When dealing with children in a basic ambulance job there are two types of parents – the calm sensible ones, and the flappers. Calm sensible parents are preferred, they keep the child calm, can give you a full and complete history and are a pleasure to have in the back of the ambulance. Flappers are another matter.
Our call was to a nine year old girl with a nosebleed, they lived less than two minutes from their local hospital and the presence of a car in their driveway had me rolling my eyes. The front door was opened by the patient's mother, she was literally running backwards and forwards with tears streaming from her eyes. She could hardly talk because she was so upset and her breathing was just a shade short of becoming full blown hyperventilation.
Obviously I had a moment where I though that the child was more seriously ill than a simple nosebleed.
Then our patient walked around the corner, she had a bit of kitchen towel held up to her nose, but there wasn't any active bleeding. There was one or two drops of blood on her blouse and otherwise she looked fine.
I finally got the mother to calm down enough to explain what had happened. Well, I say calmed down, what she actually did was thrust a piece of paper into my hands. The child had ITP, an often mild clotting disorder. Examining the child it seemed that the nosebleed had already stopped and there was a large jelly-like clot in her nose. The best thing to do is to leave well enough alone and give the wound plenty of time to clot – if you start fiddling around with it then the chances are good that the bleeding will start again.
There wasn't enough blood loss to fill an eggcup.
But still the mother cried, ran up and down and generally did her best to inadvertently scare the child. While the child seemed quite sensible (she'd done the right thing in clamping the kitchen towel to her nose) she was obviously frightened by the mother.
So I turned on my 'everyone keep calm' demeanour. I tried to calm the mother down, I told her how it wasn't serious, how the bleeding had stopped and how the blood loss was tiny. I showed both of them the vital signs that I took and explained how they were all fine and if it were anything serious then the pulse would be higher, the blood pressure would be lower and the breathing more rapid. But the mother didn't listen.
Instead of going to the local hospital (with a perfectly fine paediatric department) the mother demanded that they go to the Royal London where the child was under the haematologists. I explained that the Royal London didn't have any paediatric beds (because we'd just come from a transfer from there to another hospital) and that the local hospital would be able to cope just fine. But the mother flapped and fretted and so I agreed that we would drive past the local hospital and down the road a few miles so she could go to the Royal London.
So we set off for the hospital, the bleeding remained stopped and the mother seemed to calm down a bit. But then every few minutes she would dart forward and scream 'It's red!' and pluck the kitchen towel from the child's nose causing the patient to cry.
Later in the day I could contrast it with a 10 month old baby who had two febrile fits in the space of two days, the parent s were sensible, calm and a pleasure to deal with. The baby was fine by the time we got there and the parents were more than happy to go to the local hospital for a check-up. The calmness of parents tends to keep the child calm – and a calm child makes for a happy ambulance person.