A busy morning at the Doctor’s Surgery. A patient has presented for a routine appointment but is seriously unwell. A solo Paramedic in a fast response car (PRU) has been dispatched to help stabilise the man, who is complaining of crushing chest pains. Whilst the Ambulance Control Centre (ACC) is allocating a conveying, Double Crewed Ambulance (DCA), the solo Paramedic is beginning their investigations, taking a history, observations and a 12 lead Electrocardiogram (ECG).
The ECG shows ST elevation in multiple leads, the patient is sweaty, grey and is clearly in pain. The Paramedic, GP or Nurse administer 300mg of Aspirin, Glyceryl Trinitrate (GTN spray), and place a cannula to gain IV access for Morphine and fluids. In the ACC, a Dispatcher receives a radio update from the scene and finds then allocates a DCA, diverting them from another call. As the crew turn around, the PRU medic is transmitting the patient’s ECG tracing directly to the local Coronary Care Unit, they then call the Unit directly to discuss the ECG and the patient’s presentation.
As the Ambulance crew arrive and meet their colleague, the plan is already set. The patient will be transferred, under emergency driving conditions, to the “Cath Lab” to have a catheter guided through their arteries to find and remove the clot, and to leave a stent at the site, strengthening the vessel. As the patient appears unstable the PRU medic will also travel in the back of the Ambulance. They will be dropped back at their car once the patient is in the care of Hospital staff.
Meanwhile other patients continue to arrive for appointments. An elderly lady is leaving after seeing the Healthcare Assistant/Nursing Auxilliary to have bloods taken. A young woman using crutches is hobbling towards an appointment with the Practice Nurse to have her chronic leg ulcer dressed. And a father pushes his baby in their pram, running slightly late for a checkup with the Health Visitor. Inside prescriptions are printed, referrals made, urgent calls triaged by the Duty Doctor, and patients are seen and treated.
Reality.
Kit GM410 by Gaugemaster, 1:76 scale (OO Gauge) plastic kit building “Fordhampton Surgery”. The kit includes decals allowing it to be completed as a Doctor’s Surgery/Health Centre, a Nursing/Care/Rest Home or a Dental Practice. As this was a retirement gift for my Mum & Step Dad, Advanced Nurse Practitioner & General Practitioner respectively, I built it as the first option.
