Wednesday, January 09, 2008

My New Year

New Year's Eve, Barry had the night off - he was going up to the Embankment to watch the fireworks. Meanwhile, I hadn't been lucky enough to get the night off, so I was working. I can't remember all the calls, but those I can are related here....

The shift didn't start well - first was a 30-something woman who'd been drinking vodka since 10 o'clock in the morning, had fallen over and "cut" the fleshy part of the base of her thumb on some glass. Well, to say cut is a bit of an over reaction. She had two very small scratches. She asked if she was going to die. I got her to wash it under the tap, then she decided to put a plaster on. We left her at home.

Later, after being given a break (my first in 4 months) we went to a pregnant lady who had some bleeding. She'd noticed the blood on the toilet paper earlier in the evening, but there hadn't been any bleeding noticed the last two times she went to the toilet. She had rung 999 for advice only. As our call takers don't give advice, and the call couldn't be sent to our Clinical Telephone Advice service because it had come up as a Cat A, an ambulance - us - had been sent, along with an FRU.
"Have you rung the hospital and spoken to a midwife there?" I asked.
"No, I don't have the number cos I lost my notes after leaving them on the bus."
We got the number for the hospital from our control, and I spoke to a midwife. I explained what the patient had told me, and the midwife said "Good grief - she's called an ambulance?"
I explained about the notes. "Oh for goodness sake. OK, I'll speak to her, can you put her on please?"
I handed the phone over, and after a lengthy consultation, the midwife had obviously said she wanted the patient to go to hospital, and the patient was refusing. The call ended. We tried to persuade her to go:

Me: Look, you rang for advice, you got us, we've found you the number for the midwife, you've spoken to her, and the advice you wanted is that you should go to hospital. We're here now, and we'll take you.
Patient: Yeah but who's going to look after my other child?
Me: Is there no family close by who you can call and ask them to come over? We'll wait for them.
Patient: No, nobody. I'll wait to see if the bleeding starts again, if it does, then I'll ring again for an ambulance. (This is what she had said on the phone as well)
Me: But I'm sure the midwife has just told you not to call another ambulance?
Patient: Yeah, but it's New Year's Eve - I won't get a taxi for hours.
Me: After midnight, you won't get an ambulance for hours either, cos there'll be far more calls then there are ambulances, so some will have to wait.
Patient: (bear in mind the answer to someone looking after her child) Oh, well I'll call my sister who lives round the corner to take me.

We gave up, did the paperwork and left her.

By now it was almost midnight, and we decided we'd go and sit on one of the bridges to see the New Year in and hopefully see some of the fireworks. I pressed the "Green Mobile" button, and selected "Declined Aid Against Advice" and "Send".

Almost instantly, we got another call. "Red 1, 59YOM Cardiac Arrest, Purple"
Red 1 is our highest category of call, Cardiac Arrest speaks for itself, and Purple meant beyond help. The call had just come in, and we were only around the corner. We were with the patient inside two minutes of the call.

The patient was laid in bed, and he was indeed in cardiac arrest. I pulled back the covers, and put my hand on his chest. He was still as warm as you and I are. He'd clearly only just arrested. We got him onto the floor, and I started CPR while my crewmate set up the Defibrillator. The machine showed Asystole (flat line). A paramedic arrived on an FRU, I briefed him, and we continued to work on the patient for the next 20 minutes using cardiac drugs to help stimulate his heart back into action. It didn't work, and after 20 minutes, with the patient still in Asystole, the paramedic asked us if we agreed to terminating resuscitation. We did, and the patient was declared deceased. We checked our watches to get the time of death, and realised it had gone midnight.

There were now various bits of paperwork to be completed, and the paramedic said he would deal with it all. We wished each other a Happy New Year, and we left.

Next was a panic attack, which with everything I could hear kicking off on the radio, I suspected the hospital wouldn't have been impressed with us taking in, so we spent an hour and a half talking the patient out of the panic attack. We succeeded, and it turned out she was a student nurse, and felt very silly that someone had called an ambulance for her, had never had a panic attack before, and said she would go to see her GP about it.

Two or three more calls that I can't remember, and we were looking for our "off job" - a call that is fairly easy, goes to hospital, then we go home. What we got was a call miles away to a care home, where a little old lady had fallen out of bed, and waited almost three hours for an ambulance.
It was a care home that actually does care. If you read ambulance blogs regularly, you'll know that they are few and far between in our experience, so this made a welcome change.
At first, it seemed our patient hadn't hurt herself, and we got her up and watched her walk with her frame. She was limping. "Is that normal for Mavis?*" I asked her carer.
"No, apart from using a frame, she usually walks normally."
Bugger. I really hadn't wanted to take this lovely old lady to an A&E bursting with loud abusive drunks vomiting all over the place and trying to pick fights with each other, but now I'd have to.
"Which hospital does she normally go to?" I asked, stealing myself to be told a hospital that was even further away from home.
"Town Hospital," said the carer. Oh yes, someone was watching over us, it was the hospital nearest to our ambulance station. I gave a silent thank you, we got Mavis into our chair, and we took her to hospital. It wasn't as full as I'd expected, but the nurses were pleased to see someone that wasn't drunk for a change.

I arrived back on station to find Barry, his girlfriend, and my girlfriend (Barry had taken her with them so she wasn't on her own for New Year) all sleeping on the sofas. I accidentally-on-purpose dropped something heavy and woke them up. "What are you lot doing here?"
"Can you take us home? We missed the fireworks - we were stuck on Waterloo Station - there were so many people trying to get out that the police closed all the exits and kept us in there. All we heard of the fireworks were faint pops."
They'd finally managed to find an exit that nobody else had, and got out of the station just in time for the fireworks to finish. Then they couldn't get back into the station to get a train home, and had spent the next five hours trying to get to the ambulance station to ask me to take them home.
I told them we'd missed New Year too doing a resus, and we all commiserated each other.
We'd Sky Plussed the BBC's New Year programme, so last Saturday, Barry and his girlfriend came round to us, and I started the programme at 11.10, as it had on New Year's Eve, and at midnight, I opened a bottle of champagne. We sang Auld Lang Syne very drunkenly, and had our own little New Year celebration, watching the fireworks on the TV**. The neighbours must've wondered what on earth was going on, but we enjoyed ourselves.

Happy New Year everyone!

*Mavis isn't the patient's real name

** Note to the BBC's director - next year, we'd like to actually see the fireworks, not watch two blokes racing up and down the Thames in a boat, and the crowds going "Ooh" and "Ahh". Thanks.