Monday 28 May 2012

Here we all are

"28 year old male, fitting"

It was 05:10. I was tired. My crew mate was tired. In five minutes we could only be given a Red 1 (Cardiac Arrest). The clock was ticking by and we were ever hopeful of being off on time. It was not meant to be! Our radios went through their routine of beeping in the most annoying, cutting tones whilst frantically vibrating. I'm not going to lie, there were a few expletives uttered about being 'stitched up' with a late job! Never mind, it was nothing new, we kind of expected it. At least it was a genuine job, a fitter, still fitting, wife on scene blah blah blah. I was glad I wasn't going to be late off for a 19 year old reveller in stilettos, a skimpy dress and hair matted with vomit that was lying in the kerb after over doing it on the Jaeger-bombs. We arrived at what was probably the worst signed estate I have ever seen. Numbers were not consecutive at all. We were looking for 87. We found 85 and 89 but not 86, 87 or 88. Eventually we found them on the opposite side of the compound on the top floor. By now the FRU had joined us, so up we went. It was now 05:30. All three of us had finished yet we still hadn't met our patient, *grumble, groan, moan and bitch*

We were met at the door by the patient's wife. We were shown into the living room where our patient was lying on a mattress. He wasn't fitting but had been. He was post-ictal, giving confused answers whilst looking around with very vacant eyes. We gave him some oxygen to bring him around a bit whilst we asked his wife about what had been going on. She said he had been fitting for about 10 minutes:

"Is he epileptic?"


"So is this his first seizure?"

"No he's had 3 before"

"Has he been treated at hospital?"

"Yes, he has had scans and everything"

"And what have they said? Have they not said he has epilepsy or given any medication?"

"Yeah they gave him a prescription after the last one"

"When was that? How long has he been taking the medication?"

"It was three weeks ago but he hasn't started taking it yet"

"Why not?!"

"Because we haven't picked it up yet"

"Why not?!"

"Because we didn't think it would help"

Seriously, what is wrong with people? Why do they not take the advice they ask for?! It's madness! Yet they seem surprised they are not cured! Whilst I helped cannulate the patient the FRU continued the conversation where I had left it.

"So he has had previous seizures, he has been diagnosed with epilepsy, he has been given a prescription for Epilem to stop the seizures but he hasn't taken it because he doesn't think it will help. Now he has had another seizure and here we all are"

"We don't think that taking loads of the tablets is the best way to treat things. The body doesn't need all the chemicals"

"It's the only way to stop the seizures!"

"Oh, we didn't realise"

Tired and frustrated, we got the chair and carried him down the many, many stairs and onto the ambulance. We did his ECG and gave Diazepam when he had his second seizure en route to hospital. Really though, would this make him change his ways? Would a fourth trip to hospital do anything? Would we be back in a few days or weeks because he is still 'anti medication'?! This was a totally avoidable waste of resources, not only for the ambulance service but for the hospital too. It's as bad as parents 'not agreeing' with antibiotics, being 'against' immunisations or not 'believing' in giving paracetamol for high temperatures, then being surprised their kid has had a convulsion; it's nonsense, and irresponsible. Billions of pounds are invested from taxpayers' money to find cures and treatments and pay for medications to reduce an ongoing cost for continued treatment. Failure to heed the advice given and take medication prescribed should trigger charges to pay for future treatment & combat this avoidable use of the NHS. It's ignorant at best, which really riles me.....especially when it makes me 2 hours late off! Rant over! 


  1. Just a query/observation Ella, I thought JRCALC now suggested no oxygen post ictal unless hypoxic ? But you said you gave him "oxygen to bring him round a bit"

    1. True, but they are guidelines and we had no means to get an SPo2 reading due to missing kit. Gave o2 due to the confusion as we couldn't rule out hypoxia. He responded well to it so we took it off. Albeit briefly as he started seizing again.

    2. Okay thanks for the reply!
      First Year Spara

    3. No problem! Good question and well spotted!

  2. Reminds me of recent patient complaining that they were still having 2 to 3 day periods of low mood but not taking their prescribed mood stabilizers but were injecting amphetamines i mentioned with a very straight face that their may be a connection there

  3. how bizarre. Why go to the doctor in the first place? You should turn this blog in to an e book!

  4. Unfortunately as a pharmacist I see it from the other end. Bin-liners full of unused medication returned to the pharmacy for disposal, which due to Health & Safety regs can't be reused. Patients who attend GP surgeries and hospital clinics, receive a dignosis, receive a prescription, get it filled at a pharmacy and then never take it.

    I asked one of our regulars why she was still ordering so many of her tablets if they were just going to be wasted. Her answer was because she didn't want her GP to know she wasn't taking them...

  5. Bit late to reply here (reading all your posts)

    My hubby is epileptic,frontal & temporal lobe epilepsy, he's on AED's although they help to a degree they haven't stopped all his seizures. He still has them, up to 15 a week. Not always a full on TC but absences as well.

    Luckily I know what to do, we have the rescue meds and he hasn't go into status epilepticus or clustered for about 3 years now, so no need to call for an ambulance, yet.

    I do live in fear of SUDEP though. Scary thought.

    Thank you for telling them that taking the drugs will help, even if it takes gods alone knows how many different drug combinations to find the ones that suit him personally.
    My hubby has tried just about all of them, some sent him to intensive care after a whoppingly bad reaction to them, but he has found the ones that seem to help him the most, even though he never will be seizure free.

    Love your blog by the way.



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