Showing posts with label Asthma. Show all posts
Showing posts with label Asthma. Show all posts

Saturday, 4 January 2014

24 - Season 3: Episode 1


For some it’s the season to be jolly. For other’s it’s the season to reflect on what an utterly crap year it’s been. For me, it’s overtime season. It’s the time of the year where I literally sell my soul to the ambulance service in the vain hope of affording a holiday at the end of it. Tonight was a self inflicted overtime shift, but with someone I very much wanted to work with so you won’t catch me complaining. 

I couldn’t write that with a straight face! Of course I’m going to complain!


The following takes place between the hours of 12:00pm and 18:30pm


12:00

Despite volunteering to work a night shift I wasn’t happy about it. I had given up a lovely little 8 hour day shift on request of my crew mate who going to be single on the night and wanted someone to do all the work for her. As requests go it was pretty outlandish! Asking ME to do a night shift instead of an early! Despite my faux protestations I was more than happy to and even offered to provide the grub. I’m nice like that!

So, instead of sleeping before the night shift I slaved away in the kitchen! Mainly because I can’t sleep during the day and also, because I predicted severe hunger throughout the night and didn’t want to leave anything to chance! 

Food made, washed and groomed, packed and dressed I was just about ready to head off in to the night. All we needed now was pleasant patients and we would be in for some easy money!


18:30

That ominous feeling that every night shift brings was well and truly upon me as I walked into a rather strange looking ambulance station. I chucked my stuff on the vehicle and headed for the kettle. Caffeine was going to feature heavily! 

‘Breakfast’ was prepared by my crewmate and we feasted like kings. It made a nice change from my usual routine. The bliss didn’t last long…..


19:00


“36 year old, asthma attack”

We headed off into the night. True to form, my cremate was driving and I was writing. When I suggested that maybe at some point she could write and talk to patients she laughed. And laughed hard! This was going to be me for the night!

We pulled into the alley way where we’d been sent to. It was in a particularly grotty part of town and the alley itself didn’t offer anything up, other than a bad smell and sludge. Up the metal staircase we trotted, full of unparallelled enthusiasm. The front door was open so we headed into the smoke filled hovel. It was like walking into a cloud of irony. Sure enough, sitting in the smoke filled room was our patient, wheezing away like a good’un. He had been treated in hospital that day already for his asthma and unsurprisingly, was having a relapse. They really didn’t seem to grasp that sticking an asthma patient in a smoke filled room would cause a problem. In fact, they blamed the bad treatment of the hospital for his current predicament! Gotta love the NHS! Failing patients at every turn….by not making them immune to cigarette smoke! The scoundrels!

Anyway, my crewmate handed out a speech, laden with sarcasm and health promotion do’s and don’ts whilst I gave him a nebuliser and off we all went to hospital like one big dysfunctional family! We handed him over to the nurse, making sure she was aware of the environment in which he was found and headed back to the ambulance to eat some dried mango. Yep. Mango. If you don’t like it, you have no place being here!


20:19


“66 year old male, chest pain.”

I’ll be honest with you. From the information we were given I wasn’t holding out much hope for this being a job that could hold my attention. Some chest pains read like proper chest pains, others read like chest pains for a quick ambulance. This looked like one of them. It had all the tell tell signs. Abdo bad, DIB, symptom after symptom, and eventually chest pain chucked on at the end for good measure. All was just itching to be revealed. 

We pulled up, grabbed our stuff and headed inside.


“Wheeeeeeeyyyyy.”

That is what we heard as we walked down the corridor. In the living room, sitting in the chair was a beard. Well, the beard had a rather large man attached to it, but the sheer magnificence of the beard was overwhelming. It made Santa Claus look like he only had designer stubble! I’m serious! It was most off-putting!


“Wheeeeeeeyyyyy.”


“Hello Sir, what’s the problem today?”

“Wheeeeeeeyyyyy.”


This could be a long conversation….. Luckily, I was quickly interrupted and told that he doesn’t speak any English. So, all history taking was done through a translating relative. I was dubious about some of the answers because I asked about the pain score the patient spoke at lighting speed for about 10 seconds only for the relative to say “8”. 


“Wheeeeeeeyyyyy.”


I muddled through and established he’d had chest pain for about 3 days but this evening it was much worse. I also learnt that trying to stick ECG leads onto someone who effectively has a mature weeping willow hanging off their chin requires a unique set of skills and preferably three arms! Eventually we were good to go!


“Wheeeeeeeyyyyy.”


*presses print and waits*


“Wheeeeeeeyyyyy.”

*’analysing ECG…….’*


“Wheeeeeeeyyyyy.”


*prints out ECG*


“Wheeeeeeeyyyyy.”

MASSIVE HEART ATTACK! Shit! My cremate quickly vanished to get the chair whilst I stuck a cannula in. We gave all the drugs, wheeled him to the ambulance, put in the blue call and headed off to the cath lab!

“Wheeeeeeeyyyyy.”

Once there, we handed over to the cardiologists and assisted transferring him to the operating table for the procedure. During the transfer my cremate was unfortunate enough to get an eyeful of old-man-penis. (“Wheeeeeeeyyyyy.”) I didn’t ask for details but going by the beard on his face and the pained look on her face, I imagine there is more to that encounter that met her eye. Poor lass. Bet she wished she was on the board! As if……

Despite the short period of excitement we’d just encountered, we needed coffee and some more mango so we quickly made our exit and headed back to the safety of the truck! As we wondered down the corridor all that could be heard was “Wheeeeeeeyyyyy.”. I'm still not sure what that noise was all about!



Monday, 16 July 2012

A Quick Fix

"67 year old female, Asthma attack"

I like asthma attacks. It is one of the few jobs where our actions can cure someone in front of our eyes. I've been to people who are a few minutes away from death and after a few drugs, a hope and a prayer, they are sat up talking to you. Most of the jobs we do we never see the results, or hear the outcome, and that can be really frustrating, so it is refreshing to see the fruits of our labour.

We got the job in the middle of the night and after a short run we arrived on scene at the same time as the FRU. We piled into the tiny lift and went to the 8th floor. As we entered the flat I could hear the wheeze! Never a good sign! Our patient was sitting on the edge of the bed really struggling for breath so we gave her a nebuliser straight away. She was a lovely lady, apologising for wasting our times in between gasped breaths! It always amazes me how the elderly feel they don't deserve an ambulance when they are in fact the most deserving. The nebuliser worked well and she was soon talking in full sentences. Job well done! We gave her a full MOT and suggested a trip to hospital would be wise but she refused. Our concern was that her symptoms would return and she'd need to call us back:

"Did you use your inhaler when this all started?"

"I tried but it didn't work. It's new but doesn't give any spray"

She had one of the new types of pump, no canister to squeeze down in the traditional way, just a mouthpiece to breathe through. When you inhale it delivers the required dose of spray. Simple! I asked to have a look at it. She opened her drawer and passed me the brand new looking inhaler. I opened it up to see if the canister was full. It was. I manually squeezed it to see if it was working. It was.

"You do know that there is nothing to squeeze now don' t you?!"

"Yes, I read the instructions and did what it said"

"Can you show me what you were trying, we'll see if we can get it working"

"OK, i'll give it a go"


She put the inhaler in her mouth and took a deep breath in. Nothing!

"See!"

"You're holding it upside down, try it the other way up"

"AM I!!"

"Yes"
I said, while chuckling away!

She turned it around, exhaled slightly and took a deep breathe in. The all telling sound of the spray was audible to all. Her face lit up with excitement!

"Well I never! You mean it wasn't working because I was holding it upside down? I'm so sorry for wasting your time. That's how I have always held it. The other style works that way."

I assured her that it wasn't a waste of our time and it was an absolute pleasure to help. It is worrying though, how ill someone can get from not knowing how to use their medication. The doctor or pharmacist should really ensure it is being used properly. I see similar cases far too often when patients who speak little english simply don't take their medication because they don't understand when they are supposed to. Luckily today, we were there in a timely fashion and were able to solve the mystery of the upside down inhaler!