Silver Lining

There is a common, but weird, syndrome that I come across on a regular basis, in this case the specific presentation meant that I got a cup of tea.

For some reason the patient feels an overwhelming urge to pretend to be unconscious. Normally this is precipitated by an emotional response – often an argument. This syndrome is more common in women, but has been known to strike men.

I will often arrive and the relatives, who are worried by this 'collapse', will often neglect to tell me that there was some form of disagreement previous to the sudden striking of the illness.

In this case the woman was laying on the bed and our FRU had been on scene long enough to determine that she wasn't physically ill and the that collapse was a response to some emotional cue. The woman was also being treated for depression.

We agreed that it would be best for her to attend the hospital and that an assessment by a psychiatrist would be helpful. So we then stood the patient up to move her downstairs.

Then she punched me in the chest and started pulling her hair out.

Us and the family restrained her and we arranged the police to attend. The police are helpful in a situation like this because people tend to calm down a little when there are police officers around. This combination of the emergency services managed to persuade the patient to peacefully come to the hospital.

The police asked me if I wanted to make a complaint against the woman – something that I would consider a waste of their time, so I refused.

But it did mean that I would have to fill out the required ambulance paperwork, partly to record an 'assault', partly to highlight the address for the safety of other ambulance crews.

But most importantly it meant that I could get a quick cup of tea at the station while filling out the paperwork – the only cup I had for that particular twelve hour shift.

26 thoughts on “Silver Lining”

  1. A bit different as this doesn't require the patient to breathe too fast. If it is caused by hyperventilating the patient can stop breathing for a minute or two – which is a little scary if you weren't sure of your diagnosis in the first place…(Perhaps this could be an upcoming blogpost)

  2. Tea makes EVERYTHING better… I can't survive without at least three cups a day… It's probably unhealty, but I don't care! 😀

  3. Sometimes after I've had a fight with my boyfreind, it feels like I'm unconscious- it really fries my brain- I can see why people fake it.

  4. “good be oft interred in the bones while evil dothe live on”, the bardfor the man in the street, it takes 1000 ata boys to equal one o shite.or squeeky wheel gets all the oil.otherwise known that's life.A thank you is so nice to hear or see 'rit' as it be so rare, and it is very uplifting to appreciate the goodness of others.The bad is really quite small percentage of the good, 'tis why we hear so much, it makes the head lines but “good” [so boring] rarely makes a good story, not even in the Bible .The olde English cuppa works for many, saved many a day when thee be under the barrage of words or shells.

  5. Ahhhh tea, giver of life, nectar of the gods and so on, it does rather make the day better doesn't it. The only reason I don't drink it more is it's a “like a little tea in that sugar?” situation.

  6. In response to the actual condition: I've heard of -but never seen- a person getting so upset that their breathing will actually be so quick and shallow that they will actually pass out due to lack of oxygen. Once they're knocked out, they naturally return to a normal breathing rhythm and will wake up a short time later.My instructor/paramedic told us that he's actually seen it several times.

    Any way these could be related or even the same condition?

  7. Oh, my!I thought that these hysteric reactions were typical of “Latins”, since I saw them affecting people originating from Southern Italy and Southern Americans. Never seen such reactions in Northern Italians or people from other Northern countries.

    EMTs in Milan (where I work and live) use to call this hysteria “Southern Syndrome”.

    Rob

  8. You could always start an IV. Seems to wake people right up.You only got ONE cup of tea in a twelve hour shift ? Isn't there some sort of law about work/rest period ?

  9. well, a stressed-out, stomach-churning, highly-emotive argument is a tiring thing to have. And it's not, generally, a situation in which you can suddenly stop what you're doing and say “I'm sorry about this, I don't feel very well, can we stop for five minutes while I have a little sit down and get my head together, and then we'll carry on?”But, it's a big jump from feeling drained from an argument and wanting it to stop, to lying on the floor trying to inconspicuously peek out of one eye while letting your loved ones fuss and fret and call ambulances. And another jump still to try and fool the ambulance crew, make everyone dance around you to the hospital, and so on.

  10. Yeeesss: that bothers me a bit TR. You and I know that most crews manage to sort out a tea/coffee/fag (as appropriate) at the hossie when booking the patient in. Are you saying you only managed ONE in an entire shift. That would point to possible dehydration problems…. wouldn't it??

  11. hi Been lurking for a while. Am hoping to join the service…so am I mad? what do I do without my cuppa? Having said that when I have been third manning, I have usually manged to pick up a few brews when dropping patients off at hospital. Sounds like you need some insiders at EDC!!

  12. Ah! his genetic switch be on camel for the shift, very useful when there be no safety or sample bottle, it not supplied by the nursing staff, as they be all in use, else there must be budget problem for fitting out said ambulance.Seriously tho, Surely that be against all medical recommendations, one cuppa of char, as it be said one should always consume a minimum of 8. 8 oz of H two O in order to stay hydrated.Where be thy Union,else thee need a wife to go to the central consul to berate the dispatcher that be ig naw ing you.

  13. Too true. Once had a young woman (post very emotionaly fight with family) brought by ambulance to ER. She'd had a violent 45min “seizure” at home & enroute and then became “catatonic”(the physican's descriptor) upon reaching the ER. She'd never lost her airway, was not incontient, and had no oral or other trauma during the “seizure”(it could happen). As her nurse I did a quick eval and then drew up the coldest ice water to be found, and with a needless syringe, quickly shot her between the eyes. The young physicians getting ready to examine her went from being horrified at my behavior, to shocked at her immediate and dramatic response. She sat bolt upright, with open eyes exclaimed “what the F”, saw everyone staring at her and immediately became “catatonic” again. After questioning me at great length on my “benign and non-invasive method”, the one pysch doc. decided he was going to do a “study” on this “new and inovative diagnostic tool”. And here I just thought it was good judgement and quick triage. }:>

  14. If she'd have punched me, she'd have got more than a bit of ice-water between the eyes!Can't believe you didn't have her prosecuted. Depression / pretending to be unconscious / pseudoseizures do not excuse violence.

  15. …also it would be a complete waste of time as it'd mean two police officers being off the street for a few hours filling in the paperwork only to have it all thrown out by the CPS.I am aware that everything should be investigated in theory – but then that doesn't really fit in with the real world unfortunately…

  16. Luckily, for me, I didn't get punched. The “ice water in the needless syringe between the eyes” (must be done quick & hard for startle effect), keeps you at a safe distance from being swung at. If you don't get the response I did that time,Then, you put in the IV…. otherwise you can get clobbered. (I'm a safety girl}:>I also agree with Tom. File the incident to warn those behind you. But pressing charges on such individuals just takes everyones time & creates more mess. In the end it's usually swept under the carpet. Pity, the real world doesn't align more to the idealistic one….but hope springs eternal for the damned.

  17. People are tossers. To assess the general public, take your own worst mood, amplify it by 20 fold, and then act like the thickest person you know.I agree, start an IV or state that the only possible treatment for this state is a lemonade enema, then watch the grateful return to consciousness, or make a fortune on Youtube….

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