Chauffeur driven...

In my introduction to this blog, I wrote that for ease of use, whenever I talk about Paramedics, I'll be referring to EMT's as well. In a large number of our cases it makes no difference whether the crew are made up of either. However, every so often, the advanced skills that the Paramedic has been trained in are required. If that Paramedic happens to be a single responder in a car, and the crew that turn up are EMT's, then the Paramedic might end up travelling with the crew to hospital.

Richard was, according to the call we'd been given, nearly 80 years old and having an allergic reaction. I pull up on scene only seconds ahead of the crew, and we're met by a relative looking frantic.

"How bad is he?"

"Not sure, but I don't think his breathing's very good. He looks blue!" At that, I pull all my bags out the car and get moving. We walk in to the room, and at first glance we all thought that we had a resus on our hands. Richard was very blue, unresponsive, and for the first few seconds he didn't take a breath. A few seconds longer and the first breath was drawn. He was breathing at around six times a minute. We instantly put him on oxygen and his breathing picked up with little further intervention. In fact, by the time we arrived at hospital, he was at 40 times a minute. One extreme to the other.

With a very poorly patient, like with the trauma patient, it's vital to remember ABC's. So we started at the beginning. A - airway - clear. B - breathing - better than it was, air going in and out of both lungs. C - circulation - ah. No bleeding anywhere that we can see, but a blood pressure so low (about 50/30) that it's almost unreadable. We decide that Richard needs to be a little more stable before we even think of moving him. Gone are the days in the Ambulance Service of "scoop and run".

This is where the Paramedic bit comes in, and the reason I would have to travel with the crew. We decide that it would be a good idea to give Richard some fluids before we transfer him to the ambulance. A needle in the arm and 500 mls of fluid later and Richard's BP is still not great, but a little better, so it's time to move. Ideally we'd like to keep him flat, but that's just impossible in this house or on the route out of it, so stick to using our carry chair and regularly assess him on the way to the ambulance. We reassess Richard in the Ambulance, his BP is still low, so as we start moving (fairly rapidly, having put in a priority call to the hospital), I decide to put another IV line in his other arm and give him some extra fluids. Just as well, as he decided to pull the first one out as we were travelling.

As we arrive at the hospital there is an improvement in Richard's condition. He's responding to some questions, his vital signs were better, and we're quite proud of our efforts.

Time to get back to my car. The crew who have kidnapped me ask control to return me to the scene of the call, but are given job after job, and I end up staying with them for several hours, unable to get back to my car. To be honest, I was pleased of the company, and it helped pass the night even quicker. Eventually I was abandoned at the hospital when another FRU came to my rescue.

In fact, I enjoyed being driven around so much that night, that I came back the following night and worked on a "proper" ambulance... Chauffeur driven again!