I came across a patient yesterday who had a really good idea, it was an idea that helped us, helped her and helped the hospital.

We had been looking for a job to last us until the end of our shift and had thought we had got it with a drunk in the street. It would have been fine if he'd let us take him to hospital, but unfortunately he woke up and wandered off home. So we were stuck with forty minutes until the end of the shift. We would have to hope for a nice quick and easy job - something like a two year old with a head injury.

(Two year olds with head injuries are easy jobs because the injury isn't severe, it's normally stopped bleeding, we don't have to do any serious observation taking and the mum or dad looks after the child while we essentially act like a taxi).

Of course, what we wish for is often very different to reality.

From our 'patch' we were sent to a train station in the middle of London. Miles away.

At least it was Sunday, so the traffic wouldn't be so bad.

Our patient was having an asthma attack, the first responder on the scene was asking for an ambulance as quickly as possible, so it was obviously something a bit serious.

I don't like people having asthma attacks - they can tend to go wrong very quickly. Also the patient is having a very hard time of it and it's never nice to see that. I heard a description of an asthma attack once as, "trying to run a marathon while breathing through a drinking straw", and that description has stuck with me for years.

So we got there as quickly as we could through unfamiliar streets to find *two* motorcycle responders there. They had been waiting a long twenty minutes for us.

Our patient was still receiving the nebuliser treatment that the two motorcycle responders had started. They told me that the patient's chest had nearly been silent when they had arrived. This is a sign of a very serious attack.

Our patient had obviously been in this situation before as she produced a neatly typed sheet of paper with all her details, her allergies, here previous medical history and the type of treatment options that worked best for her. It told me that she was a 'brittle asthmatic', which always makes me bluelight these patients to hospital when they are having an asthma attack. If you are having an asthma attack it can be difficult to talk - so all our patient had to do was hand over the sheet of paper to whoever was looking after her.

It was a good thing that she had that bit of paper because every time she removed the nebuliser mask from her face to talk her oxygen saturations (a measure of how well she is breathing) dropped rather quickly.

So we loaded her up and sped to the nearest hospital.

I wish that all our patients had such a bit of paper. Where I work there is often a language barrier, even heavy accents can make my life difficult, so a little sheet like that would make my life so much easier. Also I find myself going to patients who don't know what is wrong with them. All they know is that they take a 'little white pill in the morning and two brown pills in the evening". Of course, this is more a failing of the Primary healthcare provider in not making sure the patient is kept informed about their health.

More importantly imagine going to a 'collapse in the street' only to see a bit of paper stuck to their jacket saying, "I'm OK - I'm just drunk".

As a question to you all, utterly unrelated to this blogpost. How can I be tired after thirteen hours of sleep?