The Nation's Health + Paramedic

24 - Season 2: Episode 1

What is an average day? There isn't one. It is as simple as that. Last year I blogged a 24 period, in real time, as it happened on my shift. I felt it would be therapeutic to visit the idea again and share a random day shift as a lone responder. Here goes. Eyes open, to eyes shut, to eyes open again. Sorry about the toilet stops!


The following takes place between the hours of 4:30am and 08:41am

04:30

No one should ever have to wake up at this time. Ever. No one should really have to know what 4:30am looks like! The light from my phone physically hurt my eyes as I turned off the dulcet sounds of Michael Buble's Mack the Knife! (Don't judge me!) Despite the desire and need to snooze, I couldn't. I got dressed, jumped on my bike and cycled the 5 miles to work. The cold air made my eyes stream the entire way and by the time I arrived, it looked like I'd just been to a funeral......in a hurricane! I had a shower at work, got everything ready, uniform on, drugs signed out, me signed in and all my kit on the car and I was ready with about 10 minutes spare to grab some breakfast!

06:01

"94 year old female, abdo pain, dizzy"

With half of my cereal left behind on the mess room counter, I jumped into my car and shot out the garage. As it was so early, the roads were clear, so I got on scene within a couple of minutes. As it was still dark out, I left the flashing beacon on the roof so the ambulance could find me in the rabbit warren of the estate I was on. I grabbed my stuff and handed on up. I was met at the door by a very anxious, frail looking lady. I helped her back to her armchair and sat her down.

Her symptoms were quite vague and not that severe. So much so, that the illness code I gave her was 'generally unwell'! All her observations were OK, she had a bit of this, a bit of that and could probably have waited for the GP and been treated at home, but at 94 I certainly wasn't going to begrudge her my time or the resources. I made her a tea an some toast whilst we waited for ambulance. 94 is a lot of years and she had plenty of tales to tell me and seemed to enjoy telling them! Back in 1947 she tested racing cars and that was just one of the anecdotes I got from her fascinating life! After about 45 minutes of chatting, the ambulance arrived.

I gave a handover, helped them get her downstairs and on to the ambulance. I got back in my car, appreciative of my second caffeine hit and finished off my paperwork. Job done!

07:03

"2 year old male, fitting"

Yikes! Blue lights on again, yet this time the rush hour was upon me! Being on a car, I can fit through smaller gaps and go faster but that doesn't help being sat stationary in what is effectively a car park! Traffic really does mess with your emotions! On the one hand it makes you livid at the stupidity of some people and their inability to drive. On the other, you have a traffic jam, a potentially very sick patient and no way of moving. You are the person needed to help, yet you can't move faster than the traffic will allow and that can be extremely frustrating and worrying. Luckily, most 'fitters' have generally stopped fitting by the time we arrive and 'most' fitting 2 year olds are actually having a febrile convulsion. Obviously, today was never going to be 'most days'!

As I pulled up on scene a teenager came running outside waving frantically! One word popped into my mind.....'SHIT'! I grabbed everything and hurried into the house, knocking over the clothes horse and a photo off the wall as I bundled up the stairs. In the bedroom, my patient was lying on the bed, fitting. Foaming at the mouth, body shaking and contorted, the mum crying, the other children all crying, it was one of my worst nightmares. I put the oxygen on him and started trying to get a history. From what I could work out he had now been fitting for over 10 minutes. He wasn't a known epileptic but had had a seizure in the past and had been prescribed an emergency dose of buccal Midazolam in case it happened again. Well it was happening again, but in the panic, no one had given it, so I did. Whilst waiting for that to take effect I checked his temperature and blood sugars. All normal.

There was no sign that the fit was stopping to I decided to give some of my Diazepam rectally. Just as I was administering it the ambulance crew arrived. We were pushing 20 minutes of fitting now, the boy had had the maximum amount of drugs he could, so we needed to run.

"Hello guys, 2 year old male, fitting now for almost 20 minutes, given Midaz and PR Diazepam, let's just go, yeah?!"

Generally speaking, if in an ambulance crew arrive, and the FRU says 'let's go' as they walk through the door, it's a case of no questions asked! Especially in sick kids. We are not equipped or experienced enough to deal with small children.

No sooner as the boy and his mum were on board, we left for hospital. I put the blue call in on route. You've then got that terrifying 10 minute journey, where you can only watch. Watch a tiny, helpless 2 year old boy violently fit, and there is nothing you can do. You try and reassure the mum, but doing so, without the fear of god in your eyes is near impossible. As a parent I can't imagine the fear I'd be feeling. She held his tiny little hand whilst I held him in position on the bed. It was one of the longest 10 minutes of my life.

On arrival at hospital, he had been fitting for over half and hour. His condition was critical. We handed over to the paediatric team and they took over his care. We left the mum standing in resus with tears pouring down her face. I did my paperwork with the crew and then got back in my car which had kindly been driven unto hospital by one of them.

I never found out how the boy got on. I never will.

08:17

"42 year old male, collapsed, fitting, O/S supermarket"

The sex, age and location told me all I needed to know. I knew exactly who it was! It was one of our regular alcoholics and this was his morning fitting hotspot. He'd either have had a fit and now be recovering or will simply be asleep! He would most likely smell and once compos mentis would no doubt hurl abuse and then walk off down the road! I wasn't far away, so I lit up the roof and off I went.

As I pulled up outside the caring member of the public who found him waved me over. There, in all his glory was Steve! Lying, asleep, face down in some bushes. And yes, the smell made my nose sore! He was actually a really nice guy when sober, when intoxicated however, he was ghastly!

"Hello Steve, wakey wakey!"

The onlookers seemed shocked that I wasn't doing CPR and sticking a biro through his neck like they do on casualty. My lack lustre approach was justified when a moment after I told him to wake up he promptly told me to 'f**k off'.

"I'm afraid not Steve, I can't leave you face down in a bush!"

"F**k off, leave me alone."

"Up we get Steve, you know that I'm not going anywhere until you are standing up!"

"Just f**k off will ya."

The ambulance pulled up and gave me a knowing grin!

"Steve?!"

"Yep! He's not pleased to see me!"

Between the three of us, we pulled him out of the bush. He was looking worse than normal, clearly the 8am Whiskey run had taken its toll.

"How about we pop you up to the hospital Steve? Get you cleaned up and fed."

"Just f**k off will you!"

"At least let us check you over."

"F**k yourself" he said as he wondered off down the road.

That was Steve! Anyway, just like a Hobbit, it was time for me to have my second breakfast! I think I'd earned it!

To be continued.....

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Relevant to: 24 - Season 2: Episode 1 + Paramedic