Clockwatching

It's 3 a.m. in the lonely hours of the morning and I'm nervous.

We are in the bedroom of a six year old boy. His mother found him having trouble in breathing half an hour ago.

His airways are so tight that every breath that he takes turns his chest inside out. He is trying to breathe so hard that I'm waiting for his breastbone to snap under the strain.

From across the room I can hear the air whistling through a tiny airway. He has the classic posture of the asthmatic trying to force air into their lungs – he's sitting upright, hands on knees.

He can't cry – he hasn't the breath for it.

I want him in the ambulance. No, I want him in hospital.

But we can't go just yet. The single mother has two other children, both under the age of five and they can't be left alone in the house. They need to be woken up and dressed. One needs to be thrown, still sleeping, into a pushchair.

I'm counting the seconds, I'm waiting for the boy to start turning blue.

I'm eyeing the kit in our bag, how much experience has my crewmate had in intubating a closed down airway?

We are already giving him all the drugs that we can. He's so sick that he quietly accepts the noisy nebuliser mask.

I help the mother dress one of her children – socks and shoes slipped onto sleepy feet.

Then it's time to go. Like all parents she worries about out insistence that we leave the child topless as we walk out into the cold air. It's due to his high temperature I tell her. I don't tell her that it's also so we can easily see that he's still breathing.

For once my big fear isn't a complaint from the mother – it's that the child will die in the back of our ambulance.

I pass the blue call over the radio to prealert the hospital, the radio isn't working too well so I have to repeat some of it. I don't think that the radio operator understands one of the medical terms that I use, it's not their fault as it's pretty obscure. The broken radio means that I can't be sure of the read back.

I don't care, as long as they have the paediatric doctor waiting for us there I'll be happy.

We are 1.9 miles from one hospital, 2.4 from another. I go for the further hospital, the drive is straighter and I can use the A13 which at this time of the night is clear. The other hospital has too many speed-humps and side turnings on the route.

I'm listening to what is going on in the back of the ambulance. My crewmate sounds relaxed and over the sound of the engine is the reassuring noise of the child's breathing.

I glance at the speedometer – I'm hitting 80mph, I didn't know that these ambulance reached that kind of speed. I'm thankful that the road is clear and empty, and that there are no hazards.

I spot the patient's young sister looking at my face in the rear-view mirror, her eyes wide open now.

We pull up to the hospital and I take care of our patient's siblings, I bed them down in the relatives room while the doctors and nurses and mother look after their brother.


It's only half an hour later that I'm talking with the paediatric nurses – while it looked touch and go for a bit, our patient responded well to the medications that we can't give. His breathing is back to normal.

I love the paediatric A&E nurses at this hospital, they are experts at what they do and despite the cynicism that is endemic in the NHS, they really do care for their patients.

We are chatting and laughing at the memory of our fear. We have fought back against death, and this laughter is our victory cheer.

The family are reunited.

I still have that memory of fear though.

15 thoughts on “Clockwatching”

  1. Its amazing the change of emotions from adrenalin and fear and the urge to run to hospital as soon as humanly possible to reliefe as the paed team take over and you can start to relax and take stock of what has just happened. You will never recreate that feeling elsewhere.And it's amazing what speeds ambulances will hit with poorly children in the back, have hit almost 3 figures on the motorway in the middle of the night.

    I work 16 miles away from the nearest hospital.

    Congratulations on a good job well done

  2. Make sure you eat plenty of protein with that pasta – too much carbohydrate (esp if it's white pasta) will give you a surge of energy followed by an inevitable slump. Sorry I can't offer any help with having to go to work at stupid o'clock!

  3. Not even Alfred Hitchcock could produce suspense like this. You can add the ability to make us feel the story as well as read it to you other qualities.

  4. Just great to know he was OK in the end. How scary for his poor family.Reassuring as a Mum to now that the people out there who can help in such a crisis really do care.

  5. Strange that you should title this post 'Clockwatching' – that's exactly how I refer to the feeling of having an acute severe asthma attack, with a slightly different emphasis.For me, it's the way time seems to slow to a stand-still, watching the clock in Resus, as the hands creep around, waiting for the drugs to kick in. Even if I knew I was going to feel completely better within five minutes (which is never the case) it would still feel hugely, monsterously too long.

    'I was clock-watching' is my way of saying 'it was a bad attack'.

    Top job and top post. I've had paramedics attend me who have failed to recognise that I'm having a life-threatening attack, mainly due to the absence of wheeze when I'm 'silent chested'.

    Emily H (junior doctor and brittle asthmatic)

  6. That'd be Nam?I think I've met your punter. 😉

    (Although, in hindsight, I guess this is anoned, so I probably didn't, and one AE asthma is much the same as another)

  7. If it was life or death would you have been allowed to take the child to hospital without his Mother?I understand that she couldn't have left her other kids alone, but surely she could have told you to just go and she could have called a taxi to the hospital herself as soon as she could?

    I know it is better for the kid to have his Mum there, and legal permission may need to be given at the hospital for any procedures, but if a few minutes might mean his life what is the position?

  8. It was life or death, just not *quite* at that moment of time. If he'd started to do the things that come before dying, or if I thought that the mother was taking too long to get ready I would have scooped and run.Then wait for the charge of kidnapping. (I'm not joking there).

    It's a tricky one, and highlights once again the sort of line that we walk everyday.

  9. This brought tears to my eyes. I am feeling the fear, now- it's the fear I had a few weeks ago when transferring a woman in to hospital with baby's heartrate so low that we'd usually assume the baby was about to die. Every minute seems like an hour, every hesitation seems like an eternity. Thankfully in our case all was well too- but those journeys seem like they go on forever and all you do is look at the clock every 10 seconds, willing yourself to get there quicker.

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