. Mind you, after the week before, I didn't mind too much.