Once in a career.

I promised in my last post I would write about the RTC (Road Traffic Collision) I attended last month. This was by far the worst I’ve seen in my short career and also the worst the Officer on scene had seen in his 19 years in the service!

-On a side note, I know I haven’t written for a while, I’ve been on holiday in Italy where I purposed to my girlfriend. So yeah, kinda busy-

Not long after the start of my shift in the city station, we receive an emergency where details state that there are “3 cars, 1 on fire, 2 persons trapped and critical”. This gets the adrenaline pumping let me tell you!

We arrive at the now dark scene which is a fast stretch of country road with no lighting, on a long sweeping bend down a steep hill. We can see that there are two cars (the third I later learned had been driven away as only had minor damage), each on their own side of the road but clearly showing signs of a high speed head on impact. I say high speed because the Traffic Officer estimated that the total impact speed would have been in the region of 130mph.

We were met by our Senior Officer who directed us to one of the patients trapped in his car. With him was a BASICS Doctor (BASICS Doctors are a group of trauma and medical specialists who choose to respond to emergencies in their own time. They are an enormous asset to the service – especially at a time like this).

In training, you’re taught to start assessing the patient ‘from the door’ to quickly ascertain if they are ‘big sick’ – that is to say time critical, or ‘little sick’ – meaning that it is a minor ailment that can probably be dealt with at home.  We’re taught to look at their skin colour (pale, flushed, grey), work of breathing and general appearance. This chaps general appearance was ‘on deaths door’.

So worried was the BASICS Doctor that he had tried to drag the patient from the car to begin treating him, but he was trapped.

I then looked to the car for the mechanism of injuries we were likely to find. I looked down and couldn’t figure out where his legs were.

The driver’s seat had been shoved forward 6″ and the steering wheel pushed back against his chest, so he was slumped over the wheel. The dashboard had been forced back onto his pelvis and the car’s engine block sat where his legs should have been.

We looked at each other and knew we had to get him out as soon as possible or there was a high chance he would die in the car.

We liaised with the Fire and Rescue Service (a separate emergency service here in the UK) who understood that it had to be a rapid extrication.

While the Fire Service cut away various parts of what was left of his car, my colleagues began treating the patient as best we could. We gained IV access in both arms so we could give him strong pain relief and fluids, we gave him oxygen and monitored his heart rate and blood pressure. From these observations, it was obvious he was in shock.

When the public say “he’s in shock”, they mean that they’ve had a nasty surprise and are in a bit shaken. When we say “he’s in shock”, it means the life threatening condition where the body is failing to get oxygenated blood to the brain and tissues of the body. When someone is in shock, they will die if untreated.

For 70 minutes the Fire Service fought to cut him free, and we fought to keep him alive.

Once he was cut free, it was a case of life over limb. That is to say that where we would normally work hard to protect the alignment of the neck by using a hard collar and a series of techniques to get them out while keeping them in a straight line. However, this man was on deaths door, so it was decided that we would drag him from the car and slide him onto our longboard to be carried to our stretcher. I was holding the top of the longboard and so could see down the length of the patient. I could now see where his legs were: broken in several places with open fractures and scissored beneath the car’s pedals.

We got him our and he was losing huge amounts of blood from somewhere internally. I covered the open woulds on his legs through which his broken bones were poking. Then my crew mate and I assisted the Doctor and the Air Ambulance Paramedic in sedating the patient so we could control his airway and breathing. It also meant that he was feeling no pain.

We loaded him onto our ambulance and drove quickly to the air ambulance which would fly him to the regional major trauma centre.

And just like that, my crew mate and I were in a field, in the dark with an ambulance full of broken glass, blood, cut clothes of the patient, used bandages and oxygen hose, empty bags of fluid, and a sense of awe for what we had just witnessed.

We radio’d our control to ask if we were needed back at the scene. They said the scene was in order so we could head to a nearby station to clean up, restock and have a debrief with the Officer.

We all agreed it was a horrendous incident. We spoke about what we felt went well, and what we thought we could have done better. We had a chat and a cup of tea – the ambulance remedy for witnessing something horrific.

It took us over an hour to clean the blood off the kit and restock the mountains of equipment we had used before we were ready to return to duty. I was glad of the extra time to compose my thoughts.

The following day, I received an email from the Officer who was at the scene. He had thanked us all for our hard work and forwarded an email from the BASICS Doctor who praised us for our teamwork and professionalism through what was a very difficult situation. He informed us of the patient’s injuries which included: Bruised Lungs, Bleeding in the abdomen a shattered pelvis and multiple open fractures in both legs. He had lost so much blood internally that they had to replace pints and pints of blood in the hospital before he was stable enough to be taken to the CT scanner. He was still sedated and was in an Intensive Care Unit. I was very pleased, but very surprised to hear that he was still alive.

The second patient in the other car who was also trapped had only minor injures. I didn’t even see him as we were so focused on our patient. But he had another crew, and doctor and another Fire team looking after him.

This was such a horrific incident that I may not see another like it. Then again, I may see one tomorrow – that’s the beauty of this job, it’s like a box of chocolates.

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