“4 year old female, vomiting, DIB”
I see a lot of different people in this job; a lot of people from different backgrounds, different ethnicities, different religions and different sexualities. People come in all shapes and sizes, all ages and each with their own unique medical histories. Some people have nothing wrong with them; some have very complex needs and care packages. Until we arrive at someone’s house and go in, we have no real idea of what to expect. A 4 year old vomiting with DIB is nothing out of the ordinary and could mean anything from a minor stomach bug to a life threatening condition. The latter is unlikely but always possible.
On route to a job it is not uncommon to get an update, namely because we are dispatched automatically by a computer as soon as an address or mobile phone co-ordinate is obtained. As more information is received we are updated.
“UPDATE: Patient has special needs”
This could mean anything but made the job a little more interesting. We arrived at the front door, which was opened by a small child who pointed upstairs. Up we went, bags in hand. In the living / bedroom was about 8 or 9 members of a family ranging in age. Lying on the bed, on her back was our patient. She was very small for her age, her legs were not properly formed and her face was slightly contorted and swollen. In the corner of the room was a very complex looking wheel chair with head and leg straps and a torso restraint. It was clear her needs were very complex so vomiting could be a serious issue in terms of aspiration.
“What’s the problem tonight?”
“She vomited”
“Anything else?”
“She’s not breathing normally”
“OK, so what medical conditions has she got?”
“She can’t walk or talk”
“OK, but what is specifically is wrong with her, what condition has caused this?”
“She was born like it”
“OK but what condition is it that she has?”
They just looked at me blankly and then the mother passed me a folder. Normally when a folder is passed by a relative, it is a care folder with medical history, medications and patient details. The folder we were given contained financial information relating to the kid, benefit allowances, bank statements and letters requesting more money. A bank statement dated 2 weeks previous showed a balance 4 x my monthly salary. It also transpired that no one in the house worked for a living.
“This has nothing about her medical history, what is wrong with her?”
“You tell me, you’re the paramedics.”
“Yes. I know that, but without knowing her history or what she is normally like at 2am it is hard to form an opinion of the cause to the vomiting. What condition does she have that causes her to be in a wheelchair?”
*Shrugs shoulders and kisses teeth*
While I was fighting an uphill battle trying to get any kind of history, my crewmate had been checking her over. She grabbed the oxygen and put on a full flow mask. Very low oxygen levels, a very high respiration rate and a very congested chest suggested she might have aspirated on her vomit.
“Right, we are going to be going to hospital, can you grab a bag of stuff for her”
The mum passed me a bag.
“Can you carry that? We have our bags to carry”
“Oh, do I have to come with you?”
“YES! She’s your daughter!”
“But we’ll be sat there for ages, can’t someone just call us when she needs to come home?”
“NO! One of you has to come with her.”
A look of sheer annoyance spread across her face. Was I really hearing this?! Do people like this actually exist?! Why is this poor child allowed to live somewhere where she clearly isn’t being given the care she requires? I really do despair at what society has to offer. Lying on the bed in the ambulance was a little girl who has a very poor quality of life at the best of times. Couple that with parents full of apathy and who’s priority appears to be what money they can get as a bi-product of her condition and I was left feeling sick. Sick that there has been no intervention, sick that situations like this exist. I don’t know if this behaviour was a cultural thing but as far as I was concerned it wasn’t something that should be tolerated in any culture or society. I certainly wasn’t going to let it go un-noticed.
In a heavily antiquated system there is too much red tape to cross, things simply take too long to take effect. Protocols need to be in place to enforce the strictest of penalties when the care of a child fall short from what is expected. Not just for the extremes in children with complex medical needs but in children who display anti-social behaviour, truancy and crime. I personally think that parents have to be held accountable for their failings at all levels otherwise their culture and apathy towards parenting will be evident in the next generation. Maybe I am being harsh but I really do despair at what we as a country allow to happen.