I like my coffee.  I mean, I REALLY like my coffee!

“QUICK!  Someone’s being beaten up! By five men . . . over THERE!”  The old man looked frantic and genuinely concerned.

I was about to take the first sip out of an extra hot, posh, independent artisan cappuccino that I’d just purchased.  As such, I wasn’t overly impressed by this rude interruption.  So, just like the fishing pilot at the beginning of Raiders of the Lost Ark, who had the dilemma of finishing catching his fish or starting the plane to escape, I toyed with my coffee for a few seconds before exiting the FRU in a grump to see what was up.

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I did an observer shift in Control a while back.  I wanted to watch and listen to how calls come in, got triaged, allocated and then managed.

So, sitting with Laffieres*, a Clinical Team Leader, I was able to listen in to a patient call back.  They had rung 999 feeling faint and had won themself an Amber response that could see her waiting a long while for an ambulance.   London were holding a ridiculous amount of calls and, as usual, only had a finite amount of ambulances to send.  So, it was Laffieres’ job to ring the patient back and re-check their clinical status to see if anything had changed and to see if there were any ‘alternatives’ that could be used to help the patient.  This was all done using the Manchester Triage System, a quick, more concise generalised system to help clinicians triage a patient’s needs over the phone.

After a short conversation Laffieres concluded the patient did not need an ambulance at all.  And, upon receiving the news that they were no longer going to be getting one, the patient’s demeanour changed.  One second their voice had been woeful and demure, the next it was harsh, cruel and direct.

“If you don’t send me an ambulance I’ll ring 999 again!  And I’ll keep ringing, over and over!”

My jaw had genuinely dropped.  I could not believe what I’d just heard.  Laffieres laughed.

“We get it all the time mate.  Every day, over and over.  She’ll call back in a minute, I guarantee”

And she did . . .

London Control Room

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“Seriously?!”
“Yep”
“He apologised?”
“Yep.  Admitted he had been a dick and had put the whole thing on, and was genuinely apologetic”

The officer was referring to a patient that, a couple of nights previous, had almost caused a mini riot and forced me to call for ambulance back up over an open mic, as Red 1 . . . for a pseudo fit!

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A neighbour let us in to the patient’s flat and led us to where she was lying on the kitchen floor.  The poor old girl had simply fallen and not been able to get up, and had subsequently been lying for over six hours.

Now, I don’t have much of a sense of smell.  I put this down to constant exposure to horrible smells over time.  And thus, when we stepped into the kitchen, the smell of faeces that hit me was like a ton of bricks to my senses.

My god!  I thought.  That really MUST smell bad if I can smell it.

And to make matters worse – that sneaking, creeping, terrible feeling of awareness started prickling at the back of my neck . . . .

We were going to have to clean her up!!!!

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Working on a pre hospital emergency you can be forgiven certain etiquettes in standard procedures.  Like intubating a patient whilst they’re on a filthy floor in a corner of a darkened room. But, as long as there is no ‘real’ harm done to the patient then it should be fine . . . shouldn’t it?

I opened the roller clamp on the IV Paracetamol and held the bottle above the patient’s head to watch the flow.  But, instead of seeing the drips coming down, I saw the patient’s blood run vertically up the tube toward the bottle!

Ah . . . I thought, this is awkward . . .

Antecubital Fossa (ACF)

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