This blog now at http://www.traumaqueen.net
Kal
12:50 AM
Friday, January 11, 2008
0 comments
Times move on and on.
You'll have noticed that things have been michty quiet on here of late, you all know that I had a minor wig-out a few months ago, that everything piled up a bit and I started writing bad poetry.
I'm also acutely aware that there's been a seven day hiatus of updates on here. Bad Kal. No biscuit.
But things have been changing at Trauma Towers, dear readers. The job has been expanding and, post-qualification, I've been festooned with requests to do other stuff. Not just looking after little people last week, but acting jobs and lecturing, this afternoon I'm off to a primary school to do an "I'm a Namalace-man" talk, tomorrow I leave for the Highlands to run a Halloween ghost-walk, telling stories in cemeteries while I try not to scare myself too badly.
I'll be away from home for a good few days, so if you want to burgle my house, or sneak in and dress up in my uniform and prance around Edinburgh yelling "Look everyone! I'm Kal! Lalalala!", then before the weekend would be wise time to do so.
I'm going to regret that, aren't I?
But anyway, I have multo-multo-commitments so something's got to give, I've got to let something go.
And I'm sorry to say that it's Blogger.
No...
Not bloggING.
Blogger.
Trauma Queen is moving, dear hearts. I'm off to Wordpress, with my own hosting and domain name and everything.
From now on, your stories of derring-do and blue-light antics will be found at http://www.traumaqueen.net
My email address is now kalATtraumaqueenDOTnet
And if you go over there now.
Right now?
There's a brand new story for you all.
You lucky little pixies.
See you at the end of the week.
Much love, and a farewell to Blogger.
K
xxxLabels: Journal
Kal
11:01 AM
Tuesday, October 30, 2007
4 comments
"Right, Uncle Kal and Grandma, we're going on a bear hunt."
"OK NephewO."
"You're going to be the bears and I'll be the hunter."
"Uh-huh."
"And you hide under the slide and when I find you, you go "Raaaah" and chase me."
"Kay."
NephewO marches through the swishy grass, fast flowing river, oopy-gloopy mud, dark spooky forest and frosty frozen snowstorm to arrive at the cave.
Uncle Kal and Grandma give it some "Raaah", as directed.
NephewO dissolves into tears, expaining afterwards that he feared we were "going to eat [him] up."
Grandma and Uncle Kal feel like shits. Ooops!Labels: Journal
Kal
9:15 AM
Tuesday, October 23, 2007
5 comments
So the cops wear stab vests. That's a good thing.
The environmental wardens in Edinburgh wear stab vests. We take enormous delight in asking them how many bits of chewing gum have pulled blades on them. They do not find this funny.
School kids in Edinburgh get stab-proof uniforms. Ohhh-kaaaay.
Me?
Me, the bloke who, for the past three knife-related jobs, has only seen the police when they've opened the back doors and said "All quiet then? We'll see you at A&E." while we patch up horribly punctured people?
I get "Retreat and wait for police attendance."
Great.
I'm not concerned about the knives I know exist, I can keep my distance from them.
I'm scared about the one in the guy's pocket who thinks stabbing an ambulance man would make him look hard as fuck in front of his mates.
I'm worried about the shard empty beer bottle in the drunk and mouthy teenager's hand,which, with a wee tap against that wall he's sitting on, would become a highly effective way of saying hello to my insides.
We have a new chief executive soon, he's sent a letter to the Station saying that he's interested to hear people's views.
I'd like a stab vest, please.
Please?Labels: Ambulance, Journal
Kal
3:49 PM
Monday, October 22, 2007
5 comments
"He'll never travel."
"Nah...I'd be surprised."
Alcholic seizure patients hardly ever travel, the condition's a cruel joke, as chronic alcoholics cut back on their drinking, the body reacts to the withdrawal by convulsing. Just when you thought it was safe to go back to the juice bar, you're doing the horizontal tango and your family are gathered round you, wondering why, as you've taken such steps to improve your health, you've been struck down by this new affliction.
But at the top of the stairs, tonight, we find a man sitting on a mattress on the communal landing, feet flat on the floor, head in hands.
Both Bryson and I stop halfway up the stairs, our collecive spidey-sense tingling like the a dodgem hook. You can smell the ozone from our caution.
"Alright mate?"
He looks up at me, bleary eyes.
"Yeah."
"What's going on tonight?"
"I've had a seizure."
"Oh right."
I'm always a little cautious of people who tell me "I've had a seizure", particularly as people I've SEEN having seizures couldn't tell you WHO they were, let alone what has caused them to end up in an ambulance. Post-ictal patients are rarely in a position to give you a comprehensive medical history.
"So why are you sitting out here?"
"My mate left me here."
"On a mattress?"
"Yeah."
Ohhh-kay.
"And where do you live?"
"Here."
He points to the door to his left.
"Shall we go in?"
"I can't...lost my keys."
"Well, is anyone else in?"
"Yeah, my partner."
Exactly why he hasn't rattled the door and had his missus let him in is a mystery, and remains so for the rest of the night. I flap the letterbox, shout through the door, pound on the wood with my fist.
Nobody comes to let us in.
"We could kick the door in..." offers the patient, Bryson and I are hasty to dissuade him from the concept and that's assuming that this IS his house.
He digs again into his pocket and brings out a bunch of keys with a surprised and somewhat pissed "Oh....", one of the keys fits the door and we let ourselves in to a darkened corridor.
The patient strolls down the corridor and into a living room, the house is typical of my working environment, rubbish is strewn across the floor, vomit is dried into the carpet, overflowing ashtrays and empty bottles crowd each other off a cheap coffee table.
"It's a bit of a mess..."
"Don't worry mate, we've seen worse."
Just.
I'm chatting to the patient about his seizure and whether or not he wishes to go to A&E when Bryson calls me from the passageway.
"Kal...?"
It's one word, but his voice tells me chapters more, a voice that tells me that if we're not running as fast as we can from this job in the next minute, we should at least be shoulder by shoulder.
Things have gone wrong.
Out into the passageway and I see his torchbeam swim over the floor and walls of the flat. I see the problem immediately, but he underlines it, quietly, in my ear.
"There's blood everywhere..."
It's dried on the laminate flooring, smeared along the walls, soaking into the edge of carpets, a crusted brown veneer on a pile of towels. Some of it has been hastily mopped up, other spattery pools left without a second thought.
It's heavier and thicker as we look down the passageway, the puddles larger, the smearing more obvious on the doorframe of what is clearly a kid's room. Princess Jasmine adorns the door, a pink sparkly towel just inside the threshold, the cheap plastic shell of Barbie's latest mass produced lifestyle addition casts a shadow against the radiator.
"Jesus..."
He investigates further while I keep an eye on our patient, who is blundering about the living room looking for tobacco.
Bryson peeks around the door of the bedroom and returns to the passageway, shaking his head with relief. Nothing in there.
"Where's your partner, mate? You said she was in?"
"She'll be in bed."
Bryson pushes open the last door and I hear him speak to a hidden figure.
"Hello, Ambulance Service...we're here with Bill? D'you want to come through?"
A drunk, naked woman staggers past us, her legs are bloody, her feet stained red, her calves russet.
"D'you want to put some clothes on?"
She waves a hand at us dismissively, sits on the couch.
"She needs to go hospital." blurts Bill "Her period's been on for about a fortnight."
I look into the bedroom, the bed is black and brown and crimson, the sheets rough and brittle. Our patient changes. I wonder how I'll explain this chain of events to our new electronic tick-box PRF.
We see them hours later, wandering arm-in-arm through the car park at A&E, heading back to their flat of blood and vomit and empties.Labels: Ambulance, Thrilling Installment
Kal
3:58 PM
Sunday, October 21, 2007
10 comments
Thoughts from NephewO's school Eid party:
When the lovely smiley Somali ladies offer you a samosa and say "Careful...they're spicy.", then laugh at you when you say "Great!" you should know that something is afoot.
Because when it comes to spicy samosas and smiley Somali ladies?
Those ladies are not fucking about.
Not
Even
A
Little
Bit.
*whew*Labels: Journal
Kal
10:02 AM
Saturday, October 20, 2007
1 comments
There's no such thing as "just popping out" with a two year old.
There's nothing so brilliant as hearing someone little mangle your name for the first time.
People refuse to accept that a bloke might be looking after a kid - "Is it Mummy's day off?"
It doesn't matter how melodious you try to make it, if you're sitting in 'music time' and everyone else is female or tiny, your male voice will sound like a troll.
Trolls really can't sing "If you're happy and know it."
Two and a half is the best age to be. Ever.
Having a small victory and exclaiming "Alright!" to hear a copycat "Ol-RIGH!" from the buggy not only made me laugh, but reminded me not to say "fuck" for the next five days.
(I'm being Uncle Kal for the next wee while, at least until the middle of next week, so stories of drama and derring-do may have to wait. I do have the story of how Bryson and I utterly shat our pants, which I shall endeavour to get to you all at some point over the weekend. No promises, mind. I've got a life :)Labels: Journal
Kal
12:11 PM
Friday, October 19, 2007
4 comments
Back with Bryson for a few night-shifts before I head south to look after NephewO and NieceN for a wee while. The sun sets, the bakery on one side of the station smells like it's making apple pie, while the indian ready-meals producer on the other seems to be on tikka masala. Cargo trains rumble past us in the twilight.
No hassles, no worries.Labels: Ambulance, Journal
Kal
5:40 PM
Wednesday, October 17, 2007
1 comments
I've always been the calm one in the middle of the maelstrom, keeping my head while all around are losing theirs; it was one of the major drives towards applying for my job. In some way I feel that those with a mindset to deal with emergencies have a social responsibility to use it for the greater good. In another, this job feeds a variety of my needs, it makes me needed, salves my shitty self-esteem and gives me a chance to 'perform'. My facade at each job is just another mask I pull on, the uniform just another costume to shrug into in the wings. Kal the Technician is a very different person from Kal.
"Ohhh, I couldn't do your job," people gush at me on a regular basis, "It must be terribly difficult."
Yeah. It can be emotionally draining, but I don't *know* these people, they're not my family, not my tragedy and that suits me just fine, thankyou.
I was having breakfast with Bambam this morning and discussing her new job as a Social Worker. She chatted to me about her placements, her case studies and the difficulties she'd faced in each one.
I thought the job sounded awful; protracted struggles against red tape and procedure, all the while embroiled in people's personal problems, with them looking to you for the answers and solutions.
We talked about what drives her to do it, and she told me about her faith in 'good'. That no matter how bad things were, you could make a difference to people and improve their lot, that the benefits would make all the bad stuff worth it in the end.
I couldn't do her job, it sounds terribly difficult.
Lots of you who read this are involved in jobs that people "Couldn't possibly do.", emergency workers, health care staff, security and police.
What makes you do it?Labels: Journal
Kal
1:00 PM
Tuesday, October 16, 2007
14 comments
To the person who got here searching for
"maths test answers ambulance scottish"
They send you a sample paper, if you can do that, you can do the exam.
Honest.
PS - Did you really think I'd be stupid enough to post answers online? I *like* being employed.Labels: Ambulance, Journal, Pish
Kal
10:54 PM
Sunday, October 14, 2007
2 comments
Only what the story tells me.
There's an unwritten allegiance that appears to span the globe between firefighters, medics and cops.
I'm ashamed to consider myself in the same field as Andrea Eichhorn.Labels: Journal
Kal
12:59 PM
Friday, October 12, 2007
4 comments
Apparently I can't have my eyes lasered for free, the deal's only for doctors.
You know, those poor, impoverished doctors that don't earn five times more than me.
*sigh*Labels: Journal
Kal
11:45 AM
4 comments
"No."
His jeans are stained, russet brown splodges on pre-distressed bleached denim, his thumb bleeds steadily and would probably clot if he'd stop wiping it on his trousers. The cop seems concerned for the upholstery in the back of his car, where my patient sits.
"They can't arrest me, you know."
"Really?"
"No, I need medical treatment."
"Yup. How did you manage to cut yourself?"
The cop speaks up.
"He hit the two lassies over the head with pint glasses, apparently he cut himself when the second glass shattered."
I nod. Dog's in the back of my motor picking pint-pot pieces out of hair.
"You can't arrest me until I've been treated for my injury. My uncle's Prominent Left Wing Political Figure."
"Is he really?"
"Yes, and I'm warning you now, if I'm arrested without adequate medical treatment, he'll have your jobs."
I idly wonder how his uncle will "have my job" and also wonder how his vocally socialist policies weigh up against threatening public service staff.
With a twizzle of a bandage, his thumb is dressed (quite neatly too, I congratulate myself).
"There you go, right as rain."
"Aren't you going to take me to hospital?"
"Nope."
"But I need medical treatment."
"You've just received it, you don't need to travel to hospital, you have a cut finger."
"But my uncle's Promin..."
"..ent Left Wing Political Figure. You said, yes. I don't care."
"I beg your pardon!"
"I said I don't care, sir."
I've always enjoyed making the word "sir" sound like "shit-head". It's a talent of mine.
I smile at the cop who appears to be trying not snigger into his stab-vest and return to my vehicle.Labels: Ambulance
Kal
12:02 AM
4 comments
So I drove home from North where I'd spent some time and where The Parents had said "There's a big box of all your school stuff up here, we're sick of lugging around, d'you want it?"
Realising the nostalgia value of such an item, I chucked it in the back of the car and brought it back to Edinburgh where, last night, Aarayan and I (and a number of bottles of cider) went through it.
I wanted Aarayan by me, because she's one of my oldestest friends and also because she's a teacher, she's let loose with the impressionable minds of south east Scotland's children.
So I figured she wouldn't take the piss too much.
We were able to conclude that I was precocious as hell, which I already knew, that my 4th year English teacher couldn't write for shit (because I shouldn't have to explain "irony" to regain lost marks) and that at the age of five I wrote a short piece about the dangers of leaving alsations with babies (we're not sure either).
It was my 1st year History procect on the Vikings that gave us our biggest insights into my psyche, however, and I quote direct from the manuscript:
"twenty hefty men shouting blood-curdling threats...the golden sun glinting off their pale blue Scandinavian eyes"
In conclusion...I was one gay twelve year old.
Still got a thing for blondes, though...Labels: Journal
Kal
11:12 PM
Thursday, October 11, 2007
3 comments
Memories of a rural childhood.Labels: Photos
Kal
8:53 AM
Tuesday, October 09, 2007
6 comments
It's the third time in the shift that Chop and I have been sent to this locus; just outside Prima's flat, his uncle's restaurant is bright and busy and noisy, the tight wee cobbled street lined with double-parked vehicles, everyone wants pizza and drinks before they hit the clubs.
You can't move down here on a Sunday morning, well-off church goers swarm to the Italian deli down the road for their latté and biscotti, parma ham, fresh basil and property pages.
But of the early hours of the weekend the neighbouring clubs vomit out their football topped clientelle, swaggering and swearing, slinging bottles and punches; the under-18 disco across the road provides a steady trade in stranded, teary-mascara wearing teenaged lassies, gutted because one friend won't talk to another, or will talk but not to her, or looked at her boyfriend's arse...or didn't...or something.
I'm getting old.
The first job here was for an elderly Polish man smashed over the head with a bar stool, having dropped him off we were called back to deal with a woman pulled to the ground and kicked in the head by a gang of twelve year old girls.
Third time lucky and the sun is setting over the Greco-Roman structures on the top of Calton Hill as we hustle down towards what is, apparently, 'our' patch for the night. The address is a bit funny, it doesn't seem to make much sense and when we drive to where we believe we SHOULD be, there's nobody on the pavement. We tend to look for WPCs (not Woman Police Constable...I'd tell you, but you all seem to have so much fun working out acronyms in the comments that I think I'll refrain) outside houses to guide us in, but on this occasion the best we could do was start pushing on stair-doors and shouting.
After a few tries at this game we find our job, a young man lies at the foot of the communal concrete staircase, its grandiose sweeping spiral one of the many features that people love about Edinburgh's tenements...until they fall down them.
There's an older woman fussing about the patient in an efficient, but ineffective manner, she's clearly had some sort of medical training, but nothing that's prepared her for this.
"He's had a seizure."
"D'you know him?"
"He's my neighbour, he takes seizures quite often."
"Did you see him seizing?"
"Yes, I heard a bang and found him here shaking about."
The patient has clearly fallen down at least a dozen steps, he would have fallen down a further four steps at the bottom of the staircase if he hadn't done such a good job of arresting his descent. Unfortunately his braking method appears to have been to hit his face off the wall with significant force, his mouth and nose are one big bloody mess. I'm sure there's are anatomical landmarks in there somewhere, but I'm damned if I can see them. I'm also trying to work out if his current level of consciousness (GCS-Oh-Crap) is due to recently having a seizure, or due to smacking his face off a tenement. Equally it would be nice to know if he had the seizure and fell down the stairs because he was dancing-lying-down, or whether he fell down the stairs, smacked his face and fitted as a result of the head injury.
By the looks of things he's not going to be telling me much for the foreseeable future.
My medical memory banks spool and dot-matrix out a starting point for me - Airway with consideration for C-Spine, I want this guy to breathe, but I don't want to extrude his spinal cord through his vertebrae like so much gnocchi in the process. His shoulders rest on the half-landing, his head lolls uselessly down the top step, his breathing bubbles and burbles in the back of his throat. Spreading my hands behind his ears I gather his head up so that his neck sits in a position as close to 'neutral alignment' as I can get, though his arm is twisted behind his back and stopping him from moving. I need a hand and Chop has reacted swiftly to the fact that this guy is affy-nae-weil by running back to the vehicle to get everything we're likely to need.
"What's your name?"
"Alice."
"And you're what? A first aider?"
"I used to be a nurse."
"Awesome...I need your help."
She nods and swallows, looking at the blood splattered lad snoozing in my hands.
"I don't have any gloves."
"I do, you'll need to get them out of my pocket."
She walks to my right and starts undoing 'the rucksack' on my belt, it's a ludicrously big pouch, but it carries damn near everything I could need on a job. Except gloves.
"No, no, they're not in there they're in my back pocket."
"Your back pocket?"
"Yup."
"Do you say this to all the girls?"
We share a laugh and she digs herself out a pair before reaching over me to straighten the patient's errant limbs out. By this point Chop has arrived with the trolley and spinal immobilisation equipment and between the three of us we manage to get the patient onto the bed and out into the ambulance. I over-rule Chop without thinking, the "you're new" attitude in my head more potent than any actual maths regarding his time on the road. He corrects me as I pop the portable suction off the wall.
"I've got that."
"You sure?"
"Sure I'm sure, I can handle this."
I take another look at him, he's right, he can.
We switch places, he takes the more challenging and vital role of maintaining our boy's airway and I slap ECG pads and BP cuffs on him before hopping out of the back, ready to crash through traffic to the ED.
Outside someone has turned off all the lights, black rain clouds have covered the entire sky, the world is dark purple and black and as I swing myself into the cab, a belly-growl of thunder barges through the streets. Rain pours from the sky so viciously that I have to repeat my stand-by call to the hospital. My wipers struggle to keep the windscreen clear, the noise on the motor's fibreglass roof is obscene and I mutter and curse as I crawl through town, lights flashing, peering through the glass like Mr Magoo.
I checked up on our boy later on that night, everything was clear, a broken nose from falling down the stairs, a night on the ward and a realisation on my part that my tenure increases in direct proportion to those who came after me.
Stretching seams.
Kal
5:24 PM
Sunday, October 07, 2007
10 comments
NameThatDisease.com - Test your disease knowledgeLabels: Pish
Kal
10:37 PM
Saturday, October 06, 2007
5 comments
The car is on fire and there's no driver at the wheel,
And the sewers are all muddied with a thousand lonely suicides.
And a dark wind blows.
The government is corrupt and we're all so many drunks,
With the radio on and the curtains drawn.
We are trapped in the belly of this horrible machine,
And the machine is bleeding to death.
The sun has fallen down,
And the bill boards are all leering.
And the flags are all dead
At the top of their poles.
It went like this:
The buildings toppled in on themselves.
Mothers crushing babies,
They picked through the rubble,
And pulled out their hair.
The skyline was beautiful, on fire.
All twisted metal, stretching upwards.
Everything washed in a thin orange haze.
I said "Kiss me, you're beautiful,
These are truly the last days."
You grabbed my hand
And we fell into it.
Like a daydream,
Or a fever.Labels: Lyrics
Kal
9:51 PM
2 comments
A few years I was offered the chance to get my woefully inadequate sight lasered into perfectness, free of charge. I've worn glasses/contact lenses since I was ten years old and they are, I suppose, a part of me. But they're a pain in the arse as well, and a constant expense. I bottled out of getting it done, thinking to myself "But I don't know what will happen down the road, what if I go blind?"
I've just been offered the chance again, once again for very little financial outlay and my attitude has changed.
Yeah, it's a fairly new technique (although it's coming up for twenty years since the first procedures went ahead), yeah it might have unforeseen side effects when I'm older. Yeah, my eyeballs MIGHT turn into baby wolverines after twentyfive years.
But then again, I might well be dead in a week.
You just don't know.
I'm sick of being careful, mature, sensible Kal. Kal who weighs up all the options. I've weighed up options before and been so busy doing the "will I/won't I?" dance that the options have sailed past me, beeping their horns and waving as they vanish in a cloud of dust.
Live for the moment, do it now and maybe in thirty years time I'll look back and think "Jesus, I'm glad I had my eye surgery when I did."
Labels: Journal
Kal
3:08 PM
Friday, October 05, 2007
12 comments
Kal- "Right Dog, we have a four minute old baby and a placenta in the toilet. One of these objects needs wrapping in a blanket and cooing over, the other needs fishing out and chucking in a plastic bucket."
Dog - "I'll get the placenta."
Kal - "Are you sure? I'm attending, mate, it's really my job."
Dog - "No, no, it's fine. First time for everything."
Kal returns to cuddling the tiny person, Dog goes fishing.
I love not being the new guy.Labels: Ambulance, Journal
Kal
1:07 AM
Wednesday, October 03, 2007
4 comments
An anti-masturbation suit from Prague. Apparently to be *glued* to your pants.Labels: Photography
Kal
8:52 AM
Tuesday, October 02, 2007
4 comments
JohnDog sits in the attendant's seat by me, we laughed at the start of the shift about how he read TQ months before joining the Service and now, a year and a half later, he's riding in my motor. The new electronic despatch system in the cab starts howling, a siren sound effect plays every time a job is sent to us, whether it's an emergency or not. It's not the noise that most crews would have chosen, it sounds a lot like a kid's toy. In fact, it's exactly the sort of noise you might choose to alert an emergency crew to an incident if you had never been in an emergency vehicle in your life.
But I digress.
The cause for the wailing siren tonight is explained by the despatcher over the radio "Kal's Vehicle, this is a police call for a male assaulted in Barrow St, it sounds like it might be a stabbing, so exercise extreme caution on approach."
Not needing to be told twice, we start on up the hill towards Barrow Street, I'm not convinced I want to attend a stabbing there, it's surrounded by pubs and clubs, the streets will be busy, its likely to turn into a circus.
Horsing up the road I spot a woman standing on the pavement waving both her hands above her head, behind her sits a man being supported by two others. He looks very drunk and the job we're on our way to sounds very serious, but we have a duty of care to all. I notify Control, if we're needed here then someone else is going to have to start making to Barrow St.
"Kal's Vehicle?"
"Control, we've been flagged down here, do you want me to continue to Barrow St or attend this incident?"
"What's the problem?"
"Not clear at the moment, I'll check it out and get back to you?""Perfect, Control out."
JohnDog hops out of the vehicle and jogs over to our patient and I follow with the bag and O2. The punter's a man in his early forties, chalk white, sweat running down his face. He looks awfy nae weil. Everyone's talking at once, there's nothing wrong with the guy that's immediately visible, I haven't a clue what's going on. Gradually as I listen to four or five excited versions of a story it becomes clear, the patient got smacked in the back of the head with something and then felt an impact in his back. After feeling the second blow, he 'felt something pop' in his back and since then hasn't been able to stand up. He's also howling that he can't feel his feet and that his legs feel 'funny'.
JohnDog hauls the patient's shirt and jacket up, a tear-shaped stab wound leaves a bloody kiss on his back, roughly at the level of his navel and right in the middle.
Right in the middle.
Oh shit.
I dash back to the vehicle and flag it up to Control, alerting them to the fact that we're at the west end of Barrel Street with a male being stabbed, so won't be able to go to Barrow Street and deal with the first incident. In the heat of the moment the similarity between the two locus names doesn't strike me and instead I think to myself "Some kid's running around the City happy-slapping people with a blade."
Cops arrive, lots of them, and with their help we manage to get the patient onto the trolley and into the back of the vehicle. He's fully concious, not bleeding massively, but still pale around the edges and agitated. He also starts making worrying comments about "feeling all twisted".
I've only ever heard one other person say they felt "all twisted" when they were lying out straight and that person is me. It's one of the stock phrases I use when I'm portraying a casualty with spinal trauma for students doing assessments. I use it because it makes people think "oh shit."
Hearing him say it makes me think "oh shit."
Oh shit.
While I'm contemplating the fact that this guy has very possibly been chibbed in the spinal cord, JD has got on with some actual ambulance work and is busily slapping a BP cuff on the poor bloke. The defib whirrs and buzzes, pumping air in and out of the cuff as it occludes and...whatever the opposite of occludes is...the veins in his arm. It does its inflate/deflate cycle a few times and decides it doesn't like what it sees.
"Bingbingbingbing", it yells, which, in defib speak, translates as...
"Oh shit."
His BP is 72/32.
That's very, very low, the kind of low that makes people be unconcious, or die.
Our man's looking very concious and alive, I'm not convinced by the BP, so I reach across and punch the button to retake it.
Whirr, buzz, hiss.
"Bingbingbingbing"
72/32
Oh shit.
I poke and prod the patient in the belly, feeling for solid lumps that would suggest that the knife has passed into his abdominal cavity and he's bleeding into the potential spaces around his organs and find nothing. He's not obviously bleeding internally, there's a dribble of blood coming from his wound, but not enough to cause his BP to crash. I can't think of any reason why a injury to the spinal cord so far down his body would start effecting his circulatory centres so I'm stumped. If I was a paramedic, I'd cannulate him and fill him full of fluids to pull his BP up, but I'm not, so I can't.
"Let's GTF, Dog?"
The police are at the back doors, one of them catches my arm as I walk to the cab.
"Is it bad?"
"Ummm..."
"LTP?"
"Not necessarily."
"So not bad then."
"Well it's bad, mate, but not necessarily LTP."
"So he's NOT LTP."
"Probably not."
"So he's ok?"
I sigh, the police really have to come up with a system beyond "Will he die?" for "Is this person badly injured?", I'm aware they need to look at cases such as this as attempted murder vs common assault, but surely I'm not the only person to come up against this "bad/good" system with some frustration?
Having battered through traffic to A&E I'm loitering in the Resus room while the medical team work on our boy. His BP comes up with a bag of fluids and the team turn to examining his neurological status, he's log-rolled and examined (spinal trauma exams are not nice things, they finish with what doctors euphemistically call "a wee feel around your back passage" and involves a gloved finger up the arse). Our patient has shat himself monumentally, a fact he seems completely oblivious to and probably indicative of every muscle below the point of injury going all floppy, one of the doctors gloves up and performs the rectal exam.
"Squeeze down on my finger, mate?"
"What?"
"Squeeze on my finger."
The patient looks at his two hands bemusedly.
"Where's your finger?"
We all exchange glances before the patient starts getting more aggy.
"Is your finger in my fucking arseho....."
He catches himself, take a deep breath.
"Is your finger in my anus?"
"Yes."
"Oh...well, I can't feel that, I was lying here wondering when you were going to do that bit."
His response was similar a little later on when he was vigorously catheterised by an eager, but not overly delicate student nurse. A few hours later he was transported to the neuro-trauma unit across town for further tests. I've discussed the job with a few colleagues since and the best answer that we can come up with for his hypotension is the lack of muscular action below the injury would have reduced his venous return, causing his blood to pool in his legs. Smart guys, my colleagues.
So Kal's lifestyle tip for the week?
Don't get chibbed in the spinal cord.
(You might like to say hi to Dog in the comments, he was a solid wingman all weekend, I might have to start recruiting all my partners from the blog; any takers?)Labels: Ambulance, Thrilling Installment
Kal
6:03 PM
Sunday, September 30, 2007
15 comments
Driving North from the Nerfs this morning I found myself poking along in a slow-moving queue of traffic. A line of three cars doing forty in a sixty, with a hearse at the head of it.
I dawdled along at the pace of the traffic, waiting for the car behind the lead to overtake and for us all to get on our way, but they didn't. Perhaps I'd been caught up in a funeral procession, making it's way to the cemetery? Nope, unless the mourners at this funeral drove pick-ups and 4x4s with mountain bikes strapped to the roof. Turns out we're all just driving along behind this hearse because we don't dare overtake.
Why not?
I have a healthy, professional respect for the dead, but when all's said and done, their social status is really only supported when surrounded by their familes. The average cadaver couldn't give a shit if you're standing solemnly by , or dancing the can-can and hollering to the roof about your sparkly enchanted hooey. (Note...I do not have a sparkly enchanted hooey...nor can I can-can)
It's the familes that are left behind that deserve this respect and don't get me wrong, if they were there, I'd cruise along at forty and enjoy the scenery. But I'm damned if I'm driving 30 miles at forty mph when I could be home before my CD finishes. I wasn't concerned about offending the driver of the hearse, nor did I see my fellow motorists having anything to be upset about if I passed them. Why are we so precious about a boxful of corpse?
Dropping a gear I leap-frogged up the line of traffic until I got to the head and took off into the distance. As I passed the hearse I glanced left at the driver and her partner. They were dressed solemnly, black ties and top hats and as our cars drew level, I saw them sharing a bag of Wine Gums and laughing merrily to themselves.
So what's your thinking guys? Are we too uptight about hearses, or am I an arrogant little shit who deserves dressing down and sent to parade-rest on street corners, bowing my head for society's recently departed?
See you in the comments.Labels: Journal
Kal
4:38 PM
Friday, September 28, 2007
9 comments
Go and play with this, it will make you go "Bleeurgh!".
And then you'll do it again.
Back in Edinburgh now, working all weekend, nights with JohnDog who I first met as a commenter here, now he's my partner for the weekend.
TQ will eat itself :DLabels: Journal, Pish
Kal
12:30 PM
Thursday, September 27, 2007
4 comments
"Kal, if you're "bored" - we're really short staffed in the inverness emdc!!!!!"
Guys, you've made my night.
Bastards. :)Labels: Journal, Pish
Kal
8:02 PM
Tuesday, September 25, 2007
0 comments
An aside, guys, I'm writing a series of stories for an event in the Highlands and am looking for proof-readers to give me an opinion.
If you're interested in being involved (because you guys know my writing style better than anyone else!), please drop me a comment with your email address, or contact me directly (kaldottraumaqueenatgmaildotcom) and I'll add you to the list.
Would really appreciate it if some of my 'old faithfuls' could come through on this one, particularly Sewmouse, Meggie, SD etc.?Labels: Pish
Kal
10:27 AM
11 comments
So in a cloud of dust and middle fingers I bid farewell to Embro, I'd taken some leave that meant I'm not due into work for a long long time and it seems to have landed at just the right time. The past year has been all about the job, how have my skills changed in my job, I've lost some weight and look better in the uniform that I wear in my job. I've had some massively life changing experiences and all of them have been connected to my job.
Hey? Did I tell you? I've got a job.
First year of being a Technician is solid, hard work. Theoretically, if you fuck up, they can fire you out on your ear and you're away. Once you've swum through the swamplands of exams, assessments, case studies and being referred to as 'the laddie' then you're given a pat on the head, a Mars Bar and told to get on with it.
For a year I've been "Kal Traumaqueen - PAT" (Probationary Ambulance Technician). Now I'm "QAT" (Qualified Ambulance Technician) and soon I'll be "AT" (Been doing this for so long my qualified status needn't be justified, this is just my job.)
The difficulty of this both-feet-in-balls-to-the-wall attitude is that it's easy to get immersed up to your hairline in the job, leaving little room for much else.
I am extremely guilty of this.
No. 3 and Firsts For All both sent me home in tears. I have good friends who took me for pints and let me vent, texting me later "If there's anything I can do?"
The last minute falling-through of a commitment made me realise that I had a week and a half off.
Into the car, up the road, to the Highlands, where there is nothing to do, but see friends, take photos, listen to music, play Scrabble and write. My hang-ups about being idle melted away with the help of a few hangovers (it's hard to feel guilty about sitting around doing nothing when all you want to do is lie very very still on the sofa).
I've been up here for eight days and I've relaxed. Really, properly relaxed. I've cut out caffeine, I'm going to bed at a reasonable hour, my muscles feel easy and comfortable, my head doesn't clamour at me if I sit down and do nothing for a bit. And I've learned a lesson.
The lesson states: You have a brutal job, it's stressful and surrounded by people who are experiencing life changing events right there in front of you. That "?CVA" that you squeezed in before your meal break is, for someone else, "The day Granny had the stroke...she was never the same."
And for all your professional distance protects you, you're only human and, dammit, still fairly young; the human impact of what you deal with every day will wear you down unless you take action.
I'm taking action, shuffling my job sideways to let other things in.
I came up from Edinburgh an Ambulance Technician called Kal.
I'm going back a guy called Kal who takes photos and writes stories and sees his friends and goes out and loves the cinema and theatre and cycling and climbing and seeing his family and oh, by the way?
He works for the Ambulance Service too.
Labels: Journal
Kal
7:06 PM
Sunday, September 23, 2007
8 comments
Watchful eye over NephewO's shoulder, shot blind.Labels: Photography
Kal
8:49 AM
5 comments
Hard-Hat and I are meandering our way back to station after a quiet morning. The sun's been blazing all day, we've been 'standing-by' different districts of the city, finding sunny spots to recline the front seats, slap on the sunglasses and doze in the heat.
The good Burghers of the Capital are too busy enjoying the sunshine to bother their arses getting ill. Who wants to sit in an ED when you could be lying in the Meadows with a cold one in your fist?
The radio buzzes and it is immediately apparent that things have gone Very Wrong Indeed, the despatcher doesn't even wait for us to say "hello" - blurting his message as soon as the channel is clear.
"410 emergency call to A&E to collect Medic One for HorrendousSoundingRTA on BusyCommuterRoute.”
Medic One is a dedicated vehicle parked at A&E that "brings the hospital to the patient". When it was devised as a concept 25 years ago it was revolutionary, transporting two doctors and a nurse to patients who faced lengthy extrications from debris or road accidents.
I've called Medic One out once, been at several jobs that it's attended, including a triple roll-over on my first ever shift.
Your first Medic One shout is surprisingly easy, you're so overwhelmed by the scale of the job or extent of the injuries that you run about, fetching and carrying, not involved, little more than a bystander.
After a while you learn to get stuck in; to see the gaps where everyone else is working and fill them.
Every Medic One shout has a cast of characters on scene, there’s the caller; the crew who arrived on scene and shat themselves, stabbing buttons on the radio, begging for help.
Then there are the back-up crews who arrive afterwards, thankful not to be first on scene, not to be responsible for the situation until an officer arrives.
And then there's the driver. The doctors aren't blue-light trained, so a crew is despatched to the hospital to drive the trauma team to the incident.
Today that's us.
I've never driven Medic One before, I don't know the vehicle, I don't know the layout or what's expected of me.
I screw my eyes closed and mutter a prayer to the Gods of Despatch. Maybe when I open my eyes I'll be working with Pally, or Node...even Jaffa would do at the moment, someone who knows their stuff, who’ll look after me and hold my hand at the edge of this abyss.
Sunlight squints through my eyelashes, I turn to the attendant's seat. There sits Hard-Hat, two months out of school, her eyes and mouth forming three perfect circles as she looks to me to have the answers.
I don't know what to do, so I light up the roof and U-turn hard in the road, stomping the gas down the hill towards the ED where staff bustle between the front door and Medic One.
"Hard-Hat? Grab our PPE and the response bag, I'll go and have a word."
My boots take me from my motor to the Medic One bay, a nurse hustling around the doors, securing gear, locking boxes shut. At the back of the vehicle, a young registrar (Reg) stands on one leg, hopping into a pair of hi-vis trousers; as wobbly on his feet as I feel on mine.
"You my crew?"
I nod.
"You'll need these."
A hedgehog of keys lands in my paw and I jog to the driver's seat to work out which is the ignition. Hard-Hat jumps in, cramming our jackets and helmets in at her feet.
"Reg needs to sit there."
An ED consultant at my window, pointing at the bench seat between Hard-Hat and I.
We stamp our jackets under the seats, chuck the helmets over the head rests and shuffle up to make room for the nervous young doctor while the nurse and consultant strap themselves into the back seats. I start the engine, push the gas and nose us out of the car-park. Medic One is a Mercedes and our Mercedes ambulances can shift like shit on a greased shovel.
The consultant at my ear.
"ETA?"
"Six minutes."
"Excellent, I'm going to brief Reg, alright?"
"Course."
He starts a lecture to his junior colleague, battering into him those actions that are second nature to ambulance crews: safety, access, communication, triage and THEN airway, breathing, circulation. We pull onto the main road and I open her up.
Medic One grumbles and snorts, sighing up the hill, apparently it's older than the Mercs in our garage. I curse under my breath and update the doctor.
"ETA eight."
"K."
I'm not stupid when it comes to blue-lights, I can drive at speed when I have to, but I'm not fool-hardy enough to push the limits of a vehicle that I've only just stepped into. I don't know the motor, it doesn't know me, we're both feeling our way along the road as fast as I dare.
It is, apparently, one of the first times that Reg has travelled up front on blue lights, because as he listens to his superior's briefing, his eyes rarely leave the traffic. I feel him tense his muscles when I face down oncoming cars, muttering "RedlightredlightREDLIGHT" as I blast through junctions and when the one car that hasn't seen us pulls into our path he blurts a little "Jesus!"
The consultant wraps up his briefing, ending with the statement "If you get stuck, ask the ambulance crew, they have more experience at doing this than you ever will."
Thanks mate, no pressure, huh?
A radio bleep, my Controller's voice through the speaker.
"Medic One...Stand by for incident update."
"Medic One, receiving."
"You are responding to a job so distinctive that Kal’s local readers would know the people involved…suffice to say it sounds horrible and you should be scared shitless."
My sternum becomes a long sliver of ice.
"Thankyou Control, all received."
Through roadworks and roundabouts I pull onto PopularCommuterRoute and see...nothing.
There's no crash here.
Where's the fucking crash?
The whine of a siren behind me and a silver Audi traffic car nips at my heels, I shimmy Medic One into the gutter, the consultant butts in.
"Why are we pulling over?"
"We've got an escort."
"Ahh, excellent, when was that arranged?"
He thinks this has been arranged? I'm just thrilled to find someone else who knows what's going on, probably shouldn't let that show.
"I requested it through Control."
"Oh! Good job."
The Audi smacks past us and I swing into its wake, he can afford to be more aggressive at tail-gating the traffic, he has the braking and acceleration potential that I lack.
I just hope he's going to the same job as me.
Round the corner and the road is filled with lights, emergency vehicles are parked diagonally across lanes, in the absence of the traffic cops everyone has tried to seal off the incident to the best of their ability. I weave my aging vehicle through the gaps, following the madly waving firemen into a barely ambulance sized parking space.
Here we find three fire engines, two ambulances, an officer's car is parked behind them. Police cars and bikes are descending on the scene from both ends of the road.
In the middle of this maelstrom lies a car, its wheels waving forlornly at the clouds, the roof crushed to the head rests and a conclave of firefighters and green suits prostrated on the road around it. That would be our entrapment, then.
People die, most survive, there are tears and recriminations, the emotional impact of what’s occurred slaps me hard in the chops. Late to the party as I am, there’s little for me to do, so I busy myself with treating and assessing the minor injuries of various other affected parties.
Once the worst is over we load the consultant back into our vehicle and blue-light him back to A&E where his skills are urgently needed.
At hospital I return Medic One's keys to a nurse and boil the kettle. I visit the chocolate machine for Hard-hat and I and on returning to our motor, discover she's done the same.
She's sitting in the vehicle, head in hands, staring at her boots. It's been her first really big job, I should say something, but I'm shaking as hard as she is.
"You alright, mate?"
"I had my hat on backwards."
"You what?"
"I've never worn it before, I didn't know, they don't TEACH you that in College, I was standing in the middle of that job and Woody came up to me and said "Hard-hat? Do you know you've got your helmet on back to front?""
A laugh bubbles from my throat, it steals the energy of the tears and vomit and rage I want to expel and the two of us roar at the image of the visor down the nape of her neck, the black sizing wheel slap bang in the middle of her forehead.
And a nickname is born.Labels: Ambulance, Thrilling Installment
Kal
8:33 PM
Thursday, September 20, 2007
11 comments
Late rising,
a list of errands,
shoulders and hips shrugging past each other,
in and out of unfamilar clothes.
Stepping back from the kerb, look right and left and right again and walk across together, alone.
Space inside and out, time to think and reflect, readjust, reframe, rewrite and reshoot.
Bags packed manically,
shorts and socks and shirts stuffed into corners,
razor and toothbrush,
laughingly stopping at the garage to top up the car's radiator;
sensible, responsible, dependable Kal.
Like you know.
Off and into the evening sunshine,
my head out one window,
wind in my ears,
tail between my legs,
the city's grimy stink in a cartoon dust cloud behind me.
And I'm gone.Labels: Journal, Poetry
Kal
5:05 PM
Tuesday, September 18, 2007
2 comments
One day a farmer's donkey fell down into a
Well. The animal cried piteously for hours as
The farmer tried to figure out what to do.
Finally, he decided the animal was old, and the
Well needed to be covered up anyway;
It just wasn't worth it to retrieve the donkey.
He invited all his neighbors to come over and
Help him. They all grabbed a shovel and began
To shovel dirt into the well. At first, the
Donkey realized what was happening and cried
Horribly. Then, to everyone's amazement he
Quieted down.
A few shovel loads later, the farmer finally
Looked down the well. He was astonished at what
He saw. With each shovel of dirt that hit his
Back, the donkey was doing something amazing.
He would shake it off and take a step up.
As the farmer's neighbors continued to shovel
Dirt on top of the animal, he would shake it
Off and take a step up.
Pretty soon, everyone was amazed as the donkey
Stepped up over the edge of the well and
Happily trotted off!
Life is going to shovel dirt on you, all kinds
Of dirt. The trick to getting out of the well
Is to shake it off and take a step up. Each of
Our troubles is a steppingstone. We can get out
Of the deepest wells just by not stopping,
Never giving up! Shake it off and take a step up.
Remember the five simple rules to be happy:
Free your heart from hatred - Forgive.
Free your mind from worries - Most never happen.
Live simply and appreciate what you have.
Give more.
Expect less
NOW ............
Enough of that crap . . . The donkey later came back,
And bit the farmer who had tried to bury him.
The gash from the bite got infected and
The farmer eventually died in agony from septic shock.
MORAL FROM TODAY'S LESSON:
When you do something wrong, and try to cover
Your ass, it always comes back to bite you.
Labels: Pish
Kal
1:30 PM
3 comments
Emergency call received at 0502 for "female unconcious, head injury", arriving on scene (a cycle path in an industrial estate) at 0512.
On arriving at the general area of the scene, the crew were flagged down by a cyclist standing on a path at the top of an embankment running perpendicular to the road.
Taking the response bag, defib, oxygen and blanket, the crew climbed the embankment and were directed along a path to the patient.
On approach, the crew noticed a series of personal items littering the path (handbag, mobile phone, shoes) and several moderately sized pools of blood (approximately 100ml volume in each).
These pools of blood were not consistent with spattering that may occur at the time of injury, but appeared to have been caused by a bleeding patient being stationary for some time.
The patient was found to be a female in her 20s, lying supine on the border of the path and the grass verge. She was protecting her own airway, breathing adequately without distress or obvious effort, well perfused and reacting to painful stimuli. Her torso was covered with a jacket that had been lain over her.
Immediate observations of the patient showed her face to be smeared with dried blood. She had multiple facial contusions and haemotomas, a laceration to her right temple and, (reacting to the possibility of her having sustained a head injury sufficient to cause unconciousness) as the crew manually stabilised her cervical spine, her hair was found to be soaked in fresh blood.
High flow oxygen was administered via a trauma mask at 15lpm in response to the patient's head injuries and diminished level of conciousness.
Her pulse was found to be 80 beats a minute, regular, strong and present at her radius (giving an approximate systolic blood pressure of at least 90mmhg), her capillary refill was normal (<2seconds) and her GCS was 9 (Eyes 2, Voice 3, Motor 4).
A second male, claiming to be the patient's boyfriend, was also on scene.
History was difficult to ascertain, the patient's boyfriend was heavily under the influence of alcohol and was vague and evasive in his answers. He stated that on walking along the path he and the patient had become seperated and on returning to her he had found her in a collapsed state.
He claimed to have helped her to her feet and she had collapsed a second time. He further stated that the patient's injuries had been sustained solely as a result of these falls. He admitted that both he and the patient had consumed alcohol and diazepam.
It was immediately clear to both crew members that two falls were unlikely to have caused such a wide variety of injuries, considering their locations, types and apparent ages. The attendant continued to manually stabilise the patient's cervical spine and monitor her airway while the driver returned to the vehicle for an orthopaedic stretcher, cervical collar and straps with which to extricate the patient to the ambulance.
The cyclist offered to assist the driver with fetchig this equipment, but was asked to remain with the attendant. Both crew members were uneasy about the boyfriend's presence and intentions. While at the vehicle, the driver requested a second crew for extrication and urgent police assistance.
On returning to the patient, the attendant continued to maintain the patient's cervical spine while the driver carried out a rapid head-to-toe check to check for further serious injuries. Finding none, the crew applied a collar and clipped the orthopaedic stretcher around the patient, securing her head with blanket rolls and tape.
With airway, c-spine, breathing and circulation all assessed and found to be adequate, a secondary survey was carried out.
In assessing the patient's face and head it was noted that both pupils were constricted and non-reactive to light. Remembering the boyfriend's comment about diazepam use, 400micrograms of Naloxone were administered IM in an attempt to raise her level of conciousness.
On removing the jacket from the patient's chest, her teeshirt and bra were found to have been pulled up to her chin and as the attendant ascultated her chest to assess respiratory function, she became more agitated, pushing his hands away and moaning.
Further examination found no obvious rib/sternal fractures, nor bruising that could suggest that the patient was responding to pain. This further heightened the crew's suspicions regarding the incident history.
The patient's abdomen was found to be soft, non-tender and without obvious injury and she made no movement or complaint on her pelvis being palpated or rocked.
By this time several police officers had arrived on scene and both the cyclist and boyfriend were detained for questioning. Two police officers assisted the crew to carry the patient to the ambulance, whereupon the second ambulance crew arrived.
The scoop stretcher was removed from the patient, lowering her onto a rescue board which had been placed on the trolley. Head huggers and forehead/chin straps were applied with consideration to her facial injuries.
A four lead ECG, blood pressure and sugar readings were taken, finding the patient to be in sinus rhythm at 83bpm, with a blood pressure of 139/70 and a BM of 9.3.
Her GCS had altered, with motor responses rising by one point, but vocal responses had dropped to 2, leaving her total GCS at 9.
Recognising the possiblity of an indecent assault, the importance of maintaining forensic evidence and in an attempt to reduce the distress caused to the patient, further examinations were not carried out.
A female police officer travelled with the attendant and patient in the back of the ambulance and the patient was conveyed to New Royal Infirmary at Little France, Edinburgh. A stand-by call was passed before leaving scene and a resus team were ready and waiting for the crew on their arrival.
On the patient's arrival at hospital, doctors found her to be agitated and combative, with a GCS of 8 (1,2,5).
Her temperature was low at 31.4 Celcius and her Alcometer reading was recorded at .72 (legal driving limit being .35).
On log-rolling the patient, hospital staff found her spine to be uninjured and with no abnormalities and the patient spontaenously adopted a foetal position mid-way through this procedure.
Wide-spread bruising was recorded across her face, head and limbs. She was anaesthetised, intubated and sent for a head CT and chest and C-spine x-rays. All of these were returned with no abnormality and the patient was moved to a High Dependency ward for further monitoring.
Labels: Ambulance, Case Studies
Kal
10:08 AM
Saturday, September 15, 2007
3 comments
Actual real sick people!
A bloke with pericarditis, which I managed to diagnose with a combination of hunch, barely remembered study notes, WebMD.com and the fact that the Lifepak said "Fuck me...he's got pericarditis" when we ran a 12-lead ECG.
Then onto a great Orcadian fellow, we chatted,
identified ourselves and by the time we were ready to leave for hospital, he was slagging me off in inter-island banter.
"Can Janet come?"
I look at the multitude of people at the back door.
"Janet would be your wife, sir?"
"Aye."
"Sorry. We've not been introduced, I wondered perhaps if you had a series of women available and you just picked them at random to accompany you."
"Nooo...that'd be the behaviour I'd expect from a Northern Isles man."
"Hi! Watch it beuy, you're not at the hospital yet."
After sitting in the Control room slurping tea and arguing with our despatcher ("Do you want an inter-hospital transfer?" "No." "Make me another cup of tea?" "Ok." "Perfect, I'll give that job to someone else."), we were sent to a charming wee seven year old girl who, despite breathing like a tea kettle and occasionally coughing like an angry harp seal, was smiley and pleasant and even let me jab her finger with a spike to test her BM.
In fact, she was so helpful and compliant that I was able to take such a smorgasbord of observations that the doctor at PaedsA&E looked at my PRF and muttered "Nice job, Kal. Have you left us anything to do?"
My final job was to a 22 year old woman who'd fallen out of the pub, landing on the back of her head. There was a wee dribble of blood on the pavement from a cut on her scalp that had stopped bleeding by the time we got there. Not keen to disturb the clot that had formed, I left it well alone and plugged her seat belt in. The following conversation occured on the way in.
"My head really really hurts."
"Yeah I know, mate."
"I need a bandage."
"No, you don't."
"But look."
She shoves her hand into her blood soaked hair and waves it, sodden, in my face, Lady Macbeth in sequins.
"Yes, your hair is bloody, but you're not bleeding."
"Oh."
"Do you have any other health problems I need to know about?"
"No...ohh...no, wait, I do. I had a heart murmur when I was a baby."
"Oh right, and has that been dealt with?"
"I don't know."
"Your ECG is fine. Do you often see a cardiologist? Is your heart checked regularly?"
"No."
"Has it ever been?"
"No."
"Ok, I don't think we need to worry about that."
"But it might be very serious."
"Well...if it was, I'm sure you'd be under investigation."
"But I do think we should get it checked out."
"Ok, Laura, you know what? If it needed to be checked out, I'm pretty sure there would have been some impetus for that to occur other than you getting pissed and falling over."
"Am I going to die?"
"Not from this head injury, nope."
"Can you promise me I'm not going to die?"
"Ahhh...I never promise people that, mate, not in this job. But I've never, ever seen anyone die from a head injury like yours. I'm sure you'll be fine."
"Ok, so what's going to happen? I'll get stitched up and then I'll have a brain scan and go home?"
"Brain scan?"
"Yes. I'll need one."
"You're not getting CT scanned, mate."
"But I'll have to."
"You don't have a serious head injury."
She grabs my hand, squeezes the life out of it.
"I do...I really do...this could kill me."
*sigh*
Labels: Ambulance
Kal
1:36 PM
Friday, September 14, 2007
3 comments
35YOM - Toothache.29YOM - Dizzy
19YOM - Split lip
28YOM - Vomiting for four hours
Whatever happened to staying in bed and seeing how you feel in the morning?
Labels: Journal
Kal
3:46 PM
Thursday, September 13, 2007
5 comments
"AS1 - 19yof slashed wrists, not violent, police aware"
"Well then they'll know where to send the mortuary van when we get chibbed, huh?"
My partner grunts.
Dawn's light is hauling itself over the rooftops, forty five minutes from finishing, neither of us are in the mood for doing anything other than sitting down and closing our eyes.
But the calls keep coming.
I've seen countless people who've 'slashed their wrists'. Only one has ever made me concerned for their immediate safety, having sawn diagonally down between her ulna and her radius with a bread knife, she was white as chicken breasts, even her tongue looked pale.
Fact is it's nigh on impossible to bleed out by cutting the insides of your wrists, the arteries are well protected in there and a cut 'across the highway' tends to clamp down on itself fairly quickly. Cutting 'down the lanes' works better, opening the arteries along their length, denying their muscular walls the ability to contract. I've heard that sitting in a warm bath helps too, stopping clots from forming and denying the patient hypovolaemia's shivering adrenaline rush that gives them second thoughts and sends them scrambling to the phone.
Most times when we attend 'slashed wrists' calls, we find people with stutter cuts on their forearms, the injuries inflicted when the brain's instincts try to override the concious effort of sinking a blade into your own flesh. They're small and superficial and often their pain shakes people off the idea of doing anything more serious.
On occasion we find the patient is a 'cutter' or DSH (Deliberate Self Harmer), though the title is a misnomer, as not all DSH use sharp objects, others smack, punch or pinch themselves, pull handfuls of hair from their scalp or slam their hands in doors and drawers.
People habitually hurt themselves for various reasons, sometimes to punish themselves for perceived wrong doings, sometimes to gain control over aspects of their lives, sometimes the pain inflicted on oneself will eclipse other distress, giving some respite from what ails ya. Sometimes they do it because it's become a habit, just a fall back in times of stress.
Others use self-harm for attention or to win arguments.
I have no truck with the latter group.
The health care profession are often disparaging of self-harmers and understandably so, we're busy enough with people who've hurt themselves accidentally without the added workload of those deliberately putting themselves in such positions.
But they wouldn't do it if it didn't serve a purpose, humans are intrinsically selfish, every action, at some level, feeds a hunger that we feel. Even the most apparently altruistic action fill a gap in our psyche.
Those who curse self-harmers have no claim to their position on the mount, if you've ever had a cigarette, coffee or beer in times of stress, exercised til the burn in your lungs exceeds your emotions or punched a wall in anger then you too, my friend, are a self-harmer.
But to our call.
We're downstairs in a basement flat, the patient a tear streaked lassie, her grim faced boyfriend hovering in the doorway. A pinkly winking laceration at her elbow. It puckers and smacks as she waves her arm, she's barely split the skin, not even ruptured the subcutaenous fat, hardly an emergency call, but the boyfriend obviously panicked when he saw her draw the craft knife across her ivory skin which strained and split, dribbling crimson spatters on the chequerboard kitchen lino.
She wails, gasps, sobs, one part subsiding rage at the forgotten argument, another part embarassment at our presence.
"It's nothing...it's nothing."
"I see that, it's alright."
"No, it's not. You don't understand."
"It's cool, mate, let me patch it up."
"That's all you people ever do, isn't it? 'Patch us up'? You don't have a fucking clue, you think I'm some stupid Emo-kid, fucking NHS, nobody gets it."
"Hey...hang on. That's not true and frankly? I find that quite offensive."
"Why should I give a fuck about what you think? Why should I listen to you? What do YOU
know about my problems?"
I lean in close, push my forearm into her field of view, a silver scar on the inside of my wrist, my teeth together, hissing words.
"The FUCK d'you think that is, pal? Right? I get it. Now, you going to let me dress that cut, or what?"
Her eyes widen, she trips and stumbles on her words. She smears tears from her cheeks.
"I'm sorry...I didn't mean, umm..." A swallow. "Sorry."
"No hassle mate, but no more of this "nobody understands me" shit, right?"
She nods, mirrors my moves, pushes her arm towards my pile of dressings.
"Thankyou."
"Not at all."
My scar is from an ironing accident earlier this year, I have no DSH marks on my arm. I understand the concepts behind it because of personal experiences and friends who were affected, details of which have no place being published here.
But I get it.Labels: Ambulance, Journal, Thrilling Installment
Kal
9:49 AM
Monday, September 10, 2007
11 comments
So Lee won a prize in the Face/Off competition and I've not the first feckin' idea what to send him.
Any ideas?Labels: Pish
Kal
9:03 AM
3 comments
Rosie, Izzy and Hector came to visit and after a leisurely breakfast, we all went shoe shopping. Rosie's known me since I was as old as Izzy is now, I've known Iz since she was four, Hector since he was two.
The three of them rock the house.
We're trundling back from Ambutown's shopping centre, the sun keeking through grey drizzly clouds, the kids sacked out in the back of the car.
I dig my camera from the bag and get the shot, they're big, but still wee.
"Ya know Rosie? I really am inordinately fond of you guys."
"Well...we're inordinately fond of you, so I guess that works."
The camera's shutter snicksnicks as I work on exposure, aperture and focus in a moving car with crappy lighting.
"I probably should have spoken to you about this before..."
"What?"
"Well...it seems a bit pointless now they're so old, I should have asked you when they were babies."
"Asked me...?"
"My kids don't have a Godfather. I'm not interested in the religious aspect of it, but I'd like them to have a solid male role model to refer to, that's going to be around for a while."
"Uh-huh."
"Since my sister died and my Mum's got older, it seems like my family's thin on the ground and I want to plug the gaps, just in case anything happened, you know?"
"K."
"So?"
"So...? Are you asking, or discussing?"
"I think I'm asking."
"I'd love to."
"Cool."
I'm a Godfather.
:)Labels: Journal
Kal
4:10 PM
Friday, September 07, 2007
10 comments
