Thursday 9 January 2014

24 - Season 3: Episode 3

The following takes place between 00:00am and 03:26am


It was fair to say we had broken the back of the shift! It’s always nice on nights when you consider yourself to be on the home stretch! We tucked into our cold dinner as the clock ticked down to when we had to green up for the next one. Sadly, that time arrived far to quickly and once again we were off. I was also starting to yawn which with 6 hours to go, isn’t ideal! Again, I tentatively suggested we swap round but the only thing I got was laughter in return. Worth a shot! 

“30 year old male, DIB, Asthma. From NHS 111”

You’ll be shocked to hear I was sceptical! As far as I’m concerned, people who have asthma no what an asthma attack feels like and know what to do when they have one. They also know exactly when they need to call 999 so I find it odd for an asthma patient to call 111 for advice. As had been the theme of the evening, my cremate posed me a simple question:

“On a scale of 0-10, 0 being breathing so perfectly it makes me feel positively wheezy and 10 being unable to breathe, requiring ventilations, a silent chest, tracheal and sub-costal tug all needing immediate inspiration and a blue call, how bad is his DIB?”

“I reckon a 2. Possibly a 3. He’s probably got a cough. In fact, change that to a 1. Normal everything, no wheeze but thinks A & E will be some kind of great adventure!”

We pulled up at the block of flats. The address details said ‘4th floor’. There was no lift. Can you imagine the joy that was flowing through my veins?! By the time we got to the top, both of us were breathless and therefore, by my prediction, more in need of an ambulance than the patient. 

BINGO! *takes a bow*

There was our treasure of a patient, sitting on the sofa grinning away. There was no cyanosis, no increased respiratory rate, no obviously distress or difficulty, just a big grin. The grin itself was mildy unsettling! 

“Good evening Sir, what’s the problem tonight?”

“I’ve had this awful cough and cold. I think I’m wheezy with difficulty in breathing.”

“How long has this been going on?”

“Since the afternoon.”

My crewmate, complete with wry smile, did all of his OBs. All normal. Oxygen levels were 100%, there was no temperature, blood pressure and heart rate were normal. I couldn’t find anything wrong with him other than being sniffly. 

Despite my sound medical advice and suggestions of alternatives to accident and emergency he wanted to go and get ‘Antibotics’. I didn’t think he needed Antibiotics but there was definitely no indication for ‘Antibotics’. Rest assure though, he had taken ‘Paretomol’ and ‘Buprofen’


Anyway, overnight bag packed he headed back down the stairs to the ambulance and headed off. On route I had a fascinating conversation with his wife about diabetes. She had been diagnosed with type 2 diabetes a year ago at the age of 26. I can’t say I was surprised, she must have been in excess of 20 stone and rather short. Diabetes was somewhat inevitable. However, she assured me that she’d ‘caught it’ of her mum. Yep, that nasty contagious strain of diabetes mellitus was at it again, jumping from host to host, catching people unawares. It was just sheer coincidence she happened to be morbidly obese, a smoker and didn’t exercise. But yes, blame the parents! 

What these two need is the health promotion version of the ‘birds and the bees’ chat. An actual in depth conversation about lifestyle, risk factors, causes, what constitutes being ill and PRONUNCIATION of very common medications! Every time someone says ‘Buprofen’ a puppy dies. Spread the message and help cure the madness!


Thoroughly frustrated and now verging on irritable I no longer felt on the home straight. It felt like there was absolutely years to go until the end of the shift. Urrrrrgggghhhh!!

“23 year old female, tearing abdo pain, From NHS 111”

Really?! ‘Tearing’ seems the new buzzword that NHS 111 seem to be asking patients. Tearing abdo pain is a symptom of a very dangerous, life threatening Abdominal Aortic Aneurysm. (AAA). These patients often die. Unfortunately, if you ask someone who is ringing for advise if the pain is ‘a tearing pain’ it is highly likely a fair few will just say yes. Cue the Red 2 response of FRU and an ambulance. 

“On a scale of 0-10, 0 being calm, relaxed and whistling ‘ Always Look On The Bright Side of Life’, and 10 being the worst abdo pain since records begun, causing eventual loss of consciousness and a necessity to anaesthetise immediately, how bad do you think the pain is?”

“Definitely a 2. No more. But I want a bonus if she says 11 or 12 then laughs.” 

Up ahead of us were blue lights, we slowed down by the police car and saw the wreckage of a car. 

“Evening! Need a hand at all?!” 

“Yes please, we’d just requested you, got 1 trapped”

“RUNNING CALL: RTC, Car vs Tree, 26 year female trapped, injuries unknown.”

Pulled over and the road was subsequently closed. In the passenger seat was a young lady very distress and upset. The wouldn't open and her leg was trapped. A second ambulance was on scene within a minute or so and one of them got into the back, much to his annoyance! Everyone else claimed seniority so it was he who hat to sit in the back, holding her head for probably an hour whilst we got the fire brigade to cut her out. 

As I’ve said before, the fire brigade are great at what they do and we can’t get these patients out of the car without them. They arrived on mass much to the amusement of the police and myself. A sea of daffodils bundled out of all 3, yes 3 fire engines plus a specialist rescue unit. There was at least 24 of them around this tiny Nissan Micra. 

“I can’t stand around here watching them all swinging their bollocks around in some blue light mating ritual. I’m taking the driver to the truck and see how he is!”

Well, that was my cremate gone! And she had a point. Despite explaining that I just wanted the door off they seemed determined to take the roof off! My patient had no neck pain or back pain but was trapped and her leg was hurting. I wanted to get her out with as little faff as possible but that was proving an impossible task. The ‘white helmet’ ( 1 of 3) attempted to patronise me with phrases such as ‘Look here luv…’ which went down a treat. They didn’t need to take the roof off, the door would surface so much to their annoyance I pissed on their parade and stuck to my guns. Rolled eyes and head shakes followed but I didn’t care. It was freezing cold, raining and my patient needed to be in the warm with some decent pain killers. This wasn’t the time of the place for a training exercise. 

With the door off we got her fitted into a KED (fancy extraction devise) and promptly pulled her out of the car sideways onto the bed. She had escaped with minimal injuries so was taken in the other ambulance. We took her husband to the same hospital and left the 24 deflated egos having a collective bitch about that stupid paramedic! Ooops!

This encounter had woken me up somewhat! By the time we were fed and watered and ready to go again it was approaching 03:30 so time for 1, maybe 2 more depending on the customer! Winning!

Time to press the button again…..

To be continued…..


  1. "No neck or back pain" with a distracting injury that you can't assess due to physical/ mechanical entrapment and a mechanism of vs tree on a wet road.... Unless she was time critical to justify a rapid ex I think that the "daffodils" had a point.

    Oh and I speak as a fellow paramedic, not a member of the fire service. I have institutional issues with the fire service: as a whole they are massively over resourced while the police and ambulance services are struggling. However on an actual doing the job front I have never found them less than helpful, cooperative, friendly and willing.
    I wonder if this will get posted...
    A Suffolk Paramedic

  2. You love comments? Hmm... Three days and you haven't posted mine. Is it because I've been critical of your clinical practice? This doesn't make me a troll, it makes me a concerned fellow HCPC registered professional, who is qualified to question and discuss your actions. Actions that you have boasted about in your writing in the post above.

    "All genuine comments will be posted" you say? When?

    A Suffolk Paramedic


I love comments! All bloggers do! If you have something to say, agree or disagree I would love to hear it! I will reply to all! (or try my very best!) If however, you're a troll, save your breath!

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