Call Me

“19 year old male, chest pain”, that's a blue light, sirens, whizzing through the streets sort of call. Not because he's nineteen, but because it's a chest pain. Remember, chest pains are one of the things that we need to get to in eight minutes or the government will slap us on the wrist.

Nineteen year olds don't often have heart attacks, not unless they have been hitting the cocaine rather hard. Where they do have heart problems it sadly tends to be of the sort that causes the heart to stop suddenly.

So we arrived and the young man was very pleasant. He certainly didn't look like he was having a heart attack, he was upright, he wasn't sweaty, he wasn't dizzy and he wasn't having any trouble with his breathing.

“I've had this pain for half an hour, and I've seen those posters, the one with the belt around the chest, so I thought I'd call you”.

So we popped him into the ambulance and did all the tests that we normally do including an ECG and a full history.

He'd been working out at the gym the day previously, the pain got worse if he took a deep breath in and the ECG was more normal than my own.

I told him that we couldn't be sure, that the only way to be certain would be with blood tests, but the patient seemed happy that he wasn't having a heart attack.

“I suppose you think I'm silly”, he said.

“No mate, I'd rather come out to someone who is thinking they are having a heart attack than to come out to someone lying dead on the floor because they ignored their heart attack”.

Sometime I moan about people calling the ambulance for inappropriate reasons, the verrucas, the runny noses, the period pains – but I never moan about people calling me out for chest pains.

Chest pains are 'boring' jobs for us, you need to do a lot of things and run over the same questions and there is seldom any change in the circumstances of the patient.

But I don't go to work to be entertained. I go to work to get paid help people, and that is why you should call for an ambulance if you get chest pain.

24 thoughts on “Call Me”

  1. I had chest pain in July, I was also blacking out and short of breath, but I'm 20 years old and knew that it was highly unlikely I was having any serious heart problems, so I booked an emergency appointment with my GP for a few hours time. He did an ECG, and said he's never seen one quite like it! I ended up spending 3 days in hospital with heart block (2nd degree, Mobitz type 1 for the medics) which I didn't know young people could get!I work for the ambulance service in control, and I've taken many, many chest pain calls, mainly for elderly people, and any patients with heart block tended to be in their 80s, so I guess I'm old before my time….! I used to be a bit cynical if I took a call for a young person with chest pain, and joke to my colleagues that they knew how to play the system, but now I take them deadly seriously.

    Thinking back, I think I should probably have called an ambulance, or at least called on the admin line and got the advice from my colleagues on the clinical advice desk, what do you reckon?

  2. I fell over skating and smacked my chest on a kerb on a tuesday, on wednesday I was jumped on by a large rottweiler. On thursday, I had a huge coughing fit while carring a large box of books, something made a cracking noise, and I felt something shift, in my right side, just under my bra and breathing got uncomfortable.NHS direct just about ordered me to A&E, where they insisted on checking my heart (funny place for it, I thought) and informed me that I couldn't possibly have cracked a rib because I was too young and fit. My heart, to nobody's surprise, was fine. After that they basically lost interest and kicked me out.

  3. Talking of heart attacks I almost had to deal with one today.Luckily “Man, sitting at side of the road, clutching chest” doesn't always mean heart attack.

    I'm glad theirs people just 8 minutes away if I do need to make that sort of call

  4. I had the same happen to me both time that I broke my ribs and when I sent down a flight of stairs counting the steps with my coccyx…..far too young to have caused any damage…Or my father who went to the same A&E having plummeted over 40ft into a drystone brick wall after the thermal (hot air pocket) dropped causing his paraglider to fold and drop him like a dead weight…..they never even xray-ed him……the 2nd a&e discovered fractures in 6 vertebrae…..but he was far to young to have an injury (at 44)…

  5. That's weird, whenever I've been in A&E x-ray we'd pretty much x-ray anyone, I've never heard of people being too young to break bones! Esp with a history like that (paraglider). On the other hand if the A&E docs are weeding them out we would never get to see them.

  6. Re Texas @04:48 – No wonder NWAS wouldn't allow “that calendar” – the defib paddles are in the wrong positions!

  7. I lost a friend at 26 to a heart attack. It's always worth checking.Never heard of the 'too young' theory of broken bones before. Someone really needs to get that pick-tree looked at.

  8. My dad was a very lucky one, he had a heart attack 10 years ago and ignored his symptoms, he was in Portugal and just kept taking Asprin until he got home 24 hours later when he went from the airport to the hospitalI was so furious with him ! He kept saying he wanted to walk me down the Aisle as I was getting married a week later…….still don't think he realises just how lucky he was to even make the wedding let alone walk me down the aisle.

    I guess he was scared but I still don't understand, we could have lost him

  9. I had chest pains at 19 that were dismissed as “viral infections” – luckily, eventually, one bright spark realised my left lung was 80% collapsed! My blood 02 was still 98% at the time.

  10. I was sent home from a&e with a fractured collar bone sustained from playing rugby for the same reason! They didn't bother x-raying me, I was far too young to have broken anything! I then walked around in pain for a few days until my family doctor said he thought it might be broken, then I demanded an x-ray. Not broken but pretty badly fractured at 15 years old.

  11. My dad had “indigestion”. There was “no need to call an ambulance”At the time I was working in an A&E Dept as a receptionist – I called an ambulance.

    5 days later dad died of his “indigestion” a large and on-going heart attack

  12. Thanks Tom for posting this. I had 'discomfort in my shoulders' earlier this year – I couldnt localise it so I didnt describe it as 'pain' and it was higher than I call chest. I'm 42 and had no risk factors for a heart attack. I called NHS direct looking for advice on painkillers. They called an ambulance. Paramedics said it probably wasnt cardiac but took me in to get it checked out. A&E doc said it probably wasnt cardiac but did a blood test to check. I had had an infarction – it turned out to be caused by an autoimmune vasculitis, rather than atherosclerosis. I am so grateful for the professionalism of all those in the health service, who took it seriously even though they thought it wasnt likely to be serious, and ignored my continued apologies for wasting their time with what I thought was bad RSI. I wondered if the paramedics went away (not knowing they outcome) thinking it was a 'waste of time' job, but I hope they shared your attitude.

  13. Too young to break bones , where the 'Blankety blank” , have these super educated bleeders been.Back in the forties, One 11 year old with me in the casualty ward had 21 fractures falling off a ladder [ 6 feet] [calcium deficient], I had by the time I was 18 had a broken tibia , smashed ankle [all the bones pushed in a lumped]and also with me were many other young men hanging from the ceiling on wires while have their extremities supported while healing, later two collar bones split, a nose that was adjusted for beauty . all were just normal accidents.

    No bones broken by the young, Yuck, yet my wife who has done her 3 score and ten + took a tumble down 3 flights of stairs at an airport, all recorded on tape , just got a “******” scare both of us most thankful.

    Chests Pain problems should always be investigated, Autopsies have shown many a person has had problems , shown by the lesions on the heart that they survived, It is a muscle and can from stress seize up just like a charley horse. unlike a charley horse it can stop oxygenated blood getting to brain.

    Tis why the good guys have means to evaluate the condition on the spot rather than wait for evaluation.

  14. I can see the UK uses strong methods like they do in Qubec, though not for the same problems. The poster just gives me the creeps. Hated it more every time I saw it on a bus in London. I guess that's the purpose.

  15. When I lived around the corner from you (a while back now), I once woke up very early in the morning (2.30ish) with something very disturbing happening in my chest. I had to thump myself over the heart to get the rhythm back. I thought it best to lay there quietly until I thought it was safe to get up. Of course, like Jo above, my local quack's diagnosis was that it was indigestion. I'd like to think that there are some medics out there who really do know what they're doing. However, I doubt many are working in the NHS. (BTW I always ate my evening meals before 7.30pm….yes I do know how long the digestive process takes and am resentful of quacks like the ones I was registered with).

  16. Hello, I've been reading your blog for awhile and it definitely has some interesting stories. And since I'm an EMT from the U.S., it's interesting to hear stories from other parts of the world, but the same job.

  17. Hi TomI certainly recommend you listen to your body, I tried to dissmiss a 'chest ache' for 3 days before going to my GP, I was 46, I was diagnosed with unstable Angina, and by the time I had my angioplasty I was 99% blocked and in danger of a heart attack at any time, its not a nice experience and difficult to accept at the time,

    take care

    joan

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