This week has undoubtedly been a challenging one on placement with the London Ambulance Service. Alongside many blue calls and time-critical patients we have responded to some very thought-provoking jobs.
A 999 call was made at the start of the week stating a water pipe had burst from underneath the road, causing severe flooding to the surrounding streets. On arrival, there were at least 11+ fire and rescue pumps, two London Fire Brigade command support vehicles and dozens of police cars. A senior police officer gave my crew and me a brief introduction to the scene, which was in Angel, North London. He stated many people had been evacuated to a nearby pub for warmth and shelter as the on scene emergency service workers battle to stop the flow of water. Our Hazardous Area Response Team (HART) followed us into the pub ready to triage any potential patients. When we got there, though, there were no patients at all, just a lot of damp shoes and socks! The Metropolitan Police declared it a major incident so we stayed on scene, with HART, until the Incident Response Officer (IRO) stood us down three hours later.
A whole five minutes after greening up in Angel, the alarm sounded on our Mobile Data Terminal (MDT), which displayed RED1 Cardiac Arrest, was on going just around the corner. With no hesitation we made our way to the address and arrived at the same time as a FRU (Fast Response Units). I entered the property first, but struggled to find anyone inside. My mentor heard noises coming from the kitchen, which was hidden around the corner of the living room. It was an incredibly small space, and she discovered the stepbrother performing CPR on the patient. Unfortunately we found the patient to have rigor mortis; there was nothing we could do for them.
We acquired the 30-second rhythm strip, which showed the patient to be in asystole and declared ROLE (Recognition Of Life Extinct). He was so hypothermic our tympanic thermometer read ‘LOW’ instead of a number, and he had fixed and dilated pupils. His death was completely unexpected, and he only had one common medical condition, which was well controlled by medication. The police were in attendance as standard procedure. It was a heart-breaking situation to be in and we consoled the stepbrother as he began informing the rest of the family. Soon to arrive was the brother of the deceased. We had to tell him that his brother, who was just 29 years old*, had passed away unexpectedly. His reaction was horribly upsetting, and he asked to see the body, to which we said yes. I went into the room with him so he could say his goodbyes. His breakdown and the sound of his cries will stay with me for the rest of my career.
This was a terrible start to the week, but we carried on with the shifts as normal and proceeded to attend an Inferior Segment Elevation Myocardial Infarction (STEMI) as our next job. We followed protocol and blued him into the nearest Cath Lab, which was St Bart’s Hospital in the City. Thankfully the cardiologists deemed her not table worthy, but instead admitted her to the ward for close observation and investigation. The next few days brought us an array of patients including a lady who fell down the stairs and sustained a head injury. I managed to cannulate her and my mentor gave Ondansatron and Paracetamol as treatment.
Sometimes on placement we go to jobs that can be daunting, horrible and emotionally straining, but it’s part of the career I’m going into. This is the reality we live and work in. The brother of the deceased 29 year old* said to me on the balcony of the block of flats: “I guess this is the s*** part of the job you have to deal with?” I was near enough speechless, as I couldn’t begin to imagine what he was going through, but yet he recognised the work we had done and thanked us for our attendance. Not many 19-year-olds have told a family they will never see their brother, stepbrother, son, friend and nephew again. It’s the small things that count in this line of work and it’s the people you meet with genuine gratitude that give you the energy to keep going.
*Not actual age of patient.