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Fall from a ladder

Duane on the ladder, by doortoriver, on flickr

Duane on the ladder, by doortoriver, on flickr

So, after that call I explained to Charlotte how unusual it is to get someone back from cardiac arrest. Changes in the way we carry out basic and advanced life support have dramatically improved the odds; however it isn’t something that a paramedic sees everyday and happy endings are unfortunately rare. The risk of brain damage from the oxygen deprivation can mean that even if the patient lives, they may never live an independent life again. This is why bystander CPR is so vital.

Charlotte and I had only just recovered from the exertions of the morning’s drama when we got a call to an older man who had ‘fallen from a ladder – through a conservatory roof, not conscious, not breathing.’ Here we go again, I thought, as we popped on the lights and sirens and sped to the scene.

The man’s family were there in the garden and stood watching helplessly in a state of disbelief. As soon as I arrived and confirmed the situation I tried to call for the helicopter but it was on another call already; luckily another ambulance and the fire brigade were on their way to help us and we were less than a mile from the hospital too.

The family told us that the man had fallen from approximately first floor height, through the old glass roof of the conservatory and landed on his head. He had come to rest on a pile of clutter and then more rubble and glass had come down and all but covered him. During this time of course, the man hadn’t received any CPR. With the help of the family we formed a human chain to move the rubble and glass from him and once he was free we carefully moved him to where we could safely begin to perform CPR without the risk of shards of glass falling on to us. Back up arrived promptly and pretty soon the whole backyard was filled with emergency services personnel; the street was grid-locked with our vehicles too!

He was in full cardiac arrest and we swung in to action, cannulae were sited, an endotracheal tube was placed and drugs given – alongside some good continuous chest compressions – then incredibly against all the odds, we soon got a pulse back on him. Once we had him collared and boarded securely we did some further checks and moved on to hospital in the ambulance.

I saw the family a few days later and they told me that the brain damage had been very severe. Although he was currently on life support, this brain injury – in addition to the extensive injuries that he had suffered from the fall – meant that the decision had been taken to switch of the life support machine later that day. Very sad indeed but I guess that those last few days together gave the family time and space to say their goodbyes.

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