The Nation's Health + [trauma]

A Spot Of Bother

It was a rather quiet morning on the car! I'd taken the temporary lull in jobs as an opportunity for coffee with a fellow FRU! It's nice when you get some company on the car as it can me quite a lonely place at time. It's been described as prolonged periods of boredom, occasionally interrupted by moments of sheer terror. I think that is pretty accurate!

"New Road @ Station Road"

Not two sips into my coffee, a job! A road name @ another road name, usually means an RTC. It could be someone just outside by more often than not it's an RTC. I had no other details yet so just started heading in the right direction. One of the problem with the FRU is when you're driving on blue lights it is very difficult to see any updates that appear on the screen. A buzzer goes of and the message appears in red when the call taker gets more information. The next update was the determinant, which is the main problem, i.e.; Breathing problems, Chest pain, Stroke, RTC etc.

"New Road @ Station Road, Stabbing / Shooting"

Really?! On a tuesday-bloody-morning! Come on! I upped my pace slightly, because despite my shock and horror at a stabbing or a shooting so early in the day, I bloody love stabbing and shootings! I'm not weird, most of us love a juicy trauma really! I started making mental plans of what I might see, what I might need etc.

"New Road @ Station Road, 17 year old male, impaled on metal fence, report on arrival"

IMPALED?! How did he manage to get impaled?! What is he impaled on?! What is he impaled through?! No time to come up with a plan though, I was arriving on scene!

There was a small crowd beneath the patient, supporting him up in the air. All the heads turned to face me as I got out of the car. That look of expectation mixed with panic on all of their faces!

*cue emergency face*

They were looking at me as the 'specialist in impaled human removal'. Sadly for them I was far from it! I'd never done an impaling so I was about as experienced as all of them! The patient was panicking atop of his spiked metal fence and to be fair, I would be to! The spikes were about 8-10 inches long and by the look of things he was impaled on two of them, through his inner-thigh. It was hard to tell because he was 8ft in the air!

His panicking was getting worse. I wanted him to stay still, and wanted everyone to continue helping to support his weight. It really was a logistical nightmare! I radioed into control and requested Fire, Police and HEMS. Fire to chop the fence and bring some ladders, Police to block the road, and HEMS to.....well, just do what HEMS do best! Unfortunately, hearing me ask for the entire world and his wife, the patient panicked further and despite my shouting at him not to, in one big burst of energy he lifted / prized his body off the spikes and fell into our waiting arms.

"Red base, patient is no longer impaled, cancel fire, update HEMS, patient has an arterial bleed from his femoral artery."

There was blood everywhere. The good samaritans moved back, some freaking out at the blood, others just starring. I put all of my weight onto his groin where there blood was coming from. It took an incredible amount of pressure to stem the bleeding. The problem was I now had no hands! I barked order at people to get me things from my car, to press the talk button on my radio so I could get an ETA for my ambulance and to use my scissors to cut up his trouser legs. It was organised chaos!

Within a couple of minutes the ambulance was with me which was a huge relief. I was getting cramps through my arms, they were literally shaking with the amount of pressure being used. A pressure dressing was prepared, as was an extensive wound dressing. In a fluid movement I swapped places with one of the crew and we got the dressing in place. The patient was white as ghost and sweating profusely. He was in hyopvolemic shock and needed surgery very quickly.

I set about getting lines in his arms. Luckily for me and the patient he was athletic and had HUGE veins which just popped up nicely for me. As I was setting up the fluids the helicopter appeared above us. What a relief! The bed appeared next to use so whilst waiting for the HEMS team to be driven to us by the police (*cough* not just crime fighters!), we got him loaded onto the bed. Based on where they landed we would have to drive him to the chopper and we didn't want to waste any time. His blood pressure was in his boots, his pulse was racing and he was becoming increasingly groggy. To help stem the bleeding we gave him some Tranexamic Acid which aids clotting.

With HEMS with us they took over. They started giving him units of blood as we all started loading him onto the ambulance. I felt quite satisfied that that was all they could really do. We'd managed to do everything else before they arrived and that is always a good feeling! Within a minute or so we were next to the chopper and transferring him. Having to keep huge amounts of pressure over his femoral artery made moving him slightly awkward but he was quickly on board and taking off.

His friend had stayed with him until take off and was awfully worried.

"How did he get impaled in the first place?!" I asked him.

"He dropped a £10 and it blew under the fence, he tried to run up and volt over, but it went wrong he got stuck on a spike."

"All that for £10?! Couldn't he have just gone through the gate down there?!"

"Oh year, didn't see that."

I had to laugh! Even his friend begun to smile, despite being covered in blood. I was covered to! I looked like Carrie! It was a sight to behold! My arms were literally red! It was time for a shower, uniform change, a re-stock, a fair bit of paperwork and my cold coffee! Just another tuesday!