Hot Stuff

"38 year old female, feeling hot"

Now, the question is, was she feeling hot because she was unwell and her core temperature has risen slightly? Or was she simply hot because it was a hot day? Or maybe she just had too many layers on? OR she was wearing little black dress and killer heels and as such, simply felt HOT and wanted to share this?! Hmmmm, the former was most likely but the latter would amuse me greatly! I headed round to the address anticipating this medical emergency with baited breath!

'Good morning my dear, what's the problem today?'

'I feel really hot'

'In what way?'

'I just feeling really hot'

'Any other symptoms at all?'

'No'

*facepalm*

'And what did your GP say?'

'That it wasn't an emergency so I couldn't have an appointment until Thursday.'

'I see, did they advise calling an Emergency Ambulance?'

'No, but I didn't know what else to do'

*facepalm*

'OK, let me just take your temperature............36.7, it's fine'

'Yeah I know, I already took it.'

'Well I'll check you over but without any symptoms there's not much I can treat.'

'I reckon it's because I'm due on my period. I normally get hot flushes before it starts.'

*facepalm*

And that is how my week started! Wearing green, living the dream, saving lives and making a difference. 

"Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity." Martin Luther King

Bridging The Gap

"18 year old male, on railway tracks, multiple injuries"

I'm assuming most of you have heard of The Darwin Awards?! If you haven't, they are basically a fictitious award that recognise individuals who have contributed to human evolution by self-selecting themselves out of the gene pool via death due to their own unnecessarily foolish actions. The awards are now more official after a serious of books and the criterion for the awards states, "in the spirit of Charles Darwin, the Darwin Awards commemorate individuals who protect our gene pool by making the ultimate sacrifice of their own lives. Darwin Award winners eliminate themselves in an extraordinary idiotic manner, thereby improving our species chances of long-term survival". Now, this nominee didn't die, somehow, but his actions and the similar actions of others is what provides us with job security! 

There he was, lying on the tracks, about 2 foot from the train. He was covered in blood. He had head injuries, broken teeth, a broken ankle and a dislocated shoulder. He found it all very amusing, due to the fact he was totally plastered. We found the general situation less amusing. I'm sure the 1000s of passengers at this busy station during the rush hour were also not amused.  Neither did the police, the fire brigade, the station staff, HEMS and the rest of the gang who'd arrived. That is A LOT of resources! Anyway, we treated all of his injuries, packaged him up, lifted him off the tracks and got him off to hospital.

"I don't know what all the fuss is about." he said. 

*Facepalm*

45 minutes earlier......

He had been drinking with friends all day whilst watching the cricket. He was well dressed and frightfully well spoken. He went to a very expensive, private school and made sure we all knew about it. Anyway, the cricket had finished and it was time to get home 'in time for supper'. He arrived at the station with friends and they were cutting it fine to get their train. If they'd have missed it, they would have had to wait a whole 15 minutes until the next one. They rushed up the platform in a loud and garish rabble. They had come up to the wrong platform and their train was approached. They were faced with a choice. Do they a) cut their losses and wait for the next one or b) run back down the stairs, along the corridor and back up to train. It appears our patient had a better idea. He had option c)!

*Facepalm*

Option c) involved a leap of faith. A jump of at least 16 feet, across two train tracks and onto the concrete platform on the other side. 16 feet is a long way, especially with a small run up and especially when landing on concrete!

With the train approaching, and to the horror of onlookers, he went for it. He ran, he jumped, and about 8 ft short, he landed. And landed badly. Despite breaking his ankle he managed to scramble, fuelled by adrenaline to the far platform edge and climb up. Somehow, he made it! In what was a pure act of bravado and showmanship, he stood up, and like Rocky Balboa, raised his arms above his head in celebration. 

FACT: Standing up straight when drunk can be a challenge. Standing up straight when drunk, with a badly broken ankle is never going to end well. 

Sure enough, with the train now 20 ft away he fell backwards. 

*Faceplam*

He again, land on the tracks with a thud. The train slammed on the brakes but not quite soon enough. By all accounts the patient somehow managed to stand before the impact and was then bounced backwards before the train came to an abrupt halt. 

He was alive and not critically injured. He had multiple broken bones, delayed 1000s of people getting home and needed the assistance of every emergency service. And all because he didn't want to be late for supper! Genius! One thing is for sure. There will always be candidates for The Darwin Awards and there will always be people intent on providing us with job security. I suppose that in itself is a blessing. 

Prat.

Can I Go Down There?

It is with great pleasure that I open the floor to my first Facepalm Friday guest post! This week I welcome the award winning, much revered, mental health guru that is @MentalHealthCop from MentalHealthCop! It occurred to me that all the emergency services interact with the public and therefor, we all come across candidates for the Darwin award on a daily basis! This comedy gem from Inspector Michael Brown is from his earlier days as a police officer. At a guess, it was probably in the late 1870's! ;-) 

"Adult male, wanting to go down there" 

I found the Friday Facepalm idea intriguing! - 999 services see human stupidity on an epic scale and we've all got these stories, but my blog doesn't lend itself easily to letting off the necessary steam around them.  Thanks to Ella, I have offloaded some major stress from my early career.

Well over ten years ago, I was a front-line PC in Birmingham.  My partner and I were called to a gas explosion on a very small traffic island where four approach roads intersected.  A engineer for a telecoms company had been working on underground pipes / cables, on the pavement which rounded the corner of two of those approach roads and had managed to ignite gas by cutting electrical wires.  The subsequent blast singed his hair without causing major injury and sent a thirty foot high flame into the sky.

An early Facepalm! for the engineer - but this is merely incidental to the stupidity that followed.

All three 999 services went down there: Ella's lot were helping the engineer change his underwear whilst Simon and Dennis were using their hoses to put out the fires caused to trees and bushes as the gas plume licked back and forth in the wind, torching anything within it's reach.  The only way to stop the plume of burning gas was to get the gas company to dig up the road around fifty metres away and isolate the supply - this would take hours so we were asked to support cordons on the roads and pavements for public safety.

The fire truck blocked one road, the police car another and the two less frequently used approaches were taped off.  There were two cops and a few fire officers to keep saying "No" to the question that always gets asked on these occasions -

It's been the since human pre-history that when you put a cordon on something, some members of the public will still ask "Can I go down there?"  It's important to understand I'd managed nearly two hours of "Can I go down there?" whilst sweating profusely on a what was already a very hot day, underneath a thirty foot plume of burning gas and we'd had to get another patrol to drop cold drinks up to us because it was quite demanding.  So to say I was a bit tetchy about "Can I go down there?" is to understate things.

The clue is:  my police car is across the road with blue lights flashing, we've taped off the road and you can see highly dangerous flames burning brightly and gently toasting us all.  They're licking backwards and forwards fairly unpredictably and there are fire personnel putting out fires as quickly as they can each time one starts.  You've probably seen other people approaching us who ended up heading back the way they came, so what do you think the odds are that you can "just go down there?"

Then happened one of the most unbelievable things I have ever seen - I will remember this until I die:  on the less often used approach, which was taped off and kept in view, but where no-one was permanently standing, a suddenly saw a young boy approach the tape and lift it in the middle. There was a Mercedes in the road, facing me and the boy looked like he was attempting to allow the car underneath the tape. Hang on: that car is slowly moving FORWARD!!

Stop!! 

*Double Facepalm!*

I ran from the opposite, busier cordon shouting "No!"  The vehicle's bonnet was under the tape, the tape stretching across the windscreen and the boy trying to lift it higher as the car inched slowly forward. There was a hairy arm out of the driver's door also attempting to force the tape higher and flick it over the height of the roof.  "Stop!"  The vehicle was approaching the roundabout on the side where the plume of flames was nearest.  Surely he can see it?!  The fire engine was to the right hand side and he could see it from where his car was and both Simon and Dennis were waving frantically in between planning their second jobs and having a snooze.

"What on earth do think you're doing?" I enquired.  "I live up there." he said, implying outrageous unreasonableness on my part.  The wind blew the flames towards us and I felt the temperature really increase before subsiding as the wind dropped.

"Can't you see the tape, the explosion, the blue lights?" 

"But I live up there!"

"It doesn't matter,  Sir - this road is CLOSED!"

"But I live ... just there!!"

"So find another way around, but this road is closed."

"This is ridiculous - I can just drive on the opposite side of the roundabout.  I'll be home in seconds."

"No you won't - because THIS ROAD - IS CLOSED!"

"You're being obtuse, officer."

"If we're offering viewpoints - I have one about using your son to lift police tape without permission and pushing him into demarked areas of extreme danger.  Shall we talk about that?"

"It can't be that dangerous ... they're letting you move about in it."

"They also let me arrest violent criminals, Sir - I'm guessing you don't want your son doing that either?"

"Fair point."

It took the threat of prosecution to get him to reverse and find another way.  I walked up to his house - it was just fifty yards beyond the opposite cordon and gave the appropriate advice.  I think I had hoped he would have realised the main learning opportunities from this encounter.  It amazed me to find he was still furious for the extra five minutes on his journey.  He informed me of that he would be complaining about my attitude and would like to speak to the duty inspector in respect of the complaints procedure.  Fortunately, Carlsberg do make duty inspectors - a man on whom I've modelled my very own approach to that job.

*Triple Faceplam* - the scale of fail.

Keep On Running

"22 year old male, severe pain in legs, unable to stand"

To say I was sceptical would be an understatement. 22 year olds, generally speaking, don't spontaneously lose the ability to walk. 82? Maybe. 22? Not a chance. There was no other information to go on so we'd have to wait until we arrived to in what critical condition the invalid was in. My crew mate was less than impressed with the presenting complaint. He had run the London Marathon the day before but had forgotten to book annual leave. His legs hurt but he'd dragged himself into work knowing there was a distinct possibility his tired legs would have to carry people down stairs. He was however, content in the knowledge that this patient would not be carried anywhere!

We arrived in middle class suburbia, new build after new build, mid range hatchbacks on every drive way and headed to the front door. A woman opened the door. She pointed up the stair case in quite an abrasive manor. 

"He's up there." she said.

Up we went. My crew mate didn't seem overly impressed at having to negotiate 13 stairs! One door on the landing was open so that's where I headed. Lying on the bed, topless and wearing just his boxers was our patient. He had a pained expression on his face like he was in a Greek tragedy. I wasn't buying it.

"Hello Sir, what's the problem today?"

"The pain, the pain in my legs is just too much, I can't even stand."

"Where exactly is the pain?"

"All over."

"And what pain killers have you taken?"

"None"

*Facepalm*

"And why not?"

"Because the pain is too much, they won't help."

"Is this a new pain today? What's caused it?"

"I woke up with it."

"And have you done anything that could have caused it?"

"Yeah, I ran the marathon yesterday."

*Double Facepalm*

I stepped back and allowed my crew mate to take over. Not because I had nothing to say, but he had much more to say!

"I ran the marathon yesterday, and I'm at work today. You ran 26 miles. Your legs will hurt. Take anti-inflammatories, take pain killers, have a massage! Pain is normal!"

He really was getting quite animated! I was loving it. The patients mum appeared in the door. I assume she'd been listening in!

"I told you. I told you not to waste their time. When will you grow up and start acting like an adult?"

YEAH! What she said!

"So, what do you want to do today?"

"Erm....go to hospital." he said in the most sarcastic of voices.

"You don't need to go to hospital. They will tell you that you have just run a marathon and should go and take pain killers."

"You lot are all the same. Just lazy. That's what the last ambulance said to me. You're idiots man."

"You've already had an ambulance today?"

"Yeah, about an hour ago" his mum said.

*Triple facepalm*

Discuss........

I Didn't Think

Welcome to Facepalm Friday! I've decided that each week I will share with you a patient, or a conversation or an encounter that has simply left my head in my hands. Far too often I'm left questioning how some people manage to exist being so moronic! If anyone has their own tails to share, of people they've met or contenders for the Darwin award, I'm happy to have guests posts! Enjoy!

So......

"47 year old female, dizziness, pain in jaw, headache"

10:15am: Patient phones NHS 111 and lists her symptoms. She told them she had chest tightness radiating to her jaw. She said she had severe ear pain. She said she was dizzy. She also had a headache. Despite it's faults, NHS 111 correctly requested an ambulance to be dispatched because of the priority symptoms. 

10:26: Because the patient has told the call taker she has chest tightness it is categorised as a high priority of call. An FRU (Fast Response Unit) and an ambulance were dispatched.

10:32: FRU arrives on scene (me!)

10:33: Ambulance arrives on scene

10:51: After much knocking and shouting and several attempts by control to phone the patient back the door is answered by the patient. 

"Sorry, didn't think you'd be so quick, I normally have to wait ages for my ambulances. I thought I'd have a shower before you arrived."

In my humble opinion, if you are well enough to jump in the shower whilst you are waiting for your emergency response you are a) not that ill and b) not an emergency. Also, the phrase 'my ambulances' grated on me. It means she has us out a lot, probably for similar symptoms. 

"What's the problem today?"

"I already told them on the phone!"

"But that wasn't us was it?!"

"OK, I've got this awful headache and dizziness and this pain in my jaw."

"Do you have any chest pain?"

"Nope."

"Oh, you told the call taker you did! What pain killers have you taken?"

"I haven't taken anything."

"Why not?"

"I didn't think they would work"

*Facepalm*

Seriously! Why do people not take pain killers! The clue is in the name! Time and time and time again it's the same futile conversations! "Are you in pain?", "Yes", "Taken pain killers?", "No". Why?! Why?! Why?! Can someone please suggest an answer to this age old question!

"So what time did the symptoms start?"

"About 2 weeks ago."

*Facepalm*

"Has you seen your GP?!" I asked, fully expecting her to say 'No'!

"Yes."

"And did he diagnose anything or give you any medication?"

"Yeah, these." she said as she passed 2 packets of drugs.

Ah, clarithromycin and prochlorperazine! The former, an antibiotic which she was given to treat an ear infection and the latter is a medication used to treat dizziness caused by inner ear problems. Both should be alleviating her symptoms.

"How long have you been taking these?"

"He gave them to me a week ago but I haven't taken them."

*Facepalm*

"Why not?!"

"Because I thought they'd make me feel sick ."

*Facepalm*

Notice she said 'thought'. She hadn't felt sick because of them. Her, an expert in general practice and pharmacology (not) had opted against the medication given to treat her symptoms. Instead, she called for us! The conversation continued in much the same way whilst we were checking her over. We did her ECG and the full battery of tests we do on most people and found nothing untoward. 

"How about we leave you at home, you take your course of medication and if that doesn't work make another appointment with your GP?"

"Nah, I think I should go to hospital. I know my body, something's not right."

*Facepalm*

Yeah, you have an ear infection and needed clarithromycin and prochlorperazine to cure your symptoms! It's not rocket science! Why do people go to their GP, call 111 or 999 and then ignore all the advice they are given?! Why?! Why?! Why?!

I gave it my best shot at convincing her she didn't need to go to hospital but she was dead set! We walked her out to the ambulance. On board I continued to ask her questions about her symptoms, specifically the jaw pain. 

"So how long have you had this pain in your jaw?"

"About a month, I've seen my dentist about it and he says I have a tooth infection."

"And did he give you anything for it?!"

"Yeah, these." 

She produced a box of Amoxicillin from her hand bag. I don't know why I had to ask, I knew what the answer would be but I was curious!

"And have you been taking them?!"

"No, I don't agree with antibiotics."

*Facepalm*

11:17: I got out of the ambulance to let them get on their way.

11:37: (ish) Patient arrives at A & E and her 4-6 hour journey of waiting, triage, waiting, being told off, waiting and discharge begins. 

There are times when I write my blog and I really really wish that what I was writing about isn't true. Frustratingly, it is painfully true and not uncommon or an isolated incident. It happens every day!

NHS 111 has its faults, the GPs have their faults, hospitals faults are well documented as are those of the ambulance service. As for dentists, again, it isn't perfect, but we know we have to a) wait and b) pay. People have a got over the 1996 semi-privatisation of dentistry so don't moan as much! My point is though, all areas of the NHS have faults, but people like this are not the fault of anyone. The GP and the dentist saw the patient and offered treatment. She didn't take the medication. NHS 111 had to call an ambulance because she lied about her symptoms and we had to take her to hospital because she insisted. The hospital then had to see her, triage her and waste the valuable time of the doctors and nurses; for what?! To give her another prescription that the tax payers are funding and she isn't taking. She can't be charged the £1000s she cost the NHS. She is unemployed. She can go home, not take her medication and then call us back in a few days because she's still ill and the cycle continues until her body heals itself....until the next time anyway. Unfortunately you can't medicate stupid.

*Facepalm*