I have had the pleasure of a student paramedic called Charlotte riding out with me on one of my recent shifts. Despite the omnipresent threat commonly known as the ‘curse of the observer’ we had a very interesting shift. I have actually met Charlotte previously when she spent a shift with me; as I recall she attracted her fair share of trauma then too…
Collar, blocks, scoop
On that first shift we got called to a plumber who had accidentally fallen down the stairs while working in a customer’s house; he was in a lot of pain and we couldn’t rule out any neck or spinal problems at this point. We called for an ambulance to assist us because we needed to ensure that there was no further damage done to his neck and spine by any unnecessary movement. This meant manually holding his head still until we applied a neck collar and secured him on the metal ‘scoop’ with head blocks and straps around his body to prevent movement. Later that evening we were called to help a young lad of seventeen who was walking to meet his girlfriend when he was ‘jumped’ by a group of other lads. They repeatedly punched him in his face. He sustained lots of facial injuries including an obviously broken nose and he also had a painful neck. We called for assistance again as an injury to his spine was likely and once more we utilised the collar, blocks and scoop.
At the beginning of the second shift I asked Charlotte what she was hoping to get out of the day. She fancied a bit more trauma experience, perhaps a road traffic collision with the fire brigade there to cut the roof off a car. Be careful what you wish for, I cautioned!
(More) Collar, blocks, scoop
The shift began with a couple of false starts, we kept getting sent jobs and then they were cancelled. Then we had a couple of run of the mill calls. I suggested we grab a quick coffee and we parked up. Charlotte decided not to join me in case she was tempted by any of the sweet snacks that she had given up for Lent, so I popped in while she waited in the car. As I walked in, out of the corner of my eye I saw a lady laying face down at the bottom of an escalator with someone kneeling over her. I went to offer some help and was told the elderly lady had fallen from the top step of the escalator; she had sustained some really nasty injuries. Her dentures had broken; her nose, lips and chin were all very deeply lacerated by the jagged steps. She also had arm and neck pains. I asked someone to run out and get Charlotte to come in with some equipment and I called for an ambulance to assist us. This lady takes Warfarin (a blood thinning drug) and so she was bleeding profusely from her wounds. Luckily the ambulance arrived quickly and we packaged the lady up with the neck collar, blocks and scoop ready for the journey to the nearest Trauma Centre. We gave her some strong pain killers. All the way there I held on to her top lip with gauze to try to stem the bleeding. Unfortunately, we found out that she had sustained a fracture to one of the bones in her neck as well as her other injuries.
Wishes do come true
The last job of the day Charlotte got her wish. A drunk driver with a passenger drove over a mini-roundabout, through a fence, through a tree and into the wall of a house. The driver was fine as he had been wearing a safety belt. His passenger unfortunately had not. His head had ‘bulls eyed’ the windscreen and smashed it in to a convex shape. This type of damage suggests a high risk of serious neck injuries. So once again we requested help from an ambulance and this time we also needed the fire brigade. Charlotte got to sit in the boot of the car and hold this chaps head still while the fire brigade cut the roof off of the car. I can still picture her squashed in there in her Hi Viz jacket and hard hat – she appeared to be in her element!