Tuesday, 29 November 2016

Doctor knows best

One in a series of stories about patients that stand out for one reason or another. No names, no pack drill, no dates.

As a Community Responder, I get called out to many things (mostly chest pains where the patient clearly has forgotten where his or her chest is) but occasionally (on average 1 in 20 calls) it is a Cardiac Arrest.

A Cardiac Arrest is where the heart has stopped beating effectively (no pulse detected), as opposed to a heart attack, which is where most of the heart is working (beating) but part of it is being killed off by a clot.

Myself and a colleague had just cleared from a Job and were being sent to another. We had (at the time) pagers that sent through details of all jobs in the area, whether or not we were allocated to them. The details all included a Job code in the form 'number letter number'. (AMPDS for those that know). This job came through as a 6A1, which is a cardiac arrest - the most serious - and also showed the road, which I was just about to pass. I called in to Ambulance Control and was rapidly stood down from the job I was on my way to and reallocated to this. 30 seconds later I reached the door......

......only to be shown into a very much alive patient.

I started to get a history and it turns out that he'd jut been discharged from Hospital after receiving heart bypass surgery and was told to go home and take it easy. He did as anyone would do, given those instructions and took himself off to the pub for a smoke and some beers to celebrate.

Upon returning home, he had, indeed, gone into cardiac arrest, but had come round by the time that I, hotly followed by an Ambulance Solo Responder, arrived. As we started to get all this history, his heart stopped again. A quick precordial thump (not by me, I hasten to add) and the old ticker was running again....until it stopped.

It probably stopped and restarted 3 or 4 times by the time that an ambulance crew arrived to take him to hospital and we managed to get it going each time. Inbetween, he was perfectly awake, sat up and chatting away to us.

As far as I know he is still alive today, he certainly survived that day. Blokes (I'm sure this has to be a male trait) if your doctor tells you to take it easy as your heart has just been through hell and back, trust me. (S)he knows what he/she is talking about. Put your feet up, moderate exercise and lay off the stuff that earned you the bypass in the first place.

It's funny the things that stick out. Obviously, for the reasons above, the job itself sticks out, but I also remember him wearing a jacket, taking an interest in his appearance. Never mind his heart stopping from all those cigarettes, at least he looked presentable.

PS. Why do I go to a lot of patients with emphysema / COPD from years of smoking. They are on permanent Oxygen therapy, piped around the house for their benefit, catching their breath yet the rest of the household still see fit to puff away. Quite often I come home and shower as the air is so thick with tobacco fumes it gets everywhere. Spare a thought for your family member struggling to breathe in the next room.

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