The Worst Kind of Call
When a “suspended” call pops up on our screen on the dispatch desks, there’s always a quick rumble of activity. There’s no “Hello Greenwich, how are you this morning? Got a call for you… little old lady hurt her hip… in Eltham… L202 having a cup of tea, are they? Shall I send it down to L203? Okay, have a nice day.” Instead it’s “Greenwich, it’s a suspended.. L203? Thanks.” And the crew rush out to the vehicle just like they do on Casualty (so I’m told) and put their foot down just that little bit extra, because in this situation more than any other, every second counts.
So what’s worse than a suspended call? A suspended call that involves a young person. These are far less common than you’d think. As far as I can recall, I have taken eleven such calls in two years:
- Two people who’d been hit by cars. One was trying to cross the North Circular, which is like a motorway.
- A motorcyclist decapitated by a pillar whilst driving in an underpass.
- One person who’d jumped in front of a train.
- A fatal stabbing.
- A twenty-something year old man who mysteriously dropped dead whilst having sex with his girlfriend.
- A young man who’d died of a drug overdose.
- A teenager who, I think, vomited in his sleep due to a stomach bug and choked to death on it.
- A 37 year old woman with a brain tumour who just didn’t wake up one morning.
- A severely disabled ten year old boy who’d stopped breathing. His parents were very calm, apparently it wasn’t the first time this had happened.
- Two cot deaths.
The call which popped on our screen on Wednesday morning was another. It simply read “21 year old male suspended”. Not wanting to send the two crews we’d immediately dispatched into a dangerous situation, our sector controller lifted the receiver and listened into the call. She could hear a hysterical woman describing a horrible scene.
The patient was her flatmate. She’d got up that morning to go to University, knowing he had to be up at that time too. When she’d finished her breakfast and he still wasn’t up, she went and knocked on his door. He hadn’t answered. She’d peeked her head around the door to see if he was there. He was. Lying in the bed, eyes open, his face purple, stiff, cold, obviously dead. The caller had screamed her head off, then grabbed the phone and continued to scream down it. The call taker was gently trying to persuade her to take a closer look and start CPR, but the caller was having none of it. She wouldn’t even touch him. I couldn’t blame her - I wasn’t even *there* and I could tell this patient was beyond any help.
At this point, a man - another flatmate, I think - took the phone. He was calmer, but confirmed what I suspected: when the call taker asked him to start CPR he said there was no point, the patient was clearly dead. The call taker asked him if he knew what had happened, and the caller said he had no idea. The patient was epileptic, but he hadn’t had a fit in ages, and otherwise he was perfectly healthy. He just couldn’t believe what had happened…
The crew arrived at this point. It was less than ten minutes before they called back to say yes, the patient was “purple plus” (ambulance speak for “dead beyond any possible doubt with no chance of resuscitation whatsoever”) and could we arrange for the police to attend due to the patient’s young age. There were no obvious suspicious circumstances, he said, in fact there was no obvious cause at all, and it seemed likely the patient had simply had a fit in his sleep, causing his tongue to block his airway rendering him unable to breathe.
I could still hear the patient’s flatmate wailing in the background.
This incident was a wake up call to all of us about how deadly fits can be. We get hundreds of fit calls every day, and 99% of the time, these are routine - the patient starts to recover before we’ve even got off the phone and doesn’t always need to go to hospital. This was a reminder to us that if the patient doesn’t have someone to turn them on their side and check their breathing afterwards, a fit can be anything but routine.
on October 13th, 2006 at 10:54 am
I think it’s the same with chest pain calls. It’s one of our most common calls, yet we tend to think it’s “just” a chest pain, and straighforward. But they could turn to a cardiac arrest at any time…
on October 13th, 2006 at 10:57 am
They sound pretty horrific to deal with.
I thought it was a myth that you could swallow your tongue / have it block your airway because it’s attached underneath to your lower yaw. Is this not the case?
on October 13th, 2006 at 10:59 am
You can’t literally swallow your tongue, but it can end up in a position where it blocks your airway. That’s what the “opening the airway” business in the resus instructions is about.
on October 13th, 2006 at 12:23 pm
[…] Nee Naw […]
on October 13th, 2006 at 1:52 pm
Mark,
I can agree with everything you’ve said mate. The ones where peeps are obviously dead are in a way better for us. Observers to the situation, while upset, can see what’s happened.
What can be worse is when we have a ‘working’ job. You guys in control are working your nuts off sorting the caller out and getting motors to the scene. We drive as you put it with our “foot down just that little bit extra” then have to carry on sorting out the bystanders and do the equivalent of 100 press ups a minute, plus remembering the new protocols with the right drugs at the right time.
And there’s no knowing if you’re going to get that beep to tell you that it’s all come together. (1 out of five for me so far - that’s what comes of being in a rural area - 10-15 mile blue light runs are the norm)
It’s a shame you’re not linked to the LAS website. I reckon you do as much for them as any public info campaign.
Tommy
on October 13th, 2006 at 4:59 pm
Mark and Rob, you are correct. It is impossible to “swallow” your tongue as it is atached underneath as well as at the back.
However, the tongue is a muscle, and at the point of unconsciousness, all the muscles relax - including the tongue, and gravity takes over. If the patient is laying on their back, then the tongue falls to the back of the throat, blocking the airway.
The act of tilting the head back and lifting the chin causes the tongue to stretch and flatten out, therefore clearing the airway.
Hope that helps.
on October 15th, 2006 at 6:44 am
Q: how often do you never hear “the end of the story” ?
In my agency (and it’s police dispatching, not medic or fire dispatching) we sometimes don’t ever hear what happened after the officers arrived. Something tragic or spectacular will always cause us to seek out that closure.
But we’re pretty busy and with semi-regularity I will be on the phone with a child who is witnessing (and I can hear in the background) a serious fight between his/her parents. Responding officers will go “10-8 clear” ( no report required) and we’ll just never know if we misinterpreted the severity of the situation or if the parents just managed to con us into leaving them alone.
Frustrating.
on October 15th, 2006 at 9:41 am
It’s a tragic fact that of the 1000 deaths from Sudden Unexpected Death in Epilepsy (SUDEP) in the UK, 400 are them are thought to be avoidable, if people had access to better care services.
on October 17th, 2006 at 12:14 am
Eric - in my part of the country, the dispatchers will get to hear what happened to the more life-threatening calls, in the form of the crew giving us the details of the request they made to the hospital to have them standing by ready for the patient’s arrival under blue lights, as these need logged in the computer system. Details including, what happened / what medical condition they are in, what drugs and treatment have been given, the patient’s GCS (level of response) and the ambulance’s ETA. I usually follow those details with “And how’s the patient now?” as I’m very caring/interested/nosy. Once the patient’s in the hospital though, we rarely get to hear what happens. In the other extreme, we hear why the ambulance crew aren’t taking a patient to hospital, as those details need logged in our computer system as well as in the crew’s paperwork before we close the job. Anyone that actually goes to hospital but doesn’t require a standby passed - we’re left wondering, unless you can catch the crew in a free moment to ask them questions…..
on October 21st, 2006 at 11:04 am
I’m sorry to ask morbid questions, but I’m curious as to why suspended calls are (fortunately) so rare… About 170 people sadly die in this country (sorry, euphemistically, become suspended, I guess!) every day (the country’s annual death rate is cited as approx. 10.18 per 10,000 people) — let’s say a mean average of two people per county. That would mean that you personally would probably take such a call about once every 2-3 weeks. But then I guess a lot of severely ill people will already be in hospital, so that would take it to once every few months.
OK, I’ve answered my own question — I was wondering whether people were calling folks other than yourselves when they find that someone has died, but it’s just that, fortunately, not all that many people pass away each day, and many of those are in hospital. Is that reasoning correct? That’s rather good — I think intuitively I had felt that you’d be taking lots of these calls all the time — I’m glad you’re not.
on October 21st, 2006 at 11:32 am
Suspended calls aren’t rare — it’s suspended calls to young people that are rare. I’ve taken seven suspendeds in one shift before, but they were all elderly people.
on October 21st, 2006 at 11:37 am
Ah ok, understood. Though in that case, it’s quite surprising that you get so many, given the back-of-envelope calculations above! I guess it’s because you’re in a particularly populous area…
on October 23rd, 2006 at 4:07 pm
I agree with Sarah as I do believe we used to work together. But yeah you don’t always hear, nor sometimes do you want to. I had a recent job of an RTA/RTC with the possibility of a child being involved and possibly fatal, I wanted to know and got lucky to find out, but not always. It depends largely are you the kind of person who can simply leave it and move on or if you have to/need to know, I mean I am a bit of both but I think it is the way of the job whether you take the calls, dispatch them or whatever.