Bark worse than his bite!

Back on front line shifts again last night. Fab! Have missed them.

Can you tell? Still at the keen and eager stage!!

Got called to a young man 30's with altered level of conciousness last night. We were lucky as we were just finishing a job around the corner, so the call came at 07mins past the hour, we went mobile at 08mins and were there by 09mins past the hour. Not a bad response time I feel.

Walked into the house, having locked the truck, yes that part of town! Met by Mum and a neighbour, who explained that they had found their son dazed and confused when they returned from a shopping trip. He had shown no signs of improvement in the hour prior to them calling us and was now talking complete rubbish. Also he was a known diabetic.

At this point the neighbour sparks up "Don't worry, his bark is worse than his bite." This is often a good clue to leave, lock one's self in the cab and call the Police, several of them.

On describing our preferred plan of action, we were quite bluntly told that if the Police show, he will really kick off and that could be bad for all concerned. This little insight sort of confirmed our previous choice of action but being a bit of an eager newbie at the moment, I offered to talk to him, to assess the level of threat Also confident in the knowledge that if his LOC (Level of Conciousness) was that altered, I could probably out run him.

I stuck my head around the door of his bedroom to find the pt. lying in bed looking fast asleep, I gave him a precautionary nudge and called his name, at which point his Mum came in and started giving him a round of verbal abuse (after shutting the door behind her! Great trapped with psyco 4ft 2in Mum and 6ft 6" nutter), this woke him up smartly and off he went shouting at her in some strange 'soup dragon from the Clangers' dialect (for those old enough to appreciate quality kids telly).

I obviously left.

After a minute of shouting, the pt. came out and staggered into the other bedroom and turned the telly on, that's handy, primary survey done then, not about to die on me.

A short chat with Mum about how it is not easy to assess her nearest and dearest, whilst she is winding him up and in I go again. Got agreement for a pulse check but got something that sounded like f*** off when I asked for a blood sugar test and BP. He has every right to decline me sticking a very small needle into his finger for that test and I was not about to push it.

I did manage to get him to open his eyes enough to check the pupils and they were seriously constricted. At that point my crewmate came in (wearing his high viz jacket) and this set him off again (assumed he thought he was a Police Officer) Up he got shouting 'soup dragonese' at us and back into his room again, slamming the door. Crew mate looses high viz jacket for fear of being beaten up and calls the Police anyway.

The pupils and his manner told us everything, opiate drug use. Despite the family denials, we proceeded to try and chat with the pt. to confirm this.

We moved rooms again! The Police had turned up at this point and we briefed them on the less than happy reception they would get if the pt. saw them, so everytime he stormed from one room the another, the coppers all ran outside to hide. Did not fill me with confidence.

Finally agreed to give the pt. a drug called Narcan, which is an inhibitor for the opiate family of drugs and would reverse the symptoms. I got to draw up the drug under the supervision of the Paramedic and armed with a 5ml syringe and needle, we discussed the problem of getting close enough to inject this guy without bodily harm.

Both agreed that we should have access to an out of hours big game vet service, as darting him from outside the room with a gun was the best option available, as the NHS in their wisdom have not yet invested in this scheme, plan B would come into force and newly qualifed trainee would have to go in and stick him with something much bigger than a blood sugar needle!

Decided the best course of action would be bribary, he seemed really pissed we were there waking him up all the time and asking loads of questions, I offered a solution. Let me give you this small injection and I will piss off and leave you alone. Agreement !!

Administered the Narcan and legged it. We waited 15 mins and went back in. No real change.

"Did you give him the whole dose?" the Paramedic asked.

"Yes"

"Half in each arm?"

"Er No, jabbed him, hit the plunger and legged it"

Right then, another dose, in the other arm then. Off you go.

Successfully administered another 4 shots before he started to come around, he then jumped up, walked into the kitchen and started making a sandwich?!?!

The munchies!! A sure clinical sign of recovery. We left, finally, two hours after getting there.