Double Take

I concentrate on not looking at how close we are getting to the cars while they part to let us through. The main road into the Big City is always bumper to bumper at this time of day. But we know the road and we know how people react when they see us so we make good progress towards the call.

'RTC , One car, one injured male. Police on scene'

This is all the information we're privy to. Usually if the police are on scene we get an update if its serious so we know what to expect.

As we approach the blue lights indicate the scene, I take in the positions of the vehicles involved. Nothing looks like it has rolled or been crushed in the process of coming to an abrupt stop. It just looks like the small car has shunted into the barrier clipping a van on his way towards it.

"Hello guys whats the story?" I say breezily as I approach the policemen coming towards me. He is radiating calm so I'm not immediately concerned that I'm going to be faced with a grizzly scene.

"Hi. We have a young man who was in the car. Witness reports he swerved into his path for no apparent reason and he bumped the van while he was at it. He seems pretty out of it, the van driver reports they weren't going over 30mph. The guy had his seat belt on and was still sat in the car when we got here. The car smells heavily of cannabis and he's not talking. We did a search and found a substantial bag of weed on him. A search of the car found us a spliff on the go. Negative breath test for alcohol though"

"Right. Well shall we get him in the back of the motor and see how he's doing? Any evidence of him hitting the windscreen or being injured?"

"Like I say he's not talking. But he doesn't appear to be in pain, but I'm no expert on that"

An officer gets out of the car and takes the patient by the arm to guide him to the ambulance. He is walking like a toddler just learning to walk and has his eyes half shut.

We place him in the hot seat and ask the police officer if he'd be willing to wait by the door. The patient may be more willing to talk without them around.

"Ok, first things first, Whats your name?"

Nothing

"Ok, do you have any pain anywhere?"

Nothing

"Right. Listen, we're not the police we're only interested in making sure your ok and finding out if you need to go to hospital and it would be really helpful if you talked to us."

Nothing, he is starring ahead through slits for eyes and ignoring us. In a world of his own.

"Can we do some tests to check you out since your not willing to chat. Blood pressure? Blood sugar? Your eyes?"

He rolls up his sleeve, holds his arm out and makes an effort to hold his eyes open wider. This is good enough for me as an informed consent. At least he's with us in some way.

So I carry out the battery of tests available.

ECG is normal, oxygen Saturation are 99% on air and his blood pressure is better than mine. Blood sugar is within normal limits as is his temperature. His pupils are equal and reactive.

"Ok, I need to do a top to toe to check you out for any injuries..............it would be easier if you just told me."

He nods in agreement but doesn't talk. So I start at his head and work my way down. Palpating a little harder than usual to try and illicit a response which might indicate an injury. Nothing, not a scratch on him. No medi-alert bracelet.

"Do you want to go to hospital for a full check up?"

Nothing

"I can't take you against your will so I need to know your decision. Would you like to go to hospital?"

Nothing, not even a nod. I head out to see the police officer.

"He's not talking and everything is checking out fine. He has responded by giving permission to carry out checks so as far as I can tell he understands and is fully aware of what is going on. My problem is he isn't consenting or not consenting to go to hospital. If I take him and he claims he refused I get it in the neck. What were you guys planning to do with him?"

"He's getting lifted for driving under the influence. We'll take him for now since he's checking out medically. We'll probably take him for a full check once we've booked him."

"That sounds good to me. I'll report our findings and the situation, any problems just give us a call back. Can I take your name just to put as reference?"

I get the information and explain to the patient what is happening. I'm met with the same blank response.

15 minutes later


We settle down with a brew hoping that we'll be able to finish it. Signs are looking good as the other crew is on the bell.

As if on cue the phone shrieks into life. Cynic* rises from the chair with a sigh that contradicts his speed to answer.

"Concrete Jungle 2. Yes. Uh huh. Right. Ok. Thanks."

He puts the phone down and throws on his jacket

"You guys just do a refusal on an RTA? The guy went with the police?"
"Yeah, why?"
"He's having a seizure"

Shit.

My head starts over drive. Questioning the tests we did, his reactions, his manner. Was I wrong to assume he was with it and understanding everything? Was there a test I missed? Had he hit is head? Did I miss an injury that triggered a seizure? What would have happened if I'd taken him and not the police? Would I have noticed anything on the journey that would have changed my mind about his neurological state?

SoItIs* looks at me. "Bloody hell, you've gone pale! Don't worry. You did everything, its all documented. What were you going to do when he wouldn't talk? There is nothing you missed."

"Suppose. I'll still feel better when I know whats happened though"

A few calls later and we return to station to see Cynic* and Glasses* sat calmly with a brew. The wind up starts immediately but I'm not interested.

"Just tell me what they said about it at the hospital. I'm not in the mood. Was it something I missed?"

"No. He's epileptic. It was in his records once they found out his name"

The relief was palpable and his words instantly lifted my mood.



In some jobs if you drop the ball a quick wrist slap off the boss is probably expected, maybe a proper telling off or a disciplinary.

In our job if you drop the ball it can mean someones life. No matter how much you tell yourself that you did everything right and didn't miss anything, its scary shit when a job comes back a bites you.