Faculty: Medical Science
BSc (Hons) Paramedic Science
Category: Allied and public health
11 May 2016
18:30, Friday 23 April: just another night shift as a Student Paramedic in Central London. This time I was not with my regular crew and mentor, instead I was a third person staffing an emergency ambulance crew operating out of Islington in order to boost my placement hours. They kindly let me on board and once we had done the vehicle and equipment checks we ‘greened up’ and immediately got sent out to a Red 1 call which was a Cardiac Arrest. Thankfully we were stood down en route as other resources arrived on scene quicker than us. This gave us time to chill out for a minute and mentally prepare for the shift ahead.
The first few 999 calls we attended were to people who has collapsed in the street having had too much to drink. When people who make the 999 calls say that the person has ‘collapsed’ and is ‘unconscious’, it is immediately graded as a Red 2 call, which requires an emergency response. On arrival we usually discover that the patient is in fact asleep. You can argue that the grading system of calls can come under scrutiny for this, however you can never diagnose a medical condition just by making a judgement by looking at the patient. A person who appears to be drunk could in fact be Type 1 diabetic and having a hypoglycemic episode or, thinking trauma-wise, nursing a severe head injury that results in reduced GCS, confusion and vomiting. Thankfully my first two patients of the night were in fact intoxicated and uninjured.
The calmness and normality of the shift was soon to be overturned unexpectedly, during my third job, around 22:30. We were tasked with a critical transfer of a patient who was undergoing a blood transfusion due to prolonged cocaine use, which had eroded his airway, impeding his speech. This patient was conscious though and also had a great sense of humour! Roughly five minutes into our hospital transfer I heard screams coming from outside the ambulance, and saw a small group of people blocking the road ahead whilst frantically waving at us. We pulled over and my crew mate went to wind down her window to see what all the fuss was about only to be met with a torrent of abusive language and gestures by a teenage boy. It was a very busy and confusing scene, I was in the back trying to distract our transfer patient from the commotion outside. I soon heard the words “You better help us, my mates been run over by a car!” being shouted by the boy. The paramedic who was mentoring me on shift decided to step out of the vehicle to go and investigate. Upon returning he said that a 17 year old female had indeed been run over whilst running across the road, and got struck on her right side. She had significant maxilla-facial injuries including many knocked out teeth, and was hemorrhaging from the mouth. She was sat upright on the pavement, in the cold and the rain so we had no choice but to encourage her to come aboard the ambulance and sit in one of the seats next to the trolley bed, where our first patient was eagerly lifting his head up to see what was going on.
Once we helped the poor girl onto the ambulance, I was trying to juggle the treatment of both a trauma patient and a patient with significant chronic airway problems, thankfully with the help of my other crew mate. My mentor was busy at this stage trying to safely disperse the angry crowd that had gathered and surrounded the ambulance demanding their questions be answered, which really pressured the situation. I soon learnt that the girl was intoxicated and was actually in quite good spirits. She didn’t have any significant pain anywhere, other than her face, which she had hit on the road.
We waited for police backup as well as another crew to takeover the care of the girl for what seemed like eternity. Eventually, we were able to handover our second patient to a relief crew and we continued the transfer with the first patient. After we had all calmed down and focused on the transfer again the patient mentioned he was a music producer so he kindly agreed to play some Bon Jovi on the radio for the remainder of the transfer!