Monday, 27 April 2009

Business as usual again

I was on a night shift the day after getting back from Devon and it was uneventful. My trainee crew mate drove all night as none of our patients went to hospital. Even the one and only genuinely ill patient refused! She was short of breath with oxygen saturation's of 87% on room air and her lungs sounded like they were filling with fluid. Her oxygen levels increased with a nebuliser but that was only easing her symptoms and not treating the cause. She said she felt better even though her levels had dropped again but still refused multiple times. She thought she could leave it until the morning but I wasn't happy with this so I referred her to the OOH GP. I also made sure that I noted my concerns on our paperwork and left her a copy. Her daughter was due to visit so hopefully she would have read them. Outcome unknown.

I was on the early day shift over the weekend with a newly qualified EMT and the majority of work was genuine.

Got off to a slow start and after a couple of stints of roadside standby things picked up. We did 6 jobs in total. Here are 2 of them.

We were passed a 'Headache' call 9 miles away. 'Here we go again!' I thought. But when we saw our patient she looked dreadful. She was clutching her head and was very pale and clammy. The light was hurting her eyes and she was vomiting. Her husband said that she never had headaches and wasn't one to complain. I honestly thought we were dealing with some sort of cerebral bleed. The lady said that it was more than a headache and it was really debilitating her. On board we took some obs and because she was in a lot of pain I was going to give her some pain relief. It was going to be a long journey to hospital so I started off by giving her an IV anti emetic. I with held pain relief because after some oxygen the pain was easing slightly. Was this just a migraine or cluster headache or was something more sinister? I don't know but if I treat her for the worst case I should have every thing covered. I called ahead to the hospital to let them know we were coming. By the time we arrived she was so much better. No vomiting and the pain had eased right off, her colour had started to return. She apologised for wasting our time but I told not to be so daft. The main thing was that she was going to be alright. I'd rather treat something like that seriously and it turn out to be nothing than get it wrong.

Another call was to a male with chest pain. He wasn't too clever. He had previously been into hospital with lung problems and was now suffering left sided chest pain. His temperature was 40.9 and he was breathless. His pain was severe enough to impair his breathing so I gave him some Morphine for the journey. I pre alerted the hospital and continued to observe him.
We were met in Resus by a DR and Nurse where I handed him and his blood samples over. Within a few minutes the DR ordered IV Paracetamol and thanked us.

Stroke, sudden death, cardiac arrest, baby with chicken pox and vomiting and a paediatric who fell from a tree and fractured her arm.
I'll post about Sunday soon as I'm now feeling very tired. ALTOGETHER NOW...............AHHHHH!

No comments: