The Nation's Health + Paramedic

Not Alert

"2 year old male, high temperature"

This was my first shift back after a prolonged absence so as boring as the job sounded I was glad it was nothing to strenuous. It was an Amber 1 call which meant it was deemed to be serious but no immediately life threatening. We had a fair way to go which meant I had plenty of time to finish my Costa and Jelly Babies. That is my staple diet by the way. A shift without them is unheard of to be honest! We were about two miles away got a cancellation. 'Cancelled, higher priority call'. We accepted cancellation and waited for the new job to come through.

"2 year old male, high temperature"

Same job, same distance, different address but this time it was a Red 2 call. One which is deemed to be immediately life threatening and would warrant a response from an FRU too. The reason given for the severity of the call was the much maligned term 'not alert'. Not alert is the most misused phrase by control. The simplest of jobs are upgraded because 'the patient is now not alert' and it is such a leading question to ask a caller. As far as I'm concerned you are either conscious or not. Being 'not alert' is the grey area of consciousness that the lay person is not equipped to decide. We will decide when we arrive and be the judge if they are indeed alert and orientated. Saying a 2 year old is not alert to me is like saying a cat has epigastric abdo pain. You just don't know! My thought on the right and wrongs of 'not alert' aside we headed round to the address. The car was pulling up as we arrived so the three of us all bundled into the house.

We were greeted by the entire family all dressed and ready to go. Parents, siblings, grandparents and the opare all standing and staring at us expectantly. Our patient was already strapped into a travel seat and was indeed 'Not Alert'. That's because he was asleep......

"OK, whats the problem today?"

"He's really hot and cold and grouchy. He also seems really tired"

"What makes you think he's hot and cold? Have you taken his temperature?"

"No but I think he's got a cold and you get hot and cold when you have a fever don't you?"

Whilst talking to her, I took the kids temperature. Normal. Pulse. Normal. Respiration rate. Normal. Skin. Normal. Chest. Clear. Seemed well to me!

"You can do but he seems OK. We'll pop him up to the hospital if you want but he's asleep and doesn't appear unwell"

"That's the problem, he is constantly tired, I'm having to wake him up every half an hour or so to make sure he's OK, I'm just so worried that he's been so tired and grouchy recently, I think it's best a doctor looks at him. Could it be chronic fatigue syndrome?"

"No. It isn't that. I promise you! You wake him up every half an hour?!"

"Yes, to make sure he's OK"

Clearly the sarcasm in my tone was lost on her. We took him to hospital despite my advise, with a people carrier of family following behind. I had to put up with unnecessary questions and over reactions the entire way whilst everything I said /suggested was being ignored. I didn't even see the point in lecturing her about what an emergency ambulance is for or how to care for her third child. What do I know?! Some people are simply beyond help. If someone woke me up every half an hour being tired and grouchy would be the least of their worries! What a tool!

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Relevant to: Not Alert + Paramedic