Saturday, 28 March 2009

The end of another week

A weekend off at last! Well not quite. I spent all day today finishing off my daughter's bedroom.
I had to take the day off on Wednesday to look after my family as they all, in turn, were suffering from a horrible bug. I rarely have time off but in this instance it was justified. Family first! I on the other hand have seemed to escaped the wrath of the D&V bug, touch wood. Must be that good old ambulance immune system kicking in!

Back to work on Thursday and to be honest it I can't really remember what calls I went to. All I know is there was nothing of any real interest. We did have an army medic come out with us. We have a lot of these at our hospital and they frequently ride out with us to get an insight as to what we do. Trouble is, like any observer, they bring with them the dreaded observer's curse. It's well known that when ever an observer comes out with us nothing interesting ever happens.
We did do a transfer from a private ward at our local hospital to a private hospital 30 miles away. It really annoyed me because it didn't warrant an A&E ambulance at all. The patient was a pleasant man who was going for an operation. He was having a CABG, pronounced cabbage; CABG stands for coronary artery bypass graft. We took the stretcher up to the private ward but as soon as one of the nurses saw it she said ' He won't go on that, he'll probably walk down'. I couldn't believe it. 'Does he not need to be monitored?' I asked. 'No, he's been in all week and is not having the op til tomorrow, he's OK.' He didn't even have a line in.
Control told us that we had to do the job as the patient needed monitoring and that the urgent journey vehicle couldn't do the job as it didn't have the required kit. Oh well. He was fully clothed and looked a picture of good health (and if you didn't know what he'd been in hospital for you would have thought he was a perfectly fit & healthy man ). He walked down to the vehicle and sat on one of the seats and we chatted on the journey. He couldn't have a stent fitted as the narrowing of his arteries were on a junction and a by pass was the only option. Naturally he seemed a little nervous and so would I if that was me. When we got there we had to wait while he filled out a registration form and then escorted him to his room. In the lift he apologised and said that he felt embarrassed that we had to bring him over and that he thought it was an inappropriate use of an A&E ambulance. Although I completely agreed I just made up some excuse about the other vehicle not being available. He was a really nice chap and I hope everything went according to plan. But I can't help thinking that these sort of jobs don't help when the government are putting increasing pressure on ambulance trusts to get to people in 8 minutes. When a transfer is booked with ambulance control I think more questions need to be asked as there are more appropriate resources available and they need to be used properly.

Friday and I was working with my old school mate. No matter what jobs we go to we always have a good shift, he is a top bloke! And true to form it was a pretty unremarkable shift. We did have one patient who was in an awful lot of pain. He was only in his 40's and suffered IBS (Irritable bowel syndrome) but for some reason he was experiencing severe abdominal pain. The pain was the worst pain he had ever experienced and was also vomiting. Another problem was that he had difficulty in breathing (DIB) and he said that he felt like his whole chest was in spasm. His wife was really concerned and said that this is so out of character for him as he usually has a very high pain threshold. Because off the spasm in his chest it was actually impeding his breathing and as a result had actually caused his oxygen saturations (SPo2) to drop, they were in the low 90's. On board the vehicle I gave him some IV Maxalon and 5mg of Morphine, this wasn't doing much so I gave 1mg every minute until his pain was controlled, he had 8 mg in total. It took the edge off the pain and also helped his breathing. He was now able to take a deep breath and his SPo2 was now a more acceptable 98%. I probably would have started with Entonox but due to his DIB I was doubtful that he would have inhaled it effectively.
As with all the other patients I'll probably never get to find out what was wrong with him. All I know is that we delivered him to hospital in a better condition than when we first saw him.

Everyone says that I get all the decent jobs but it's just not true. Yes I do usually get a lot of unwell patients and regularly get to use my skills but I too get days when not much happens.

Back Monday for 2 days and 2 nights. We'll see what that brings.

1 comment:

40lizard said...

The dreaded third rider syndrome! UGH!