I accept that the police do not have in depth medical training is arrest (and a breath test) always the priority?
tinyurl.com/7e3s8ua (Daily Mail)
|
Of course it isn't.
They obviously weren't suspicious the lady was unwell.
(Or were idiots).
I saw a fair number of injured DDs in casualty and the Police always kept out of the way until the medics were happy that the patients could be approached.
I've also seen a few people appear to be drunk and then either show more obvious signs of brain injury/stroke, or occasionally hypoglycaemia (low blood sugar) which can also mimic drunkeness/severe stroke.
|
>>I saw a fair number of injured DDs in casualty and the Police always kept out of the way until the medics were happy that the patients could be approached.>>
That was after medical intervention.
I prefer the idiot theory. :-)
Last edited by: Old Navy on Fri 13 Jan 12 at 21:25
|
Two examples that happened when I was driving with my daughter, a doctor, as a passenger.
We came across a scene where a medical emergency had just occurred and she rushed from the car to assist.
!. A couple of years ago where the police were thankful she had directed and organised treatment for some time prior to the paramedics arriving.( sadly the guy survived less than 24 hours)
2. 2/3 weeks ago with a person on the road in the middle of a pedestrian crossing and CPR being applied and paramedics also not yet in attendance. (One vehicle had been rear ended). She promptly returned saying her attendance was not required!. She was rather taken aback saying that as her experience knows CPR takes quite a bit of effort and why turn away skilled help. Most odd. Paramedics did attend prior to us leaving the scene.
I had an unhappy daughter that day.
On all the other many occasions she has been on hand early to assist has she ever been told "not wanted".
|
It was 03:30 and even if she'd not touched a drop might there have been a smell of drink - spillage? Don't drunks have facial droops? Stuff happens. Would the outcome have been different if the Coppers had been paramedics who recognised the problem.
I'm sorry but the breathy outrage in every Mail story, particularly those about public services, gets wearing. Two stories today:
Young woman's fairly vague symptoms turn out, against the odds, to be cervical cancer.
Albeit the odds are against it causing a problem blood transfusion nurses are instructed not to touch skin post application of a sterile wipe.
Both are of course presented as scandalous failures.
Last edited by: VxFan on Sat 14 Jan 12 at 00:17
|
Perhaps 5% of what the redtops say about medical matters is worthy of note.
You'll learn faaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaar more reading wikipedia / NHS websites if you are that interested.
|
www.walesonline.co.uk/news/wales-news/2012/01/13/stroke-victim-julie-hawkins-died-after-drink-drive-arrest-error-91466-30115090/
A slightly more detailed version of events. The ambulance was sent to the wrong place, that didn't help. An event that didn't cover anyone in glory. Really bad call though as ever hindsight is an exact science
|
>> I'm sorry but the breathy outrage in every Mail story, >>
I tend to agree but the style of reporting does not alter the facts.
The outcome was probably unavoidable, but it smells a bit of assumptions even after a suggestion from someone that it may have been a stroke. The police may have to be assertive in certain situations but should take all options into account. I accept that I was not there and they may have had good reason for their response to the incident.
|
While I'm not defending the police (they're big enough to stand on own two feet) the symptoms of a stroke can look very like drunkenness. True there is usually a measure of sided paralysis but a facial droop can be caused by other things, and could have been pre-existing in this case.
I learnt about strokes when I did the first aid at work training.
|
We had quite comprehensive first aid and life saving instructions at police college in the mid 60s.
It included recognising symptons of stroke and epilepsy as well as CPR...mouth to mouth then.
Working on foot patrol in a busy major city centre meant coming across cases on a regular basis.
I've restrained a couple of epileptics, sat on the pavement in the rain with passers by, gently holding their limbs so they didn't damage themselves. No chance of confusing them with drunks. Strokes may be somewhat less easy in some circumstances .
Maybe first aid training is not as 'in depth' nowadays due to financial restraints and the fact that paramedics can be called upon, unlike the 60s when ambulance men were first aid trained drivers whose main job was to ' scoop and run '.
Ted
|
A member of the public suggested to the coppers it may be a stroke.
Even with this hint, Pc Knacker went ahead with his drink driving arrest.
Typical "we know best" attitude.
|
A former / late neighbour was returning by train from visiting hi son in Cambridge.
He made it as far as the local station (1 mile away). He was fond of a beer and undoubtedly would have had a can or two on the train up - he suffered a stroke on the platform - he lay for quite sometime on the platform having been "diagnosed" as being drunk.
Eventually an ambulance was called and he made a 90% recovery.
He had a few medical issues prior and post stroke - open heart surgery, partial blindness, stroke.............6 months after the stroke we found him on the roof of his 2 storey house trying to adjust the aerial during a windy spell...........we talked him down, he'd had a tinny or two!
|
Iffy,
If you read the second report you'll see that there is a dispute as to when the motorist told the Police Officers about his suspicion that's not mentioned in the Mail report.
|
...If you read the second report you'll see that there is a dispute as to when the motorist told the Police Officers about his suspicion that's not mentioned in the Mail report...
There would be, wouldn't there?
But it's barely relevant.
The police, as they often do, decided in advance what happened and then set out to prove it.
A middle-aged woman, no smell of drink, and her claim not to have taken any, should at the very least have raised a question in the officers' minds that it might not have been a straightforward drunk driver crash.
|
>> A middle-aged woman, no smell of drink, and her claim not to have taken any,
>> should at the very least have raised a question in the officers' minds that it
>> might not have been a straightforward drunk driver crash.
>>
You don't always smell drink.
I wonder if it will have been the officers thinking she was faking it, sadly wrong in this case.
There are many, many occasions when drink drivers try to fake medical conditions to get to get out of being caught. The odd few have warning signals on the Police National Computer about it.
I have seen people go off in an ambulance, when both the police and paramedics (or in some cases police doctor) all think they're faking it, but to make sure send them off to A&E anyway.
It's an unpleasant version of 'cry wolf' and highlights the difficulties of medically unaware people interacting with people who have a medical condition in circumstances when many try it on.
...and as RP has said........hindsight.......
|
>> The police, as they often do, decided in advance what happened and then set out
>> to prove it.
Developing a theory and not stopping to reconsider, even when that are big clues, is hardly unique to police is it?
Plenty air crashes happened because both pilots have interpreted something wrongly - Kegworth for starters. Press/broadcast too - didn't That's Life run a campaign against a news agency chain only later finding they'd jumped to conclusions from a narrow base of poor evidence?
|
...is hardly unique to police is it?...
No, although we were discussing the police.
I've known journalists who get themselves into a pickle and do lots of extra work in an ultimately pointless attempt to make the story what they think it should be.
I can't be bothered to do that - the tale is what it is, and must stand or fall on its merits.
And such attempts rarely work long term - the truth, or at least a version of it, will emerge.
As has happened in this case.
|
Whist analysis showed no evidence of alcohol a witness stated she had a coke and a bottle of beer. The Police state she stated she had a "couple of bottles of Stella".
So perhaps a smell of beer present.
|
Police arent doctors, its just tough luck to suffer an unusual circumstance, you cant resolve every incident in a satisfactory way unfortunately.
I do wonder why, if this drooping was noticeable as is suggested, it didnt raise some questions with the officers though, forget what the passer-by said or didnt say.
Is it possible to have a serious stroke and to just act 'drunk' without the facial clues? I only know from when my grandfather had his first stroke, it was pretty hard to miss. Still, they are only human and Im sure they regret what happened on some level.
|
>>Is it possible to have a serious stroke and to just act 'drunk' without the facial clues?
Absolutely.
en.wikipedia.org/wiki/Stroke
Plenty of reading but in addition to the usual "Face, Arm, Speech (Time)" as in the adverts, any of the following can also occur with or without the F.A.S.T. symptoms.
"A stroke affecting the brain stem and brain can produce these symptoms:
-altered smell, taste, hearing, or vision (total or partial)
-drooping of eyelid (ptosis) and weakness of ocular muscles
-decreased reflexes: gag, swallow, pupil reactivity to light
-decreased sensation and muscle weakness of the face
-balance problems and nystagmus
-altered breathing and heart rate
-weakness in sternocleidomastoid muscle with inability to turn head to one side
-weakness in tongue (inability to protrude and/or move from side to side)
If the cerebral cortex is involved it can produce the following symptoms:
-aphasia (difficulty with verbal expression, auditory comprehension, reading and/or writing Broca's or Wernicke's area typically involved)
-dysarthria (motor speech disorder resulting from neurological injury)
-apraxia (altered voluntary movements)
-visual field defect
-memory deficits (involvement of temporal lobe)
-hemineglect (involvement of parietal lobe)
-disorganized thinking, confusion, hypersexual gestures (with involvement of frontal lobe)
-anosognosia (persistent denial of the existence of a, usually stroke-related, deficit)
If the cerebellum is involved, the patient may have the following:
-trouble walking
-altered movement coordination
-vertigo and or disequilibrium
Loss of consciousness, headache, and vomiting usually occurs more often in hemorrhagic stroke than in thrombosis because of the increased intracranial pressure from the leaking blood compressing the brain."
There are probably also more stroke events that pass unnoticed by people and are only picked up when they have a brainscan - repeat 'silent' strokes are probably responsible for some types of dementia ("vascular dementia").
Stroke medicine is a specialty in its own right - massive range of presentations and treatments - if you're unlucky enough to have a stroke a major factor in how well you recover is whether or not you are attended to in a specialist stroke unit or not.
|
Is it right that the majority of strokes are caused by high blood pressure?
Seems to me very inportant to have bloodpressure checked regulary if always high need medication.
|
High blood pressure is a major risk factor as is smoking.
Atrial fibrillation (completely irregular pulse) is also a potentially significant factor especially if you are over 65, have high blood pressure, or have a dodgy heart valve.
The biggest risk factor for having a stroke is getting older.....
|
>>Atrial fibrillation (completely irregular pulse) is also a potentially significant factor especially if you are over 65
What if you're not over 65 and all the above applies?
|
You can use this calculator to work out a guesstimate of stroke risk (go by the number of points, not the percentages as they seem a bit wonky):
www.mdcalc.com/cha2ds2-vasc-score-for-atrial-fibrillation-stroke-risk
If you have damaged heart valves and atrial fibrillation you should be on warfarin whatever other risk factors you may or may not have.
Score 1 and you'd probably be advised to take aspirin on a daily basis to reduce stroke risk, score 2 or more and you should likely be taking warfarin unless there is a good reason/desire not to take it.
As usual this degree of health advice needs to come straight from a doctor who knows the patient - these are guidelines, not strict protocols.
|
Is it worth looking ahead at these sort of factors when your in your 30's?
I ask because I have a detailed knowledge of my family's medical history ( several generations in my family died from cerebral haemorrhage for instance ).
I know my dad has had his heart valve issues but apparently the rest of his heart was in good order and I also know my grandfather did die of a stroke, I was there when the second one finished him off.
Im curious about how much your surrounding family history can point to the future on this.
|
>>Is it worth looking ahead at these sort of factors when your in your 30's?
It's worth having the usual risk factors assessed - blood pressure and a listen to the heart are probably the most useful tests - cholesterol has less bearing on strokes but is worth knowing if there is a strong family history of angina/heart attacks/bypass grafts - excluding diabetes/pre-diabetes is always worthwhile too.
One problem with family histories of disease is that stroke, heart disease, and cancer are all very common (responsible for roughly 10%, 35% and 25% of deaths respectively) so a couple of people with the same disease may well be purely by chance.
Another problem is historical - what is on a death certificate may not be the true cause of death - stroke on a death certificate could be either a blocked blood vessel, a ruptured brain blood vessel, or a 'best guess' that fitted the clinical story.
If a few close relatives had bain haemorrhages it's worth asking if you could be at greater risk of the same - cerebral aneurysms can be hereditary and if they rupture the result is usually catastrophic.
The flip-side of this is that sometimes scans pick up abnormalities that are causing no harm whatsoever but then lead to a lot of anxiety and potentially unnecessary interventions.... bit of a minefield so best to speak with someone who can spend time doing a thourough assessment.
|
>>blood pressure and a listen to the heart are probably the most useful tests - cholesterol has less bearing on strokes but is worth knowing if there is a strong family history of angina/heart attacks/bypass grafts - excluding diabetes/pre-diabetes is always worthwhile too.<<
I had my blood pressure checked when I signed up at my local doctors and she said it was spot on at that point, I also dont drink alcohol at all, nor do I drink, both of which my father did to excess in his younger days and he still smokes, even after his heart issues ( grr ).
I know my father and his mother both suffered angina, my dad has no problems at all now he has had his surgery though. They did say he could have had the valve issue all his life, it just took that long for it to reach the critical point ( he was 70 ).
My mum has an irregular heartbeat which was looked into but they didnt feel it was an issue after monitoring it, but her mother has no heart issues that we know of, though her grandmother did and died of a heart attack at 87.
No diabetes that I know of in direct relatives though my nans sister has had it for years, but my nan doesnt despite her primary diet consisting of sugar and bad carbs!
Funny you mention aneurysms - my dad currently has one ( which scares the hell out of him ), in his stomach area I think, which they picked up on one of his post-op check-ups, but he just had it checked and it hadnt grown in the last 6 months.
Im just about to tuck into a bacon roll, I dont suppose thats gonna help :-p
|
Abdominal aortic aneurysm (AAA) is a different beastie - the aorta (the huge artery that takes blood from your heart towards the rest of your body) is usually about 20mm in diameter but in AAA it swells like an overfilled balloon.
These can be fixed surgically but are usually monitored while they are under 55mm dia.
Above this, the risk of spontaneous rupture (10% per year at 60mm, >30% at 80mm) outweighs the risk of surgical death during surgery (around 5%) - rupture anywhere outside hospital has ~90% chance of killing the patient.
I think in England there is a scheme being rolled out to invite 65yr old men for a scan to look for AAA (others over 65yr old can self-refer to the programme) which should be fully operational by around 2013.
Risk factors: smoking, high blood pressure, being a man (5-6 times more men than women get AAA), getting older (...), and a family history of AAA.
Last edited by: Lygonos on Sun 15 Jan 12 at 20:13
|
|
Very interesting info. My dads is 40mm atm so not too bad as they go.
|
A mere tiddler ;-)
Below 55mm it is generally accepted the risk of surgery is greater than that of the problem - monitor only!
Here's a link for some more info.
www.gpnotebook.co.uk/simplepage.cfm?ID=798621731
|
|
They do have boxes to tick too you know! Bad presumption on their part if the facts are true, especially when the Stroke possibility had been proffered.
|
|
We know police arn't doctors but training in regonising stroke or hart failure symptons wouldn't go a mis. They have a duty of care and why not listening to the motorist who warned them about the stroke symptoms.Have the police compulsary first aid training?
|
|
They have and they have out re-classify every couple of years or somesuch.
|
Police training must cover various sorts of health emergency and lifesaving treatment. But the fact is some people are much more in tune with this sort of stuff, sensitive to it, than others. A bit of emergency training will 'take' a lot better with some than others.
Of course there is an anecdote somewhere upthread about the fuzz turning away a proper medic offering help. That sort of thing can happen too. Easy to understand if not to approve.
Obviously some officers see themselves as public servants and mean well all round. Others though must become quite brutalized and cynical. In fact some do, as we all know. But we also know (I do anyway) that they aren't all like that, or not as like that as we may fear.
It's a bit of a lottery, collapsing in the street. Something I worry a bit about sometimes.
|
>> It's a bit of a lottery, collapsing in the street. Something I worry a bit
>> about sometimes.
>>
God help you if you keel over in front of me AC. There's no way i'm kissing you. ;-)
|
Kissing is out now, the current thinking is no mouth to mouth but fast chest compressions
ala
www.nhs.uk/Video/Pages/vinnie-jones-how-to-perform-cpr.aspx
|
|
For the time being, every year it changes. Give it a couple of yeras and it'll be back in.
|
|
Chest compressions Vinney breaking your bones.>:)
|
Police duty of care? - Lygonos
