Friday, 23 November 2007

Ranty blog post.......

This may turn out to be war and peace so I won't hold it against you if you don't get to the end!

Let me tell you about a shift I had recently. By the end of my shift B (D was still on leave) and I had worked out that had the four people we attended that day, or their friends or relatives, thought about what they were doing we wouldn't have been needed by any of them.

Patient #1: Let me start with not the patients fault..... It was a call to an elderly lady with breathing difficulties, found in a bit of a pickle by the sheltered housing scheme manager. When we arrived she had taken her inhaler and was looking ok if a little short of breath. She was deaf as a post so it was hard going. Inside the pts NOMAD (drugs box) was a note from the pts daughter saying 'please help mum with her inhalers she is having trouble breathing'. My thoughts there, ring the Dr, your Mum shouldn't be having trouble breathing and may have avoided us dragging her into hospital with saturations of 88%........

Patient #2: Definitely the pts fault..... Woman in early stages of labour, has had gradual increases in blood pressure which has meant she has had to be seen by a consultant at another hospital rather than the one she is booked into. The consultant decides she is not suitable for a midwife led delivery and she is moved over to the care of the other hospital for a consultant led delivery. Today she goes into labour and rings the midwife led centre to see if she can go in. Over the phone she lies and says she has had no problems during pregnancy and has only ever seen midwives. She turns up at the midwife led hospital and is told she can't deliver there and as she is too far into her labour to go by car we have to go pick her up and take her to the other hospital. Now I wouldn't want to go to the other hospital but she had enough notice to up hospitals and book into a closer, nicer hospital, not just lie and turn up at a hospital you have been told you can't deliver at because you and your baby could be at risk.

Patient #3: Blame can be spread between three parties, my control, the supermarket and the pt. We got the job as pt feeling lethargic, stiff neck, pins and needles in hands feet and around the lips, aches all over. For starters the job should never have got to us. Next, we arrive and the pt is a young male, looking a little wiped out but GCS 15, well perfused and talking happily. He states that he just doesn't feel himself, feels weak and achy and very tired. We check him over, BP a little on the low side but then he was young and slim and temperature a little up (about 0.4 of a degree higher than mine), we then checked his O2 saturations and ECG, everything fine. The pins and needles was from all the deep breathing he was doing because he felt a little nauseas. We send him home in a taxi to be looked after by his girlfriend with instructions to see his GP. He most probably has a virus or something similar. He apologised for us being called but I get the impression he didn't do much to stop it. The real problem arose when the staff cancelled the taxi they had called the pt for him to go home and called an ambulance instead.......

Patient #4: Male, diagnosed with gastroenteritis three days previously, with SEVERE abdominal pain. When we arrived he was laying on the sofa, not in obvious pain but I'm not saying he wasn't in any. We checked him over from top to bottom and found nothing wrong. He had had diarrhoea for a while but was showing no signs of dehydration or ill effect. There was some tenderness on palpation of his abdomen but other than that nothing....... So I did the spiel, I can't see what is going on in there but I expect it to be as diagnosed, nothing more serious. He had had all the tests the hospital could do so what more could we do. Nothing had changed since the hospital visit it just hadn't got any better. I suggested they speak to the Dr about better pain relief and they said that they had spoken to the GP while we were on the way and he had said to let us deal with it. Thanks..... In the end the chap went to bed with instruction that they should visit the GP if nothing had changed after the weekend or earlier if necessary. Were we needed, nope not really.

I have to say with regard to any ambulance call that to dial 999 you must be worried therefore you will always get my full attention and all the tests I can do for you to ensure there is nothing worrying going on. I just wonder sometimes that's all........

The next day, apart from our first call and one in the middle which were 'B' cats, all our other emergency calls were given as 'A' cats. I know that two of them were 'A' cats and another was likely to have been but we didn't get there as we were stood down as there was a closer crew cleared down. All of these 'A' cat, eight minute response, calls came in when we were on base or close to base and were a good 10 minutes away down the motorway...... I think someone must have put something in the water........and there was an hours bed wait at the hospital throughout most of the day. This made me late off.........

2 comments:

mdmhvonpa said...

Busy, busy, busy. Hey I finished the whole thing but already forgot the 1st half!

Anne said...

Sounds like one of my typical shifts in inner city Philadelphia many years ago!

So many calls for people who don't really need ambulances...so many walk-ins to my Emergency Room, treating us like their family doctor's office.

And full moon time brings out all the loonies, druggies, and boozers. Saturday 11/24/07 was full moon.

You've earned your rest.
Take care,
Anne