Tuesday, 29 September 2009

Frostbite

We have a code for paperwork for every ailment, disease or injury we meet. There are about 100 options for the calls that we are most commonly called to. Ones not covered go under the "other medical problem" code. Every so often the list is updated, something added, something taken away, and the alpha-numeric sequence is shot to pieces again. I've memorized a large number of the codes, and rarely have to look at the crib sheet to remind myself. I'd hazard a guess that every single London Ambulance Service paramedic knows that 62 is the code for Alcohol Intoxication. That one hasn't changed for years. We probably also all know about 75 being a minor head injury. Friday and Saturday nights especially. But our all time number 01? Sitting at the head of the table? Abdominal Pain.
I believe it's number one not just for alphabetical reasons (although I'll admit that AB at the start of a word will give it a pretty good chance in any alphabetically organised list), but also as it's probably the most common complaint that we come across. Abdo pain is a potential minefield. It can be anything from gastroenteritis to food poisoning, from a heavy period to appendicitis, from labour pains to a ruptured placenta. It could be a potentially fatal bowel blockage to a very unlikely to be fatal under-cooked doner kebab making some very unhappy returns. In some patients abdo pain can signify a heart attack, in others it could be a ruptured aortic aneurysm, both potentially lethal. With no CT scanners, ultrasounds, or X-rays available in the back of the ambulance (yet), it can sometimes be a matter of educated guess work, at least initially.
However. I'd like to guess that the patient who's had mild abdominal pain for three (yes, 3) months (yes again, months), probably wasn't in a life threatening condition. In fact, she knew she wasn't. She told me so herself. She was about to go to the GP for a repeat prescription for some regular medication, but realised that the surgery had shut ten minutes earlier. So she called an ambulance to take her to A&E so she could get what she needed.
I had to ask what made her call an ambulance for what was clearly not an accident or an emergency. I'll give her her dues. She was honest. "It doesn't cost anything!", she said. The cab to the hospital would have cost her £5, possibly less. Less than the packet of cigarettes that she was holding in her hand.
As I'm in the FRU, just a car, and not really supposed to transport patients, technically there's a "big" ambulance on its way too. I'd love to be able to say to this person that she doesn't need an ambulance and she should get on a bus, but it's just not worth it. Sometimes I just can't be bothered for the argument, but I'm sure they sense my unease. I cancel the ambulance and inform control that they may as well save it for a worthwhile call. The "patient" wants her friend to go with to the hospital, so I move my luggage out the back seat and sit them there.
The 7 minute drive to hospital was spent in frosty silence, until it was broken by the radio.
"General broadcast all ambulances - ambulances needed for two possibly fatal stabbings in local area. One with multiple stab wounds, one with slashed neck. Anyone available please respond!"
In a moment of Mouth before Brain (unusual for me), I look in the mirror and mutter loudly "Unfortunately this taxi is already in use. Sorry I can't be of any help."
Did I mention the silence? It could have induced frostbite.

5 comments:

Anonymous said...

did you actually make them get out in whichever random place you happened to be on the way? and was it a million miles from the nearest bus stop, taxi rank etc?

(i hope the answer to both is yes!)

Fee said...

Sadly, someone as ignorant as this is unlikely to get the message. If I could, I'd grant you the power to tell idiots like this exactly what you think of them!

Tom said...

We were turned out for a footballer, who mindfull of the scouts watching him from a big club was playing a rubbish game, decided, in company with his 'agent' to do a dying swan act and promptly collapsed with a # R leg in front of an appreciative crowd.

"Bugger"

So we turn the wheels in, and pick up the Beckham wannabee, and whisk him of to Kingston hospital, complete with splint, gas, and the 'agent' worrying about his meal ticket.

Perfect, because this is what we do. We pick up the 'sportsmen' and spend the rest of the shift cleaning the motor.

En route to the hospital, horror-of-horrors, we are stopped by police to render assistance to an RTA involving a car and Motorcycle. Needless to say the biker came off second, and was in the process of expiring, when my crewmate and I elected to take him to Kingston as a priority. Please note this was in the day we had two cots.

Many buisy moments later, we 'swooped and scooped' the patient, and blued and twoed him to the hospital. On arrival, he was met by a trauma team, and the Beckham wannabee was ignored, while we frantically dealt with our proposed organ donor.

Returning to our motor after the drama there was no sign of the broken 'prince' of football or his 'agent' but a suddenly empty bus.

I suspect they both suffered severe frostbite the ********. Good.

Sadly, know the feeling.

End of rant!!

medic999 said...

Ben,
The sad thing is though, that no matter how you try and educate these people, many of them will just look at you with a "so what?" expression on their faces.
Its at that point that you realise that sometimes, it really isn't worth wasting your breath over, because they don't have that missing wonderful attribute called a social conscience.

Anonymous said...

Couldn't you just tell them to get out!!!!