Saturday 4 February 2012

Where's my Oxygen?

"56 year old female, DIB, Asthma patient"

It had been a pretty miserable night shift, a constant drizzle of rain, non descript jobs one after another and we were miles out of area. The job was sent to us and we headed off towards the address. About 5 minutes before we arrived we got a message telling as an FRU had arrived on scene. We pulled up on your typical Edwardian terraced road with nice big houses. We entered the address through the ajar door and made our way down the dark corridor. There were no bulbs in any of the light fittings so we used a torch to follow the sound of voices. The property had been turned into a bed sit of sorts. Each room was locked with hand written numbers on the doors. What a waste of a lovely building. We entered the room at the end of the hall way which would have once been a living or dining room in its hay day. Inside was our patient, sitting on her bed. The room resembled that of student accommodation, a self contained pod with a mish-mash of paintings, posters, books, magazines, junk, a TV and mess all over the floor. Our patient was sat next to her Pomeranian dog which to be honest, was better presented than she was. Her hair was wild and greasy, she was in pyjamas, faded and smeared make up on her face and plenty of evidence suggesting she was alcohol dependant. A haze of stale smoke engulfed the room and a stain of ochre covered the ceilings. It wasn't pleasant. The FRU gave us a half smile of frustration (LOB) and a brief handover.

She was complaining of DIB for the last hour. She was an asthmatic and proudly showed us an array of inhalers. She also produced a stack of Patient Report Forms (PRF) indicating a large number of ambulance attendances in recent months. She always refused hospital and they all painted a similar story. Called with DIB, all OBs normal, no wheeze, refused hospital and GP referral. Sure enough, all her OBs were normal. 99% oxygen saturation, a normal respiration rate, good chest rise, no cough and no wheeze. Her pulse, temperature, blood pressure, blood sugar and ECG were also normal. She wasn't ill and unsurprisingly she declined hospital and refused a GP referral. 

"Gimme one of those neblizers"

"You don't need an NEBULISER. You haven't got a wheeze"

"So, the other crew gave me one"

"Well I'm assuming you had a wheeze then. Today you don't and as thus, you don't need a nebuliser"

"Gimme some oxygen then"

"You don't need oxygen, your saturation is excellent"

"I don't care, it's my choice"

"I'm afraid it's not. We only give drugs if it is clinically indicated. In your case it isn't. If you are concerned you should come to hospital with us"

"Oxygen ain't a drug"

"Yes it is"

"How dare you come into my house and refuse me oxygen. It's my right. I pay your wages"

"You called us. We assessed you, advised you to come to hospital, you declined, don't shout at us for refusing to give you a drug you don't need"

"It isn't a drug"

"OK, we'll have to agree to disagree, and for the record, the taxes I pay also pay my wages. What do you do for a living?"

"I can't work, I'm disabled, I got Ostoritus (i'm assuming Osteoarthritus but it wasn't evident in her medication) but I USED to pay your wages"

"I never said you didn't...."

"You implied it"

"Are you coming to hospital or not?"

"No, get out of my house seening as you have refused to treat me"

"I haven't refused, I have offered you 2 care pathways, both of which you have refused. I have refused to give you drugs you don't need"

"Get out of my house"

"OK, good night, nice to meet you"

"Get out"

Not much else to say really. These are the people ambulances are wasted on. This is why elderly fallers have to wait hours on the floor. This is why the service and the NHS is under constant pressure. But it's OK. She pays our wages!


  1. I find this absolutely incredible! So much so I can't think of anything else to say on the matter!
    (shakes head, mutters under breath and walks away dumbfounded!)

  2. People like this should pay the expenses incurred.

  3. I agree.ive only needed an ambulance once.I had a seizure due to post concussion syndrome.the care was excellent but it was almost a 900.00 bill.I know they charge for services here in the US.ive often wondered why more places don't


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