A few weeks ago, I went on an observation shift with Steve and his crewmate. We had a touch of Observer’s Curse - only four jobs over the whole shift, about half what I’d expect for a busy station like theirs - but all the calls were interesting in their own way and I’d rather see four “real” calls than eight cases of flu!
There was also a rather amusing incident when we took our rest break at another ambulance station, and all the crews at that station, not knowing who I was or even that I wasn’t just another paramedic/EMT, decided to launch into a diatribe about how much they hate control staff, how evil we all are and how all we care about is screwing them over and giving them rest breaks. I covered my “Emergency Medical Dispatcher” epaulettes and sank into my seat. I now know how it feels to be a mouse in a room full of cats. All I can say is that if the offending crews were on my sector, I’d have them attending every projectile vomiting call I could get my hands on for the next week!!
Anyway, on with the four calls. I don’t have time to write about them all at once so each will get a separate entry. Just to keep you on tenterhooks, the last one is the most exciting!
The first call of the day was to an elderly female on the floor. In Control terms, this is about as simple as you can get - it is non life threatening, so you do not have to bust a gut getting someone there, but it is also a valid call, so as soon as someone is available, off they go. But I was about to discover that something simple for us is not so simple for an ambulance crew.
Elaine, aged 80, has lived alone her house since the death of her husband. Her younger friend, Sandra, comes to visit every day and helps out with the shopping. She also has meals on wheels and a home help. Despite having arthritis, bilateral knee replacements, heart trouble, mild confusion and depression, she gets by. On this bitterly cold morning, she was getting out her electric fire and, carrying it to her bedside, slipped over. She felt awkwardly against the bed and an agonising pain shot through her right leg.
Luckily, Elaine had fallen by the phone so she was quick to summon help. Not wanting to bother the emergency services so early in the morning, she rang Sandra. Sandra had come straight round but after a quick examination she had realised Elaine had hurt herself badly in the fall and that an ambulance was needed. Enter us.
Elaine was in good spirits and not a lot of pain when we arrived. Her sense of humour was intact, laughing at herself for falling, and she was very apologetic about calling us out. The genuine callers always are. I wondered if it was going to be an “assist only” job, where the crew lift the patient, put her back to bed and make her a cup of tea. However, as Steve straightened Elaine’s legs, I could see clearly that one was shorter than the other and drooping to one side - a clear indicator of a broken hip.
Seeing the concern on our faces, Elaine became worried.
“What is it? What have I done?”
“I’m afraid,” said Steve, “you’ve broken your hip”.
“Oh!” said Elaine, relief coursing across her face. “Is that all?”
I wondered what she thought we were going to say.
Now came the difficult and unpleasant part. With the aid of some Entenox (pain relieving gas), we tried to assist Elaine into the carry chair so we could get her downstairs and into the ambulance. But the slightest movement had her in complete agony. The gas seemed to be making her confused, too, and she forgot what had happened to her and kept yelling out: “What’s happened to me? What could be causing all this pain? I have never felt this uncomfortable in MY ENTIRE LIFE!” She was shaking and turning terribly white. It wasn’t pleasant to watch. As control staff, you are generally distanced to people’s pain. You get all the emotional upset and lurid descriptions of gory events, but the physical pain is something you don’t think about. You tend to think - broken hip - non life threatening - simple without really getting your head around what it is like to have one. Elaine’s agony is something I will remember every time I have a “broken hip” call waiting on my screen.
Once we stopped trying to move Elaine, her pain subsided somewhat and she returned to the cheery old lady we’d first encountered and apologised profusely for “being a big baby”. Meanwhile, Steve’s crewmate, who is a paramedic, decided Entenox alone was not enough to get Elaine out of here. It was time to bring in the big guns. He fired up a vial of morphine and injected it into Elaine. Then we sat around a bit and waited for it to work. Sandra conducted some breathing exercises whilst I helped pack up Elaine’s belongings. Eventually, Elaine started going a bit woozy and getting a big grin on her face and we were able to lift her into the carry chair. There was a lot of hollering as we moved her, but this was immediately followed by relief from everyone as we all announced “Well, that’s the worst bit done! Off to the hospital!” It’d taken over an hour to get her into the ambulance.
By now, Elaine was away with the fairies. Steve tried to get her to give a score to her pain. Earlier, she’d given it nine out of ten.
“Oh,” she said, flapping her arms dismissively. “Hardly anything!”
“I need a number,” said Steve.
“Erm, I really don’t know,” said Elaine. “I can’t remember any numbers!”
“Elaine,” smiled Steve. “I’m not taking you anywhere until you give me a number!”
“Um….. sixteen!!!” announced Elaine, and broke into fits of giggles. Steve gave up at this point and we went off to the hospital.
I am sure Elaine will be fine although it is clear her bones aren’t what they used to be and perhaps she will have to give up living in a two-storey house by herself. It is sad that such a lovely person who is so cheerful and friendly and has clearly lived such a full and rich life has ended up being let down by her own body and even sadder to think that whatever I achieve with my life more or less the same will happen to me. I shall never look at “old woman on the floor” as just a simple, boring call again.
May 8th, 2008 at 10:06 am
Good to see you’re back!
Elaine sounds so sweet
How comes you were riding along witht he crew? is that something that call dispatchers do from time to time?
May 8th, 2008 at 12:23 pm
Great post. I felt as if I was there.
My own M.I.L. broke her hip about 10 days ago and I have to say the paramedics were wonderful.
May 8th, 2008 at 1:10 pm
Contrast her ‘not wanting to bother the emergency services so early in the morning’, with the recent Random Reality post.
And weep.
May 8th, 2008 at 10:47 pm
Oh HOW I sympathise with you on “the Curse of the Observer”. I’m a Community First Responder and am encouraged to do the occasional shift as an observer. I’ve been out three times in the last year and every time the crew or paramedic have said how quiet a shift they were having.
The last time I did a 12-hour Friday night (as I thought that the Curse couldn’t happen then) - first job was a patient transfer from Derby to Leicester!
We had a drunk who’d been belted (but would have needed us anyway if he’d been drinking for another hour). We got his name, but his address was “fuggoff” as was his age. In fact, after we had his name, “fuggoff” was all the reply we got.
We had a lass who’d fallen over (slipped rather than incapable) in the toilet of a club, and a regular self-harmer who was drunk but who’d “fallen over and cut his head”. This one originally appeared genuine, but he hummed and hawed about going to hospital. In the finish, after we’d been there over an hour, he decided that he didn’t really need hospital - against our advice. It was a bit strange though, that the cut was very straight an an obvious incision, and there were no sharp edges in the bathroom where he’d cut himself - except for his razor, of course.
That was virtually it - on a 12-hour shift in a city centre. Even the A&E staff commented on how quiet a night they’d had.
May 9th, 2008 at 11:48 pm
What a vivid picture you paint…I’ve had elderly relatives suffer in a similar fashion, and, having observed the results, can see beyond the simple words…but you’ve made me think again too…thanks
May 10th, 2008 at 3:53 pm
Kryptobabe: Yeah, management let us go out for a paid shift with an ambulance crew once a year (we can do more if we like, but we don’t get paid. Unfortunately I don’t really have the time at the moment unless I am paid). It’s supposed to be to improve control/crew relationships (see my rest break experience!) and give us an idea what crews actually have to put up with. An unintended effect is that it makes us all very depressed that their jobs are more interesting than ours.
May 10th, 2008 at 8:40 pm
>> I am sure Elaine will be fine
Unfortunately, at that age mortality from hip fracture is around 25% within one year from the index fall. If they are left lying for more than half an hour it’s more like 50% in 6 months.
May 12th, 2008 at 8:30 pm
Oh. Damn my optimism…