We have a code for paperwork for every ailment, disease or injury we meet. There are about 100 options for the calls that we are most commonly called to. Ones not covered go under the "other medical problem" code. Every so often the list is updated, something added, something taken away, and the alpha-numeric sequence is shot to pieces again. I've memorized a large number of the codes, and rarely have to look at the crib sheet to remind myself. I'd hazard a guess that every single London Ambulance Service paramedic knows that 62 is the code for Alcohol Intoxication. That one hasn't changed for years. We probably also all know about 75 being a minor head injury. Friday and Saturday nights especially. But our all time number 01? Sitting at the head of the table? Abdominal Pain.
I believe it's number one not just for alphabetical reasons (although I'll admit that AB at the start of a word will give it a pretty good chance in any alphabetically organised list), but also as it's probably the most common complaint that we come across. Abdo pain is a potential minefield. It can be anything from gastroenteritis to food poisoning, from a heavy period to appendicitis, from labour pains to a ruptured placenta. It could be a potentially fatal bowel blockage to a very unlikely to be fatal under-cooked doner kebab making some very unhappy returns. In some patients abdo pain can signify a heart attack, in others it could be a ruptured aortic aneurysm, both potentially lethal. With no CT scanners, ultrasounds, or X-rays available in the back of the ambulance (yet), it can sometimes be a matter of educated guess work, at least initially.
However. I'd like to guess that the patient who's had mild abdominal pain for three (yes, 3) months (yes again, months), probably wasn't in a life threatening condition. In fact, she knew she wasn't. She told me so herself. She was about to go to the GP for a repeat prescription for some regular medication, but realised that the surgery had shut ten minutes earlier. So she called an ambulance to take her to A&E so she could get what she needed.
I had to ask what made her call an ambulance for what was clearly not an accident or an emergency. I'll give her her dues. She was honest. "It doesn't cost anything!", she said. The cab to the hospital would have cost her £5, possibly less. Less than the packet of cigarettes that she was holding in her hand.
As I'm in the FRU, just a car, and not really supposed to transport patients, technically there's a "big" ambulance on its way too. I'd love to be able to say to this person that she doesn't need an ambulance and she should get on a bus, but it's just not worth it. Sometimes I just can't be bothered for the argument, but I'm sure they sense my unease. I cancel the ambulance and inform control that they may as well save it for a worthwhile call. The "patient" wants her friend to go with to the hospital, so I move my luggage out the back seat and sit them there.
The 7 minute drive to hospital was spent in frosty silence, until it was broken by the radio.
"General broadcast all ambulances - ambulances needed for two possibly fatal stabbings in local area. One with multiple stab wounds, one with slashed neck. Anyone available please respond!"
In a moment of Mouth before Brain (unusual for me), I look in the mirror and mutter loudly "Unfortunately this taxi is already in use. Sorry I can't be of any help."
Did I mention the silence? It could have induced frostbite.