Tuesday, 31 March 2009

The observer rides again

As I said in my last post we would be having an observer coming out with us again. He was a medical student in his 5Th and final year and had been doing a GP placement locally.
I recently had a phone call from an Emergency Care Practitioner who works at the same surgery, he asked if I minded if a med student came out with us for a shift. No problem. So today was the day that he experienced first hand exactly what we get up to at the sharp end. Or something like that. First we went through all the kit. I think he was impressed with the EZ-IO http://www.vidacare.com/ez-io/index.html and the amount of drugs we carry. It's surprising just how many Drs and other health care professionals don't know just what we carry.
After a brew I had him sign some paperwork, gave him the observer PPE kit (personal protective equipment) and adopted the usual morning pose....................................in other words we took up positions on some comfy chairs and waited for the first job to come in.
It wasn't long before we were out, not a job but out on standby at a local GP surgery. We weren't there long before being sent back to base. We didn't make it and were soon on our first call.

1. ? CVA/stroke. Female collapsed. We checked her over and found no real signs of a stroke. The only abnormality was that her blood pressure was elevated and she was a bit vague. She perked up with a bit of Oxygen and we decided to her take to A/E for further assessment. Whilst on scene a gardener ran over shouting that there was a man in a door way feeling unwell. I went over and saw that he was conscious and that there was no life threatening problems. I reassured the gardener and said that another vehicle would be on it's way soon.

2. GP 999 chest pain. This was a guy with obstructive airways disease who the GP thought was having a PE (pulmonary embolus-blood clot on the lung). He was having problems breathing, severe chest pain and was coughing up blood (also known as haemoptysis. Some Oxygen, IV Morphine and some bloods before heading off to the hospital. His breathing and chest pain was now bearable after the pain relief.

3. GP Urgent renal problems. According to the GP this guy was nephrotic and had current renal problems. After getting some blood results the GP decided that it was best to organise an ambulance for this chap. He was waiting at his door with his bag packed, walked onto the ambulance and walked off again at the hospital.

4. Cat A Fall. Life status questionable. We thought it was going to be a cardiac arrest in the street but it turned out that a passing motorist saw an old man fall over, rang 999 and carried on going. We spent 10 minutes driving around looking for our patient but found nothing. Control called us back and said that the motorist saw someone fall, get up and walk off. How this came in as a
Cat A I'll never know! Stood down and back to base..........................................and more tea!

5. RTA/RTC/MVA (whatever it's called this week!) Car vs Cyclist. A lady was cycling when a car (just pulling out of a junction) clipped her back wheel. Nothing serious, only some abrasions to her knees. What we call a brush and dust off job. We checked her over and offered her a trip to A/E but she declined. I quizzed her why she wasn't wearing a cycle helmet and her reply was that she read some research that stated that their was no real evidence to support wearing them. 'I only wear them on serious rides, I didn't expect this' she said. Unbelievable. We dropped her and the bike back at her house which was just around the corner.

6. Fall. Lady who twisted her foot on the way out of a dentist surgery. Slight discomfort on the instep and little toe. An ice pack was all that was needed. Her husband picked her up and took her to the minor injuries unit as she had declined A/E. I doubt she broke any thing.

7. Cat A fall. Male in his 70's who had collapsed/fallen, we really didn't know. His head was covered in blood and he had a nasty laceration to the back of his head. He appeared dehydrated, short of breath and was very repetitive and confused. He wasn't well at all and was covered in vomit and faeces. Oxygen and an IV as his blood pressure was initially low and off to the hospital.

We also finished on time for a change. I think the med student enjoyed himself and after thanking me and shaking my hand he said that it was nice to see what we got up to. I just said that that was a typical day. Not like casualty where there is major incident every shift!


Richard Keatinge said...

The trouble with bike helmets is that the figures don't show that they work - helmet laws have stopped a lot of people cycling and have done nothing for head injury rates, see Robinson DL. No clear evidence from countries that have enforced the wearing of helmets. BMJ 2006;332: 722-5. http://www.bmj.com/cgi/content/full/332/7543/722-a. It appears that helmets break easily, but don't absorb the impact, see the engineers quoted at http://en.wikipedia.org/wiki/Bicycle_helmet. A broken helmet has simply failed. Helmets have also strangled some young children who were wearing helmets while playing off their bicycles.

It's far too dangerous not to cycle - regular cycling, Danish style, not too far, not too fast, nearly halves the death rate, see http://archinte.ama-assn.org/cgi/content/abstract/160/11/1621 All-Cause Mortality Associated With Physical Activity During Leisure Time, Work, Sports, and Cycling to Work. Andersen et al, Arch Intern Med. 2000;160:1621-1628. Wear a helmet if you want to, but don't imagine that it'll do much for you or for anyone else.

Tom said...

Hey Mac. I haven't even heard of a blog before especially not one of this kind, so when I came across this by mistake I was amazed and signed up myself. This is excellent! Get in touch. tom-shaw@hotmail.com I wanted to ask you something.regards, Tom