Paramedic placement: The Good, the Bad and the Ugly

Alex describes the exhausting recent shifts his ambulance has attended, with an abusive hypoglycaemic patient and a stab wound victim.

Making sandwiches for a patient

I recently attended to a lady who had fallen on the floor in her flat. She had many disabilities and healthcare needs, but thankfully she was not injured and in good spirits. My observation taking revealed Blood Glucose of 3.9 (normal ranges 4 to 10) so I decided to make her a couple of sandwiches before we left. I wish I could get sandwich making signed off in my PAD, as I thought it was one of the best I have ever made! Elderly fallers are quite common for the ambulance service, but there’s nothing to say we shouldn’t go the extra mile every now and then, especially if it results in one very happy customer.

Helping a diabetic patient

The past three day shifts have been rather exhausting, despite only attending five or six patients for each shift. Most of the patients have had special requirements or safeguarding concerns, which takes up a lot of time to fill out the appropriate paperwork. On a wet Sunday morning in London I attended to a lady who was fitting and a known diabetic. We arrived to find an FRU (First Response Unit) was on scene and the patient had been bleeding heavily from the mouth. We tested her Blood Glucose and it was 3.1. She was very aggressive and abusive towards us; this is normal behaviour for someone who is hypoglycaemic. When your body is starved of glucose and eats up its reserves it alters your mental state and causes a lot of confusion. It took an hour to get her to eat some cake and two tubes of Glucose 40% Oral Gel. By the time we left her levels were now 7.9, she had capacity and denied hospital.

Proceeding to an unclear incident without police assistance

So that’s been the good and the bad parts of this blog – now for the ugly. Our last job with my mentor and her crewmate brought us into Central London. On the MDT (Mobile Data Terminal) it stated “38yom (38 year old male), sharp object thrown at patient, bleeding heavily” and that was all the information we had. Due to the lack of information it was not graded as a Category A job. Red Base even pinged us on the radio to say how confusing the situation was, and asked if we were happy to proceed without police assistance; we all agreed to carry on but with caution.

Treating a security dog handler with a stab wound

We arrived to find our patient was a security dog handler on duty at an event. He told us that there was overcrowding in the room and 500 people were screaming and shouting whilst trying to get out, this caused the dogs a lot of distress. His dog went to bite someone and got the lead caught around a ticket barrier, causing him to tumble to the ground. Five seconds later our patient felt a warm sensation on his back, and discovered he was heavily bleeding. Other dog handlers pulled him away to a place of safety and a private ambulance company provided first aid prior to LAS (London Ambulance Service) arrival. We inspected the ‘sharp object’ wound to find it was scarily knife-like. Despite wearing a stab vest, the wound was posterior right shoulder and almost superior to the scapula, where there is no ballistic protection.

Pre-alerting the hospital

His t-shirt was torn in a perfect line, exactly the same length of the wound. This suggested it was not snagged on a wire for example as the shirt would be a lot more messy and jagged in shape, however, nobody witnessed the event. We treated for a stab wound, and proceeded to follow full Major Trauma protocol – a full secondary survey head to toe was conducted to reveal no further injuries. He scored the pain 1 out of 10 and there was no catastrophic haemorrhage. I put the pre-alert in, which went a little like this:

“Good evening Red Base this is Golf 101 can you show us Blue to St Marys Major Trauma Centre.”

Control Reply

“We have a 38yom Query Stabbed Right Shoulder, ready for obs?”

Control Reply

“Resp Rate 25, Heart Rate 90, Blood Pressure 127/82, BM 7.9, Temp 36.2, and our ETA six minutes”.

Control Reply relay everything to confirm correct details

We arrived to the Resus room to find 10 doctors and 15 nurses waiting eagerly for the patient handover!

Working at Open Days

In other news, I have been representing Anglia Ruskin at the Bradford and Cambridge UCAS fairs. This gave me the opportunity to meet thousands of Sixth Form students wanting to study a degree – I personally spoke to roughly 20 students who showed interest in our BSc Paramedic Science course!

Once again, thank you for reading my blogs, next week is my last ever week on placement!

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Alex studies Paramedic Science at ARU. You can find out more about this and other degree courses at one of our Open Days.