Warning: Declaration of googlechrome_walker::start_el(&$output, $item, $depth, $args) should be compatible with Walker_Nav_Menu::start_el(&$output, $item, $depth = 0, $args = Array, $id = 0) in /homepages/26/d132669229/htdocs/blog-it/aspie/wp-content/themes/gchrome/functions.php on line 12
Stop » Blogging AS an Aspie
msgbartop
Matt has Asperger’s Syndrome (AS), an Autism Spectrum Disorder (ASD) and is writing this blog so that people can gain more of an insight into how people with the condition process thoughts, feel emotions, react to situations and generally handle life.
msgbarbottom

29 Aug 08 Stop

All names changed to protect patient confidentiality and to anonymise the incident. Posted to this blog to help others understand what went through my mind.

“Come on Steph, not far now.” “Steph, stay with me girl, please, you’ll be ok soon enough.” “Steph, are you with me?” “Steph?” “STOP!” All eyes turned to me as the carry chair was brought to an abrupt halt; “She’s unconscious!” is all I needed to say to confirm everybody’s initial thoughts.

I dropped the oxygen bottle and bent down to assist, Ryan told the police officers to hold then move the carry chair on command as he and Becca, our nurse, went to grab Steph, whose airway needed protection.

Then everything happened at once, and of the medics, I was the only one with ‘nothing to do’. Becca had gone to Steph’s head to open her airway and change the masks; Ryan was waiting for her ‘go’ for the compressions. A policewoman was calling an ambulance – “Cancel that call” – last thing I needed was a 999 ambulance turning up without going via our controller first. A policeman was calling for CCTV cover on us – although it would have been easier to get Control to lean out of the window; it was right above us!

A second policeman was about to hit his radio for an ambulance – “Don’t even think about it. I need to run this via medic control.” Looking back, there were many better ways to say what I did to the police, but at the time, my mind was focussed on finding out what we needed for Steph, and getting it back to our controller. I simply didn’t engage the part of my brain that deals with the social niceties and etiquette. The shock of the incident had shut it down, to allow the protocols to take over – rigidly take over.

Hang on, Becca and Ryan had our team radios; how do I get backup? “Ryan, what do you need? Para backup? Stretcher?” “Yes, yes, now!” “Ambulance – no?” “No.” “Becca, want me to ring medic control from my mobile?” I asked because I had set one of my speed dials to be medic control in case of radio failure, and neither Becca nor Ryan had a free hand to work a radio.

I can’t remember the exact call, I blurted something like, “This is Matt with medics 18 and 24 with a patient outside of event control. I need a paramedic backup and a stretcher immediately please.” I was asked to repeat it, because I was talking too fast, and I also remember hearing the controller say “Stand-by, on phone to crew.” I was still kneeling down, and all of the police were providing a human cordon from the crowds to give us working space. I held the paperwork in my hand, knowing I should be writing something, but I think I froze due to the shock of having a patient collapse on me for the first time.

I don’t know how long passed, but it must have been a short time, but Steve turned up. I asked him, “Want me to keep the line to control?” He answered, “This phone? I hung up 2 minutes ago.” I suddenly realised that Steve was our controller for the weekend. I think Steve was watching for the backup crew to arrive. I suddenly remembered that there was a patient in front of me, who was now half-sitting, leaning back on Becca’s knee. She was drifting in-and-out of consciousness, and I put plenty of effort into trying to keep her with us.

“Steph, come on, it’s Matt, stay awake for me, girl.” “Steph, you’re doing really well, keep focussing on your breathing for me.” “Come on, Steph, don’t go to sleep on me, I need you to really try and keep your eyes open.” “Steph, come on, look at me, that’s a good girl.” I basically kept repeating those lines, and kept her looking at my eyes, I would at least then know if she was with us. My entire attention was with Steph, I didn’t even know what Ryan or Becca was doing at this point.

The backup crew arrived, Emily and Tom. I stood up to give them room, and gave as much handover as possible to Emily, aiming to be as concise as I could. As I finished, I noticed Steph’s friends, who I hadn’t spoken to since her collapse, were in tears at what they could see. Although I knew I had been quite harsh with them in getting Steph’s details from them, I think I may have been the only medic available to talk to them. I held my hand out; she instantly grabbed it and looked to me for reassurance. “She’s going to be ok, she’s came round, and we’re just moving her up the road to our base where we can look after her easier.”

As she was loaded onto the stretcher, her friend asked if she could accompany her, “Of course you can, just give me a moment, I’ll stick with you.” I bent down to gather all of the kit that wasn’t with Steph, and went back to her friend, who again grabbed my (now rather full) hand. “Can I hold her hand?” “Yes, you can, but just give us 2 minutes to get her into our treatment area and off the streets.” “Thanks.”

As we arrived back at base, I handed over the paperwork (both sets) and walked round the back. Emily asked if I could get the team back out to post, as the medics were low on cover. “Hang on, we need a good 5.” As I walked into our refs area, I noticed Becca was crying – and it was seeing her that brought my social skills back into play – “Are you ok?” “I’ll be fine, just give me a minute.” “Ok, would you like a cuppa or anything?” “No.” I left her, because I didn’t know her personally, and there was plenty of crew on base that did.

I was also in shock myself. Steph was the first patient I was treating to collapse on me. But, it wasn’t that which was bothering me. I felt a massive amount of guilt, sadness, and uselessness – just 30 minutes before the collapse, we had come across Steph who was having a minor incident, and we offered our help. She refused, and it took me ages to get her to sign our refusal form. I tried hard, but I didn’t get any of her details, medical or otherwise. Her friends were just as unhelpful, and I know I was quite persistent with them. I documented the refusal to give details, and made as many observations as I could, following Becca’s advice, “Write as much as you see, in case she self-presents to base later tonight.”

I wish she had presented to base. I wish I had been more persuasive. I felt really bad, because in the 30 minutes or so we’d been away from her, she was getting worse. We all knew that the reason for the collapse was directly related to what we had predicted when she refused treatment. There is only so much we can do as medics, but that statement is of little consolation. 6 days on, I still feel bad about seeing what Steph went through, and for not trying to do more when she was refusing.

For information, Steph did recover from the reason she collapsed.
Please see the next post – The reflection – for my regrets in my personal dealing with this incident.

Reader's Comments

  1.    

    Sorry to be blunt here Matt BUT you cant force somebody treatment. I can see why your upset/flustered but personally I’d be pissed off. She caused you all a lot of trouble and stress that could have been avoided if only she’d listened to the professionals (which is what you are after all).

    From reading that you could NOT have done any more.

    Remember we ALL learn on the job and next time you will be better (if you even can be!) and each time after that you will get a bit better to the point where you walk away and think “oh wow, i didnt really need to think of my social skill stuff there!”

    Reply to this comment
  2.    

    I know. I wasn’t pissed off, because I care way too much for my own good. I was upset because of the detoriation I saw in the time I wasn’t with her; and because of the look on her face when we were actually treating her.

    I’m sure some of my colleagues were rather annoyed with her, but I wasn’t.

    I know I couldn’t have done anymore, but that doesn’t really change how people feel, does it?

    I have used Pride as a massive learning experience, and when writing my notes to submit for the debrief, I did a lot of personal reflection, and I think I have learned a lot both in terms of first aid and social skills.

    Thanks for your advice, it’s really helpful!

    Reply to this comment

Leave a Comment