Fitting In Shopping

It's a fear every parent has to deal with. You child becomes sick. I don't mean vomiting, I mean big sick. Or,they may not actually be 'big sick' but you think they are! And that isn't a criticism! I was the same, if my boy farted and it didn't sound right, I panicked. He he stayed asleep I'd poke him until he cried just in case! It's what we do, we want to do everything we can to make sure they are OK and nothing will get in the way of that! NOTHING! It would be a very brave person to try and get in the way of a manic parent! Unfortunately, not all parents seem that caring. Some, quite simply don't give a dam, or so it seems. Some's priorities are so warped its hard to see what part of them is a parent. If someone in the medical profession told me my boy needed hospital that second I would move heaven and earth to get him there, that second. To me, there is nothing more important than my child's health and happiness.

"1 year old male, having seizure, in pharmacist" 

This job had all the makings of a simple job. Generally a 'seizure' In a 1 year old is a febrile convulsion, normally caused my a high temperature. They are very common in under 5s and most parents end up seeing them at some point. They can be very scary to watch if you've never seen one before and it's no wonder most parents we see are running round like headless chicken when we arrive on scene, beside themselves with angst! This is what we expected anyway, but I should know by now that in this job, always expect the unexpected. 

We pulled up outside, grabbed our stuff and headed into the pharmacist. One of the pharmacists gave me an excellent handover while taking me throughout to their treatment room. Apparently the kid had started having the seizure so the mum put the boy on the floor and 'wondered over to the counter and asked for something to stop the shaking'. The pharmacist picked up the child and took her into the treatment room whilst a colleague phoned for us. Lying on the bed, still fitting was this little boy. Holding his hand was one of the pharmacists who quite rightly looked very concerned. Sitting on a chair, texting, was the mother. How caring! 

The boy had been fitting now for 12-14 minutes which got alarm bells ringing in my head! We gave him oxygen and administered diazepam to try and stop the seizure. To all our relief, within a few minutes he stopped. He laid the panting away, it's horrible to see. His mum, still texting had nothing to say and seemed totally un-moved by the whole event. 

"Right, we need to get him to hospital, do you want to carry him or shall I?!" 

"Does he have to go to hospital? He's better now." 

*pause whilst my bottom jaw drops and hits the floor with a thud* 

"YES! He's not very well at all." 

"Alright, can you carry him, I've got stuff to carry, I'll be there in a sec." 

With my jaw dragging along the floor, I carried the boy to ambulance. H was still limp. I laid him onto the bed, reattached the oxygen to the vehicle supply and connected him up to the monitoring. The mother hadn't followed us and was still in the pharmacist. I left the boy with my crewmate whilst I marched back to the shop. What was she doing? Some shopping! 

"What are you doing? We need to go now!" I exclaimed. 

"Alright, keep your hair on, there's just a few bits I need to get?" 

"That can wait, we need to go now!" 

She ignored me and wondered over to the till. 

"Did you hear me? We need to go now. You son is not very well at all." 

Seeing my concern and anger the pharmacist told the mother to just take the stuff and go the ambulance, which she did. I was speechless. As we got back to the ambulance the boy started fitting again. 

"Right, lets just go, I'll put the call in on route" 

Off we went. Me standing, boy fitting, mum texting. 

"Red base, blue call when you're ready for details." 

"Go ahead." 

"We have a 1 year old male in status epilepticus, 1 seizure lasting 14 minutes and currently having a second seizure. Pulse of 168, resp rate of 48, oxygen saturation of 100%, temperature of 40.9 C, GCS 3 (unconscious), patients on full flow oxygen and has had 5mg of diazepam PR (up the bum), ETA 4-5 minutes" 

"Rog, passing it for you now." 

By the time that was done we were already hurtling up the road towards the hospital. With one hand I was holding onto the ceiling bar, the other making sure the boy stayed on the bed. The mum was still full of apathy and my jaw was still on the floor. As we pulled into the hospital, boy still fitting, she spoke.... 

"How long do you reckon we will have to wait before we can go home?" 

"A LONG TIME. Your son is still fitting, he is not well at all, as I keep saying, it isn't a case of waiting for 2 hours then going home." 

"I was only asking." 

The tail lift opened and we wheeled the bed out and rushed into resus. The team were waiting for us and in a change from the norm, I started my handover the second I was in earshot of them. They knew from the call the seriousness of the situation in a child so young. Perhaps one of them will be able to drag the mother away from her phone to explain that. 

I really was speechless. What is there to say? Never have I seen such apathy and disregard for a child from their mother. This poor little boy could well be fighting for his life and shopping came first. I'm often critical of various people's attitudes in society for a variety of reasons. I'm often judgmental and question the morality of what a lot of people do, but never have I seen someone so unfit to have the privilege of being a parent. And it is a privilege. I will live my life judging myself by the way my son is brought up and how I acted as a parent. How people like that are allowed to keep their children I will never know. It truly breaks my heart thinking about it. 

Deja Vu

"12 year old male, rash on body"

My first thought was 'as opposed to the rash not on the body'! Lucky I had arrived to work early as is the norm because even with the best will in the world, I couldn't have signed in, drawn out drug packs, morphine, got my bags from my locker, checked the vehicle over and been ready to go in 17 seconds as they had hoped. That is why we are all compelled to come in half an hour early, unpaid, so we can be ready to go when the first job comes in. 99% of calls that involve a rash are minor, that is, if it is even visible. Very rarely it will an allergic reaction, even rarer it will be anaphylaxis and even rarer than that, it will be meningitis. Due to the latter two, in children especially, most calls with the word 'rash' are given a high priority of call to be on the safe side. I think this is a good thing, especially as even the most calm and reasonable of panicking parents don't want to answer multiple questions about the rash, they just want an ambulance. Also, if it is serious, time really is of the essence. 

Needless to say, we weren't very panicked! We weren't judging the call but the in the information we had there were no priority symptoms like difficulty in breathing or swollen lips etc or anything that would lead us to think the patient was going to be particularly unwell. Oh how wrong you can be! 

We pulled up outside the house to be greeted by 'that frantic wave'. You know, the wave I have mentioned before that tells you something isn't right and you really need to get a wiggle on. I followed the mum through the front door straight in the lounge. The boy was just wearing his underwear which enabled me to see most of his skin. Every part of him was bright red and covered in the worst hives I have ever seen. His face was swollen and he was in untold discomfort. He stood up and rushed to the toilet. It turns out he also had uncontrollable diarrhoea. Although his tongue wasn't swollen and he denied struggling to breathe I felt his condition was bad enough to treat for anaphylaxis and after a brief conversation with our Clinical Support Desk they agreed. 

Once I'd decided what we were going to do, I then had to do it and this is where the second guessing begun! It is very rare to have to cannulate a child and if we had been 5 minutes from hospital we'd have just run but the fact it was longer and the fact his rash was getting worse by the second I wanted to try for a vein before they all completely vanished. The panicked parents didn't help my nerves. I got everything prepared but suddenly became 'a dropper'! More by luck than judgement the cannula was successful. I then checked and double checked dosages for the drugs I was giving. Whilst I was cannulating my crew mate had drawn up and administered the Adrenaline into his muscle and had given full flow oxygen. I then gave some Chlorphenamine (Piriton) and Hydrocortisone  and we left. I felt very conscious that I was shaking slightly, and even managed to drop the radio when putting in the blue call! How embarrassing!

We arrived at the hospital and went straight into resus where the team of paediatricians were waiting. There had been no improvement from any of the drugs we had given and his rash and breathing were now notably worse. At least he was in the right place, and I could breathe! 

This is a weird job, in the sense that you are taught about what to do in a lot of situations for a lot of medical conditions yet you obviously only get to see the conditions you are dispatched to. I can count on one hand the amount of times I have seen anaphylaxis and this was by far the worst I had seen it. It had been maybe two years since the last time I'd seen it too and in all honesty I felt very rusty during the job. Nothing was missed but was I bit slow in treatment? Probably not. Did I do it all correctly? I think so. Did I look or sound confident when doing it? NO! I tend to stay calm in some of the most frantic of situations like most people in the ambulance service but like everyone else, the thought of having a really sick child deteriorate in front of you is by far the worst feeling there can be. At least I will have this memory to draw on the next time I'm faced with it. Anyway, no time to ponder! Time for the next one......

"5 year old female, allergic reaction, known allergy to nuts, has ingested nuts, swollen tongue, DIB"

Are you serious?! I've said before that jobs tent to cluster in a shift and the first generally dictates the rest but really?! Again?! Well, at least I had a clear plan in my head! Off we went and after a short drive it was like deja vu! Out came the waving parent, the only difference was this time, she was followed closely but the father, carrying what looked like a limp child. *cue shiver down spine*

I'm sure I was out of the vehicle before it had stopped moving. The kid was conscious, just, but extremely floppy. We got her straight on to the bed, dad at the head end, mum next to me and crew mate moving around in any space available. The fact she was so compliant said a lot. Hardly any whimpering, all her energy was concentrated on breathing and that was a clear struggle. She got high flow oxygen a nebuliser, IM adrenaline followed by hydrocortisone & chlorphenamine a few minutes later. I didn't even look for a vein, she was so small and we were only a few minutes away from hospital so the latter drugs were given on-route into the muscle. If the last job had scared me, this one terrified me, but in a different way. This time, I knew I'd done everything quickly accept in my head I was planning a resus. She was that bad. 

9 minutes after arriving on scene we were at the hospital again and for the second time in 45 minutes the team of paediatricians had seen me rush in with an extremely ill child! Only difference was this time I was a lot calmer. Amazing what effect the lack of doubt had on my ability to hold things steadily! We weren't even two hours into the shift and I was pretty much out of drugs and totally exhausted! Once the paperwork was done and signed I called up control. 

"Red base, due to the last two jobs we are all out of drugs, can we start heading back to station to re-stock please."

"Rog, no probs, start heading back and we'll try and leave you alone."

We can't be shown unavailable as we can still 'render aid' apparently! What that means is if there is a job we will be sent and they will hope we have enough kit to get by! As long as it's not another allergic reaction we'll be fi....

"10 year old male, allergic reaction, eyes swollen"

Of course it is, what else was it going to be?! The one thing we can't deal with is the one thing we need to find a way to deal with! 

"Red Base, we have no drugs to deal with an allergic reaction. Is there a Hotel car running on this?"

"Rog, they are 3 minutes away."

'Hotel' is ambulance jargon for paramedic and I don't know the origin of it. If there is a paramedic on a vehicle it becomes a Hotel crew. Anyway, we pulled into the road just before the car and I took great pleasure in ticking the 'first on scene' box! Like we had done twice already we jumped out and headed in. This time it was slightly calmer. The boy had a huge swelling under his eyes and a rash over his torso and arms but wasn't too unwell. It was very itchy and causing him a lot of discomfort so thanks to the FRU, we gave him some Chlorphenamine which worked well and within 10 minutes the itching had stopped and the rash was decreasing. By this point we were back at the hospital where we handed him to the waiting paediatrician who looked at me and laughed!

"Again?!"

That was it! Not for the shift, but for the allergic reactions and quite frankly, I don't think I could have coped with another! As for the shift, there was still 10 hours to go! *cries* 

As for the patients:

Patient 1: As of 8 hours after we arrived he was still in a very, very bad way. The doctors didn't know the cause and despite a list of drugs and therapies as long as my arm he hadn't improved. The kid was awaiting a transfer to a specialist hospital. I won't find out how he did.

Patient 2: Fine and dandy, sent home 6 hours later and told to stay away from the macaroons.

Patient 3: Discharged 4 hours later with another washing product to add to the list he is allergic to. 

Kids eh! Aren't they fun!