The Nation's Health

3am

I was a total surprise when the much vaunted and incredibly talented blogger Big Fashionista asked me to guest blog for her. Not only was I massively chuffed but was also massively nervous! A new audience, new people to critique my writing! I didn't have a clue what to write about so stuck with what I knew best. Blood and Guts! Thanks again to Kellie for inviting me onto her blog. It was an absolute pleasure. Please follow her on twitter @bigfashionista and visit we website www.bigfashionista.co.uk. You won't be disappointed! Promise! Anyway.....here is my blog that appeared on her website!

"18 year old male, fall from height, cardiac arrest"

I had been driving for the best part of 8 hours on the wrong side of the road. Not because the traffic was busy and I was on blue lights, but because I was driving back home from Europe after an impromptu few days away. The kicker was that I had a night shift to get back to. I got home at about 4pm, quick shower, ironed uniform and off I went for my 6pm start. In all honesty the prospect of a 12 hour night shift filled me with nothing but dread, but what's a girl to do!? Things started just as expected and just as they always do. A job, straight away; quickly followed by job after job after job after job. It was a typical Friday night; all alcohol or drug related, just a thoroughly exhausting evening. For those of you who have worked night shifts you will know exactly what I mean by 'the 3am lull'. Eyes are heavy; an overwhelming sense of fatigue engulfs you and the thought of another three hours, three patients, and three lots of paperwork makes you feel physically sick. Your handwriting is getting worse and worse, your mood is becoming more and more fragile and your patience is well and truly gone! You spend 15 minutes at hospital eating sweets, drinking coffee and doing anything you can just to stay awake. It really is a horrible experience and if you can go through life managing to avoid 'the 3am lull' I highly recommend that you do!

Well, it was 03:11, the rain was pelting against the windscreen, it was dark and cold. We pressed the button knowing full well we'd get a job straight away and headed out of the hospital. If anything will wake you up, this job will. The words 'cardiac arrest' still gives me the adrenaline rush, the pumping heart and the excitement. Two miles to travel, that was all. I lit up the roof, turned on the bells and off we went. There was still plenty of traffic about and with the torrential rain filling the roads it was a nervy drive. Visibility was terrible, road marking and signs were invisible and all you could see was the headlights and brake lights of cars. I have never seen rain like it to this day. We pulled off of the main road into some kind of alley way. 0.1 miles to go, surely we would see something soon? We got a message to say the response car was on scene as we turned around a tight left corner. That was the moment that I can see like a freeze frame. No more than 50 feet away was a silhouette of someone doing CPR, lit only by the strobe of the blue lights. The rain was cutting across the view at a 45 degree angle and there was a constant whistle of wind pelting down the alley. We ground to a halt about 5 feet from them, grabbed some kit and ran over.

Lying on the floor, illuminated by headlights was our patient; he was in the gutter of this tiny cobbled street, a crowd was gathering a few feet away and to be perfectly honest, what they could see wasn't a pretty sight. Because of the background noise, there was a lot of shouting to let each other know what we were doing. All we knew was he had fallen, where from we didn't know. Apparently he had been breathing for a few minutes before, but had now stopped. There was blood everywhere; the guy had landed face first and had massive cranial destruction. It took two of us to vaguely secure his airway but no sooner as we had suctioned blood out of his throat more appeared. HEMS arrived within a couple of minutes and took the pressure off. The six of us worked on him for about half an hour, his chest was cut open, his lungs decompressed, drugs were given and I was just watching it all in a rather detached state. I was ventilating him; once the airway was secure it was a case of kneeling there, in a pool of rain and blood, just breathing for him. I remember looking and staring at his face. A young guy, good looking, an entire life time ahead of him and here he was. Lying motionless, dead in the gutter, doctors, paramedics and technicians tirelessly working to save him and I was thinking 'what a waste'. From his head, I could see every injury he had. It would need a miracle to survive the trauma his body had suffered. It was a very disturbing sight and one that still haunts me from time to time.

He was declared dead on scene. There was that moment when the decision has been made, you have all agreed to end the resus, CPR is stopped and you take away the mask. That's it. His final lifeline. Until that point there is hope. Until that moment you have the distraction of the situation. Now you are aware of the crowd again which is now 100 strong. They had watched on in the rain. Just staring, in silence. They had seen every compression, every ventilation, every incision, every needle, every shock, every drug, every effort we had made. It is most likely the single most distressing thing most of them have seen and will ever see. In many ways I felt like I'd let them down. Stopping a resus is always a bit of a tough moment, doing it in public you can feel all eyes on you as you step away from the body. And that is all it is now; a body. He was covered in the blanket and as we stepped back, all in a daze, we found out what had happened. He had fallen from the roof, the roof of this 4 storey building. A 70 foot plunge. No one knew what happened. Was it suicide? Was it an accident? Was alcohol or drugs involved? What was his name? Why did no one know him? I don't want to think what was going through his mind as he fell. I hope nothing. I hope no one has to suffer that fear of inevitability. That moment before death. A young man with endless possibilities ahead of him had lost his life and whatever the cause, it was tragic. We all piled into the ambulance for the debrief. Everyone just sat there feeling thoroughly dejected. The saturated, blood soaked uniforms a stark reminder of what this job can throw at you. One thing was for sure, I was very much wide awake now. Only an hour and a half until the end of the shift. A quick uniform change and time for one more...

Since writing this blog, I was send a newspaper article, detailing the circumstances of this tragic accident. It spoke of a talented young man who fell to his death after a night of alcohol and cocaine. What a awful waste of a life.