All by myself (aka. Here I go again… PtII).

No one has invented a word yet for the feelings and emotions you experience after you have just explained to someone that the last time they spoke to their loved one was, actually, suddenly, very unexpectedly, the last time they would ever speak to them alive.

I had been single crewed since the start of my night shift, not very busy as it was midweek and in the middle of the month. It was also summertime so lots of people were on holiday, or feeling the pinch having just been on holiday. I was in the mess room alone, the volunteers had finished and gone home. The messroom radio was playing music and I was relaxing. My handheld radio screeched and vibrated on my belt and brought me back to earth rapidly! The call was a code purple – “life status questionable”. On my way to the Ambulance the radio rang and the dispatcher apologised for sending me alone, but there was no one available to back me up. The city was obviously busier than the rural areas. The dispatcher was a favourite of mine, so I knew they were struggling and I was the last resort. I arrived at the scene and rushed into the residence with all my equipment. I was met by the patient’s distraught partner.

An elderly couple, they had been on holiday recently, as both were tanned. The patient had then been away for work and had returned late the night before. A young grandchild had stayed over and was sleeping in bed with the partner so the patient had slept on the sofa in the living room. When the partner woke, they had gone through to the living room and attempted to wake the patient. As soon as I began to examine the patient it became very apparent they had been dead for some time. Rigor mortis had set in and they were cold. There were other indicators too. This was when I had to explain it to the partner.

I sat them down and explained as sympathetically as I could that there was nothing I could do, their loved one was gone, and I was very sorry for their loss. “There must be something you can do?!”. I shook my head an suggested we put the kettle on and that I should call a relative or friend. This was partially to take the partner out of the room the patient was in. I called the couples’ oldest child (who was in their 50s) and, thankfully, the phone was answered by their partner. I explained the situation and they said they would be at the scene shortly.

I had to do some official paperwork and, because it was still an unexplained death, had to contact Control to arrange for the police to attend. I couldn’t leave until the police had arrived. 5 minutes later the peace was shattered! The patient’s oldest child arrived and went into hysterics – “They’re not dead! They’re just sleeping! Look!”. Trying to explain to a relative that their loved one is currently a crime scene is a very definite never. Trying to stop said relative from shaking the deceased patient is difficult, physically and emotionally. Thankfully their partner intervened.

I felt extremely lonely, the bearer of bad tidings, the outsider in a moment of family grief. I took the words of a close friend seriously at that moment – “a wise man once said….nothing”. The police finally arrived and I handed over to them, gave them my paperwork and left. There was no point talking to the deceased patient’s partner, there was nothing I could do or say that would help. Their child’s partner nodded at me on my way out, a “thank you”, accompanied by a painful smile. It made me feel slightly better.

A different shift, still single crewed, night shift again. The radio came to life as I drank another cup of coffee. “Pt fallen down stairs, ?#L arm”(query fractured left arm). It sounded simple enough. Then the radio rang – “5638. Apologies for sending you to this job single crewed, we are aware of protocols”….uh oh… “Pt is a known alcoholic and is intoxicated, backup will be en route as soon as I have someone available”. Single crewed personnel should not be sent to alcohol related jobs, a rule frequently broken by desperate dispatchers.

I arrived to find a very drunk patient screaming in pain, their partner at breaking point, not knowing what to do anymore. The reason for the screaming became apparent very quickly – the patient was in severe pain, having fractured their humerus (the thick bone between the shoulder and elbow) and was waving their arm around in a grotesque fashion! Crepitis was a word I’d learned during training – when the two ends of a fractured bone rub together. I’d felt it before in various patients’ bones, that night I heard it from the other side of the room!

The involvement of large quantities of alcohol negated my ability to use most of the analgesia we carried, so I called control to get a second opinion from the duty Paramedic Advisor (more to have a backup should anything go wrong). We agreed that entonox, “gas and air”, would be acceptable. This might have worked, had the patient been more sober and willing.

I tried to explain the benefit to the patient, their weary partner tried too. More screaming and screeching. Eventually I managed to get some form of sling attached to the patient and secured the elbow to the patient’s body, a slight immobilisation of the arm. Backup finally arrived. I explained the situation and they took the patient away. I’m not sure who was most relieved, myself or the patient’s partner. I met the crew that had backed me up at a few more jobs that night, and at each job they commented on how they’d struggled with the patients all the way to hospital, and how I must have struggled on my own.

Thankfully, I’m reliably informed, single crewed shifts are less common now. Although I found it was a very good way to learn fast.


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