Tuesday 23 September 2008

Sunday

Sundays have become one of the busiest days in our area and it's not unusual for us to have to que up in A/E so that we can hand our patients over. Again nothing too much to write home about.

1. Male in his fifties, OD. We were called to a methadone OD and as this was a potentially violent patient (so we were told) we stood off and awaited police attendence. The police were on scene so we made our approach. There was the usual gang of kids cycling round us being nosey, instead of being at home having an early night for school the next day! In the hall by the front door was a log splitting hammer, nasty looking piece of kit. I doubt it was used for it's intended purpose. In fact the house was home to a well known heroin user/dealer but we weren't there for this person. We were called to her so called partner who owned the house. He had drunk 6 cans of extra strength lager and thought he would see what her methadone tasted like. He necked 70mls of the stuff. Her daily dose was 30mls. He was actually charming and not violent at all and just wanted to sleep. We couldn't let him do that as the combined effects of alcohol and opiates would eventually stop him breathing and we would only end up there again later. Probably to resuscitate him. After much persuasion we got him on board the vehicle, pupils pin point, deep sighing respirations and sleepy we decided to give him some of the 'ole pick me up', Narcan. His partner was a right pain in the rear end, trying to tell my crew mate that he needed Narcan and constantly saying 'Look his eyes there pinning'. Yes thank you we do know what we're doing! He was in A/E within 10 minutes and being closely observed by the staff. Later we found out that he self discharged and was moaning how he was going to get home. I couldn't see what the big deal was it was only an 8 mile walk!
2. Dr's Urgent admission, patient in his 80's with urinary retantion and bleeding. This man was a dementia patient from a care facility. The GP hadn't even seen the patient but was referred to A/E after the staff had an several unsuccessful attempt at a bladder wash. A/E weren't impressed as the Out of hours (OOH) GPs next door hadn't even been out to see a patient yet and A/E was chock a block.
3. Female 50's, abdo pain. She was under investigation for gall stones and called us for pain relief. When we explained that if we did give her any analgesia then she would have to come to hospital. She point blank refused so my crew mate arranged for the OOH GP to come and visit her. Why she couldn't of rang them in the first place I don't, I mean it wasn't as if she was in agony. She had the pain on and off for 2 weeks.
4. Female 18, another abdo pain. This time the patient was 7 weeks pregnant and had some lower abdominal pain, no bleeding and all her observations were fine. To be honest she could of gone in a car.
5. Female 98, Cat A severe respiratory distress. An anxious little old lady who couldn't bring up some phlegm. 'I can't breathe, I can't breathe' she kept saying. 'But you are breathing' I said reassurringly.' We calmed her down and checked her over, absolutely fine. She coughed and said she bring anything up so we said cough a bit harder, that did the trick. We left her at home. Bless her she lived alone in a warden assisted flat and was very anxious. She just needed reassurance.
6. Female 81, Fall. This lady is a regular faller and this job was no different. Back on her feet and into bed. All observations fine and paperwork completed. One half of the day shift that was supposed to take over from us forgot that he was working and didn't show up and that's why we ended up doing this job. Fortunately for him it was a local job and a simple fall. We finished pretty much on time.


In amongst all the jobs over the weekend we also managed some stand by at various response posts and had several jobs that we were assigned to but were stood down before we got to them.


Oh well I'll be starting my RRV shift soon. As it's overtime I just close my eyes and see £ signs flashing. Kerching

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