"He's wedged behind the door you'll need to go in through the back"
"Ok, how do we do that?"
"Well, it involves climbing the fence to go through the garden"
"Ok"
The action women in me likes the sound of this! The RRU Paramedic says she'll try the front door and see if there's a way in around him.
The neighbour who met us shows me around to the correct garden fence. I can see the sliding doors and the patient's wife pottering about in the kitchen.
I clamber over the slimey fence panels and drop down into the gap between the fence and a spiky tree. The spiky tree is of course the more dominant of the two obstacles and I pick up a few scratches on the way down.
I head down the garden and knock on the sliding doors. The elderly lady turns and looks at me then turns back to the work surface without moving to open the door.
Hmmm. Interesting.
I knock again. She doesn't even turn this time. I try the door and it slides easily.
"Hello, I'm with the ambulance, we're here to see your husband."
She doesn't even look round but continues to attempt to make a cup of tea.
"Through here Lou!"
I walk through the living room and find that skinny RRU Paramedic has managed to shuffle through the gap between the patient and front door. Part of me thinks 'well done, skinny cow!' but there is a little of me that's really thinking 'my way was more fun anyhow!'
Our patient is laying half in the living room with his legs taking up the small space at the bottom of the stairs. He's over 6ft tall and appears to be all limbs. He is complaining of a sore back. There really isn't a lot of room to manoeuvre around him.
"I came round to check on them. He looks after her as she has early dementia. He hasn't been well recently. I found him like this. He isn't making much sense which isn't like him." His neighbour is obviously concerned but calm which makes a good extra pair of hands to employ.
Our patient is talking to us but appears confused. He can't tell us how long he's been there. We manage to get snippets of information that make some sense. He woke with a headache and knows he didn't fall from the top of the stairs but from less than halfway up. But then the confusion and agitation hit again.
He is complaining of lower back pain but is displaying signs of a head injury as well.
This appears to be one of the those jobs where the patient is more ill on the inside than the outside tells us.
First things first, we need to move him carefully. We get the neighbour to help us straighten out his legs and move him more into the living room. A little furniture removal to start with and we get equipment passed to us through the slit made by the open door.
As we're moving him to get him positioned on the board he tries to talk to us but is still not making much sense.
There is sense of something being very wrong but I can't put my finger on it.
When we roll him a quick look and feel down his back doesn't illicit any abnormalities. He has no obvious signs of injury. His pupils are equal and reactive. His oxygen levels are good. His pulse is strong, steady and regular. His respiration's are regular and adequate. The only thing telling me this man is really ill is the fact that his behaviour is significantly different to normal.
That's not a lot to go on but sometimes its all you need.
The neighbour agrees to stay and look after his wife until their usual home care can come. A quick thanks for his help and we're ready to role. All I can do for our patient is give him oxygen and monitor for any changes.
I call in the standby and run in watching our patient like a hawk.
A quick run down of the available information to the receiving A&E staff and we're away onto the next job before you can blink. Looks like its going to be one of those days.
A few hours later and I manage to get back see the consultant who treated our patient in resus.
"Yeah, he's on his way to the Big City Neuro Unit. It was a sub-dural bleed."
"Well that explains a few things, I'm guessing we don't know what came first? The fall or the bleed?"
"Nope, probably never will. Pretty irrelevant now anyway"
"Ok, how do we do that?"
"Well, it involves climbing the fence to go through the garden"
"Ok"
The action women in me likes the sound of this! The RRU Paramedic says she'll try the front door and see if there's a way in around him.
The neighbour who met us shows me around to the correct garden fence. I can see the sliding doors and the patient's wife pottering about in the kitchen.
I clamber over the slimey fence panels and drop down into the gap between the fence and a spiky tree. The spiky tree is of course the more dominant of the two obstacles and I pick up a few scratches on the way down.
I head down the garden and knock on the sliding doors. The elderly lady turns and looks at me then turns back to the work surface without moving to open the door.
Hmmm. Interesting.
I knock again. She doesn't even turn this time. I try the door and it slides easily.
"Hello, I'm with the ambulance, we're here to see your husband."
She doesn't even look round but continues to attempt to make a cup of tea.
"Through here Lou!"
I walk through the living room and find that skinny RRU Paramedic has managed to shuffle through the gap between the patient and front door. Part of me thinks 'well done, skinny cow!' but there is a little of me that's really thinking 'my way was more fun anyhow!'
Our patient is laying half in the living room with his legs taking up the small space at the bottom of the stairs. He's over 6ft tall and appears to be all limbs. He is complaining of a sore back. There really isn't a lot of room to manoeuvre around him.
"I came round to check on them. He looks after her as she has early dementia. He hasn't been well recently. I found him like this. He isn't making much sense which isn't like him." His neighbour is obviously concerned but calm which makes a good extra pair of hands to employ.
Our patient is talking to us but appears confused. He can't tell us how long he's been there. We manage to get snippets of information that make some sense. He woke with a headache and knows he didn't fall from the top of the stairs but from less than halfway up. But then the confusion and agitation hit again.
He is complaining of lower back pain but is displaying signs of a head injury as well.
This appears to be one of the those jobs where the patient is more ill on the inside than the outside tells us.
First things first, we need to move him carefully. We get the neighbour to help us straighten out his legs and move him more into the living room. A little furniture removal to start with and we get equipment passed to us through the slit made by the open door.
As we're moving him to get him positioned on the board he tries to talk to us but is still not making much sense.
There is sense of something being very wrong but I can't put my finger on it.
When we roll him a quick look and feel down his back doesn't illicit any abnormalities. He has no obvious signs of injury. His pupils are equal and reactive. His oxygen levels are good. His pulse is strong, steady and regular. His respiration's are regular and adequate. The only thing telling me this man is really ill is the fact that his behaviour is significantly different to normal.
That's not a lot to go on but sometimes its all you need.
The neighbour agrees to stay and look after his wife until their usual home care can come. A quick thanks for his help and we're ready to role. All I can do for our patient is give him oxygen and monitor for any changes.
I call in the standby and run in watching our patient like a hawk.
A quick run down of the available information to the receiving A&E staff and we're away onto the next job before you can blink. Looks like its going to be one of those days.
A few hours later and I manage to get back see the consultant who treated our patient in resus.
"Yeah, he's on his way to the Big City Neuro Unit. It was a sub-dural bleed."
"Well that explains a few things, I'm guessing we don't know what came first? The fall or the bleed?"
"Nope, probably never will. Pretty irrelevant now anyway"