We had been on a rest-break, but Control had interrupted our break in the last fifteen minutes (which is fine by me as we get financial compensation, and I'd rather not be named as 'Medic on tea-break while my child died' in The Sun)

The call was given as a 'elderly woman collapsed behind locked doors, possibly deceased'.

We got round there as quickly as possible (after taking a detour due to a council rubbish truck sitting in the middle of the road, obviously picking up some cardboard boxes was much more important than whatever we were going to). Our FRU was already there, as was the patient's nephew.

The front door was shut and our FRU pilot was nowhere to be seen. WE knocked on the door and it opened a crack. The familiar face of our FRU appeared in the gap.

"She's laying in front of the door - I climbed in from the neighbour's back garden".

We made our way through the neighbour's house and stepped over the two foot fence that separated their gardens.

The first thing that I noticed was that the house was spotless, our patient was originally in good health.

Then I saw her laying in the corridor.

She had been there for probably twenty-four hours, there was no carpet so she had been collapsed onto tiles overnight. The entire right side of her body was a huge bruise.

As you get older your skin becomes less resistant to damage, so you bruise easily, tear the skin easily and can get pressure wounds. The weight of a body can cause the flow of blood to become interrupted and unless you move (which is what people normally do) then the skin and underlying tissue can die.

You end up with wounds like this (Warning, you may not want to see this).

The right side of her body was likely going to become like the above picture.

It became obvious that she had suffered a stroke - she wasn't moving the right side of her body. Her left hand kept snaking out and grabbing at us and you could see the fear in her eyes.

She was also as cold as a block of ice. Being unable to eat or move, stuck in the draft from her front door in an unheated house meant that she was suffering from one of the worse cases of hypothermia I'd ever seen.

Her core body temperature was 28 C. (82.4 F)

We carefully removed her to hospital - any sort of physical shock at this temperature can cause the heart to stop. All we could do was to make her as comfortable as possible, wrap her in blankets, hold her hand and talk to her.

With a hypothermia this severe the hospital can rinse warm fluid around your internal organs after making a surgical hole in the abdomen - in this case though the risks to a patient this frail meant that they stuck to the safer warming blankets and warmed fluid into the veins.

It's unlikely that she will survive this episode. I hope that the stroke affected her mind, and that she wasn't aware of what was happening to her. I can't imagine what it must have been like, to lay there for so long, unable to move, gradually getting colder, not knowing if help was ever going to come.

I hope that it affected her mind, but with the look in her eyes I think that she knew exactly what was happening.

It's not a good way to end 80+ years on this planet.

---

It seems that all I'm writing about at the moment is sad things - hopefully I'll have some happier stories to tell in the near future. At least I have my Mac laptop back and can work on answering some emails.

Any doctors in the house?

If so could you answer me this. Why would a large brain bleed (probably an AVM) cause ischaemic ST changes in the 12 lead ECG?

Just curious.

(For everyone else, a proper post after I wake up sometime this afternoon...)