The Nation's Health

"44 year old male, chest pain & DIB"

Difficulty in breathing can mean a number of things: asthma, allergic reaction, chest infection, COPD, traumatic injury, panic attack, heart failure; the list is endless. If you call NHS direct or 999 and mention chest pain or breathing problems you will get an ambulance. It's that simple. That is regardless of whether you need one. They are the buzz words, red flags which mean it is not worth the risk. Not only will you get an ambulance, you will probably get a fast response car too because that is what the high category of call dictates. I get the need for it and on the rare occasions the chest pain is a heart attack, or the DIB is life threatening asthma, it's great to have the extra hands. Nine times out of ten however the chest pain is a panic attack and the DIB is a chest infection. This job was a pretty familiar call, especially at 7am. People with respiratory problems are worse in the mornings due to prolonged lying down; rather than get up and see if it improves over a couple of minutes, they call 999. We arrive, sit them up, put them in a chair, take them to the ambulance and they say 'I feel better now'! Shocker!

This job was miles away, so with the usual grumbles about being sent out of area so soon into the shift, we headed off. By the time we arrived the FRU had been on scene for a while. Inside was our patient, sat on the bed talking normally. He had woken up with some shortness of breath, 'a wheeze', and a terrible cough. We ran through the usual questions, most of which the FRU had already asked so gave us the answers. His pulse was a little fast, his temperature was a little raised, his chest was raspy so in all likelihood he had a chest infection. It was too early for the GP, and the walk-in-centre won't take patients who have had chest pain. Bear in mind, when the following conversation occurred, the FRU had been on scene for about 20 minutes and had been discussing medical history and his current presenting complaint:

"Do you want to grab some stuff together and we'll pop you up to the hospital?"

"I don't want to go to hospital"

"Why not? You've called us for chest pain and difficulty breathing and you are showing signs of a chest infection. I think you'd benefit from hospital and some antibiotics."

"I've already got antibiotics"

"What for? When did you get them?"

"For my chest infection, I saw my GP and he gave me this"

He handed me a carrier bag. Inside was a box of Co-Amoxiclav, a box of Prednisolone, a box of Paracetomol and a Salbutomol inhaler.

"When did you start taking them?"

"Yesterday"

"How many have you taken?"

"I took one last night but I still feel ill this morning?"

"You need to take them 3 times a day for the entire course, you won't get better overnight. Why did you call us then not tell us you have already been treated?! What do you want from us today if you don't want to go to hospital?"

"I just wanted you to check me over because I still feel ill so I thought the tablets weren't working"

You can imagine how the conversation continued! It was like talking to a brick wall. He didn't see my point nor did he think there was anything wrong with wanting an ambulance for a check-up. I didn't lecture him because a) there is no point and b) that isn't my job. There needs to be much more education about when we should and when we shouldn't be used, but I am not the one to deliver it. We checked him over, filled out our paperwork, got him to sign it and left.

I just do not understand some people's mentality. It is as if people don't expect to feel ill when they are ill! They think we carry a magic cure for 'feeling rough'! Well, newsflash, we don't! There is nothing we can do if you have already been given medication other than drive you to hospital. That is what ambulances do. I am just so fed up with going to people who have called 999, for an ambulance, and then don't want to go in one! I teach my son that if there is an emergency you phone 999 and ask for whatever service you need. The key word is emergency. That is what 999 is for. Having a cough from a chest infection that you have already seen the GP about, already been given medication for, and already started taking said medication, is not an emergency. It is called 'being ill'. Just deal with it! Get a Lemsip, take your medicine, make a hot water bottle, feel sorry for yourself, eat comfort food, watch Jeremy Kyle, do whatever you need to do, but as my mum always used to say to me: