Tag Archives: A-level

Critical Haemorrhage

I’ve mentioned before that our ‘Primary Survey’ (i.e your initial assessment of a patient to decide if there’s anything immediately life threatening that needs correcting) differs from that of a first aider, who’s primary survey will be:

D – Danger

R – Response

A- Airway

B – Breathing

and maybe C – Circulation

Our primary survey is:

D – Danger

C – Catastrophic Haemorrhage

R – Response

A – Airway

c (deliberately small) – Cervical Spine injury

B – Breathing

C – Circulation

D – Disability or Neurological signs

E – Everything else

F – Family/Friends for history taking

G – Glucose levels.

So, as you’d expect, it’s a bit different.

When it comes to managing Catastrophic/Critical Haemorrhage (by which I mean an arterial bleed which will bleed a patient dry in mere moments), we don’t piss around. As you can see, we control Catastrophic Bleeding before we even try to get a response from our patient, let alone try managing an airway etc etc.

Most if not all of our critical haemorrhage kits have been developed by the Military. Their ‘bread & butter’ work is dealing with traumatic amputations and massive trauma to the abdomen and chest.

They’ve developed very efficient tourniquets and dressings known as ‘blast dressings’, or to give them their proper name, ‘haemostatic dressings’. These have a chemical in them which promotes clotting to stop bleeding quickly. These dressings are idiot proof, very large and very expensive. They save lives.

I’ve never been unfortunate enough to have to apply a tourniquet, though my regular crew mate was – he was sent to a lady who was trapped under the wheel of a bus!

I have, however, applied a blast dressing to a lady with a catastrophic bleed from the chest. It works very well indeed.

We have a special bag which is a cool, special op’s style black bag with red writing which says ‘Critical Haemorrhage Kit, Trained Personnel Only”. In there we carry tourniquets, various sized blast dressings and haemostatatic gauze.

On my last day shift, we answered a 999 call for a man who’d cut himself shaving, so the bag was left on the Ambulance that day……*sigh*.

Needless to say, we recommended some basic first aid and left him to it. Another life saved 🙂

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A message of good luck.

I’m a Student Paramedic.

I work full time on an ambulance working within the scope of an ECA as a crew of two, usually with a Paramedic, answering 999 calls the same as any other ambulance. I study in my own time via the Open University, on their 4 year part time course to obtain a foundation degree in paramedic sciences. This is one of a couple of ways to become a paramedic. The other popular route is a full-time university course, now 3 years here in the UK, to obtain your degree. 

At a time when student’s A-level results are being released, I just want to wish the best of luck to all young aspiring paramedics out there. 

But remember, it’s not all guts and glory; the hours are long, the equipment may not be the best, some patients will try to hurt you, there will be hours of boredom, most of your jobs are picking old people up off of the floor, the rest feels like it’s dealing with regulars, drunks or junkies, you won’t sleep, you won’t be hungry for lunch at 2am, some sights will never leave you, the politics will make you angry, you’ll never see your friends/family because you can guarantee you’ll be working the weekend/bank holiday/Christmas!

However, don’t be put of by my words of encouragement. Because once in a while, you’ll do a ‘proper ambulance job’. A job that is life or death. A job where your progressive driving, your quick thinking and the arsenal of drugs you carry will make a difference to someone’s life. Once in a while, you’ll be truly thanked for the job you do. And that, my friend, will force all of the other stuff into insignificance. That, is why we do that job we do. And don’t EVER forget it!

Welome to the best job in the world, you’re gunna hate it, you’re gunna love it!

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