Thursday, 22 January 2009

I've had a couple of good days with our latest trainee, I think he'll fit in fine. He has a nice way with the patients and is keen to learn without being too over the top. It was also easier than normal as we had three crew members on the vehicle. After the Anaphylaxis first thing yesterday it was all pretty genuine jobs. Another patient that wasn't very well was a Diabetic who had been seen by a GP in a care home and had been then refered to the medical assessment unit. When we got there her GCS (Glasgow Coma Scale- what we use to assess a patients conscious level) was 12, the norm being 15. She was severely dehydrated with deep sighing respirations (known as Kussmul's resps) and we could smell the ketones on her breath. This was DKA (Diabetic Ketoacidosis). The DR had booked this as an urgent journey (and not a 999 call). I wasn't happy with the patients condition so I alerted the hospital. After some O2 and IV fluids she perked up a bit, just enough to respond to us. A short while later we delivered her to hospital, there they administered insulin and more fluids to try and bring her sugar down.

Today the jobs were mainly elderly people who had fallen over (a common call for us).
We did got to a collapsed patient who I thought I was going to Thrombolyse. He had central chest pain and had collapsed at his desk. A RRV Paramedic was there first and when we got there the first thing she said was 'Chair!'. You know it's bad when someone barks that to you. He was grey in colour and pouring with sweat. He looked like a text book heart attack. After we gave him Aspirin, GTN, Metoclopramide and Morphine he was pain free and a slightly healthier pink colour. His 12 lead ECG showed no evidence of a heart attack, I couldn't believe it. We still rushed him in though. The next thing was for the hospital to test his bloods, other than an ECG this is the way to determine if he had suffered a heart attack. I really thought I was going to thrombolyse this chap, never mind, we did our bit and got him to hospital in a better condition than when we found him.
He might still be at the hospital now and like so many other patients I'll probably never get to find out was going on with him.

Oh well, back to work Sunday morning.

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