Tom Reynolds - The Complete Blood, Sweat and Tea

We arrived on scene and were met by a policeman who first apologised before leading us to a man who was approximately 30 years old. The man was obviously drunk, and my crewmate told me that he smelt heavily of alcohol; along his arms were the scars of a ‘cutter’ – something else we are seeing more and more of these days. The policeman told us that the patient was refusing to give his name or medical details, only that he was called ‘John’.

We approached ‘John’ and he agreed to come to hospital with us. I got him into the back of the ambulance and he refused to let me touch him, so I couldn’t do my usual battery of tests. In fact, he didn’t want to talk to me at all, and sat in the back of the ambulance not talking; at one point he threatened to leave the ambulance but I managed to persuade him otherwise. (Don’t ask me why, I normally let drunks go as soon as they say they don’t want to go to hospital.)

All went as normal until we rounded the corner to the hospital, where he got off of the chair and laid on the trolley-bed. One hundred yards later and we pulled up to the hospital and I told him to get up, then I told him louder, then I did a sternal rub to wake him up – and there was no response! I then slipped an oropharyngeal airway into his mouth, this would wake anyone up, but not a flicker … he was deeply unconscious. This meant he was due for the Resus’ room.

We rolled him (rather quickly) into the Resus’ room and were met by a rather angry nurse – she wanted to know why we hadn’t pre-alerted the hospital. I explained that he had just lost consciousness outside the department. She then asked me why he didn’t have oxygen on him. Again, I repeated that he had collapsed when we were outside the hospital. We got him onto one of their Resus’ trolleys while the doctors in the department ran into the room.

For the third time I explained what had happened, and that I had no vital sign observations; this time they paid attention, and accepted what had happened.

To be honest I don’t blame them, the A&E department rarely has any surprises – the hospital is normally forewarned about any ‘nasty job’ we are bringing them, and to suddenly have a seriously sick patient turn up without any warning is always a bit of a jolt.

Now the patient was unconscious the nurses were able to do those vital observations that I was unable to do – and they were all normal. His pulse, blood pressure and blood oxygen levels were all better than mine, his blood sugar was also well within normal limits. There was no obvious reason why he was in such a deep state of unconsciousness.

He was quickly intubated, and we left the department. I’ve spent some time wondering if I missed anything – if there was anything I would have done differently – but to be honest I don’t think there was. Even if I had managed to get a full set of vital sign observations, they would have all been normal and there was nothing that indicated his condition changing so quickly. I can’t ‘assault’ a patient who has refused a procedure (such as observation taking), and all I could do was exactly what I did do – watch him while we took him to hospital.

The current idea is that he had taken an overdose of some sort along with the alcohol, and that it had started to work. Because the patient hadn’t spoken to me, I had no way of knowing if he had taken an overdose.

I never did find out what had happened with the patient – it’s one of the poor things about this job, that you can’t always follow them up.

Protecting Little Old Men from the Police?

We were asked go to the local police station to help with arresting someone. The arrestee (is that a real word?) was an 80 (or more)-year-old male who was accused of recently committing a crime that I would suggest required some amount of physical strength. We were to follow along because the person had heart and breathing problems – so much so that he had bottled oxygen in his house.

We met with the police officers (nine in total, and all rather scary looking plain-clothes types) at the police station, before following them to the address in question.

Once the police had made their entrance we were called forward to give the patient a clean bill of health. We watched as this frail man slowly dressed, needing help from his son to tie his shoelaces; we watched as he struggled around the house and wondered how he could possibly be guilty of any crime that needed any form of physical exertion.

The patient’s son was also a bit put out by the allegations, and promised to have a good laugh at the police’s expense when the truth came out.

Throughout the arrest the police were polite, helpful and behaved in a thoroughly professional manner at all times.

The patient/arrestee was also calm throughout and the whole thing went, as far as I could see, very smoothly, and our ambulance followed the car in which he was taken, until it entered the police station and the FME (Forensic Medical Examiner – a doctor that the police use) took over.

The next job we went to was to outside the same address: a woman had been mugged and the police who were searching the address had called us as she had a rather large bump on her head. Unfortunately, the mugger managed to get away. It surprises me that you can get mugged outside a house full of police and the mugger can still escape.

Victims

Imagine, if you will, getting sent to a job where a 15-year-old boy is threatening suicide. You turn up at the address and discover that it is a care home. Meeting with one of his carers she hands you a list of the boy’s medications and it reads like a ‘Who’s who’ of psychiatric drugs. You talk to the boy, and he seems calm, collected and very polite. He explains that he wants to jump out of a window and kill himself, and agrees that he would like to go to hospital. You take him into the paediatric department of a local hospital. As this does not feel like the normal ‘Teenager wants to kill themselves’ you have a chat with the children’s nurse and you ask them to let you know what happens to the patient. You leave, and continue with your shift. The next day you ask the children’s nurse about the patient and she tells you ‘The boy wanted to die because he wants to have sex with, and kill, small children – and that he knows that it is wrong’.

I hate paedophiles as much as any other member of society, but in front of me that day, I saw a victim.

Behind Locked Doors

One of the jobs that I both enjoy and hate is for a ‘Collapse behind locked doors’. This is when a (normally elderly) patient has not answered the front door or the telephone, and is presumed to be in some trouble. What we often get is someone who has died during the night. Although I hate having people die, the one good thing about this type of job is that I get to use my size 12 boots to kick down a door.

There is a skill to kicking down a door, and I was taught by the best – a policeman. The police also have a huge ram that they can use when their boots aren’t enough. These are very heavy, but also lots of fun to use.

We got called to a house where the daughter could see her elderly mother lying on the floor; shouting through the door and banging on windows didn’t get any response, so we assumed the worst. The daughter was (understandably) crying, so I had an attempt at kicking the door down.

Unfortunately for me, the woman had been burgled earlier in the year, and so had two locks, and a bolt holding the door shut, so it took a couple of minutes of prolonged (and eventually painful) kicking to get the door open. I also managed to wake up all the neighbours, and it’s always fun to be the centre of attention …