Tuesday, 14 October 2008

Monday: 7 patients.

1. Fall, female who had fallen down the stairs of a double decker bus as it was pulling away. She was conscious and alert with an obvious head injury that had been bleeding briskly. The usual c-spine precautions were taken. When at A/E her head started to bleed again quite heavily and she ended up in Resus.
2. Dr's 999, male in his 40's at a GP surgery. One of our RRVs was on scene first and when we arrived the patient was on O2, had a line in with some fluids running. The Dr queried an upper respiratory tract infection (URTi) and had administered 1200mg of Benzylpenicillin. I couldn't work out whether the GP had used the RRV guy's drugs or his own as the RRV's drug bag was in the treatment room. The patient was in a bad way with a pulse rate of 140 and a temperature of 39.0, he was septic and also in a lot of pain. The DR said asked if we could give him some morphine and another litre of fluid on the way in which is what we did. We have to be particularly mindful of the airway in these types of patients, even the Dr suggested we may have to nebulise him with Adrenaline if he deteriorates. The patient was so poorly he ended up in Resus and then eventually he was intubated and taken to intensive care.
3. Fall, female in a care home. Was is it a simple trip or was it a collapse? No one knew. She had a couple of lacerations to her wrists and a nasty one to her lower leg with her ankle also being considerably swollen. Monitored, wounds dressed and a bit of TLC en route to hospital. She was discharged a couple of hours later.
4. GP Urgent journey, male with a history of recent bladder operation had suffered post op complications. The Dr had seen him at home and deemed it nessecary for him to be admitted.
5. Abdo pain, female college student with what initially sounded like appendicitis. We were only 2 minutes from the hospital so one rounds of base line obs and some gas & air for pain relief.
6. Cat A convulsions, female well known to us standing in her doorway who said she couldn't cope! Inside she had an 8 month old baby which I spent nearly an hour playing with, having a young one myself I was in my element while my crew mate was busy on the phone arranging social services and getting things sorted. She stayed at home and when her mum turned up she gave her daughter a right roasting because she didn't call her first. I would like to know where the Cat A came from seeing as it was the patient who made the call!
7. RTC car into a hedge, a middle aged man was shunted from behind at high speed and ended up being pushed up an embankment into a field which was 8 feet higher than the road. The other driver tried to do a runner but was caught by police. He had been drink driving and had no insurance or MOT, his excuse was that he had an argumant with his girlfriend and was going round to see her as she said she was going to kill herself. Our patient declined transport, against our advice, despite having neck discomfort. 'I feel fine lads, if I'm not good in the morning I'll pop up to A/E myself.'

Bread and butter stuff really, overall not a bad days work.

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