Thursday 24 January 2013

Allergies & Vomiting



“2 year old male, vomiting, ? allergic reaction”

I have my very own 5 year old. In that 5 years he has vomited. In fact, he has vomited on numerous occasions, sometimes on me! Sometimes he has vomited more than once in a day. When he was a baby he would vomit milk all the time. He goes to school, he picks up bugs. He gets coughs and cold and sometimes even an upset stomach. He deals with it all. We deal with it all. Humans get ill from time to time. It’s a fact of life. We certainly never called an ambulance because he had been sick. Just sayin’!

Anyway, it was about 10pm on a bog standard weekday night shift. Me and my crewmate were parked up listening to Frank Sinatra watching the world go by when we were given a job about 100 yards away. We had pulled up, got out, grabbed our bags and rung the door bell before the 999 call had finished! We made our way up to the 3rd floor and knocked on the flat do. 

“In here, come quickly” said a frantic voice.”

We passed two teenage girls in the corridor who pointed us into the bedroom. Sitting on the bed was our patient sitting on his mothers lap. Her knee was bouncing up and down, as was the little kid! Probably not ideal for a vomiting child! I asked what had been going on and despite all the drama that was put into the story the crux of the matter was that the kid had vomited once and was now sleepy. Call me a cynic but is vomiting once a medical emergency and is it any surprise he is sleepy when it’s 3 hours past his bed time?! Despite my best efforts to calm her down, the mother was having none of it. She thought her kid was gravely ill and wanted to go to hospital. This vomiting was an apparent allergic reaction to banana. Trust me, I’ve seen allergic reaction, this wasn’t one. Even her teenage daughters found the whole thing a tad bizarre and chipped in trying to convince her to calm down. No joy!

She was convinced he was riddled with allergies and that was what had made him sick. Asking about allergies is a pretty standard question when determining someones medical history. A lot of what people are convinced they have a penicillin allergy, most don’t. They either had a side effect from taking it or simply don’t like it. The same applies to food people don’t like and in panicking parents, these make believe allergies are passed onto their children. 

“What is he allergic to?”

“Ha, what isn’t he allergic to?!”

“............” I didn’t feel that ridiculous statement warranted a response so just waited.

“Penicillin, wheat intolerant, lactose intolerant, most washing powders and nuts”

“What happens when he takes penicillin?”

“I don’t know, I won’t let him take it?”

“Why not?”

“Because I’m allergic to it.”

“In what way?”

“I feel constantly sick and ache”

“That’s a side effect. I doesn’t mean your son will be allergic.”

“I’m not risking it.”

“Has he been hospitalised or had any severe allergic reactions to anything?”

“No.”

Excellent! No known drug allergies is what I wrote down on the paperwork! This conversation reminded me of an article I read in The Daily Mash that sums up my feeling on the issue!
Your Baby Is Not As Pathetic As You, Say Experts 
WORRIED parents are being urged not to automatically assume that their baby is as pathetic and ill-informed as they are. 
Research has revealed that many parents have already decided their child will suffer from the same made-up food allergies they do.
And a recent study showed 65% of GP visits were the result of parents believing their baby is developing a Coco Pops intolerance because they have a great aunt who is hypoglycaemic.
But now scientists say there are other factors that cause babies to become feverish, develop a rash or shit themselves up to 18 times a day.
Dr Tom Logan, of the Institute for Studies, said: “It’s because they’re babies.”
He added: “If your baby is developing in a perfectly normal way, try to not jump to the conclusion that it must be suffering from that corned beef allergy you read about in Take a Break. 
“Also, if you think that you may have an intolerance to cheese, black pudding and Greggs pasties, don’t assume that your baby is going to be a delusional, self-absorbed halfwit.
“The best thing to do is wait until you have finished breast feeding and then either give the baby to Barnardos or leave it outside a big, posh house.”
We use humor quite a lot to diffuse a variety of situations and as much as i’d like to have read out the above, I used some restraint! Sometimes humor works, sometimes it doesn’t. I consider my crewmate to be very funny! He has good timing and often lightens the mood at the right times. The mother was rushing around like a headless chicken trying to put her entire life in a bag. I tried to tell her that if we are not rushing around there is nothing to worry about! That didn’t help. Maybe a bit of humor to lighten the mood?! The mother had the strongest of Liverpudlian accents. My crewmate went with.....

“That’s an interesting accent, what part of London are you from?!”

The daughters laughed, I chuckled, the mother glared.

“Is that supposed to be funny? Do you really this jokes are appropriate when my child is seriously ill?” 

SHOT DOWN! He sheepishly apologised! Seriously though, lighten up! The joke however, made the whole experience very awkward. Both of us were treated to glares for apparently not taking this life and death emergency seriously enough. What annoys me is that these people call an ambulance and then don’t respect the staff on them. I can only assume she called because she was worried and wanted some medical professionals to help. We arrived, looked, assessed, took a full history and came up with an impression of what we thought was going on, a diagnosis and a list for a differential diagnosis'. We see up to 12 patients a shift, 3-5 shifts a week, 52 weeks of the year. That equates to about 2000 patients a year. We know when a patient is ill, we know when a patient is on death's door and we know when a patient has vomited and wants to go to sleep. Why not call a taxi if you are going to ignore the ambulance crew? They will be able to do exactly what we are doing and probably won’t make any jokes.

People really need to take life less seriously and lighten up. I know that something trivial for one person can be an emergency to someone else but some people really need a reality check! If you call 999 and a paramedic tells you that everything is okay and a 2 year old vomiting once isn’t anything to worry about DON’T tell them they are wrong. Life is too short to be so bloody uptight! Chill your frickin’ beans!




10 comments:

  1. I can kind of half understand if she was the neurotic mother of her first child, but her third? Surely she's seen it all before? I would never think of calling an ambulance if my 17 month old chundered. It happens!

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  2. Although I wouldn't call an ambulence I'm an emotophobe- so puking children do throw me into a blind panic. A lot of the patients you describe on this blog (though frustrating) seem to have mental health problems of some sort. (Eg: The woman who called one because she couldn't sleep.) I know there's no excuse to call an ambulence for stupid reasons- but I do wonder whether all these people are compeltely right in the head when they do it?
    Although the lazy ones who call it as a taxi need some serious consequences. I very much enjoyed your story of the nurse who kept a patient in for several hours and she missed her appointment. A good call!

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    Replies
    1. I don't deal with vomit well either!

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    2. Is there a mental health diagnosis for "called an ambulance because she couldn't sleep"? Oh, I see. You've invented some new categories called "mental health problems of some sort" and "not completely right in the head". I'll let my psychiatrist know next time I see him.

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  3. I had an ambulance called for me by NHS Direct because my son had croup. I knew he had croup. I wanted to know if it was contagious as it was the first time he'd had it since being in nursery, and I didn't want to share if I didn't need to. (I'm nice like that!) I also know, based on the other 78million times he'd had it, that it would last for around 5 nights, that he sounds like Darth Vader until about 7.30, when he's been up about an hour, and that he presents as pale, lethargic and absent, which is mainly due to the fact he's had no sleep because he's been coughing all night. Unfortunately that ambulance was called by NHS Direct, but weren't told it was NHS Direct, so thought I'd called them out for croup! He was taken in because his breathing was still Darth Vader ish, (and it was 7am) but we weren't seen until nearly 7:45, by which time the doctor who saw my bouncing child thought I was a neurotic mother until I explained about NHS Direct. He asked on what grounds they had sent an ambulance. I said it was after they had spoken to my 3 yr old on the phone..... He sighed, and said I wasn't the first. He did however, reassure me that the child had croup, and that he wasn't contagious. Child was in nursery by 8:30, and I was at work by 8:45. Ambulance were lovely, and stopped treating me like a neurotic mother when I said about NHS Direct, but up until that point, I wouldn't have blamed them, especially now I've read stories like yours!

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    Replies
    1. Always happy to go to croup! It is an airway obstruction after all!

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  4. Well it makes a change from NHS Direct needlessly calling an ambulance for a chest pain that the patient doesn't have, and has never claimed to have. At least being called unnecessarily for croup creates a little bit of variety!

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