Friday was one of those horrible days when there are more calls than call takers, and there is always a red flashing sign above our heads telling us how many calls are waiting to be taken. Frustratingly, I always get seem to get stuck on a call with a dozy carer who doesn’t understand English (or any other language) or an RTA where no one knows where they are while ten people are waiting to be answered. You are always conscious of the fact that the calls waiting could be a lot more serious than the one you are “stuck” on.
Unfortunately, my fears were realised as I took a call which had been queueing for about a minute. The call was a panicky nursery nurse.
“This is Snowball Nursery in Southall, ” she said, “we have a little boy choking on a rice cake!”
This was a proper case of complete obstruction choking — quite rare for us to come across as call takers, as most people realise that they have to do something straight away and don’t have time to wait for an ambulance. Most of the choking calls we get are cases of partial obstruction, where all we do is encourage the patient to cough it up themselves and wait for the ambulance (back slapping in this case may encourage the obstruction to move and completely block the airway). The toddler was completely unable to breathe, turning blue and losing consciousness. The nursery staff had tried backslaps and the Heimlich manoeuvre without successful.
I was glad I had the AMPDS software in front of me to prompt me, because this was a situation I had never dealt with before. I could give the instructions for an unconscious or suspended patient without even glancing at it, but definitely not a choking patient. AMPDS may be useless for categorising calls but as far as giving instructions goes, I can’t fault it. After telling it the child’s age, current condition and what the nursery had already done, it told me that the next thing they should try is to straddle the child (who was now collapsed on the floor) and give an abdominal thrust from above. I passed this on to the nursery nurse, who instructed the child’s mother to do that. It’s not often that you get to tell people to punch a toddler in the stomach! She did this, making a delightful squidging sound, and the nursery nurse went to inspect the outcome.
“He looks a little less blue… yes, I can see that he’s breathing!” she exclaimed.
I told her to look in the little boy’s mouth and fish out the offending rice cake. This she did.
“Youch!” she cried. “He bit me! Oh well, I suppose that’s a good sign…”
At this point the toddler started to cry.
“Oh, thank god for that!” said the nursery nurse, “I’ve never been so happy to hear a child crying!”
Suddenly she burst into tears and so did the child’s mother. It’s not often you hear people crying with relief/happiness so I even started to feel a bit misty eyed myself. I was really glad that they waited until the child was okay to fall to pieces. Actually, this is something I have noticed before — people crack up and are useless when their parent is the patient, but when it’s their children they somehow manage to hold it together and do as they told. Perhaps it’s some kind of primitive instinct which makes you protect your offspring, but expect to be protected by your parents. Anyway, it was a couple more minutes until the ambulance arrived, so I had a nice chat with the nursery nurse as she pulled herself together. She asked for my name, so perhaps they will send me a thank you letter. I hope so; I have never had a thank you letter before and if someone sends you one you get your name in LAS news!
Anyway, that was one of the most exciting calls I have ever taken. I do love happy endings!
