Saturday, 11 October 2008

Business as usual

After last weeks trauma it was business as usual. Here is a round up of my last three day shifts.

Wednesday: 7 patients attended.

1. Unconscious, female in a care home who had been deteriorating over the last few days. Although she was unco she was maintaining her own airway but had very low blood pressure. High flow oxygen, IV fluids and a pre alert call to the hospital.
2. Unwell, male with lots of medical history who had been vomiting blood and passing bloody stools. All obs fine and relatively well looking. Transported to hospital for further tests.
3. Hemorrhage/lacerations, 15 year old female with a cut to her hand. After spending all of 2 minutes on scene dressing her hand and convincing her that she wouldn't loose it we took her to the local Minor injuries unit.
4. Neck pain, 8 year old on holiday who was on a water ride and was shunted by a boat. His pain had just about disappeared by the time we got there. He was more upset than anything. Mum and dad happy to look after him.
5. Deceased, male not seen for two weeks with flies at the windows. Police already on scene and broke in when we arrived. RIP.
6. Fall in the street, elderly female who had slipped on the kerb sustaining a nasty gash to her eye. TLC and taken to hospital for proper wound care.
7. Diabetic , male having a hypo at home. His wife had tried to give him lucozade and milk with sugar but he was getting worse. After popping a 18g IV in the back of his hand and giving him 100ml of Glucose 10% he was right as rain. Although when he came round he looked at our name badges twice and rubbed his eyes 'Oh I haven't had one of them bloody hypos again, have I?'. 'Yes you have!' said his wife, 'He's gets all silly when he goes low and there's nothing I can do!' she added. Nice couple and a nice job to round the day off with.

Thursday: 5 patients attended.

1. Fall, non-injury. Assistance and advice only. Not transported.
2. Chest pain, 999 call from a local DR's surgery. Female who had suffered chest pain for the last couple of days. Already on O2 and had Aspirin and GTN before we arrived. There was nothing on the 12 lead ECG and as she still had some tightness we gave her some more GTN. We took her straight to the medical assessment ward.
3. Headache, male with frontal headache which came on gradually, assessed at home with advice given. His wife had given him 2 paracetamol about an hour earlier which had kicked in while we were there. His wife said she panicked and wasn't sure if he was also suffering from one of his 'panic attacks'. Nice couple and very grateful as well as apologetic.
4. Chest pain, another female who had been having chest pain for several days! Two community responders were on scene when we arrived. We gave her O2, Aspirin and GTN which seemed to help slightly. She said to me that they have terrible trouble with her veins at the hospital. 'Right then, that's a challenge.' I said. I couldn't see any veins or really feel any but I managed to get an 18g in her right ACF and draw off 4 tubes of blood. I was pretty impressed even if I do say so myself. Careful, I may not get through the door if my head gets any bigger. Ha Ha. Knowing me I'll mess up an otherwise easy one next time.
5. Passed as a fall but turned into some thing a bit more interesting. We managed to find the location which was an alley way, after stopping at the wrong one up the road, DOH! Male in his 50's, he was a council worker who had fallen into bushes and thought he had been stung by nettles until he reached down and felt a metal spike sticking out of his leg. When we arrived he was in great pain but in good spirits. His work mates thought it was highly amusing, he was their boss. After putting a built up dressing around the spike to stop it from moving we got him onto the trolley and then onto the vehicle. He drained a bottle of Entonox (gas & air) and received 5mg of IV morphine. When we wheeled him into the A/E dept he became the centre of attention for the afternoon/early evening.

Friday: 5 patients attended.

1. Breathing problems, regular male caller. COPD (chronic obstructive pulmonary disease, such as Bronchitis or Emphysema) who was using his own nebuliser when we arrived. We gave him some salbutamol and atrovent using our nebuliser mask and O2, his mask was pretty naff so we left him one of ours. His breathing had eased after our treatment and he refused to go to hospital so we called his DR's surgery to arrange for a home visit.
2. Fall, male with Parkinson's who had sustained a head injury some time during the night but couldn't remember it. He made a good job of demolishing his sink unit when he fell. Collapse query cause, he had to go in. There was a Community responder on scene before us who had gathered all the patients meds and history for us.
3. Fall, female on a bus who had twisted her hip when the bus started to pull away without warning. She had an obvious NOF (neck of femur fracture/hip fracture). Her leg was shorter and was externally rotated, no need for an X-Ray it was that obvious. She was really calm and kept repeating her self stating that she was so angry with herself. She declined any analgesia.
4. DR's urgent admission, we were sent to another station 30 miles away for a bit of stand-by when we got this urgent job. When we arrived at the address my crew mate opened his door and before he could step out of the truck a male in his late 70's came out of the house with a holdall, strolled over to the truck and asked 'Where do I sit?' TAXI! I thought to my self. We had to take this patient to a hospital that neither of us had ever been to before and after being passed from pillar to post by various staff we finally got him to where he was supposed to be. Just a 40 odd mile drive back to base. Fortunately we didn't get any calls on the way back.
5. DR's 999 from a local surgery. Two Emergency care Practitioners were there and handed the patient over to me. Male in his 70's who was sweating profusely and had a high temperature. All his obs were fine and after an uneventful journey he ended up in A/E.

Weekend off but back in Monday to Thursday for a mixture of day and night shifts.

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