A couple of weeks ago............
After a non eventful day of transfers, GP admissions and Cat A calls 'that weren't' we were on our way back to base when we were asked to standby at another station in the next town. I was fuming, after all we only had an hour til the shift ended. Had we done something to piss control off? I doubt it. As we are so often reminded "You don't know the bigger picture!"
Anyway we arrive at the station to see 2 ambulances there. I was fuming again and so was my crew mate. But before we could even enter the station we got a job. Cat A allergy call midway between this station and ours so off we went. A tech on an RRV was also dispatched. It was to a child stung by a bee.
Mum is at the door and is already apologising for calling us out but stated that she was worried as her son was struggling to breath. Good enough reason to call I thought to myself. Sure enough he had been stung and was showing early signs of anaphylaxis. Reluctantly he got on board the truck after we reassured him that we would take good care of him and that we wouldn't hurt him. My crew mate stood the RRV down
Respiratory rate increased with a mild wheeze and chest tightness. Puffy eyes and his lower lip had started to swell. Tingling on his top lip and tongue and difficulty swallowing coupled with a sensation of a lump in his throat. Pulse rate 115. Alarm bells were ringing. He was also starting to feel itchy although I couldn't see any obvious hives.
We needed to start treatment but a child is not always the best patient to convince. Sometimes they are great and if they are that poorly they'll let you do anything as long as it helps. Other times you can't do anything but drive. I said I wanted to give him some medicine to make him better and that I didn't want him to have to wait until we got to hospital 20 minutes later. I must have said all the right things because he allowed us to treat him. I pinched his hand to let him know that the IV I was about to insert wouldn't hurt too much which he was a bit hesitant to start with but gingerly offered me his hand again. I prayed to god that I wouldn't cock this IV up. You only get one shot at a child. Funny thing was that he covered his ears with his hands but because I needed one of them to cannulate he substituted a hand for a shoulder.
And in went the 20g IV, no problem. A sigh of relief came over his face. "All done, that's the worst bit" I said proudly. Mum then lifted her jaw off the floor "Bloody hell, I'm surprised he even let you go near him!" she said. As I administered the Chlorphenamine and the Hydrocortisone I explained to the child, his mum and now the dad who had just turned up, what I was giving and why I was giving it. At the same time my crew mate had drawn up some adrenaline and injected that into his upper arm, again with no incident. Both parents proud of their child for being so brave. As a dad myself I couldn't have agreed more.
A pre alert to the hospital and we were soon there. We arrived with a child that was showing a good recovery. One of the regular Docs was on duty and said "This the anaphylaxis, airway OK?" "Yep" I said. "OK pop him over there and I'll see him in 2 ticks. I see the guys have taken good care of you, they've done our job for us." she said. "Not quite Doc, I didn't take bloods", "Doesn't matter we don't need them, good job though". The mum had a look of relief on her face that she had done the right thing.
Moral of the story especially when kids are concerned, never apologise for thinking that you bothered us. This is one of many examples of why we are here. If the mum hadn't bothered to call and decided to wait and see or chose to put her son in the car things could turned out a lot worse.
Anaphylaxis is life threatening and does and will continue to kill if it isn't recognised and treated early.
A good job to finish off the shift even if we did finish late.