I thought I would give you a brief summary of some of the patients that we saw today at the hospital.

The man who had had a lump on his arm for 3 years and then came in by ambulance (yes folks you did read that correctly – by ambulance!). He made us giggle as he insisted that he didn’t drink alcohol until the bottle of vodka fell out from his coat pocket to the floor!

The man who injured the tip of his finger 10 days previously; he was given an x-ray and no bones were found to be broken. He was sent home with a dressing. He then took himself to another hospital later that day and got a 2nd opinion and yet another x-ray. It would appear that they agreed with us and didn’t change his treatment.

Anyway, despite being told to keep the dressing dry, he got it wet a lot during the 9 passing days and when he removed it, found the skin to rather wrinkly (like when you’ve been in the bath too long).

Day 10 and by now completely pain free, the skin had dried out and become a little ‘flaky’, so he came along for us to examine it. After having a good old look, and finding everything in working order, I told him not to worry and advised him to moisturise the skin regularly until it got back to normal. He then said to me that if I didn’t mind, he would now probably go back to the second hospital again for another opinion, just to be completely certain. Naturally I told him that if he wished to do so this was his prerogative. But really…. 4 hospital visits for one very minor injury to a finger tip, I ask you!

And talking about ‘flaky’ how about the young man with a knee injury.

“I broke it last year too I think” he said.

“Do you know which bone you broke?” I asked.

“Don’t know”

“Did you have to wear a full leg plaster?”

“I can’t remember”

“You can’t remember if just last year you had to wear a plaster from your thigh to your foot and use crutches to get about?”

“No, but I have got a bad memory!”

I‘m surprised he could even recall his name or the way to the hospital if that was the case!

My last shift before my holiday was comprised of a diverse bunch of calls and here are some of them;

Firstly there was the 45 yr old lady found dead on her kitchen floor. Not seen for days; found by a neighbour who held a key. The police were on scene too and we suspect that she had fallen as she was lying in a pool of dried blood from a head injury with an over-turned step ladder nearby. When her family arrived they were extremely distressed and beside themselves with grief.

The young man with stomach ache; just one minute after the pain started his wife called 999. I arrived some 3 minutes later with an ambulance in my wake. No sooner had I introduced myself when he informed me that the pain had resolved and he had completely recovered. A total of 4-5 minutes of pain resulting in an emergency ambulance and car attending for what was most likely no more than a nasty case of trapped wind!

A 14 year old lad fell from a ramp while skate-boarding. He had sustained a really nasty injury of his forearm. I didn’t need an x-ray to tell me that the two bones were fractured as his wrist was very deformed (dinner fork deformity).  I cannulated him and gave him morphine in the middle of the skate park surrounded by at least 70 young people whizzing about me on bikes and boards.  The young people were brilliant; they helped carry my bags and made themselves generally useful. The mixture of entonox (laughing gas) and morphine made the lad very emotional and he was declaring love for those around him and literally crying and laughing at the same time which made us giggle.

A young girl with Down’s Syndrome accidentally had her finger shut in a door. It was bleeding and obviously fractured. She resisted most of my efforts to assess her, but eventually I managed to wrestle a dressing on to it to stop it flapping around and she and her family went to hospital for further treatment.

Then there was the road traffic collision. Luckily the couple were uninjured following the accident on their way to a wedding. The lovely police officer on scene kindly agreed to drop them off at the wedding. I imagined their friend’s faces as they clambered out of the back of the police van outside the church dressed in all their finery!

A toddler, newly diagnosed with epilepsy who had suffered another fit. Bless him; he was still dressed up in his fireman’s uniform when we arrived!

Last but not least was the alcoholic gentleman who had become very unwell due to his years of excessive drinking. What made me sad here though was his daughter. Rather than being able to simply enjoy herself with the trials and tribulations of being a teenager, she was instead, clearly well out of her depth dealing with the business of trying to ‘fix’ her father. She was grown-up beyond her years and told me all about her dreams to study and become a doctor – I suspect that she will be a very fine doctor indeed.

So now, I’m off on holiday – See you next week!

Image by dno1967 on Flickr

It was the last shift before I was due to go on my holidays. It was also a very hot and sunny day. The last thing that I wanted was any jobs that were going to give me any stress or cause me to break in to a sweat. I was simply intent on winding down in anticipation of my trip to Italy.

Then the first job came down to my screen in the car: ‘Male – Stabbing – please give a report for HEMS’. Oh great – just what I needed! I hurtled down there and arrived at about the same time as an ambulance and the police. We all got out and grouped together before we went in to the house. There was no answer at the front door and the police were weighing up all the options with regard to breaking in to the property when some of the immediate neighbours approached us.

Well, if their stories were to be believed it sounded unnervingly more like an episode of Holby City than downtown suburbia. They told us that one of them had apparently had a heart attack just last week and another had been shot only a few days earlier (although she looked quite well for it), and now a fatal stabbing. I could only guess at what the insurance rates would be in this particular road!

It soon became clear to us all that this was nothing more than a hoax call. Thankfully, no one had actually been stabbed, shot or had a heart attack and in fact it was all down to a single caller who had nothing better to do with their day but waste the time of the emergency services.

'Meds' by CarbonNYC on Flickr

Any ideas why people don’t take painkillers when they are in pain? It drives me absolutely crazy how someone can think something is serious enough to call an ambulance or visit an Accident and Emergency department without doing the slightest thing to help the situation for themselves first.

Obviously I am not suggesting that when you fall from a second floor window or get hit by a bus you should crawl to the nearest chemist to purchase a packet of paracetamol and a band-aid. However, if you have had a bit of a sore ankle or a tiresome headache for a couple of days, does it not make sense to see if a dose of over-the-counter painkillers can knock it on the head before you reach for the emergency services?

If you try the simple things first and they work, you have saved yourself three hours and fifty nine minute in A&E and even better the £2 bus fare home; it’s a win/win situation.

I have trouble understanding the mentality of the men – sorry guys but it usually is men – who claim to be in so much agony that they have put up with the pain for hours or days (sometimes even weeks – I kid you not) without even trying any simple measures.

When I enquire why they haven’t taken painkillers I often get these replies:

1. I didn’t want to mask my symptoms; or
2. Painkillers don’t work on me; or
3. I don’t like taking tablets (my all time least favourite)

So you don’t like taking tablets BUT you do seem to like calling an emergency ambulance for your very minor long term complaint? And if you don’t like poisoning your temple of a body why is it exactly that you are still happy to smoke 40 cigarettes a day and down them all with a six pack of Stella?

Answers on a postcard (or in the comments) please…

Image by anniferrr on flickr

We were called to an office for a man of about thirty years old. We arrived to find him lying on the floor amongst a maze of desks and chairs. Concerned colleagues were on hand to inform us that he was normally a fit and well man, but that day he had been feeling very stressed about a deadline looming for a project he had been working on. He complained of feeling unwell before suddenly collapsing to the floor where he had remained ‘unconscious’ ever since.

Had we needed to start any emergency treatment on him, it would have been really tricky because it was so cramped. We would have had to move furniture out of the way or lift him to somewhere where there was more space to work. Luckily, we were able to quickly assess the situation and felt that there was not really any urgency – because he appeared to be just pretending to be unconscious.

Why would we think such a thing? Well it was a combination of factors that informed our diagnosis, including the reports from his work mates about the project deadline being that morning, the surprisingly comfortable position he had assumed on the floor, the fact that all his observations were normal, but mostly it didn’t pass us by, that despite falling amid so many corners and hazards, he was rather fortunate to appear completely uninjured. This all suggested more of a controlled swoon than a drop of a stone. Generally, when people fall to the ground unconscious they rarely get away without a bruise or visible wound to show for it.

We lifted the ‘unconscious’ man on to our trolley bed and took him to the ambulance. His tests were still normal and all the time we encouraged him to talk to us and tell us what was going on so we could help him. Once he was in the privacy of the ambulance he ‘regained’ consciousness without any treatment or interventions from us. He blinked in the daylight and asked in a meek voice ‘What happened, where am I?’

‘You’ve been watching far too many episodes of Baywatch if you think that is what regaining consciousness is really like!’ I wanted to say, but bit my tongue instead. There may be no Oscar winging its way to this chap but he was clearly under stress at work and perhaps, looking for a way out, came up with the brain-wave idea of fainting. Perhaps he hoped he would be allowed to go home early to buy some time and finish the project. Instead his quick acting colleagues dialled 999 and within a couple of minutes the cavalry had arrived in a blaze of lights and sirens! What’s a man to do – Plan a) continue the pretence or Plan b) admit that he had be pulling a fast one and wasting everyone’s time?

Clearly he opted for ‘Plan a’ rather than risk total loss of dignity and respect of all his work colleagues who would be none the wiser; even if we were!