Tag Archives: Stroke

The Christmas nightshift

…”should be easy”, I hear you say.

“Pop your feet up and watch some James Bond, maybe nip out to pick up granny who’s fallen after one to many sherries. Or maybe a drink driver crashed into a lamp post.”

Well, yes. It should have been something similar to that, but instead, it was a rather intense shift.

Our first call (admittedly almost an hour after signing onto the Ambulance) was to a lady who has possibly had a stroke. She was 84 years old. Now, we don’t play God. We don’t think “ah well, she’s had a good innings, lets leave her to slip away peacefully.” Especially when this particular 84 year old still cycled everywhere in the village she lived in, and WORKED 2 DAYS A WEEK!!

She was sat on the sofa at her daughters house where she went every year to celebrate Christmas, when suddenly, she listed over to one side. Her daughter asked if she was ok and the mumbled reply confirmed her suspicious; she was having a stroke.

We arrived quite quickly considering the narrow lanes surrounding the village, to be met by her daughter outside in a bit of a panic.

“Through here please!” We just caught what she said as she scurried into the house. We found the living room and saw our patient in quite good spirits, considering. She had a right sided facial droop, slurred speech and was unable to move her right arm – all the classic signs of a stroke.

If caught within a certain time frame, some strokes can be treated and in many cases, the patient will make a good-to-full recovery. But not all the time.

We were well within this window, so basically ‘scooped and ran’ (a term often used to mean just that: scoop the patient up and run to hospital on blues.

I put a needle into a vein in case we needed to give her any drugs and my crew mate blued us to A&E. It was an uneventful journey, but I pre-alerted the hospital staff anyway, as is protocol for stroke patients.  We arrived to be met by a doctor who sent us into ‘Resus” (where the illest patients go) as the CT Scanner was in use – another stroke patient brought in by Ambulance who’d arrived not 5 minutes before us!!

I later found out she was Thrombolised (treatment for a specific type of stroke) and was making a good recovery. Good times!

 

Next patient was a Priority 1 backup request from an RRV Paramedic on scene back in our home town. We darted through the empty city streets and out onto the country road leading to our station, which we sped past on the way to the address.

It was a 44 year old man who was a chronic (and still functioning) alcoholic. He had End Stage Liver Disease and many other health problems. He was completely unconscious, very jaundiced (yellow skin associated with liver failure), and barely breathing. Not a well man.

The RRV Para’ had given oxygen, gained IV access and was giving fluids as we arrived. We lifted him from his bed to the stretcher (thankfully he lived in a bungalow) and wheeled him to the Ambulance. We blued him in as well. On the way to hospital, he developed a dreadful habit of not breathing every now and then, meaning I had to ventilate him with a BVM. He remained unconscious the whole way to hospital.

I handed him over (to the same doctor as earlier) who very quickly set to treating him with the expert nursing team. Once his family arrived, the doctor had the discussion with them that he was unlikely to improve and if his heart stopped, they would not attempt to restart it. The family were in agreement and were in fact relieved that his agony would not be prolonged. He died a few hours later, peacefully and in no pain with his family by his side.

 

We then did a few ‘normal’ jobs – too much sherry etc etc.

Then we got sent to the next town for “18 year old male, stabbed”.

Now, that would fill most people with dread, but I’ve been sent to so many ‘stabbings’ that have in fact turned out to be paper cuts and not much else. One man had a graze on his arm, the sort you get from scratching an itch too hard!

Nonetheless, put down your dinner and pick up the Ambulance keys, blue lights on and off we go.

We arrived to see 2 RRV’s, 3 Police cars and Police dog team on standby. We walked into the house and followed the blood trail…..ah, first clue that this might be serious.

There were our two colleagues dressing wounds, taking vital signs and details while the Police tried to gleam information about his attackers.

We quickly grabbed the stretcher and wheeled him to the vehicle for a proper assessment (cut all his clothes off for a top-to-toe inspection to make sure we haven’t missed any stab wounds) in better light.

He’d taken a fair beating:

Black eye, presumed fractured cheek bone, fractured jaw, laceration to his neck, significant cuts to his hands (typical defensive wounds), cuts to his legs and a pretty nasty stab wound to the knee, of all places. He had lost a pretty decent amount of blood and was an unhealthy shade of white.

Despite his serious condition, he was reluctant, in fact he outright refused to give any details of his attackers to the Police.

We blued him in as well, with a Police escort which was rather exciting (I’ve never had one before). Pulling up at A&E, guess which doctor was waiting for us? “You guys are proper sh*t magnets tonight!”

“You’re telling us?!”

The last I heard, he was OK. It took over an hour to clean all the blood off of him. We hadn’t missed any wounds and he was preparing to go to theatres to have his hands operated on. We spoke with the Police later that night, who told us that when the searched his clothes that we’d cut off, they found a cocktail of drugs. They suspected it was a drug deal that went wrong, which would explain his tight lips!!

 

Even on Christmas Day, you can’t guarantee an easy ride. Still, mostly genuine jobs this time 🙂

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The great pretender.

My overtime night shift last night was spent mainly dealing with students who’d had a little too much to drink.

“Goodness”, you may think, “on a Wednesday night??”

Well, yes. Sadly, this is becoming more and more normal for the ambulance service. What used to be reserved for Friday and Saturday nights, is now almost a 24/7 burden on the NHS frontline.

One of them got particularly ‘chopsy’ after his “mates” abandoned him drunk on the pavement in the  middle of the city. My crew mate and I, while being perfectly civil, reminded him quite sternly that he had gotten himself into this situation, and if he was grown up enough to go out and get drunk, then he was grown up enough to deal with the consequences and he would do so by showing respect to the healthcare staff that now had to treat him for nothing more than being drunk and unable to look after himself! (and breathe!)

We did consider calling the Police, but they’re busy enough as it is, and as he was unable to stand let alone walk, they wouldn’t want him in their cells in case he choked on his own vomit – a perfectly reasonable concern in my opinion.

The A&E were delighted to have their beds filling with people who’d had their first taste of a lager beer, a red wine or a spirit and gotten a bit giddy to the point they had vomited upon their finest evening wear. Oh dear, what a pickle!

We also had a man who was faking having a stroke. Now, a stroke is a life threatening emergency that we treat aggressively and rapidly. Within a certain time window, there is a good chance that an individual can make a good recovery. While our patient had right sided arm weakness, a facial droop and slurred speech, it was only when he remembered he was being watched (it’s worth mentioning that he was in his 50’s and was also drunk).

It’s not worth not treating it as if it was a stroke, so we gained intravenous access, performed the necessary tests and ‘blued’ him to the nearest A&E. The doctor shared our cynicism but had protocols to follow the same as we do, so went through the motions. I believe he was admitted ‘just in case’. People often pretend to have chest pain, abdominal pain, visual disturbances or anything else we can’t disprove (usually for some attention from an ex’, or for a bed for the night), but a stroke has some very specific symptoms that can’t really be faked.

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