“Delirious?”
“That’s what it says.”
“Fuck off, eh?”
“Well…aye.”
Delirious is a word our callers drum out frequently. Just like “Going into shock”.
Unless you’ve suffered some catastrophic displacement of vascular fluid, you’re not going into shock.
You’ve had a fright.
It is not the same thing.
Now wheesht.
Similary, you’re not delirious until you’re crashing around the house not knowing who, what or where you are. Being a wee bit maudlin cos you’ve a temperature is not delirium. Forgetting where you put your cocodamol is not delirium. Stop assigning scary words to your family’s infirmities; you are not helping.
The stairs up to the flat are wide granite. Steep and curling around the pit, around the mountain bikes and buggies, wet lunchtime light down through the pitched glass roof climbs as we do, puffing and panting. Buy a bungalow and never need an ambulance…
His wife is standing at the door, smiling. We step past her into the flat. It’s clean and tidy, just off tasteful with its comedy doormat and cheap ornaments.
“It’s Charlie, my husband…he’s not been well all week…but not like this. The GP reckons it’s a chest infection, he’s got these.”
She shoves a box of amoxicillin at me like a pusher through school railings.
“But just an hour ago he started up and I can’t get him to calm down.”
We’re joined by an RRU paramedic and we all troop into the lounge, my world-weary “So you’ve seen your GP and STILL phoned an ambulance” face behind my glasses.
He’s curled up on the floor, his forehead against the laminate, both hands curled around his temples. He flavours every exhalation with a gentle whimper, but doesn’t respond when I crouch next to him and ask his name.
Nor when I ask him to look up.
Nor when, prompted by his wife, I call his name a little louder.
I lay a hand on his shoulder and he scrambles from my touch, coltish legs collapsing under him, slipping and fumbling away from me. He manages a spastic step before it all goes wrong and he falls forward.
“Whoa…whoa!”
We reach out to catch him, but are too slow. He does nothing to arrest his fall, smashing his cheek and chin against the floor, his hands flapping uselessly by his side.
The pain is clear, he cries out, scared and hurt and crawls into the corner of the room, oblivious to obstacles in his way. The side table is upturned, a mug of cold tea spills across the floor.
One of my colleagues sits beside him.
“Charlie?…
The patient ignores him.
The paramedic reaches out for the patient’s shoulder and gives it a squeeze, the man screams and tries to crawl through the sofa.
We check his blood sugar, 6.9. No sign of head injury, no acrid stench of septic urine.
There has to be a reason for him to be so bonkers.
“Does your husband take any drugs?”
She’s shocked, appalled at the concept.
“He’s not like that.”
“GHB?” the paramedic asks.
“Looks like it,” I answer “or eccys.” The man looks for all the world like patients we pick up in nightclubs, howling and scrambling around the room, oblivious to all. We tend to get the cops to cuff them, wrap them in leg restraints and transport them to hospital where the doctors pump them full of benzoes to reduce their mania. Ecstasy overdoses
tend to thrash in a predictable manner, bucking back and forth. They can be carried under a line of arms like a rolled carpet.
This guy won’t work like this, he’s apparently unconscious of our presence, but sufficiently lucid to try and escape from any stimulus. We can’t carry him down three flights of tenement stairs, he’ll wriggle from our arms and smash his face on the floor.
The mental image of his thrashing body pin-wheeling down the stairs is only just less alarming than the P45 that would follow in my dookit.
We need him sedated, flat and floppy would be awesome, but we’ll settle for compliant and haulable. In these cases, we can often get approval from a doctor at the hospital to operate outside our normal protocols. We usually only give diazepam to patients who are fitting. This guy doesn’t fit, in either sense of the word.
We’ll need some IV access first, though.
The three of us sneak up on the patient and pounce, pinning him to the deck while one of the paramedics rolls up his sleeve and tries to slide the sharp into the bucking man’s vein. He throws us off, the needle flying wildly into the air as we fall off him.
“Sharp! Sharp!” a voice shouts and the three green suits freeze, scanning the floor for the cannula. It’s clean, sterile, hasn’t had anyone’s blood in it; but the stain of instincts don’t wash out easy. A needle-stick ruins your day, especially when it’s swinging through the air, threatening to land in your face, or eyes.
We secure the sharp, back away from the patient; he’s busily trying to burrow through the floor.
The paramedic looks at myself and my colleague.
“Van?”
“Can’t see another way of doing it. We agreed?”
I nod, step out into the corridor, make a phonecall.
We don’t call Medic One out often, we think at length before hauling two doctors and two nurses out of hospital to come to the scene. It leaves the department chronically understaffed, drives the waiting room duration through the roof and puts another emergency vehicle on the road. It also pulls an officer from our station as they turn out to drive the motor.
But when you need ‘em…
They’re with us in twenty minutes, marching up the stairs with a huge bag each, dressed in their one-piece Cordura outfits, bright red with hi-vis stripes. The clothes never quite fit the Medic One teams properly, stiffly beefing up their shoulders, widening their legs. When they leap from the vehicle at a major RTA they look the business, an approaching team of super-heroes that make us emergency workers breathe a sigh of relief.
In a suburban living room, they just look a little over-dressed.
They are, however, a whole extra four people and even the most rabidly psychotic patient will struggle to free himself of seven people sitting on him. He’s cannulated in seconds and sedatives are pushed in. Minutes later he’s drowsy, floppy and strapped into our carry chair.
We crash him into resus, they take blood and send it to the labs.
Back come the results.
Meningitis.
No rash, no stiffness, no photophobia.
Just utterly, totally loopy.
Don’t see THAT one on the posters, do you?
