A few months ago I walked into my first St John Ambulance evening in Cardiff. Last week I was a member of a 2-man St John crew on an ambulance helping out the Ambulance service on a 12-hour shift on New Year’s Eve. It’s been a very fast and steep learning curve to get here and I loved working the shift.

A number of cases stand out in my mind from a number of the shifts, some of which will make interesting blog posts, some of which will never make my blog for various reasons.

One in particlar sticks out. We’re called to attend a 999 call which has been downgraded to a Green call – an incident that requires a response without blue lights. We turn up and have a chat. The gentleman is in his 40s and has parasthesia from the waist down. He speaks very little English. We ascertain through pidgeon English and gestures that he’s urinating blood.

I’m not attending for this one, but something strikes me as odd. His feet are bandaged neatly – apparently he’s burned them and has been to hospital for his feet already. I look around the room and spot a box of tablets on the windowsill with a hospital pharmacy label. I point to them and he nods. Antibiotics. Paracetamol. There’s a letter with it and again he nods and I read.

His feet are injured from a scald and he spent a few days in hospital. Whilst he was there they noticed the complaint of haematuria and investigated, finding nothing and eventually referring him to a specialist in a nearby hospital. The notes go into more detail – his condition and pain seems unchanged from the time of admission. He’s also seeking asylum in this country but has had his application refused. He has multiple presentations to multiple services over the past 8 months.

On the other hand, he’s complaining of pain and does have some blood in his urine. His obs are fine and he seems comfortable unless we ask him about the pain, whereupon his face screws up. We have a quick chat amongst ourselves and we decide to try and see if we can get the out of hours GP to have a look, and control is informed. We explain to the chap who indicates that he’s happy with this – he doesn’t really want to go to A&E, it’ll be a several hour wait and he can’t afford the taxi journey home.

We hear a knock at the door and in walks a paramedic. We have a brief look between us before enquiring why he’s here. Control sent him. A handover is made and the paramedic asks the chap about his pain, then spends the next 10 minutes or so convincing him he needs to go to A&E, much to our confusion. We look confused but are happy to take him – obviously the paramedic is the senior clinician on scene here.

So we walk the chap out to the truck and drive him up to A&E. The charge nurse gave us a shitty look and we looked suitably apologetic as she tutted over the patient for a few minutes. She comes over to us saying that the best full-face helmet are not good. We explain what happened.

“Right, I see. Well, being here serves neither his best interests nor ours. I’m referring him to the out of hours GP.”

We left quietly.

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