More Strokes

We had been on a rest-break, but Control had interrupted our break in the last fifteen minutes (which is fine by me as we get financial compensation, and I'd rather not be named as 'Medic on tea-break while my child died' in The Sun)
The call was given as a 'elderly woman collapsed behind locked doors, possibly deceased'.

We got round there as quickly as possible (after taking a detour due to a council rubbish truck sitting in the middle of the road, obviously picking up some cardboard boxes was much more important than whatever we were going to). Our FRU was already there, as was the patient's nephew.

The front door was shut and our FRU pilot was nowhere to be seen. WE knocked on the door and it opened a crack. The familiar face of our FRU appeared in the gap.

“She's laying in front of the door – I climbed in from the neighbour's back garden”.

We made our way through the neighbour's house and stepped over the two foot fence that separated their gardens.

The first thing that I noticed was that the house was spotless, our patient was originally in good health.

Then I saw her laying in the corridor.

She had been there for probably twenty-four hours, there was no carpet so she had been collapsed onto tiles overnight. The entire right side of her body was a huge bruise.

As you get older your skin becomes less resistant to damage, so you bruise easily, tear the skin easily and can get pressure wounds. The weight of a body can cause the flow of blood to become interrupted and unless you move (which is what people normally do) then the skin and underlying tissue can die.

You end up with wounds like this (Warning, you may not want to see this).

The right side of her body was likely going to become like the above picture.

It became obvious that she had suffered a stroke – she wasn't moving the right side of her body. Her left hand kept snaking out and grabbing at us and you could see the fear in her eyes.

She was also as cold as a block of ice. Being unable to eat or move, stuck in the draft from her front door in an unheated house meant that she was suffering from one of the worse cases of hypothermia I'd ever seen.

Her core body temperature was 28 C. (82.4 F)

We carefully removed her to hospital – any sort of physical shock at this temperature can cause the heart to stop. All we could do was to make her as comfortable as possible, wrap her in blankets, hold her hand and talk to her.

With a hypothermia this severe the hospital can rinse warm fluid around your internal organs after making a surgical hole in the abdomen – in this case though the risks to a patient this frail meant that they stuck to the safer warming blankets and warmed fluid into the veins.

It's unlikely that she will survive this episode. I hope that the stroke affected her mind, and that she wasn't aware of what was happening to her. I can't imagine what it must have been like, to lay there for so long, unable to move, gradually getting colder, not knowing if help was ever going to come.

I hope that it affected her mind, but with the look in her eyes I think that she knew exactly what was happening.

It's not a good way to end 80+ years on this planet.


It seems that all I'm writing about at the moment is sad things – hopefully I'll have some happier stories to tell in the near future. At least I have my Mac laptop back and can work on answering some emails.

19 thoughts on “More Strokes”

  1. i also found this very upsetting. my gran went into a home this year but it took a few really near misses before it got to that stage…

  2. Tom what an awful story – makes a good case for panic alarms but as I know from my Grampie (now fortunately in a residential home at the ripe old age of 92) some people just don't wear them. Take it easy – you did all you could for her…

  3. And at least help did come. It may have been too late to do her any good but at least she didn't die cold and alone.

  4. No words sorry – I wrote this insteadNot be there

    ————–

    Just please let me not be there.

    Let hosts of angels take me on

    Quietly in an unobtrusive way

    If not then imps from hell

    They cannot take me to a torture worse than this

    Just please let me not be there

    Give me paralysis of the brain

    Before I lay like so much rotten fruit

    Let my thoughts and reason have withered away

    Before now this husk laying useless today

    Just please let me not be there

    And what is left for me

    Except for the quiet dignity you bring

    And you wound yourself with care as you take me wounded carefully away

    —————————-

    Robin Ansell

  5. Tom, for once I can remark on this with first hand experience.My Nana passed away under very similar circumstances a couple of years back. It was around Christmas time, and we were meant to have dinner with her Christmas day. However, she was feeling unwell (a bit of flu, etc), and didn't want to come over, or so she reported in the morning when we rang her up. Boxing Day, we rang her to find out how she was, and we couldnt get hold of her. We just assumed that she'd gone out to friends or similar, and didnt think anything about it. Next day, same thing. This wasn't unusual behaviour for her, by any stretch of the imagination.

    Except for towards the evening, when we got a phone call from Nana's sister – “Have you heard anything from her? We haven't.” This started the alarm bells ringing, so me and my sister (I would have been 17, she was 20) drove over there – probably about a 50 minute drive. We got there, no lights were on, and no answer to the door bell. We had a set of keys, but the doors all had security chains on them. We rang 999, and the police controller advised us to break in, and that there was a Patrol car on it's way. We did so, using a maglite and the window next to the security chain. All to find Nana lying dead on the tiled floor in her hallway. Both me and Liz are medically qualified, and it was clear to us she was beyond help.

    To this day, it still haunts us that we didnt get there sooner. She must have been lying on that floor in very little clothing, hearing the phone ringing but unable to get to it. She too had had a stroke, and she did die cold and alone.

    So I'm glad that for the sake of your patient, help did arrive before the end.

    Regards

    Nick

    http://nickhough.blogspot.com

  6. Thank you for sharing this, it reminds me why I make a mental note of the comings and goings of some of the elderly people on my street. And why I'm certifying for EMT Basic tomorrow night. (Wednesday 5/16).

  7. Reading this made me think of the residents at the care home I work in. They'll all be tucked up warm in their beds right now, and that makes me really happy. It's so tragic when stories like this come to light. We live in the 21st Century, but still people die cold and alone. It's not right.

  8. I have been to a 92 year old man who who got out of his lack of care home in the month of November a few years ago. the over night air themp was -5, hi core was 26 and he was discharged alive within a week. Just occasionally miracles do happen in this job thats why we do it I think.

  9. Help did come, maybe not in time to save her life in the long-term, but you got there, and if she knew anything, she knew that. If she knew what was going on, she would have felt you holding her hand, being there, the people at the hospital caring for her.Either way, it's still heartbreaking.

  10. Tom, am I missing something? Your post said that she was unlikely to survive but all the comments seem to have assumed she was dead. Is there an update on her condition?A sad tale nevertheless.

  11. My heart really goes out to everyone involved. A similar thing happened to my family when my grandfather had a severe stroke last September while in a sheltered flat and lay on the floor for at least 16 hours. I sincerely hope that, as you say, she wasn't really aware of what had happened to her as the distress would have been unimaginable. Sadly my grandfather, although his body had suffered greatly, was mentally unharmed and aware.I'm a medical student and I don't think I'd be able to cope with coming across a similar case. 6 weeks on the acute stroke ward and he battled to the end. I really hope that whatever the outcome was for this patient that she's now more comfortable

  12. I read this last night and, unusually for me, found myself affected…twenty four hours later I've reread it and still found it very sad…perhaps it's because I've known three or four people this (or something similar) has happened to…I guess it's not that uncommon, but still a very sad reflection on modern life – years ago, for better or worse, the family unit would all be living together…horrendous in some respects, and yet, with progress and an improved quality of life in many ways, we do appear to have lost something….

  13. She could be alive, but I would imagine that the huge tissue damage done to her by laying on the floor so long would be the thing that would kill her, if not for her temperature.Of course I may be completely wrong – if I see the doctor that looked after her I'll have to ask them.

  14. My great gran was similar again. 3-4 days on the bathroom floor (this was before I was 10). She had a stroke after a vigorous game of golf. She was well into her 70's and had been athletic all her life. Fortunately temperatures don't fall so low in my part of the world. Unable to move though, I am not sure whether she had any sores like those described. She ranted and raved at us, at anyone who would listen or was just nearby while she struggled through the partial paralysis. It was with good humour and a self deprecating wryness. A few years later, after a second more severe stroke and not long before she died in hospital (in as good care as could be given), after weeks of being unable to speak or communicate, her last (miraculously) legible words were “Who won the cricket?”. The Ashes.

  15. WOW! I totally appreciate what you are saying. I hope it affected her mind as well…but it doesn't sound like it. How frightening for her.But at least you found her and made her end a little easier.

    Kudos!

    Found you from Ambulance Driver's blog. I'm glad I did!

  16. Oh dear, I have read a lot of the comments and have to just say I am so glad I was there with my Mother the first time my Grandmother had a stroke. she was living at home at the time and we were visiting for the afternoon. I am so glad we were there. I have been reading a long time and never felt moved enough to post until now, I am sitting here having a small weep for her and my Grandma.I am glad she did not die alone and knew some one cared enough to call for her.

    Thank-you for you blog and your sense of humour. Also for your book that bought me here, it is currently my favourite to recommend to readers who need a dose of reality. (I am a Library type person.)

  17. You did your best for her Tom, and that is all anyone can ask of you. I've seen (and smelt – the first time i was nearly sick) tissue damage and know what it can do to a person. I just hope, like you say, the stroke left her incapable of realising what was wrong with her. It shouldn't happen but it does… you can't save everyone no matter how hard you try.I'm a new reader by the way, and i love your blog. My sister (a nurse) told me to read your book and it has taught me more about working with patients than the longest shift in the care home/hospital. Keep up the good work Tom.

    Helen x

Leave a Reply

Your email address will not be published. Required fields are marked *