Friday 23 March 2012

He was in Two Minds!

It happened at Redbridge Underground station. A man was seen to climb down from the platform into the pit beneath the middle rail. Not a sensible thing to do you might think. It is alleged that the man suffered with mental health issues and we assumed that he intended to take his life. Needless to say he was successful.

From information provided by onlookers, the man had a change of heart. When he heard the approaching train and felt the rush of air on his face he attempted to climb back onto the platform. Unfortunately, he was too late. He was hit by the train and knocked into the hollow space beneath the platform. When we arrived at scene, the train was stationary at the platform and all power had been switched off. With the help of the station manager we managed to identify the approximate location of the patient who amazingly was showing or should I say making sounds that indicated he was still alive. This presented us with a dilemma! How to get to the patient?

Following much deliberation it was agreed that my colleague would enter the crawl space beneath the platform at one end of the train and a member of the LTE staff enter from the opposite end. I was to remain on the platform with the station manager to liaise with him and my colleague, when he had found his way to the patient. Safety was paramount and this was a critical situation.

When my colleague had managed to crawl to the patient he found a seriously injured man in a very confined space. It was very obvious that he had suffered multi system trauma. There were significant head and chest injuries and the patient was time critical. Although the patient had a reduced level of consciousness and was essentially unresponsive he was breathing, moving and making noises. You have to appreciate that it was very dark, dirty and confined, the two rescuers were lying on their stomachs!

After consultation it was agreed that the rescuers, one at the patients head and the other at his feet, with the use of bandages would physically immobilise the patient to prevent unnecessary movement. The train was then to be decoupled at the nearest point to the patient, the power reintroduced and the train moved so that we could expose the patient and rescuers. The power was then to be again isolated so that others could get onto the tracks to help us remove the patient from the space beneath the platform onto the waiting stretcher trolley. I must say that this was a very brave undertaking on the part of my colleague and LTE member of staff.

And that is exactly what happened. By this time, further resources had arrived and they were able to assist with the treatment and management of the patient. We were deep underground and the patient was brought to the surface where the waiting ambulance blue lighted him to the local A&E. The patient survived for approximately 10 days after arrival at hospital but eventually succumbed to complications arising from the trauma that he had suffered.

It should be remembered, when this happened, we did not have available to us the resources that we now have. There was no Helimed, no Hart team, and no designated Trauma centres. We were not then Paramedics. There was of course the Fire Service and sometimes a BASICS doctor! The support services that can be called upon today we're simply not there.

Even so, our patient was successfully treated and extricated and was delivered to hospital living and breathing. Would the outcome have been any better with today's technology and resources?

We'll never know!

As for my colleague, he looked as if he had been at the coal face he was so black.

Thursday 22 March 2012

Mug the Police at your Peril!

It was at the junction of Grove Green Road and Cathall Road, Leytonstone. We couldn't believe the number of police vehicles we had passed. As we were driving along Grove Green Road to the call, it seemed as if every police vehicle in London was there. Each side of the road was littered with parked and abandoned police cars and vans.

It was about midnight when we approached the scene and there was a large group of people standing in the middle of the junction. I'd estimate between 8 to 10 people not including the patient. I recall there were others in the immediate vicinity.

When we managed to fight our way through the melee we found our patient an adult male lying on his back in the middle of the road. He was F'ing and Blinding at the other guys who were restraining him. There was two on each arm and two others were standing on his legs. It was mayhem! The men doing the restraining were police officers and the man being restrained was a criminal who had a gunshot wound to his chest. I was surprised that he was in a fit state to do anything.

We somehow managed to get this guy onto our stretcher and loaded into the ambulance. After rendering initial treatment we started out for the hospital. How we ever got there was a miracle. Despite our protests we could not reduce the number of officers wishing to accompany the patient. The ambulance seemed full to bursting and trying to do anything was almost impossible. Health and Safety! What Health and Safety? The ambulance was groaning under the weight. Somehow we got to Whipps X in one piece and as far as I know the patient survived.

He had been shot by a police firearms officer when he levelled a gun at them after being chased into our area from North London!

The story is, he was armed and hijacked two officers who were parked up in their patrol car in North London. He made them strip and tied them up before stealing the car. One of them had managed to quickly struggle free and had alerted their control which initiated a massive response. After a lengthy chase from North London into our area he was eventually cornered in Cathall Road. He allegedly aimed his weapon at the police, who responded by shooting him.

I believe that his gun was later found to be a replica.

Wednesday 21 March 2012

Confused Messages

It was about 3am. It was a clear night the streets were quiet and it was cold. We were in Leyton, London E.10, looking for an address which we believed was a block of flats. Apparently someone had collapsed. We found the building to which we had been sent but couldn't be sure which floor we needed to go to. This particular block had external communal balconies which provided access to the front doors of the flats within.

As my colleague was parking the ambulance I looked up and saw an elderly female apparently locking her front door. She was on the first floor and appeared to be dressed in outdoor clothing. Mindful of the time of day I called out to her asking if it was her address to which we had been called.

She replied saying it was her husband and he was in a bad way. By this time my colleague and I were making our way up the external staircase in her direction. I was a little puzzled as she seemed to be on her way out. I asked her what was wrong and where we could find him. We had now reached her and we were primed for action!

"Oh" she said "He's in Hospital". Well to say I was a little taken aback would have been an understatement.

It would seem that the lady had been contacted by the local hospital informing her that her husband who was an in-patient, was seriously ill and she should come immediately. She then phoned 999 telling ambulance control that her husband was seriously ill and had collapsed but forgot to mention that he was already in Hospital.

Control were updated with this news and ordered us to return. But I couldn't leave the lady standing outside at 3am in the morning in the streets of London knowing that her husband was possibly dying. So in my usual "diplomatic" way suggested to control that as the hospital backed onto the ambulance station, we take the lady with us.

I am happy to say, they saw the light and agreed.


Tuesday 20 March 2012

Pain & Despair!

There has been major redevelopment of the area and the small copse that existed was wiped out some years ago by a major road scheme linking the M11 with the east side of London. It was here that a woman in her late thirties or maybe early forties decided to end her life. I'm talking about an area not far from the Green Man Roundabout in Leytonsone London E11.

Many years ago I was despatched to a call near the roundabout. The location given wasn't very specific. Call details were sparse. Nevertheless we rushed to the area which was barely half a mile from the ambulance station. On arrival we were unable to find our patient until someone came running out of the aforementioned copse frantically waving their arms. It wasn't somewhere that we could access with the vehicle.

We quickly gathered up equipment we felt we might need and followed the bystander into the undergrowth! It's difficult to be accurate but after about 50 to 100 yards we entered a clearing. There lying on the ground in front of us was a person. It was difficult to say if they were male or female. I went and knelt at the patients side. The patient was female and she was trying to talk but couldn't.

The whole of her body was burnt, almost 100% full thickness burns. The only part of her not burnt were the soles of her feet. Her skin was blackened and I remember hard to the touch. Her eyes had gone and remnants of clothing had become part of her skin and yet when I got down alongside of her face, she was trying to tell me something. Unfortunately I was unable to make out what it was she was trying to say. Her airways and larynx had also been irreparably damaged and prevented her from making sound. I was amazed that she was still alive. It was my belief that at this point she was beyond pain.

There was very little that we could do for this unfortunate soul. We placed her on a sterile sheet and managed to lift her from the floor wrapped in the sheet directly onto our stretcher. We removed her to the ambulance and placed a Blue call via our control to Whipps x Hospital which was about 3 minutes away.

At the hospital she was rushed into the resuscitation room where she died about 15-20 minutes later. I think the Morphine that she received helped to reduce any suffering and ease her departure.

We discovered later that she had walked into that clearing in the woods carrying a gallon can of Paraffin. She poured the contents over her head and then set fire to herself. She then just stood there and burned until she collapsed in a heap on the ground.

I often wonder what it was she was trying to tell me. I also wonder what in her life was so agonising that she chose to end it in such a horrific way!

Utter despair! I will never forget!

Friday 16 March 2012

How to Shock your Parents!

We parked outside of the address. Nothing very challenging here we thought. This was a doctors urgent call. The patient was a 21 year old female still living with her parents. She had been complaining of abdominal pains and a doctor had been called out to see her. The doctor had arranged for her to travel to a hospital in Coventry

An urgent call was when the patient had been seen by a doctor who had deemed it necessary for the patient to attend hospital quickly but not usually as an emergency. In this case the doctor had requested transport within two hours. He had left a letter for the receiving hospital who he had already contacted.

When we arrived at the patients side she was with her mum and although she was suffering intermittent abdominal pain appeared well. Following an initial assessment we allowed the patient to walk downstairs with our assistance. About half way down she became hesitant and said that she was experiencing a further episode of cramping pain. She appeared to almost want to squat something that I had seen before and which aroused my suspicions.

The pain quickly subsided so we continued to assist the patient into the ambulance where we made her comfortable on our stretcher. Mum was was with us and Dad was waiting to follow us in the car. I was now very suspicious and began to question the patient in more depth. I can't remember how I got there but eventually asked the young woman if she could be pregnant. You will appreciate that there was no suggestion that this was the case and the doctor was treating her as a medical/surgical emergency.

She meekly nodded her head. I asked her when and the information she gave confirmed to me that she was full term and was now suffering labour pains. Mums face was a picture, she looked absolutely stunned and was as white as a ghost. Her daughter had successfully concealed her pregnancy from her family and friends for 9 months and had just fooled a doctor into believing that she had an illness.

This of course placed a completely different complexion on the call. We had a young pregnant female who was labouring and who had no ante-natal records and was not booked into a Maternity unit. I immediately called our control on the vehicles radio set asking that they inform the local Maternity unit in Nuneaton that we were bringing to them a patient who they had no record of. While I was in the middle of the conversation my colleague a new Paramedic cried out my name. When I looked round the patient had delivered the head of her baby. We were all taken by surprise.

After assisting with the delivery of the baby I was able to inform the Hospital via our control that we now had two patients who were both doing well and gave an estimated time of arrival. During all of this, the patients father had remained sitting in his car and was oblivious to what had just happened.

I wished I could have taken a picture when I informed him he was a grandfather!

8 Weeks of Hell

You may recall the period when Cot Deaths (SIDS) seemed to be making the news on a regular basis in the UK. News celebrity Anne Diamond became a champion for changes in how babies were managed as a result.

http://en.m.wikipedia.org/wiki/Sudden_infant_death_syndrome

It was during this time that I and my regular crewmate had the misfortune of being in the wrong place at the wrong time. In a period of approximately eight weeks we were called upon to deal with the deaths of 5 infants and a toddler all in the East End of London and surrounding areas. We began to feel that we were in some way jinxed and I almost developed a complex because of it. I don't know how but I think I have survived the mental trauma. Were we offered support - of course not! We had to pick ourselves up and go to the next call.

It is not something that I would wish upon my worst enemies. Every case was final and resuscitation although carried out was futile and we knew it! It is not only the sadness that afflicts you but the helplessness in being unable to make a difference. But the worst thing was being directly confronted with the mothers and their unbearable grief. They were inconsolable and the scenarios were always fraught and difficult.

I seem to recall that four of these children were found in the morning by their mums, pale or blue and sometimes mottled. I cannot imagine the pain of the mother on discovering there precious child in this way. The toddler was a different case he had managed to trap his head in banisters and was found hanging. He had been there too long and it was a hopeless cause.

The sixth baby was altogether a different case. Mum had been concerned for her baby for some days and had made a number of visits to the GP. It would seem that the doctor had not been overly concerned, as on every occasion mum and baby were sent home. When I arrived the baby was in cardiac arrest. Mum was absolutely beside herself. The babies abdomen was grossly distended and as hard as a drum. I could not believe that this baby had not been referred to hospital at an earlier time. I didn't show mum, but I cried, it was incredulous!

These and other experiences have altered my views of Doctors who some believe are Gods. And I always pay heed to what mothers have to say about their children even those that are possibly being overly protective.

Thursday 15 March 2012

The Man and his Fishing Knife

We were on our way to Wathamstow reservoirs. We had been asked to approach silently and not to use visual warnings. Our brief was to find a suitable location and await further instructions. A man known to the police had decided to climb to the top of an electricity pylon which was in the grounds of the reservoirs. No one was sure why or what his intentions were.

It was a dull and grey morning, there was a fine drizzle in the air. As we were travelling along Forest road approaching Blackhorse station, we could see the man at the top of the pylon in the distance. "Must be crazy" I said to my mate, "fancy messing around on an electricity pylon especially in the wet". I had no sooner said that when the dot on the horizon had disappeared. "Oh Shit!" I exclaimed "he's gone". Within moments the radio burst into life requesting that we make all haste to the location.

As we pulled up we could see the man lying on his back on grass at the base of the Pylon. A second man was on his knees leaning over him. We hurried over to the patient and were surprised to see the second man trying to force a small fishing knife through the patients temple. He was bashing it in a very uncontrolled way. This was clearly wrong and I asked the man who appeared to be of Asian origin and who spoke with broken english to stop.

The patient was in Cardiac Arrest due to his trauma which we know has an almost Zero chance of survival, however this was in pre Paramedic days before we had monitor/defibrillators and other sophisticated equipment. So we were obliged to attempt to resuscitate the patient and rapidly remove him to hospital. It was hard work and needless to say he did not survive and was pronounced dead on arrival at hospital!

Now you may be asking yourself why was the second man trying to force a blunt knife through the patients skull? Well he said he was a doctor and he wanted to relieve the pressure inside the patients skull as he believed he had a brain injury! It is recognised that relieving intracranial pressure in a seriously head injured patient can be beneficial, however it is usually a controlled surgical procedure using surgical equipment. I imagine if this person had been successful he would have smashed the patients skull and driven his knife and bone into the patients brain!

The patient had no doubt suffered multi-system trauma with injuries incompatible with life, something the doctor seemingly failed to appreciate.

Was he really a Doctor? I'll never know!