As far as shifts go, it hadn't been a bad one. I hadn't been spat at, sworn at, I hadn't had to carry anyone and no one had wound me up enough to change my mood! That's not to say that anyone actually needed an ambulance. The mere fact everyone had walked on and walked off meant that in reality, no one actually needed an ambulance but that's by the by! It was late in the evening, we reckoned that we had about two jobs left to do to see us off, so made ourselves available. We were a fair way away from station so we started heading in the right direction as fast as possible (within the legal speed limit of course!). We didn't get very far at all! Within about 5 seconds.....
"Male, U/K age, One Under"
Action stations. We were only 2 miles away so there was a good chance we'd be first there. While my crew mate drove like a bat out of hell I dived into the back to get the hi-vis on and safety helmets out the top locker. Back in the front and...
"UPDATE: Patient is screaming, injuries, unknown"
....we started to get a plan. Once we had confirmation power was of and track protectors were in place, I would get under the train and assess, crew mate pass staff and liaise with fire brigade and train staff. I began stuffing my pockets with stuff I might need; gloves, tape, torch, cannulas, bandages and a tourniquet.
"UPDATE: HEMS on way. Eta 8 minutes"
Right, that should give us just enough time foe me to get under before HEMS take over and we are sidelines! (Trust me, totally happens!). We pulled up at the station to see we'd been beaten by the Fire service and Police.
"UPDATE: HART team on way"
They can bugger right off! HART or Hazardous Area Response Team is by far the biggest waste of money the service has ever had. Always late to any incident in their fancy suits and equipment and they just sit and watch the fire service. They have lots of fancy kit that they never use and it's a classic old boys network full of wannabe firefighters. I predicted they will be stood on the platform on mass.....watching at some point during this job!
We were indeed the first medical staff to arrive so we needed to carry everything! Luckily some 'water fairies' were on hand to help. We took paramedic bag, response bag, oxygen bag, Life pack, dressings pack. suction, scoop, head blocks, entonox, straps and blankets! The problem with underground stations is some are very very very deep and going back for kit isn't really an option if you need something quickly. We made our way down, and down, and down to the platform. The fire service were on the tracks and doing a good job of talking to the patient. I jumped down to have a look and there he was. In one piece, very much alive and trapped. What was bizarre was that he wasn't trapped or tangled by a limb, which is common. He was trapped by his pelvis between the train and one of the tracks, on his side!
Now, there are no text books telling you what to do, no algorithm, no guidelines, nothing. It was going to be a case of improvise, adapt and overcome. Under I went. Blimey! I forgot how hot it is under trains! And dirty! By the time I got to him my hands were black. He was very much conscious and there was no obvious blood! Always a good sign! He was however in a lot pain from his pelvis and was obviously very panicked. He hadn't jumped. He was drunk and had tripped and was hit trying to clamber out and by all accounts the train had nearly stopped at impact. Via a gap between the platform and train, a hand appeared holding an oxygen mask. I popped it on the patient and then a blood pressure cuff followed. With a bit of a stretch I got it on his arm. All the numbers were relayed back to me. His blood pressure was a little low but if he had a fractured pelvis he could easily bleed out into that and it would only get lower.
OK, a plan......erm......
"How are we getting him out?" I said hopefully.
"We are going to jack the train up off of him and slide him out."
No idea who I was talking to!
"How long?"
"Half an hour. 45 minutes maybe."
"Is that the only timescale we have? If he has to come out quick to we have other options?"
"Afraid not"
That's was a long time as far as I was concerned but it wasn't as if he could just be dragged out! He was well and truly wedged! I stuck an orange cannula in the back of his hand as that was the only part of him I could get purchase on. Thank god for big veins! I wanted to give morphine but in the circumstances I felt a grown up should be consulted first. Luckily, as I fixed the cannula down a head torch appeared. It was the HEMS Doctor!
"You look like a chimney sweep."
Oh goody.....a mascara joke!
TO BE CONTINUED........