Thursday, November 30, 2006

Hot Children

I seem to be going to a lot of children recently that are hotter than normal for a number of reasons.

What worries me is the fact that the parents don't do anything about it and leave it to us.

The following steps would make these children more comfortable and reduce the temperature;

1. Turn the heating down - the number of flats and houses that - I have gone to houses and flats where the temperature is so high, you start sweating as soon as you get through the door.

2. Strip the baby down to the nappy - Most of them have been wrapped up as if they were eskimos in a snow storm. Surely if you are hot, you take off a layer of clothes so why not do this for the baby?

3. Give them Calpol - Given on a four hourly basis this can reduce the temperature down towards the normal.

4. See the GP - This will mean that you won't have to spend hours in A&E with the child in the middle of the night.

Why does common sense leave so many parents?

Wednesday, November 22, 2006

Holby City

Not a programe that I normally watch, but, for some reason I did last night.

Why?

I really have not got a clue.

People injured in an RTC (Road Traffic Collision), taken straight to a ward without even a thought for A&E or is this the 'New streamlined NHS' that the Health Secretary is after. After all, it would save money by not having A&E. Think about the savings for wages of Doctors, Nurses, Reception Staff and A&E Porters as well as the equipment that is only used there and building maintenance.

If we are going to go straight to the wards, does this mean a big pay rise because we can now diagnose injuries and illnesses without any diagnostic or x-ray equipment.

The other part of it is, how many ambulance crews are going to be stuck trying to offload a patientinto a ward with no beds. It's bad enough in A&E on a busy night.

Thursday, October 12, 2006

A different kind of stupid!

We were called to a lady in her late forties having an asthma attack. We were called by her son.

When we got there she refused treatment and transport to hospital.

Why?

Because she was fasting for 'Ramadan'

Even her son and her husband couldn't understand her reasons behind this. Our treatment for asthma doesn't break any of the rules for Ramadan. She did however agree that if the problem was still happening at sunset 6:00pm, she would call us back. (At this point it could have been life threatening).

Unfortunately, I don't know the outcome.

Sunday, October 08, 2006

Parenting skills

Picture the scene. The crew are given a job as '2 month old with difficulty in breathing and not feeding'.

As you would expect with a job like this, the crew got there as fast as safety allows.

When they get there they find the baby laying on the parents bed, screaming and blowing bubbles. The parents are ignoring the baby. There are also 2 older siblings running around.

The attendant picks the baby up, and, after a few seconds a loud 'burp' is heard as some wind is released. Not suprisingly, the baby becomes quite settled.

When the crew question the parents, they find out that the baby hasn't been feeding for the last 2 hours, has had no problems since birth and isn't allergic to anything. During this time the baby decides to want some milk, (no suprises there).

The crew ask if they still want the baby to go to hospital. The parents decide that they still want to go and dad takes the baby with the crew to spend at least a couple of hours in A & E while mum stays at home.

Is it just me, or, is this a waste of time?

Sunday, September 24, 2006

Cocaine

As I said in my post ‘Thieves’, I am going to tell you what happened.

We were called to a 25 year old male with chest pains. Although this can happen for many reasons, it is not normal to have the sort of chest pains associated with a heart attack.

This young man however had got central chest pains and was sweaty.

When I asked about what he had been doing for the last few hours, he told me that he had smoked about £150 worth of cocaine. He also told me that he had had a similar episode about a month ago.

We took the patient down to the ambulance and carried out several checks that we do on every patient presenting with chest pain. One of the tests is a 12 lead ECG, (Electrocardiogram).

What we saw was not normal, but, it also didn’t look like the trace expected of a heart attack and was beating extremely fast.

We made a decision to take him to the nearest hospital and not a cardiac cath lab, (which is where we can take confirmed heart attacks whilst bypassing the nearest hospital), because the ECG print out was inconclusive and we also weren’t sure if they would take a patient with cocaine induced chest pain.

After letting the hospital know we were on the way, took him in on the lights.

The local hospital accepted him and pulled his notes from the last time he was in. The hospital ECG was the same as the one four weeks previously.

Some people never learn!

Saturday, September 23, 2006

Thieves

I went to one job tonight where the FRU - Fast Response Unit was already on scene. (More about this job in another post).

As we pulled up, we noticed some glass next to the car.

Some mindless individual had smashed the window and stolen the satelite navigation screen. Not only is this stupid, but it mesans that the car and the responder are not available to respond to life threatening calls.

What sort of person decides that this is a good idea?

Monday, August 21, 2006

(Don’t) Care Homes

This is something that Tom Reynolds of Random Acts of Reality has written about before, but I think it is well worth writing about this one experience.

We were given the job as an elderly male with difficulty in breathing and unable to walk. In some ways this was true.

When we arrived, the home was clean and didn’t have the normal smell of stale urine and stale food. They even had nurses on the staff to look after the patients.

He was barely conscious and was breathing at a rate of 40 breaths a minute. (The average adult breathes between 12 and 20 times a minute). So, the first question was how long had he been like this. One of the nurses told us that he had been in this state for over an hour before they decided to get help.

As we had a closer look, the gentleman had a rash all over his body and was so hot to touch that it felt as if I was being burnt. He had a temperature of 41 degrees C. Apparently, the GP who looked after the home had decided that it was just a rash and was treating it with a cream. Great idea if it hadn’t been a septic rash that required antibiotics. More concerning was the fact that none of the nurses had realised what the rash was.

This patient was ‘Blued’ into hospital but despite all the knowledge and skills available, he only lasted another 90 minutes.

Remind me to add this home to the list of ones that I don’t want to end up in!