I was working on an ambulance with an Emergency Care Assistant on a hot weekend in the summer. We had both just finished an ice cream that we managed to sneak in between calls and were looking out over the city from our standby viewpoint.
I was just starting to lull into a false sense of security when the screen came to life.
79 Year Old Female Difficulty in Breathing
The address of the job was an upmarket restaurant in the tourist district of the city. The ECA was driving so started the engine and we headed towards the location, blue lights flashing and sirens blaring.
We pulled up outside the restaurant and could see a long table inside with lots of balloons and people sat around. One of the waiting staff was stood outside.
“Thank you for coming so quickly, shes inside. Follow me” he said as he led us inside.
Sat at the table, leant forward and looking panicked was our patient. She was covered head to toe in a rash and I could hear a wheeze. She was having an anaphylactic reaction to something.
I asked the family what had happened whilst I started my assessment of the patient in the form of a primary survey (a 60-90 second assessment that highlights any life threatening conditions that need immediate management)
“We were having dinner for Grannys birthday. We all had a set menu that we chose for her. She was having her starter when she started to cough and feel strange. That was when we called you” A lady sat at the table answered.
“Has Granny got any allergies?” I asked.
“Shellfish” the lady answered.
“Ok, and what did she have for her starter?” I asked, quickly followed with: ” And did anyone near her have shellfish”
At this moment I could see the realisation hit her. Her facial expression changed and she went pale. I followed her gaze to the table just in front of her granny. There. Sat on the table, was a half eaten prawn cocktail.
“She ate a prawn cocktail!?” I asked, shocked.
“Yeah, we organised for us all to have the set menu as it was cheaper” the lady replied.
We quickly set about getting the patient to the ambulance. Anaphylaxis is life threatening if not treated quickly so I was preparing an injection of adrenaline to give her as well as a nebuliser. When we got on the ambulance I would give her the rest of the medication she needed through a cannula.
“Nice to see I’m going to get my Birthday shots!” The patient wheezed as I gave her the injection. She hadn’t lost her sense of humour.
Once on the ambulance I asked her why she had eaten the prawn cocktail.
“My family organised me a lovely meal, I don’t get to see them all very often and my eye sight isn’t brilliant. I wasnt sure if it was prawn so I just gave it a go. We were having such a lovely time and I didn’t want to make a fuss. I’ve certainly done that now!”
With that there was a knock on the side of the ambulance. The lady from earlier was waiting.
“How are you doing Granny?” She asked.
“Would you like the good news or the bad news?” The patient replied, the nebuliser hiss making her sound a lot like Darth Vader.
“Let’s start with the bad news” the lady replied.
“Thanks to this young man your attempts at getting your inheritance early have been thwarted”
The patient replied, smiling.
“The good news” she continued, “the bill will be cheaper”.