The first of my two nights, wasn’t too bad, as I mentioned, I didn’t have to wait too long for an ambulance to turn up.
Shame about the second night…
My first call was to a 71 year old female with ‘Difficulty in breathing’.
I turned up, and was met by loads of small children. Making my way to the patient, she was using her own home medication to try and ease her asthma.
It wasn’t working.
A quick check of her oxygen levels showed 71%. It should be above 95%, below 85% makes me rather worried. You might guess that 71% really put the wind up me.
I spoke to the son while preparing my treatment. He’d obviously seen this before, as he gave as good a description of the patient and her problems as I would have expected from a medical professional. The patient had been in intensive care twice for her asthma. If an asthmatic ever ends up in ITU, then it shows how rapidly the patient’s condition can deteriorate. At the very least, it makes me rather nervous that the patient will ‘go off on me’, and it suddenly turns into a respiratory arrest.
The medication was given to the patient, Salbutamol – a nebulized drug administered straight into the lungs in the form of a gas. I was also giving her a large amount of pure oxygen in an effort to raise her blood oxygen levels.
Then I turned around and nearly fell over three rows of eight children, quietly sitting cross legged and staring up at me with big brown eyes.
“Don’t mind them”, said the patient’s son, “It’s Eid, so the whole family are celebrating”.
“She”, he said indicating the patient, “has twenty one grandchildren”.
I nearly suggested that this might be why she was breathless…
So now it was time to wait for the ambulance to take this very sick patient out of my responsibility and off to the hospital. I could see her getting more and more tired, although her oxygen levels were more normal (if only because I was blasting plenty of oxygen down her face-mask).
“Would you please leave the room”, asked her son after talking to the patient, “she needs to use the commode”.
Now, ask any medical professional when is the most dangerous time for your patient, and I would think that 99% of them would say that it’s when they go to the toilet.
“Hmmm… alright”, I said, “but someone stays with her”.
I was standing right outside the room, waiting for a shout for help and then for me to bound into the room to resuscitate her in front of twenty-one small children.
Luckily for all involved, she survived her encounter with the commode, and we settled down to wait again.
While I was waiting, I was constantly reassessing the patient. I really wasn’t happy to have her waiting so long because while my treatment was improving her condition somewhat, she needed better care than I could give.
The son offered me a cup of tea.
He knew how serious it was, he knew that the ambulances in the area were probably picking up drunks, and yet he understood my apologies, and offered me a cup of tea.
Thankfully the ambulance arrived, and because of my earlier treatment, the patient had become a little more stable. She still needed urgent hospital care, but I wasn’t worried that she would die on the back of the ambulance.
It had taken forty-five minutes to get an ambulance to the patient. Sometimes I like that I’m on the RRU when I can get to a patient in time to actually make a difference.
I also love the drugs I carry, I don’t use them much, but when I need them, they really do come in handy.
I hope everything turned out alright, because as I followed the crew and the patient out to the ambulance, the son shook my hand and said, “Thank you”.
Waiting 45 minutes for his critically ill mum to get a proper ambulance, and still he thanked me.