Monday, 3 December 2007

Couple of things

It's December, how did that happen.....? I am still saying its not Christmas from time to time but I am coming to the conclusion that I'll have to give in to it at some point. Even got the Christmas decorations out of the loft!

It's been one of those weekends, we were all very very busy, all crews late off every good for the morale...... I started the weeks shifts badly with a migraine by about 9am Thursday and got myself in a pickle in the evening when feeling sorry for myself, asking for reassurance from B and him changing the subject nicely. I did then corner him in the car and tell him what he had just done and then cried....... He just expects me to know that his feelings don't change and that he is coping with me fine. He tells me regularly that he loves me but sometimes I'll ask for the reassurance and he doesn't always get why I need it. Still we chatted in the car as we do and sorted ourselves out. I hate being needy........

Anyway, had a couple of interesting jobs, an actual ill person and my first encounter with an MS pt on the road.

I'll start with the ill pt, I have see very few really ill people recently and then the one I do see I can do very little for him other than get him on the ambulance and get him to hospital quickly. We were given a description from control that led me to believe our pt would be having a CVA. When we arrived we realised there was a Dr on scene - nice to be told. We got upstairs (as always) to the pt and at that point I decided this was not going to be good. The GP handed over, yes CVA, onset of headache had been about 6 hours previously and the pt was now more or less paralysed on the left side. The GP very helpfully had written an unintelligible letter but neglected to do any observations or get the pt on oxygen. D went straight down for the chair, I put the pt on oxygen and checked his pulse and then asked the GP to hang around and help get the pt on the chair. The GP went and got his driver to help as well. There was no way I was waiting for another crew.

We got the pt on the chair and to the ambulance, he was still making some communicative effort but was very unwell. We rolled the pt onto his side in case he vomited, did obs and an ECG, got the wife on and got underway to hospital. After a couple of attempts I got through to control to put in the courtesy call, stressing the unwell nature of the pt.

On route the pt vomited a couple of times, the second time was about 5/7 minutes away from the hospital, I had to suction then checked the pts pupils again. He had a pin point pupil and a dilated pupil. I tried to get a response from the pt, he was now GCS 3. I tried to insert an airway but he had clenched his jaws and was at the wrong angle for an OP. When we arrived at hospital they had a team ready but called a few more people down once I told them he was GCS3 most of the time.

By the time we left he was tubed and ventilated and ready to go off for CT but not expected to survive. I had been honest with the wife on the way in so she was fully aware and had thanked me for being honest. Our pt was nearly 70 but had been doing a full time job the week before and playing golf on the good weekends, such a shock for everyone in the family.

When we went back the next morning with a pt I asked after him, I was surprised to find that he had survived the night but died the next morning. I wish there was more we could do but what...??

The lady with MS was not ill but relapsing and no longer able to cope. I found meeting her hard, I know MS has no guarantees of anything but the possibilities...... No longer being able to control your arms, legs, bladder etc...... I wasn't sure what to do with her but she was at the end of her tether and wanted to go into hospital so I took her to A&E and let them know that she was under the neurology team there. Another thing I found upsetting was that she knew very little about the condition she had been diagnosed with 9 years ago.

On my day off I managed to nearly finish my Christmas shopping and meet a friend for coffee, was a good day!!


mdmhvonpa said...

Sorry about the migraine ... they can be real buggers. Mine usually last for 2-3 days. Medicate, medicate, medicate ... drink. It's the only way to be sure to make it through.

Anne said...

Migraines are murder for me. Mine can last anywhere from a day to as long as two weeks, with medication.

This last time, I started to feed on coffee and lo and behold, it was better than meds.

Sorry about your CVA pt but considering if he had come through it, it would have been a long road to probably only a partial recovery.

MS patient -- education can go a long way to avoiding trips to the hospital. Ugh, I can't believe people are so accepting of their diagnosis and yet unwilling to learn how to live with it.

Hope your migraine settles down soon.


LW said...

I live in Reading and would like to do something for ambulance crews at Christmas. Would sending round cake be considered okay or would it just make people think I was trying to poison them?

I am thinking of some posh cake from Waitrose or something of that nature. I never properly thanked the crew that helped me back in 2003 and I'd like to do a little something.