Monday, 2 March 2009


1. 101 year old chest pain. Yes you saw it right, 101 year old! This chap was a surprisingly young looking 101, still self sufficient and lived alone. Complaining of chest pain through the night, worse than his usual angina pain, he didn't want to bother any one. He called his daughter who popped round to see him and had obviously took one look at him and decided to dial 999. He had a non-stemi late last year and apart from that he hadn't been too bad. We soon sorted him out and after some aspirin, GTN, O2 and morphine he was looking a far better colour on arrival at hospital. He even managed a cheeky smile, something he didn't feel like doing when we first arrived on scene. Just imagine what he has seen in his life, all the changes, war and hardship. Bless him. I hope he has many more years ahead

2. Paediatric burns. 18 month old who had tipped hot coffee over himself. Mum was cooling his burns as we arrived. All we could do was apply water gel dressings and give ibuprofen & paracetamol oral suspension for the pain. This job pissed me off because what I really wanted to give him was oramorph (oral morphine) which is a drug we are supposed to have. We are still waiting to get it. He was too young to understand Entonox and there was no clinical justification to give IV/IO morphine due to the size of burns. The A/E staff completely agreed with my annoyance. Don't worry I'm on a mission to get this sorted and wont stop until until we get the extra drug.

3. RTA, 2 cars and 5 patients. Every man and his dog was there including the neighbouring air ambulance. See above photo. The rear of the car shown was pushed right under the back seat. The other car had relatively minor frontal damage, it was a brand new Audi. A case of new versus old.
4. We cleared from that incident and within 60 seconds were given a breathing difficulty in the next county. It was lucky we were so close because the other county would of taken ages to get there. It was a lady with COPD/asthma who was really struggling. She had a high temperature aswell so she needed to go in. We treated her with salbutamol and atrovent nebulisers which helped considerably, bringing her O2 saturations up from 85% to an exceptable 92%. We try and maintain COPD patients at around 90-93% so as not to mess there blood gases up. They rely on low levels of oxygen in the blood to stimulate their breathing where as us healthy types rely on low levels of carbon dioxide. This basically means that if we increase their oxygen levels we might remove the stimulus to breathe and cause them to go into respiratory arrest. This is rare and only happens in a few cases where the disease is advanced.
The hospital was over 20 miles away but by the time we got there her breathing was now fine. She still needed her underlying infection treated otherwise if we treated her at home with nebulisers and left her there another crew would be out later. In these patients with COPD or asthma who have an underlying infection a nebuliser is only a tempoary fix and sometimes can fool the patient and even the crew that they are cured.
5. Non-injury fall, left at home.
6. Paediatric head injury. A baby had fallen off a chest of drawers face first while having his nappy/dyper changed. Cryed straight away and alert. Small bruise appearing on the forehead. Mum and dad concerned so we popped them in to hospital just for their piece of mind.
Again 6 jobs, only one of any real note.
Elderly male with a history of Myasthenia Gravis who collapsed at the dinner table. He started having mini seizures and was a bit agitated. I popped in an IV because I thought I was going to have to give some Diazemuls to stop the siezures but after some O2 he recovered on the way in to hospital. His wife and daughter were in tears before we left because they thought he was going to die. They were relieved when they saw him smiling at hospital.

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