First off – I didn’t know that the survey was going to come out that colour – somewhere between previewing the post and it appearing on my blog the colours decided to ‘run’ into one another. I hate un-accessible web content.
Forgetting to put in a ‘not medically trained’ option in the Medical question was all my fault. And in answer to one of the comments, I didn’t know that Johnnies got the hump if called ‘St Johns’.
I was working on the FRU again for a shift, I’d turned up to work on an ambulance, but there was no-one else to crew up with me.
One of my first calls was to a possible heart attack in a GP surgery.
Once again I found the patient (a very pleasant lady) sitting out in the waiting room. There are a number of treatments that should happen with someone who is having a heart attack. First they should have a full set of vitals, then oxygen should be given along with an aspirin and, if the blood pressure is good enough, a squirt of GTN. It’s pretty standard stuff and does a world of good for the patient (aspirin alone increases your chance of surviving a heart attack by around 25%).
So – how many of these things had the GP done?
Well – he’d taken some vitals, but they were very different to what we got in the back of the ambulance. However vitals can change and I wouldn’t want to call the GP a liar.
At no point had the GP given aspirin, GTN or even waved some oxygen under the patient’s nose. The receptionist was helpful, and she led the patient from the waiting room into her office so that I could better assess her without everyone in the waiting room listening in.
I checked the patients blood pressure, gave her some GTN, an aspirin and put her on oxygen. All things that should have already been done by the GP.
Thankfully the ambulance was pretty quick in turning up, and the patient went off to hospital.
I had a chat with the GP – it’s a chat that I’ve had a couple of times now. It’s a chat about how possible heart attacks shouldn’t be sat out in the waiting room, about how ISIS-2 and NICE say that an aspirin should be given. How GTN is a good thing to give such a patient, and that oxygen can really help with the pain and anxiety.
“I don’t care about that”, said the GP, “I just want her to get TROP-I.”
TROP-I is a special blood test to determine a heart attack.
He then didn’t want to hear that perhaps sitting a woman out in the waiting room with a potentially life-threatening condition was, on reflection, a bad idea. I know GPs are busy, but is a two year old with an ear infection really more important?
I’m left in awe of GPs who don’t seem to want to treat anyone. Like nursing homes I’m sure I only meet/remember the rubbish ones. But if my mum was having a heart attack and went to the GP I’d be fuming if they sat her in the waiting room for an ambulance. It’s not hard to give someone an aspirin, it’s not hard to give them oxygen and it’s definitely not hard to keep an eye on them in your examining room while you wait the (less than) eight minutes it takes for an ambulance to arrive.
I’ve mentioned before how the LAS will visit and help train rubbish care homes – I’m begining to wonder if we should also go to GPs and let them know what the ambulance service (and by extension the local A&E departments) expect.