Sunday, 5 August 2012

The first emergency

My first emergency as a qualified doctor did not come, as one might suspect, in the hospital, but instead on the street, at night, in a different city.

It was a horrible "oh god I think I need to stop... don't I? should I?" moment, not quite sure what to do but thinking I probably should do something. I walked past as if to scout out the situation, and a bystander was on the phone, clearly to an ambulance. When I heard them say "... seizure..." my heart sank as I realised it wasn't just some drunken japes and I would need to get involved.

I was relieved to realise I recognised one of the bystanders, the person on the phone - a medical student who I'd got to know a few months ago, when they were in third year. This meant that hopefully anything immediately lifesaving that needed to be done, such as opening the airway, would have already been done. That's a nice emergency to arrive at.

Though it was all under control, I stayed around, partly because once you've arrived you can't really leave, and partly because I thought the others might want me to stick around. Much as I was relieved to see medical students there, I imagine they were considerably more relieved to see me - if I was a third year medical student attending an emergency, I would have breathed a huge sigh of relief if a medical student or junior doctor two years my senior turned up. So I guess that was a nice role to play, even if I didn't do a great deal medically, except stop the patient from rolling over, check every now and then that he was still responsive (ish) and talk to his relative.

The patient and relative had recently left hospital, and I can't help but wonder if the fact they were still wearing hospital pyjama trousers meant they had self-discharged... I think it's likely, which made me a bit more clued up to the situation.

For some reason the police arrived before the ambulance, even though the students called the ambulance, (maybe they send police to anything that might be alcohol related?). Another thing I don't understand is that the ambulance people on the phone said to roll the patient onto his left. He was nicely in the recovery position on his right hand side, and since rolling him onto his left would have involved rolling him into the road, they left him as he was, but I have no idea why the left would be better.

Anyway, the ambulance person arrived and was happy for us to go, so we left, after I'd had a bit of a catch-up with the medical student I knew, and I hope I made clear to them both that they'd done a good job. I realised later that I didn't tell the ambulance person that I'm a doctor, and maybe, since they were on their own, they might have wanted me to stick around and help had they known that, but never mind - they're experienced at working on their own I'm sure.

Despite the anxiety whilst walking up the situation, I'm quite relieved by the quiet, mild confidence I felt whilst looking after the patient - hopefully that will stay with me when something more traumatic happens in the hospital.

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