There I was, just thinking about getting in to bed when my phone rang - unknown number. That is usually my cue to say goodbye to my wife and whichever kids I have at the time (more about that in another post).
"Hello, Ambulance Control Here. Are you available for a job?" I almost always am. This one was about 15 minutes away; a car had spun out of control, left the road and landed upside down in a ditch. 4 teenagers were injured, 2 seriously.
A quick kiss goodbye, out to the car, don the orange jumpsuit (you know when you've been tango'd), and off I go.
I do love driving on "blues & 2's"; there is something quite special about the speed and the need to keep your wits about you. But I was more worried than usual on this trip. 4 teenagers, 1 confirmed unconscious and trapped. It didn't sound good.
15 minutes might not sound far, but, when there has been a major head injury, every second counts. In this instance the ambulance crew felt that 15 minutes was too long, and had already taken the most seriously injured to the local hospital, along with one of the more minor injuries.
I was greeted by a whole flurry of activity: flashing lights by the dozen, and loads of people in reflective jackets. I was directed to a girl, who I will call Samantha (that wasn't her name). She had been a rear seat passenger, and had been cut out of the car. Fortunately she had been wearing a seatbelt. She was confused, and kept asking the same questions over and over - a sign of a head injury. She was pulling at the straps and collar that had been fitted to her to prevent any injury to her neck, and was very difficult to manage. A few choice swear words at me when I put a needle into her vein cheered me up - it's the quiet ones that worry me more. I was thinking about where to take her. I didn't want to overload the local hospital, and my own hospital where I work as my day-job was just 10 minutes away. By this time (only 5 minutes or so after my arrival) Samantha was getting quieter. Oh-oh. The ambulance paramedic was looking anxiously at me. "Ok", I said, "We'll intubate her." I was talking about giving Samantha a general anaesthetic, passing a tube into her windpipe and breathing for her. This is to optimise the amount of oxygen getting in to her system, to make sure that there is no deterioration in her head injury.
In a hospital, when one does this sort of thing, there is lots of space, lots of assistance, and lots of whizzy equipment to help you. I was in the back of a cramped ambulance (fortunately not moving), with 2 ambulance crew, both of whom I know well and have worked with before, and the limited equipment that I carry in my car. Fortunately, this is what I am used to, and we quickly set up the kit, gave her the drugs, and passed the tube. Working as a team, we got her ready to start the journey to the hospital.
This is always the most worrying time for me. I have done what I believe is the right thing for the patient, but what if something goes wrong on the way? It is very difficult to monitor a patient in a moving vehicle, and I have to keep very alert and my wits about me, watching for any signs of deterioration. Lightening the mood, I call to James, who is driving, "Are we there yet? I feel sick! I need the loo!" He just grunts, and concentrates on his driving. I did feel sick; I always do in the back of an ambulance, but I just breathe deeply and concentrate on MY job.
At the hospital the Trauma Team takes over; there's not much left for them to do, except check to make sure I have done everything properly. Some x-rays and a CT scan shows no significant injuries, and I am able to tell Samantha's mum and dad that she is going to be ok. I sit and chat with them for a while. I tell them about my 16 year old, and the father asks how I can cope with what I do, having kids of my own.
The next day (well, later that day; it's already Saturday morning before I leave the hospital) I go back and see her, sitting up and complaining she aches all over. Fortunately, all 4 of the kids had survived with only bruising - a minor miracle, considering the state of the car.
11 months ago