What Do You Do, In The Bath?

Yesterday was a bad day, it started badly and just got worse – but not as bad as one of my patients.
I was sure I was working my overtime shift from 6pm – so I was a bit surprised when I got a call from my old crewmate at 4pm asking where I was.

I was in the bath.

Completely my fault – I had some form of brainfart, instead of a 6pm start it was a 4pm start. So I rushed out of my bath got dressed (leaving half my kit behind – I never need it) and dashed into work. Luckily, and unusually, there hadn't been a call in the 45 minutes it took me to get into work. I was starving, I hadn't had anything to eat since the day before, and I could feel my blood sugar crashing.

No sooner had I arrived than a call came in – Car vs Pedestrian, so we saddled up and rushed to the scene. The pedestrian had “bullseyed” the windscreen of the car, hair was embedded in the glass, yet the patient was up and walking around with no apparent injuries. I managed to assess him, but only after knocking his sunglasses out of his hands and breaking them (accidentally I'll have you know). He was adamant that he wasn't going to hospital, and the police couldn't persuade him either. So he left and walked home.

The next job was a LOL (little old lady) who had a urine infection, but who looked as if she were going to die within the hour – luckily the hospital was 3 minutes away, so we had little to do on that job.

I still hadn't had anything to eat, when we got a “Chest Pain”, way out of our area – so we rushed out to it only to find two “management types” had just beaten us there. I didn't recognise them, so we searched for the address, only managing to find it after some searching. We came across a 50 year old man who had cut his foot on a piece of glass, and who wasn't having chest pain at all. This tiny puncture wound was barely visible, yet he was writhing around the floor as if his foot had been cut off.

The two management types left, so I dressed his foot and took him into the local hospital. I finally managed to get a McDonald's large meal, and was thus sated.

I asked my crewmate if she knew who the two management types were, and she spent the next ten minutes laughing at me. Apparently one of them was our new Station Officer, and the other was the Complex Manager.

I think I've mentioned before how I like to avoid management – so I'm a bit annoyed their first sight of me was unshaven with an un-ironed uniform, wandering around an estate looking for an address…

We had started to return and had reached Stratford when we got a “suspended” in Hackney. We made it in eight minutes, although I have no idea how we got there that quickly.

We deal with a lot of crap on a day to day basis, but there are certain sounds that will send a chill up your spine. As we rushed toward the address I heard a woman wailing – just from this sound I knew that the “suspended” wasn't a “faint”, or an “unwell” – but was instead a dead person.

A 39 year old male had been working in the garden, had come into the house and collapsed dead in front of his partner and four children.

There was no electrical activity in his heart, so we started CPR until a second crew turned up which was about 30 seconds later. He was intubated, cannulated and the full works given – we rushed him to hospital where they worked on him, finally declaring him dead half hour later.

The partner was screaming thoughout the resus, although the children had been taken in by neighbours. As I'm typing this I'm thinking of how that womans life has changed completely. She has lost her partner and is now a single parent family with four young children. All in the space of an hour.

For us, the rest of the shift went fine.

3 thoughts on “What Do You Do, In The Bath?”

  1. Don't you just hate not remembering the start time for overtime shifts. I've nearly been in the similar position before…and the whole not shaving/unironed thing…been there before as well.Just intrigued about the whole transport thing for an asystolic patient. With a response time of 8 minutes, comms processing time realistically 1-2 minutes, and recognition time of at least 1 minute by the family this patient was a no go from the outset I would suggest. Is it LAS's policy to transport in this circumstance? I know that in our service, this patient would not normally have been transported – certainly age would not have been a valid reason.

    Our protocols state: if the initial rhythm in an unwitnessed cardiac arrest is aystole or PEA the survival rate approaches zero and it is usually inappropriate to begin resuscitation. If there has been no restoration of a palpable pulse after 20 minutes, then it is appropriate to stop resuscitation. If a patient has not been successfully resuscitated it is inappropriate to routinely transport them to hospital.

    I hate having to say to someone that x person is dead, when within reason in the sub 50 age group (and more so in the sub 30 group) they should have stood a better chance, but ultimately someone has to make that decision. We all know the 10% rule for each minute of a cardiac arrest rule, so realistically a large number of patients we respond to will never survive their cardiac event (etiology dependent). It makes you wonder if a) our medical director is cavalier or b) is he realistic. More food for thought anyway.

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