A Tale Of Two Patients

Ambulance shirtI’ve recently spent a few interesting months working for an NHS Ambulance Trust and to say it was an eye-opening experience would be an understatement.

In the coming weeks, I will share more stories with you but I’ll begin by relating a story which is all too common and which may explain why you have to wait so long for an ambulance.

I’m just going to report what happened in a factual way, without passing comment, you can form your own views as to the rights and wrongs. All I will say is this story is not untypical and any ambulance crew will have a similar story to relate.

It was five in the afternoon and we working a 14:00 to midnight shift, a ten hour shift is a welcome relief after the usual 12 hour shifts. It had been a busy day and we were on our way to a very common call, an elderly lady who had fallen, known unofficially as a “nan down”.

Unfortunately, because they are not usually life threatening, these are not treated as top priority calls and it’s not uncommon for there to be a delay of a couple of hours before we reach such calls.

This call was doomed to be delayed further because as we were on our way, the computer terminal in the vehicle beeped and flashed up the words “stand down” and we were being diverted to a Red call. The new call flashed up on the screen, “male, 42, breathing difficulties.”

Ambulance on blue lightsTypically, the call was the other side of town so, as the driver, I had to manoeuvre a five tonne ambulance through rush hour traffic on blue lights to reach the patient.

We arrived within the eight minute window, which ticked the boxes for the bean counters, statisticians and Government Ministers.

Grabbing all the necessary kit to save a life we entered the house to find the gentleman with “breathing difficulties” lying in bed, phone in hand, suffering from little more than man flu.

Basically, all he wanted us to do was ring his work for him to say he wasn’t well enough to go in –we declined his request, to his obvious annoyance.

He had been “suffering” all day yet had not even taken any paracetamol, despite there being some in the house. On examination, he may possibly have had a chest infection and needed some antibiotics.

We suggested he rang his GP to see if he could get an urgent appointment. He told us he already had an appointment an hour previously but hadn’t felt well enough to go. He asked if we would take him to A&E, another request we declined.

TaxiWe told him he needed to go to the Urgent Care Centre, you can guess what came next “will you take me there” – again I’m sure you guessed our response, for the third time. We suggested he phoned for a taxi, as he was in no state to drive and he wife was a non-driver, which he did and we waited until it arrived.

In all, taking into account the paperwork which needed completing, we spent over 45 minutes dealing with this patient – that’s 45 minutes a front line ambulance was unavailable, dealing with basically a minor, day to day, ailment.   

A couple of hours later, after a couple more “pointless” calls, we had a Red call to a gentleman in his 50’s, with chest pains. His wife had dialled 999, even though he had told her not bother as it was “only indigestion” and she was making a fuss.

ECG showing ventriclar tachycardiaAs soon as we walked in we could see he was not a well man and an ECG immediately flagged up all was not well. This was not going to be a “stay and play” job, this guy needed urgent hospital treatment.

As we were making the five mile drive to the local hospital, my concerned colleague, in the back with the patient, was already on the phone to the regional cardiac centre to see if we should divert there.

She never finished that call, as our patient went into cardiac arrest – in short, he had “died” on us.

Lifepak 15I pulled over, jumped into the back of the ambulance to help my colleague work on him. After what seemed an eternity, but was only about 10 minutes, another crew arrived to back us up and after about 20 minutes and a number of shocks from the defibrillator we, amazingly, managed to get him back. Despite what you may see on TV and in films that’s something which happens very rarely. Afterwards my colleague told me it was only the second cardiac arrest she had seen “come back” in ten years service.

I saw him briefly, 20 minutes after he eventually arrived in resus, having done a Lazarus on us, chatting to his wife as he awaited transfer to the regional cardiac centre. He was still very poorly but he, at least, had a chance.

He has a lot to thank his wife for, she saved his life – if she had not ignored him and decided to call an ambulance she would, in all probability, now be a widow.

Something to ponder, had we not been free when the chest pain call came through, say we were dealing with a case of ‘flu, would the chap with the chest pain still be alive?

It’s a relevant question because when we initially asked for backup when the guy arrested, there were no other crews available to help us. We had to rely on a crew  to effectively drop what they were doing after a call, to come and back us up.

Call 111The moral of the story – if you have ’flu dial 111, if you have severe chest pain, even if you think it’s indigestion, dial 999.

 

 

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