“17 year old female, vomiting, ? been drinking”
This week there were a number of articles in the media about the tragic loss of a 22 year old man named Daniel Cripps (click link to read article) most notably in the Daily Mail. Daniel died after getting involved in a drinking game and consuming in excess of 14 shots of vodka. His friends phoned an ambulance and the crew that attended assessed him and deemed him safe to stay at home and ‘sleep it off’ in care of friends. Unfortunately, shorty after the crew left Daniel aspirated on his own vomit and choked to death. The case was heard at the coroners court this week and binge drinking was given as the reason that led to Daniels death. A narrative verdict was given, basically meaning no one was personally to blame. The coroner did say however that:
“With the benefit of hindsight he should have been transferred to hospital”
Whilst I believe this verdict was correct it concerns me that the crew in attendance have come under so much criticism. The Daily Mail led with "Paramedics left aspiring model to die at party after he downed 14 shots of vodka telling him to 'sleep it off'". Legal proceedings are now being brought against the ambulance service involved by Daniels family and although it is their right to do so I think apportioning blame to an ambulance service where no neglect has been found is dangerous. Ambulance staff go to work each day and face all sorts of situations. We see the best and the worst life throws at people and everything else in the middle. If law suits are brought every time someone dies you’ll not only cause people to question the career they are in but the NHS will be inundated with patients who are being brought to hospital because no crew are willing to risk leaving someone at home. It's another prime example of irresponsible journalism where the facts are completely distorted.
A few months back we were called to a 17 year old, vomiting. We pulled up outside a huge property. Inside there was a house party in full swing. Most of the guests were underage bar a few 18 year olds and our patient was paralytic. We sat with her while she spewed her guts up and although we would rather she had gone to hospital she refused. Unfortunately, she had capacity to refuse and as there were ‘adults’ present we had no choice but to leave her at home. Like in Daniel's case, we left her in the recovery position, we gave her friends advise on how to care for her. We also left voice messages on her parents phone telling them what was happening and why. Fortunately for our patient and us she lived to do the walk of shame the next morning. This outcome would be the case more than 99% of the time but for Daniel, he was one of the unlucky ones and paid the ultimate price. There is always a risk leaving someone at home but that risk cannot become a deterrent. It frightens me to think that I could be in court and facing a law suit because someone I leave at home dies, but generally, I leave them at home because clinically and socially it is the right thing to do. Alcohol always poses a risk but now more than ever it is at the forefront of public agenda and something has to give. If we are to do our job properly, we need to do so without the fear that an unforeseen accident could end up with headlines implying malpractice. If our patient had aspirated and died the head line would probably have read "Ambulance crew left a child to die".
The problem begins with the culture of binge drinking. Night on night thousands of people, especially youngsters drink themselves into oblivion. They chose to do it despite the advise of medics, media, police, parents and the government. Daniel was an adult, he knew what he was doing and knew the risks. Admittedly, we have all had a binge, myself included, and more than likely to the same level of excess as Daniel. All that means is we got away with it. Last year there were over a million alcohol related admissions to hospitals in England at a cost of over £3.6 billion and these figures are rising year on year. Hospitals are at breaking point and ambulance service demand is constantly on the increase, in no small part because of alcohol. If every intoxicated person is taken to hospital the NHS would collapse. It is not logistically possible to do so. The other difficulty ambulance staff face is that of hospital staff. When we take in someone who is intoxicated we aren't greeted with open arms. Far from it. They don’t want the patients taking up a bed especially if they have come from somewhere where they could just ‘sleep it off’. Obviously, the suggestion to sleep it off in this case has become a headline and a criticism. Daniel was left in the care of friends in a position that would have kept his airway open and clear. It is easy to blame the ambulance crew but where were his friends?
I have the deepest sympathy for Daniels family but has horrible as it is to say, he is to blame for his own passing. Of course, our ‘blame culture’ today cannot accept this. It is always someone else's fault. It can’t be nice to hear that if Daniel had been taken to hospital he would have lived but he wasn’t. And he wasn’t because he was a young, fit 22 year old who had been drinking. He was in a place of safety, not the street. It wasn’t a medical emergency and as such no blame should be apportioned to medical practitioners. Hospitals cannot ‘cure’ drunkenness and all they would have done would be to monitor him and the crew left him in an environment where this was more than possible. Yes as the Daily Mail so kindly pointed out, he would be alive if he was taken to hospital. Yes, the hospital was only 5 minutes away and yes, he died after being told to sleep it off but that is not the point. That is like saying that if everyone who has a heart attack was in a catheter lab, surrounded by cardiologists when it happens they would survive. Sure they would but life isn't like that.
I don’t want to sit here preaching about how wonderful all ambulance crews are. Crews make mistakes as does everyone, but what I will say is that the media and relatives are far to quick to apportion blame on a crew rather than look at the cold hard reality of a given situation. Hindsight is a wonderful tool but it isn’t one we have at our disposal. We have our experience and our judgement. In this case experience said a 22 year old was safe to leave at home and judgement said he was being left in a safe environment with responsible adults. As far as i’m concerned that is enough for me and I would have made the same decision. I hope Daniel's death will be a stark reminder of the risks of binge drinking and hopefully it will go some way to influence the behaviour of our drunken teen generation. That is what the article should be about. If only a handful of people take note and act in a more responsible way he won’t have died in vein. We can but hope.
Rest in Peace x