I was reading a post over at Medic999 where we got chatting about Rapid Response Vehicles (RRV) and staffing levels.  A few years ago it didn’t matter whether you were an Ambulance Technician or a Paramedic you could work on a response car.

I was on an RRV in an area that doesn’t have its own hospital.  The hospitals were about 30 miles in either direction and I was the only resource to cover this area.  I remember getting a job “43 year old male, fitting” it was the early hours of the morning and also at a home address so it was likely that this was going to be genuine.  On arrival at the address a lady (who I later found to be the mans wife) met me at the door and rushed me up the stairs.  As I didn’t know what was causing the fit I took everything up with me.

I find a man in his bed shaking uncontrollably, I quickly give him oxygen whilst finding out what the history is.  It appears that this has never happened before and he is normally fit and well.  He hasn’t had any trauma so is unlikely to be  a head injury, it could be a brain tumour, epilepsy or diabetes to name a few…

..its not nice seeing someone convulse no matter their age or reason for it, you know that the patient isn’t getting the full amount of oxygen that they need, and you need to do something about it, and quick!

I quickly check his Blood Glucose levels and all was fine, but thankfully he seems to be coming out of his fit!  What a sigh of relief!  It normally takes a little while for people to start to come round and gain their senses, but before he can he starts fitting again.  One fit is bad, but multiple fits are Very Bad, the patient is in Status Epilepticus! I get straight on the phone, this guy needs to be in hospital now and needs diazapam to get him out of his fit – unfortunately, as a technician, I can only give diazapam to a patient if it has been prescribed to them and only via a rectal route despite me having loads of it in my drugs bag.  As the patient has not had a fit before he has not been prescribed any, so I have very little choice other than to sit and watch this patient fit, try to keep the oxygen mask on him and make sure he doesn’t hurt himself anymore.

Some 30 mins later the crew thankfully arrives and whisks the patient of to A&E where he makes a full recovery.

This was probably one of the most frustrating times for me in the last 5 years – I have a patient in front of me that needs drugs, I have the drugs and the knowledge to administer them, but I can’t….

…What would you do?