This is a retrospective message out to the ~150kg man who briefly passed out on the basement level of an event. Myself and a guard had to carry him up a narrow flight of stairs in a collapsible wheelchair (I still don't know how we got him to fit on there...), of course I had a little trip and hurt myself for a brief time.
Still thinking of you, and looking forward to repeating the experience with your brothers and sisters out there in the world...
One funny thing about working major events is the number of calls that lead you - one way or another - into the toilets.
Now, aside from the obvious joke that the toilet is where you'll find disgusting shit - a call into the porcelain shrines usually provides a few chuckles or at the very least a grin or two. That is of course providing you don't actually have to touch anything, and your sense of smell is tolerable of such places. But it seems that the drunk in particular have a unique affection for these places, and I'm never quite sure if it's the constant need to void the bladder after a few too many beers or the fact that somehow - somehow - they know there's nothing we love more than trying to lift a 130kg man from a pool of his own vomit, urine and... other surprises in a confined and crowded space.
Nine times out of ten you're there for a drunk who has either decided the small benches inside some toilet blocks would provide a better resting site than anywhere else outside, but there's always that other one time that keeps you on your toes and reminds you that this can be an unpleasant place to work.
Treating the drunks is usually easy - make sure there isn't some underlying medical problem, help them outside and watch them go on their way (and by that we mean anywhere but here).
Most of the time they just want to be left alone to go sleep off their little adventure, but sometimes they insist of vomiting on you, despite all efforts to convince them that it isn't in their - or your - best interest.
But every once in a while someone comes along to make your life hard. Maybe they've passed out inside a cubicle (a personal favorite, as there's usually no easy way to get into these urine-soaked domaciles without a high chance of getting yourself 'contaminated' - thankfully this has only happened to me once so far), passing out on the floor or (and I've only heard of this happening once) passing out while standing up at the urinals. Fun. I know this is something I'm only going to see more of now in the service, and it's something I'm dreading even before it's really begun.
For all the perks of this job, sometimes you have to put up with a little toilet humour.
I decided to get into healthcare because I felt like I wanted to make a difference. I wanted to reach out to those in need and make them better, happier or just plain alive.
It was a very short time in my life where I held those convictions, because very quickly I realised how little difference you can make, how a lot of the time reaching out to those in need can earn you a punch, that gentle words and proper treatment doesn't always help the pain, and some people you just can't keep alive, no matter how hard you try.
Despite this, I still found the work rewarding - the small victories keep you going. I loved the hands on nature of the work, chatting with different people and hearing their stories. I loved the random 'How the hell did you manage that?' casualties and the ones that make you think on your feet - sometimes literally, as you wheel a patient across to the acute casualty post.
Some patients stay with you long after you've handed them over, be it by their past, their present and why you're seeing them now or because you know what the future holds for them. A while ago I had a patient that stayed with me for all three reasons.
He was in his early thirties and had been walking home from a night out with friends. He had severe skeletal deformities of congenital origins, the details of which I'll go into in another post. I only mention this here so you'll appreciate further the next sentence. He was beaten - bloodied and bruised - by a mob of bypassers for no reason other than he looked different and was unable to defend himself. They had thrown him down and kicked him repeatedly until he had stopped crying - his arms, legs, chest and even his head.
A civilian happened to drive by approximately ten minutes after the attack and noticed him lying in the bushes, almost invisible in the night and had pulled over to see if he was ok, had noticed me driving by in a marked vehicle and flagged me down.
He was taken to the ED, examined and was found to have 'minor injuries', but was in quite a deal of pain. Combined with his history was going to spend a night or two in ward for observation.
This job stayed with me for quite some time after the attack, the sheer stupidity of it and the damage ignorance had caused. I have no doubts that alcohol was a contributing factor in this attack, and that this is becoming a larger problem each week. Still, this wasn't the first beating I'd had to treat and I wish (oh how I wish) it would be the last - but I know the world doesn't work like that. People are always going to do stupid things for no reason, sometimes damaging the life of another. 'Tough' guys with something to prove beating up an innocent, crippled man.
Despite helping clean him up, treat his injuries, I felt powerless to do anything significant at all. But he thanked me for my help, and despite my feelings of ineffectiveness I felt maybe I had achieved something - even if it was just to reassure him that he was still alive.
Some patients stay with you longer than others, but in some way every patient's story changes you forever. You're never quite the same person after a big job, be it for good or ill, but I like to think of it as I'm always growing. Each day, each job makes me a better person, maybe not from gaining hands on experience but by hearing someone's stories, watching their plight and coming through it. Through their strength I gain my own strength, through their struggles I can overcome my own.
For that I am always thankful, and ever wanting to be better at what I do.
As mentioned last post, the growing rate of binge drinkers is, in my opinion, becoming an epidemic in Australia. Worse still is the younger age of onset, with 14 year olds being given addiction counseling for drinking habits. Despite previous posts implying that the vomiting, wasting our time and resources as well as the physical discomfort associated with working with the soberly challenged being the bad parts of heavy drinking – the really bad parts are things I’ve never really mentioned.
I’ve seen families being torn apart following a member binge drinking, with often fights spilling out into the street as they leave whatever venue they’re in. I can only imagine what this must be like at home. I’ve seen ‘normally quiet, fun-loving and calm’ (friends testimonies) people swear, spit and bite and those trying to help them – including their friends. The toll taken on the private lives of binge drinkers, their families and friends is phenomenal.
Add to that any medical costs for ambulances and hospital care, police fines for drunk and disorderly, public nuisance and the financial toll becomes enormous, on top of the funds required to actually purchase the alcohol. To make this final step easier, liquor suppliers are more than happy to provide you with cask or clearskin wine at a fraction of normal costs and budget spirits and beers to keep you happy. Thanks.
Add to that the cost of a liver failing on you. Kidneys can no longer keep up with the demands being placed on them. Eyesight can fail as the small vessels that supply blood slowly waste away. Internal organs die as they’re literally preserved (and not in the good way) inside the living body. If you try and stop you might go into alcoholic seizures, your body going through withdrawal of its vicious routine. This doesn’t just happen to every-day-and-night drinkers, this can happen to those who binge drink only one or two nights a week. The physiological cost is your life – in every sense of the word.
When I recently got called to a young woman who felt the need to drink an entire bottle of spirits I wasn’t laughing about it like her friends. It’s almost a given that at parties like the one I was at there’s at least one person in this state – it’s a joke that they’ll be teased for over the next few weeks, but nothing more. I usually treat in a ‘kids… *sigh*’ attitude in these situations, which truth be told I did in this case. And, as usual, I gave a brief spiel about the dangers of drinking in excess, both the kids and myself knowing full well that it fell on deaf ears but that it had to be done – as if this too was part of the ritual. I’ve done it enough times now to know it isn’t going to change anything.
I wanted to grab the girl and scream at her – she was a university student, bright and with a good future ahead – was this how she wanted to live her life? It only takes one mistake to ruin an entire life. What if her friends hadn’t been there when she fell? What if she was alone, and started choking on her vomit? What if a sexual predator had found her instead?
A parent came later and took her home, a look of mild amusement on their face behind their outside ‘anger and disappointment’ as if they were internally reminiscing on when they were that age and got drunk. The cycle continues.
God I wish it would stop.
I’ve mentioned quite a few cases of dealing with drunks in my short time blogging, but I’m always amazed at the people who feel it’s perfectly normal to put themselves into a state of severe inebriation. Now I’m no saint – I’ve sported more than a few hangovers in my time and, on occasion, put myself into a state of severe inebriation – once following what I’m sure was a reaction to the high preservative levels in extremely cheap wine (I’m allergic to sulphur, of all things…). Thanks go out to Clare for looking after me! (Still sorry…)
I can say however that those events were fairly few and I know for a fact that my days of drinking more than a glass or two are well and truly over. But I’ve noticed some of my friends show a little disappointment in this decision – it’s very Australian to go out to the pub and crawl home.
Working with St John (and also a few bursts of looking after friends at parties) I’ve been abused verbally, had punches thrown at me, had a bag of vomit thrown at me, pulled people out of gardens, been vomited on directly and passively (explanation to follow!). You reach a point where looking after the drunkards makes you realize just how unappealing drinking is – and not just for yourself.
The times I was vomited on directly usually run something like this; security bring someone over who is obviously drunk. They deny being drunk, despite their breath smelling like the bathrooms of Young and Jackson’s Pub following St Patrick’s day and a stupor that would impress a Zen master. After taking their obs they suddenly announce they don’t feel so good, you turn to get an em-bag only to find they project over the bag and onto your uniform. I’m proud to say I have since become the ninja of vomit dodging. Unfortunately, practice made perfect.
The passive vomit stories are the worst though. We get called to a drunk who is passed out in a pool of their own vomit. They are covered in it. A sterna rub or shoulder pinch brings them to (usually angry) but we convince them to sit up. Now we have to walk them over to a post, and the fun begins. We can clean up the vomit off their face and hair, but clothes soak in the stuff – and as we’re sometimes forced to do the old ‘throw your arm around my shoulder’, we get to join in the soaking. Occasionally we’re lucky enough to have waterproof (and hose-clean-capable!) jackets or a scoop and stretcher – but often resources are spread just thin enough to make the shoulder the only quick method of transport. That is passive vomit transfer, and the stink stays for the rest of the duty.
Getting sick and vomiting is only a small part of the problem however – but I’ll save that for next post.
Stay safe.
I was with St John (as I'm known to be) at a local event where the crowd was happily served copious amounts of alcohol. While I usually dislike these events for the obvious work it provides me with, the crowd were actually a pretty good group of people all out for a nice fun time.
Of course, for two of them, the day after may have been slightly less so. Actually, for more than two - but let's just say these two in particular ;)
The first was a girl who had consumed her fair share of beer and then a little more. After that she drank herself silly. Thinking this might be a good time to head outside and purge her sins, she told her boyfriend her intent and strode forth into the night. After some time the boyfriend (who had stayed inside the warm room filled with friends) got a little worried, and before long we were called to an unconscious female in the garden.
On a side note folks, why always the garden? It's full of prickles, thorns and bugs - please, please try to pass out somewhere a little more convenient for me to get you from!
While she wasn't at the point of needing her stomach pumped, she certainly needed to sleep this off. Her boyfriend and a few friends were with us, which made my life a lot cleaner - I got them to hold the em-bag while she continued her projectile ways. The unfortunate thing for me was the fact that her location was completely inaccessible by vehicles (such as the one a friend was driving around to take her home), she was a large girl and was in no state for walking.
Out comes my best friend, the scoop stretcher. If there is one piece of equipment I recommend all first aiders get - it's this. We load her into it, secure her and (with the help of myself, a partner, the boyfriend and three other friends) take her over to the car. There was a bit of a wait, so we released her from the scoop and we sat around talking for a bit. Although drunk, she was a lovely girl and liked my sense of humor - this was also a good thing because I love an audience. A captive audience best of all.
After a few stories, jokes and musings she said something to me that I doubt I'll ever forget - "You're good at this." For some reason that simple statement made by a drunken girl sitting on cold concrete with a half full em-bag in her lap remains one of my warmest, fuzziest memories of first aid. I felt like, in my own small way, I had achieved something that night. After a bit the friend appeared and we got her into the car for her adventure to continue while we headed back to our designated spot.
A year later at the same venue and event (it runs every year) I met our second drunk. We were called to her under similar circumstances as our last friend, out in the garden 'unconscious' (of all the calls for 'unconscious' I've had, only around 5% of them actually are unconscious...).
Seriously - stop going to the garden, people.
Unfortunately this was the one time of the night when all the people requiring first aid needed us at the same time, so I was caught between treating her and also inspecting a young man who'd recently been in a fight. Luckily they were scant meters from each other, so my life was made somewhat easier. The girl was GCS 3,5,6 - but the 5 was borderline 4 depending on which time you roused her. Drunk girl this post, fighter in a later dedicated post (oh yes, it was a good one).
We got her into a stretcher (I had learned from last year), covered her in a nice thermal (foil) blanket/wool blanket combo and were wheeling her over to the car park so she could get a taxi to her friends place. She probably could have walked, but she was a very petite girl, continuous going 'floppy' and thus was extremely difficult not to drop - I was erring on the side of caution. I was also using this as a way of getting away from the 'fight scene', but again more on that later.
The girl was great when she was talking, a very giggly drunk and rather entertaining actually. While I couldn't stand it all night, a 5 minute stroll was quite enjoyable. The big laugh came when we approached the taxi area with the girl in a stretcher and, unsurprisingly the taxi just took off. We sat her up with her friends to wait for the next taxi with her thermal blanket still around her ("You look like you're about to be thrown in the oven!") and left them to the night. I was proud of the partner I was with, as it was her very first duty and she had handled herself well (which I of course told her), and she said she was impressed with all of our friendliness and humor and was keen to do more duties.
I heard through a friend of a friend that the girl made it back safely to wake the next morning still wearing the thermal blanket - but didn't remember how she got it. It's always nice to hear how our patients have recovered - better still when it can give you a chuckle.
There is of course another side of the coin when it comes to my last post. I like to think that omitting information (or flat out refusing to give it) is more of a deficit of honesty more so than lying, so I bundled some of those examples into that post. Some people, however, just flat out lie. Not through omission, not to save their skin - they just lie.
Several cases in point; at a recent festival a member of the public came to my post and reported an unconscious male locked in a bathroom cubicle. On goes the response gear - a giant pack filled with Oxygen, breathing apparatus and other gear on me with a response kit complete with trauma gear and defib for my partner. Not the easiest gear to carry but we do it without complaint or question - it's the gear we need to do our job. We make our way around the corner to the bathrooms and I check every damn cubicle - all of them in use and filled with an angry male wanting to know why I was banging on the doors. Nobody else had seen our supposed unconscious male, and some patrons had been waiting for a cubicle for quite some time.
Now, I'm not afraid to go on a wild goose chase ('That's what wild geese are for.' - Anon), because I'm fearful of that one time we don't go when we are needed. But why would someone make up a story like that? It got the reporter about three seconds attention from us but wasted about fifteen minutes of our time. Time that we had to mark ourselves as a response crew as 'responding and unavailable'. At this event we had a rather large amount of drug OD's - and they wasted our time on this? But sometimes it's not the reporting of a patient that's the lie... Sometimes we have something much more fun in store.
And these are the cases that really irritate me - people who have nothing wrong with them, but they insist on treatment. These are the teenage girls who've 'fainted' at concerts, the patrons who travel around first aid posts at large events getting paracetamol from each post (we usually catch them out, but unfortunately they can get as much as 3mg before the flags get raised), the hypochondriacs who insist on us calling an ambulance for their 'broken leg' despite walking in with no problems only to find out this post doesn't stock penthrane.
It's the active lie that can do much more damage to our patients, ourselves and our work. I can understand sometimes why people might lie - the elderly or homeless sometimes just want someone to talk to, youths often just want attention and sympathy, addicts might want to score a pain killer when they have no money - and this is one of the things that worries me most about emergency medicine. You see, the problem with medicine outside the hospital (and even in many cases inside) is that we have little in the way of diagnostic equipment. For this reason EMS is rarely allowed to diagnose patients - but it's still a big part of what we do. So how do we go about doing this without said equipment? We have to depend on the patients complaints and symptoms to guide us.
For this reason the homeless will get their night in A&E in the warm bed, youths will get their attention and yes, addicts do score free pain killers - because we have to trust them and their word, because some times there is little else we can do.
Rule 1 of Emergency Medicine is everybody lies.
Rule 2 is supposed to be 'Never forget Rule 1'.
I sometimes think a much more appropriate rule 2 would be 'Know when to forget rule 1'.
Something that always amazes, amuses and mortifies me is the truth behind rule number 1 of Emergency Medicine.
Everybody lies.
One would be forgiven for thinking that, while being in an emergency situation, a medical technician might be provided with all of the important, relevant details needed to adequately treat their patient. This is not the case. Several instances stand out in my mind when 'the gang' is gathered and sharing battle stories in regards to this.
I was at a major festival at one of the busiest posts when, not surprisingly, an underage female is brought in with suspected OD. While she was stable, it was vital for us to be told exactly what she had taken or done in order for us to treat her in such a way as to improve her condition or ensure the proper care was given... Her three "BFF's" were gathered around crying she was going to die and the usual rants we hear in these situations (they'd be amusing if they weren't so annoying), and yet not a single one of them would tell us what she had taken. Oh, they knew, but (and I quote) "[they] don't want her parents to find out!". She was in no trouble at all, the only way her parents would find out is if a) she told them or b) we were forced to send her to hospital in which case the hospital would be forced to notify the parents given she was underage.
I always like to think that if it come between getting in trouble but being alive or not getting yelled at but possibly dying, I'd choose the former. Just me, perhaps.
Another case that comes to mind was at another festival where many people were brought in with scratches, lacerations or other injuries consistent with being scraped by a wire. It was funny, but I recalled hearing on the event radios of people jumping fences... But these people told me they cut themselves on cans after falling over... Also funny, this event doesn't serve drinks in cans... What's that? This was outside the event, before you came in? Of course it was. We didn't care how they cut themselves (although our paperwork requires us to ask just for record keeping), but knowing what people cut themselves on can be the difference between knowing a simple clean and cover will suffice or if they might need a shot after scraping on that rusty fence. Of course I recommended the shot given the 'nature' of the injuries to be on the safe side...
Of course my favorite to date (although perhaps not as medically relevant) comes from the humble drunk. How did you end up in the gutter? "I was just having a drink, minding my own business and the guards kicked me out." Do you remember how you got that black eye? "What black eye?" The police want to have a quick word with you regarding the patient in the other post, the unconscious one. I'll be back in a minute. "Never seen him in my life." I'm sure his fist looks familiar. Bloody-toothed grin ensues.
The short of it; we're only trying to do our job, and the more details we have the better we can look after you. We don't disclose details to anyone without your permission (yes, even including the police) so please, just be honest.
Some patients make you sit and think about the way we live our lives. These can range from the elderly with stories of their life to the drunk 13 year old girl crying because she's afraid her parents are going to find out she's been drinking.
Others just make you wonder how they made it this far.
At an all day music festival with St John I had a 22 year old male come in to our post with blood all over his face. Oh, how I wish this was a rare occurrence at such events... Long story short, he'd split his lip, eyebrow (although it didn't need stitches) and had a rather nasty swollen eye. While getting a history he'd denied taking any drugs that day (as almost everyone else has said) but I always had a feeling he was lying. Call it a sixth sense, or the fact he was agitated, his pupils were dilated (although still PEARL) and he was having trouble obeying orders to hold a cloth to his nose to stop it bleeding. Of course it was possible he was just a nervous, oddly behaving type of guy so I had nothing I could really hold him on (add to the fact he was built like a tank, myself being built more like a mini I didn't like my odds of holding him anywhere) and he was anxious to get out of the post.
The day moves on as one would expect, and after two or three hours a familiar face is found once again at my post. He'd managed to get himself into another fight - of course not his fault - and his face was once again a bloody mess. That sixth sense was still tingling, his paranoia had increased as had his pulse and respirations. Mood was swinging a little more, but after I cleaned him up again some friends said they'd take care of him.
A few more hours pass and I was dropping off a patient into the Advanced Casualty Management Team (ACMT - a 'mini emergency room' if you will we set up for big events) when who should I spot but our dear friend Mr Bloody Face being treated by one of the nurses. I let someone in there know he was a frequent flyer and it might be an idea to have him 'move on' to the outside world.
More hours pass and I'm beginning to see the light at the end of the tunnel. I'm almost ready to go home, when I get a call to respond to an unconscious male at the security office. As I get closer and closer I see a familiar face sitting in the security office. By this stage I could recognise him bloodied and bruised, after a minute with him I could see he was up to his old tricks. He'd been jumped by four guys after he'd picked a fight, although he had never lost consciousness. He was crying and kept repeating he wanted to go home, and although I got a base set of obs and was confident he wasn't in any life threatening situations, it was clear by now that my suspicions he'd taken Ice were more than likely correct, despite what everyone was saying.
It had been a long day, he was probably dehydrated as well as bloodied and bruised, agitated, anxious, paranoid and more than likely scared out of his mind being surrounded by security guards (although they weren't crowding him, the fact he was at the security office made their presence abundant) and two people with 'Ambulance' on their rather police-like uniforms - add to this Ice is known to give massive mood swings and increased hostility/aggression. I knew these things. Still, the sudden snap caught me off guard when he threw me away from him and starting swinging at everything and anything around him.
Luckily he didn't make contact with me (apart from the rather firm shove) and guards were quick to jump on him and pin him to the floor. His friends tried to calm him as he screamed and attempted to fight off his restrainers (luckily with no success). We had called in an Ambulance and Police by this stage, and as the Ambulance arrived he had calmed down sufficiently to let the Paramedics treat him under security supervision. Knowing the night was not yet over, I headed back to my post to wait for the next call until I could return to that glorious, soft bed and call it a night, knowing the Paramedics and Police would sort out our friends fate.
I've stated previously that I don't like to judge drug users, or anyone I treat for that matter. Their life is their life, and I'm only there to help when they need it. Sometimes I just feel sorry for people like the patient I've just talked about - if they could do it all over again, would they make the same decisions? If he had have known at the start of the day what would occur, would he still have done the same things? In the end we're all responsible for our own life, and hindsight is a wonderful thing. It might be that he was an otherwise great bloke, who I would have been more than happy to share a beer with down at the pub - I just caught him at a weak and vulnerable moment. Of course he could be a complete arsehole.
I just hope when he's back in his mind he has a good look at his life choices.
Sometimes we get cases that we just know are wasting our time.
It might be that you can still move the fingers you just 'dislocated', that the throwing up has nothing to do with the eight bottles of beer you just finished and must be due to internal bleeding (despite the lack of blood) and your obvious soberness. It might even be that you've just 'fainted'.
It's a funny thing, fainting. You see, we have these little things called oropharyngeal airways, which for unconscious patients just slide right in. Fits like a glove (providing of course you use the right size oropharyngeal airway). Unless of course you are (and of course you are not) faking - in which case you will gag and cough up the airway the second it's in - a natural and almost invariably an irrepressible response. Oh, we know what's going on now - but we have to play along with your little game because there's not much else we can do. This seems to be a popular activity for teeny-boppers when that young boy comes out on stage wearing almost more make up than said 'boppers...
But then there's the other cases, where the patient is just plain stupid. They profess that they wish to become a neurosurgeon (despite a distinct hate of all and any education establishments) so that they can perform brain surgery on themselves. I'm not making this up, I've had someone tell me this. And then there was a youth with severe stomach cramps after a two week binge on junk food and alcohol...
While the last two examples had patients who were there for genuine reasons (the first was there for reasons other than brain surgery), you still feel like your wasting your time - that Darwin determined long ago they should be left to nature. Of course we still treat them like any other patient who comes for help - but its these patients who treat that little bit faster so as to get them out the door, away so they cannot accost your ear drums with their taint. You feel that little stupor that comes with not using your brain for an extended period of time after dealing with these patients, and I at least get a little angry (but of course don't show it!) at their sheer ignorance of what the world is really like.
I like to think I treat all patients equally, but even I must admit I get on better and do that little bit extra for the patients you think are really worth treating - worth our time.
It was nine o'clock on a Saturday, the regular crowd shuffles in. There was a young man brought in to me, with the stench of tonic and gin... Ok, well it was actually more of a beer smell and from memory it was a Tuesday, but let's call it artistic license.
At first he refused treatment but said he wanted water and a sit down, he was dehydrated. This is far too common at concerts like the one we were at, as we were situated right next to the stage and provided one of the best places to watch the show from. Perks of the job on quiet nights. This had all happened while I was at another post and the crew there were happy to just let him be for a bit.
After a while I moved to this post to help even out the crew numbers around the event and I was introduced to this lovely fellow with a 'I'm all right, f*** off.' I asked the intercepting crew member why he was there, as I'm a firm believer that despite our rather well placed post the spot should be reserved for casualties, and while I'm happy to have people sit down for a few minutes and get re-hydrated, the last thing I want is for the post to become a perch for the lazy and unscrupulous.
I returned to the gentleman who, for the record, was pleased to make my acquaintance again which is when I decided to inform him he would have to move on if he was 'f***ing alright', to which he suddenly remembered some wounds he had. Thinking he was just stalling (the concert was quickly nearing its end) I asked him to tell me about his wounds when a rather interesting story ensued.
He had been motorcycle riding in Country A before deciding to get even closer to the countryside by coming off the bike at high speed and spraying himself along the roadside. He had been taken to a local hospital and his wounds (which were fairly minor given the accident) were stitched, dressed and he was sent on his way. He returned back to Australia a week later and, being bored one night decided to remove his stitches with his hands and a pair of kitchen scissors. He also redressed his wounds which he thought at the time 'looked like s***'. A shining star of Australian upper class culture, this boy. I was tempted to ask if they smelled of almonds...
After a little negotiation I convinced him to let me have a quick look at his wounds, as two days had passed since his self-redressing and I was beginning to suspect they had become infected. As he removed the covering over his elbows and legs, I realised how right I was - every wound was in various stages of infection. None were what I would consider life threatening, but they would certainly require a hefty dose of antibiotics. With his new found consent, I cleaned and redressed the wounds in sterile non-stick dressings and tried to convince him to see his GP in the morning (he had already refused going to A&E), even writing up an OB11 (one of our casualty report forms) that he could take with his doctor.
Now I knew that the doctor wouldn't care less about the OB11 and that it was obvious what needed to be done, but I like to hope if nothing else it would serve as a reminder to the man to at least see his GP. He was under the influence and I wasn't too certain how much of the night he would remember, so an official looking piece of paper with 'Ambulance' written on would hopefully leave an impression on him.
The thing I didn't understand about this casualty was that he must have been in pain from the infection, even after recognising the wounds weren't quite happy it took two days and a person to tell him to leave a first aid post before he did anything about it. He wasn't about to lose his legs just yet, but infection is a serious problem that can cause major complications if left untreated. The common thought of 'If I ignore it it will get better' just isn't going to cut it in this situation, and you tend to look decidedly less macho when the doctor tells you of his plans to amputate.
At the end of the day, the only person who is really going to look after you is yourself. So make sure you take responsibility for yourself - otherwise you might be getting a visit from our friends in the shiny vans with lights on top.
Firstly, this post isn't late - the world is just spinning a little faster than usual at the moment... This also means two posts will be released on the same day, because although I started this post on time, finishing only occurred on Wednesday when I got enough time to do so and start the next post ;)
Dear Mr. Johnathon Walker (an Open Letter to those who drink),
Firstly, let me wish you health and happiness in your travels, for I know last we met you were short on such luck. I was the fortunate soul whom your limbs were entrusted to while your mind decided to go for a bit of a wander. Unfortunately, you left behind your stomach and we were thus treated to a fireworks display. Relax, we've all been in this situation (myself included), and it's something most of us will grow out of.
I wish to make a few requests for the next time we meet, so that our fun times may continue in this little cycle of ours, and so that next time my washing will be made all the easier.
Firstly, I am not a tall guy - 5'7". I am also not the most muscular person in the world. For these reasons, I would most appreciate it that if you decide to become unconscious or, for whatever reason, are unable to walk even with assistance - please do so on the ground floor of whatever establishment we may be inside. Better still, do so outside, next to the car park (NEXT to, not ON or IN) while wearing warm clothes if it's cold and the brighter (and more reflective) the better. Not too long back you decided to make your resting place in the basement with only one entry (a damn narrow and steep flight of stairs) and given your girth I'm sure you appreciated the effort I was forced to make in your extrication. My back was fine after some rest, thank you for inquiring.
Secondly, please try to be conscious enough for me to be able to ask some simple questions and for you to understand and provide some simple answers. You don't need to tell me you're not (or are, in some cases) an alcoholic, as we have already established this prior to our arrival. Honest. Another thing I would appreciate in these early stages is that, should I require to, I may need to inflict a little bit of pain to rouse you. Please don't swing at me, because nine times out of ten my co-ordination is slightly better than yours and it makes you look slightly silly. That other one time... Wait until we get to the 'Finally' paragraph.
If you feel the urge to undertake the act of emesis, please do so in the bags provided. This may come as some shock, but my shoes are not in fact emesis bags. Nor are my overalls. For the love of all things holy, if I'm in my black and whites, these are certainly not to be utilised. Once you have completed your act, just hold onto the bag unless it's full. I'm sure it'll come in handy before too long.
Emesis bags are not to be thrown at me should you decide you no longer would appreciate my assistance. A simple thank you and nod of the head would suffice.
Finally, we may very well become good friends, repeating our adventures on a regular basis. For this reason, be nice to me (and ask your friends to do the same!) - for although I will do what I need to do to make your health improve, your comfort might just be slightly increased if I know you're an ok person.
Wishing you well in this drinking season of (insert any time of year here),
KT
