“Well, well, well”
I hear you say.
“It’s that bloody Ambulance bloke. I remember he used to write regular updates on his day-to-day life on a frontline Ambulance. I’d almost forgotten he existed.”
AHA! I have returned with an apology. It’s been a very long time since my last post but life has been very busy!
I went and got myself married, started my final section of studying for my degree in Paramedic Sciences and re-joined a band I was in many many years ago. I know it doesn’t sound that busy, but trust me, it is!
Anyway straight back into it, eh?!
On the subject of apologies, I did start a post I never finished which was along the lines of this:
On the ambulance, we carry a fairly limited range of pain relief, from Paracetamol tablets, to strong IV Morphine with basically only Entonox (gas & air) in between.
To enable us to give the strong pain relief, we need to get IV access with a cannula. This gives us access directly to a patient’s veins to give morphine or paracetamol in the form of a drip. But what if we can’t get access?
I was working in the city with a different crew mate. As soon as we booked onto the vehicles, the radio goes off:
“Morning chaps, sorry to be so prompt this morning. We have an outstanding call for a concern for welfare.”
“Roger, all received, on our way.”
On go the blue lights, no need for sirens at 0630, there’s no traffic about.
We quickly arrived to find a gathering of people, most in dressing gowns but all with bed hair!
It turns out the neighbour had got up for work and head shouting from the elderly lady next door. He went round but couldn’t get. He heard her shout that she was on the floor so called 999. They had also called the lady’s daughter who had a spare key.
We shouted through the letterbox to reassure her we were there and within a short time, her daughter arrived.
She unlocked the door and we walked in. It wasn’t pretty. The poor lady (who slept downstairs) had got up in the night and fallen forwards. She had scuffed her face down the wall as she fell. She’d landed face down and was unable to get up our to pain in her hip as well as general poor mobility and low strength. And there she stayed, for almost 4 hours until her neighbour heard her calling out for help.
We set to work. Quick ABC assessment revealed nothing immediately life threatening. Then we were concerned about a possible next injury as she’d hit her head. She had no central neck pain reducing the likelihood of a broken neck. We then assessed all the bones top-to-toe.
“Surely, just help the poor lady up” I hear you say. It’s certainly what we hear a lot, but if she’s broken a leg and can’t feel any pain due to nerve damage, then the bone pokes through the skin as we move her, that could prove fatal. So we methodically check top-to-toe.
Her injuries were some nasty facial skin tears, a laceration to her shoulder, a broken left wrist and a probable broken left hip. Unsurprisingly, she was in a lot of pain. We knew that before we moved her, we needed to try to get her pain under control. The best way to do so was with IV drugs.
This is where we got into trouble. My crew mate tried several times to get access, but her veins were so small that he couldn’t find one, when he did find one they just collapsed as soon as he touched them with the needle. While he attempted that, I made a plan to get us out of the house. It involved a second crew and moving most of the furniture into the garden. The plan would be to scoop her, carry her back into her bedroom, onto a vacuum mattress – which has hundreds of polystyrene balls in and we suck the air out of it to cocoon the person safely in – carry her through the house, up the front steps and to the stretcher on the pavement.
But, try and try as well did (the 4 of us) we couldn’t get any IV access. We decided to give her Oramorph (morphine drink) but it’s not as fast acting. We had to roll her onto her back before we could do anything.
We knew it would hurt, and so did she. When she was ready, and as quickly and smoothly as possible, we rolled her. She screamed and all we could to was apologise.
We were sorry that this had happened to her. We were sorry that nobody heard her shouting for 4 hours, we were sorry we couldn’t get into the house for a while and we were sorry we couldn’t get her pain under control before we moved her.
The rest of the plan worked like a dream. We dressed her wounds and drove her to A&E with the daughter.
My crew mate and I spoke about the job afterwards and both agreed that it is horrible when you can’t do what you think is best for a patient. It’s our job to ease pain, but when you can’t do that, you feel a little bit worthless. It may sound silly to you, but it’s true.
We returned to A&E an hour later with another patient and asked how she was doing. An x-ray confirmed a broken wrist and broken hip, but she was comfortable. We popped our head round the curtain and she was led there smiling. “Thank you both so much for helping me” she said.