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.

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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?”

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“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 →

The blue flashing lights were a give away.  As were the waving arms.  But really, it was the classic rhythmic movement of someone performing chest compressions that caught my eye.  And at 200yds and closing fast you could tell the compressions were good.  Really good.  Hard and fast.

Skidding to a halt and very nearly T-boning a police vehicle (oh the cakes I would have had to have bought!!!) I jumped out the car, grabbed the Lifepak machine and headed over to the commotion.  A crew had arrived at the same time and were bringing the rest of the gear.

What was happening?  Well, an old man had collapsed in the street and gone into cardiac arrest of course. Continue reading →