Dark Heart….

April 30, 2007

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What turns people into “wrong uns?”

Why do kids want to fight each other with knives and scaffold pipes?

It was like “Knife fight at the OK Coral” last week! Two gangs, one Latvian the other Iraqi, were going at it hammer and tongs (or knives & steel pipes). Thankfully the only injuries were slash wounds to the arms and relatively minor head injuries.

Why do some people have kids when they cannot look after themselves let alone others.

We were called to a female “sick!” on one of the many estates in Big City, Ruralshire. On gaining entry to the address we found our patient slumped on the settee with a hypodermic hanging out of her arm……and a small child (approx 18-24 months old) toddling about in a dirty nappy playing dangerously near to the gas fire which was full on!

Why do some so called adults behave as if they are children when it comes to dealing with their lives?

Too many times recently I have felt as if I have been in the audience on “The Jeremy Kyle Show”. Are we becoming a nation of Chavs?

Somewhere, sometime, somehow in the past all these people probaly were decent and “normal” members of society.

I know that there are more good people than bad…but the margin is becoming narrower!


RRV and Stuff…

April 20, 2007

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Busy shifts on the old RRV/RFU. On three shifts covering the weekend late tours of duty.

Last week I worked on the Foxtrot Oscar Paramedic/Police combined response unit meeting members of the public with gashed heads/broken noses/intoxicated/drug overdoses/split lips/a stabbing…all the usual Saturday night things.

Most of these incidents were self inflicted to a degree apart from the stabbing and a couple of unprovoked assaults.

Had one job earlier that reminded me that we owe a awful lot to the people who fought in the second World War…sent to an 80 year old gent who had fallen at home. He was quite frail and his wife of 55 years was struggling to look after him.

What struck me was the fact that they were paying for all the things he needed like inco pads, pee bottles etc. as they did not want to bother any one. A very proud couple, he being an ex-paratrooper who had broken both his legs on a jump over Holland which was now giving him problems with mobility. He also showed me where he had been hit by shrapnel. Hopefully we have got the ball rolling for them to receive some help at home.

They both apoligised for having to call us out! Makes you despair of the younger generations who call us out for crap because “it is their right!”.

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Cut Finger…!

April 12, 2007

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Not 1, not 2 but 3 Ambulances…

The other night a lady of independent status and advancing years, was at home doing the washing up at 3 in the morning…as you do. Whilst washing a bowl she inadvertently smashed it and cut her finger.

So rather than stick a plaster on it she rang the out of hours doctors service to get someone to tend to her wound. The doctor she spoke to on the phone advised her to go to A/E and to this end he arranged ambulance transport.

The crew duly turned up and saw the extent of the wound to the finger of this lady. Treatment was initiated stat on scene…quick wipe and a plaster was all that was required. The crew told me that it was a nick on the side of her index finger as they came into the mess-room shaking their heads with the odd expletive interjected into the description of the said break in the continuation of the skin.

About an hour later the station alerter sounded for us to travel on Blues & Twos back to the same address. I asked what was the problem and she replied that it was still bleeding and after ringing the doctor back he said that it sounded like it needed stitching! Once again the wound was looked at and redressed. Advice was given to the lady to contact her own doctor in the morning if there were any problems.

Later on, shortly after I had finished my night shift, another ambulance was sent to her on Blues & Twos. Again she had rung the out of hours doctor who again advised her to attend A/E! Again the crew stuck another plaster on!

Totally inappropriate response from the out of hours doctor service. If the doctor had gone out in the first place and seen the patient then he would have realised straight away that she did not require an ambulance or attendance at A/E!!!

A senior officer is going to see the doctor later…. 

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A Life Threatening Wound…!!!


Aisle Be Back…!

April 10, 2007

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Every now and then something happens on a job at scene that makes you despair of the so called human race. What turns normal peoples thought processes into acts of sheer stupidity or mindless moronism (not sure if that word exists but it sounds apt!)

At approximately 1030 on a sunny morning we found ourselves called to a collapse with no further details. On arriving scene we were met by a supermarket assistant manager who quickly explained that staff were carrying out CPR.

Collecting all our kit, resus bag, monitor/defib, drugs bag, we made our way into the supermarket and quickly located the aisle where our patient was. We could see that the two members of staff were carrying out good effective CPR which gave us time to get our kit ready.

My crew-mate started to ventilate the patient who was a male in his fifties/early sixties, using the bag & mask attached to the O2 cylinder. Switching the defib/monitor on I quickly placed the paddles on the patients chest and monitored through the paddles to see what rhythm his heart was in.

This showed VF (ventricular fibrillation where the heart muscle is quivering due to the electrical impulses firing off all over the heart in a totally chaotic way). Defib pads were placed quickly on the patients chest and the paddles charged up. The first shock reverted the VF to asystole (flat line, not normally a good prognosis).

Chest compressions and ventilations were continued whilst I gained IV access in the patients arm for the cardiac drugs which he would need. All I needed to do next was gain full control of the patients airway by endotracheal intubation (passing a tube through the trachea to the lungs which gives protection from aspiration of vomit and better O2 saturation).

This was done within 15 seconds and ventilations could be done automatically now with our resuscitator. It was at this point I called a stop to the compressions so I could look through the paddles again. This is were it all got strange…a little bit surreal…a little bit mad.

From behind me I felt someone pushing me gently to one side. At almost the same time a hand, followed by a arm, reached past my shoulder from behind. Having to turn to regain my balance and locate the source of my shoving I found myself staring into the eyes of a man on a mission.

“What the frig are you doing?” I asked in as much of a professional manner as possible. He looked at me as if I was mad and that I was purposefully in his way. “I need to get to the beans!” he replied. “Cant you see we,re trying to save someones life?” I shouted and pointed to our patient on the floor beneath the shelves of tinned goods.

“But all I want is a couple of tins…!” Luckily the manager saw what was happening and grabbed this fool and dragged him out of our way. We continued with CPR and administered cardiac drugs. VF was evident again and another shock was delivered via the defib. This time a rhythm appeared on the screen with a palpable carotid pulse.

We lifted the patient onto the stretcher and into the truck all the while watching for any changes. Shortly before arrival at the A/E the patient started to make his own respiratory effort and I extubated him. Last I heard he was making good progress in CMU (cardiac monitoring unit).

As for the shopper and his beans…I hope he reflected on what he did, but I guess he wont as too many people live in their own little world and stuff everyone else!

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This does happen from time to time. Every crew will have a tale of someone getting in the way. It still infuriates me that people wont wait….I,m off for a lie down in a quiet corner. 


A Near Miss…!

April 7, 2007

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As we approached the address we turned off the blue lights and pulled the vehicle up behind the police car already on scene. A quick scan of the immediate area showed that we were in one of the better parts of Big City…no burnt out cars, no gangs of kids, no loud hip hop/gansta noise and all the street lights seemed to be working.

Taking the resus bag and the response bag off the vehicle I made my way to the front door of the address. My crew mate followed closely behind with the defib/monitor. The call had come in as a “Cat A code Red unconscious query breathing”. We had no further details to go on so it was going to be a question of…“lets see!”

Too many times I have been caught out going to a high priority call only for it to be absolutely nothing at all! Usually after lugging all the kit up numerous flights of stairs and navigating various controlled access doors! But now it is a matter of always being on the safe side…as this job turned out to be.

Once inside the house, which seemed like any normal place with nice wallpaper and furniture, the WPC directed us upstairs whilst she continued consoling the young girl in her arms. She looked about nine or ten years old and even at a glance you could tell she was well cared for.

At the top of the stairs the second police officer led us into the main bedroom of the house and pointed to the body on the floor laid at the side of the bed. She was still…very still…and her colour was not the normal colour of a fully functioning person. Although she was on her side and her blonde hair partially covered her face, we could see that she was an attractive woman probably in her late twenties and smartly dressed.

As I stooped down to check for a carotid pulse before turning her onto her back and attaching the monitor, she gave a sigh. Just one small breath, almost imperceptible in the semi-dark confines of the room. To my right on the dressing table I spied the reason for her condition and the reason for our being there…a spoon, black on the bottom with some brown residue in the bowl. She had overdosed on heroin, and was about to stop breathing for ever unless we did something.

The police officer was shocked to realise that the body was still alive and I think embarrassed at missing the clue on the dressing table. We had arrived on scene a good ten minutes after the police. We quickly dragged the lifeless form of the female from the side of the bed into some working space, and whilst I started “bagging”with the resus kit my crew-mate place the monitoring leads on.

She had a weak pulse of 80 beats per minute only palpable at the carotid artery in the neck meaning that her blood pressure was very low. Whilst getting as much oxygen into her lungs as possible we estimated that she was only breathing for herself 3-4 times a minute. Not good! My crew-mate took over the bagging whilst I searched for a vein to gain IV access before she arrested on us. I was initially thinking that it would be difficult to find a vein yet surprisingly all her veins in her arms were intact. There was no evidence of injection marks between her fingers either so that meant only one thing…femoral vein injection…in the groin!

Sure enough a small patch of blood could be seen seeping through her knickers where she had injected. Obviously she had been using this site to avoid any tell tale marks which could be easily seen by family, friends or work colleagues. The police officer told us that she had been found by her young daughter who had then rang her gran who rang 999.

After 2 or 3 minutes of bagging, the patient started to breath more normally and we stopped, placing an O2 mask on her. The Narcan was drawn up and ready to use to reverse the respiratory depression caused by the opiates. It was not needed as the patients eyes flickered open and she attempted to sit up. A minute later and she was attempting to talk…where was her daughter? whats happened?

She made a full recovery. Things would have been different if she had not been found by her daughter. She told me why she had taken the heroin…her partner had o/d and died exactly a year previously and she had met some of his old friends who provided the drugs. On the surface she had everything…a beautiful daughter, very nice home, a good job and no shortage of admirers. Yet she still put that all to one side while she nearly killed herself…Why?

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