Blackeye! Sorry

Call was to a young diabetic patient that was non responsive.

It was 2am and the traffic was non existent so the journey time was short. I pulled up outside the block of council flats and made a mental note to ensure that I locked the Ambulance whilst we were at the address. It looked the kind of place where there would be a local market stall selling medical equipment the following day if I did not.

I didn't bother to turn the vehicle around for ease of egress as with this type of patient the treatment at home is usually exactly what the patient having a hypo needs and they often do not want to go to hospital. This would prove not to be the case! Me and my assumptions!!

On entering the flat we found a young woman on the floor surrounded by a group of her mates, all stating that she was a known diabetic and they had been trying to force feed her sugary drinks.

A quick check of the BM levels revealed that her blood sugar levels were fine, so it's not a diabetic coma. Given the state of the flat and assurances that she had only smoked a little weed! we assumed drugs and started our treatment protocol based on that.

The Paramedic I was with gained IV access for the Narcan drug to reverse any opiate effects, whilst I secured her airway. Now on checking for a response, I tried the never fails sternal rub with the full force..........nothing! She must be out or have a seriously high pain threshold.

Next thing was to ensure the airway was maintained. In comes the Nasal Airway. Now, unless you are unconscious, you don't really want to have one of these put in. They are measured against the size of your little finger. So I duly opened the airway bag and pulled out a medium and large size.

The problem seemed to stem from the fact that this girl had very chubby fingers combined with a small nose. Despite a fair bit of KY and a lot of twisting and pushing the number 7 would not go in. It did however wake her up slightly for a limited period, now starts the doubt as to her true consciousness levels. Needing the skill signed off anyway, I aired on the side of caution and went for a No6. Given the pathfinder route ploughed through her nasal cavities by me using the No7 initially, this slightly smaller one went in without fuss.

We carted her down the stairs and off to A&E where they managed to finally wake her up. Appeared she was faking it and did seem to have some serious pain threshold!!

She was also sporting a rapidly developing black eye on the same side the nasal airway was inserted, a good demonstration of the close relationship that exist between the sinuses and the eyes.

Ooops Sorry!