I had a young student paramedic out observing with me this week. With her ‘gateway’ exam coming up soon Jane wanted to spend the day with an ECP to observe physical assessment techniques.
Our first patient was a young man who had fallen almost 3 metres while working on a construction site. It was raining lightly and he was laying in the middle of the muddy building site; it was simply impossible to keep our boots and uniforms clean as we worked on him. He was complaining of back pain so we needed to completely immobilse him. This involves putting a rigid collar around his neck, placing him on an orthopaedic stretcher and using a series of straps to hold him surely. To make all of this fit well we had to cut off his bulky clothing first. As I mentioned, it was raining, and no sooner had we cut in to his padded jacket than the feathers inside were released and flying all around! We were breathing them in, they attached themselves to our eye-lashes and hair, and because we were damp from the rain they were sticking to our uniforms and faces too. By the time we carried him from the building site we were a complete mess, covered in mud and feathers!
Then there was also the very last call of the day. An older man had been found, collapsed at home by the police. Having been alerted by a relative, they gained access to the house where they found him laying in the living room and immediately called for the ambulance service.
His was unconscious, his temperature only 27 degrees, and he had a facial and head injury with heavy bleeding from his nose. He had been incontinent of urine and faeces and had developed deep pressure sores on his face, torso and limbs where he had lain face-down for so long (we guessed at least 2 days). We worked with another crew to stabilize him and undertake the delicate process of packaging him up for the journey to hospital without making his condition any worse. The police were brilliant too. They helped us by holding the drip and cutting his soiled clothes off. As we navigated him out through to the hallway on the orthopedic stretcher, they were on hand again to help us lift him high enough to pass over the bannister.
He was given a scan at hospital and unfortunately his condition was very poor and he was not expected to recover. Afterwards, Jane and I reflected on what happened. We hoped that whatever caused him to fall, he had been unconscious from that moment. We didn’t like to think of him being aware of his gradual deterioration while he waited for help to arrive, help that sadly came too late.