Three and half hours I was on this job. Lovely little lady with classical dementia, who’d had a fall. And after all my investigations and tests I was eventually able to leave her at home with an acceptable “alternative pathway plan”.
But give it its due, this job saw me off bang on time at the end of my night shift. That is, until I closed the front door, locked it and posted the patient’s keys back through the letter box and realised . . .
. . . my coat and car keys were still inside!
“How much further is it?”
The Rail Guard leading us along the track glanced back momentarily, “Quite a way I’m afraid” and as an after thought, “. . . sorry, did you need a hand with your kit?”
“No. I’ll be fine.” I lied.
An ambulance crew caught us up and as we all stumbled along the track in darkness the conversation between them moved inevitably onto the topic-du-jour.
“That’s another two medics handed in their notice on our complex” Continue reading
There are two types of off-duty Doctor we meet in the pre-hospital setting – good genuine helpful ones and . . . not so good and helpful ones.
You see, without wanting to wind up the Doctor profession I think it’s safe to say that with experience comes quiet calming confidence and wisdom. When you meet these guys, they just exude knowledge and skill without even trying. Trust and likeability just radiates from them. Don’t get me wrong, I have met the odd tosser of a Consultant (see http://www.not-on-my-shift.org/2011/09/29/theatres/ . . . But I’m not bitter!).
So, it’s also safe to say, further down the “food chain” it would appear some less experienced doctors can be more egotistical and narcissistic. These are the ones who make you just want to . . . erm, slap them hard. Meet either of these in our world, the pre-hospital setting, and their true personalities really shine forth.
Here’s a couple of stories when I met both types . . .
Never a truer saying was said
With a huge percentage of “cry wolf” jobs the Service attend to day in day out, it’s hardly surprising that a small amount of cynicism and complacency can build up. So, when the cynicism has built up far enough that you’re suddenly presented with a real job that metaphorically bites you on the bum . . . I kind of like it. It’s like a much needed reality check that brings you slam-bang down to earth and reiterates everything you’ve ever learnt about showing prudence with your patients.
Our job had come down as 28 year old male, CVA (stroke) . . . called by, the patient. I was stood outside the entrance to the small set of flats with the crew. No answer to the door and no answer from any of the neighbours. The sun beat down on all of us in our thick green cotton uniforms as we patiently waited for the police to arrive and gain entrance.
There were five of us, including the patient, all crammed into a tiny lift heading down to the ambulance from the 16th floor when . . .
“DING”
The lift stopped at the 7th floor. The doors slowly creaked open to reveal a mum, her gaggle of kids and a nan smoking a fag.
“Hiya” I chimed, smiling broadly.
Everyone’s jaw dropped. In the awkward seconds that followed we desperately tapped at the “Ground” button. The kids, struck like statues, stared, as kids do, down at our patient. Our patient, currently somewhere between the realms of alive and dead, did not stare back. Instead, she lay suspended upside down in a MIBS stretcher whilst one of the medics “bagged” her from the side. Her response to the kids staring was pretty good though – bile started streaming from both nostrils, over her forehead and onto the floor.
“. . . erm, it’s probably best you all, um . . . get the next one?”
“Big sick” is pretty obvious in most people. They change colour. Breath oddly. Sweat profusely. They look . . . . pretty bloody sick.
This is what my patient looked like . . . pretty bloody sick. The first thing that struck me was the amount of sweat pouring from this guy. It really did look like someone had hosed him down and his colour was ashen grey. Call it intuition, call it a 6th sense – but something inside me was saying this was NOT going to end with me leaving the patient at home with a “GP referral”.
I was aiming down the “inferior MI” front at this stage. And with a BP of 56/24 and a heart rate of 40 everything was slotting into place for a full Right Coronary Artery Occlusion . . . Continue reading
