Wednesday, 1 April 2009

RTC Car VS Ped

I am just on my way home from taking my daughter and some of her friends (they LOVE being driven around in my car) to a party, when I get a call to an old lady who has been knocked down by a car and is unconscious. On with the Blues and Twos, and off to PoshTown. I'm not all that far away, and I arrive moments after the ambulance crew. My thoughts en route are rather negative - old people are not always very robust, and being unconscious after being hit by a car usually suggests significant head injury. But, as always, I focus on getting there safely.

I park up and jump out. I go to the boot to get my kit, and realise that I am wearing no PPE (personal protective equipment.) I would normally get into my jumpsuit at home before setting off for a job, but this time I was already driving when I got the call.

I may have mentioned in previous posts that I am rather clumsy. I look particularly ungainly when trying to get into my suit. I look at the scene - there is a lady lying on the ground, the road is blocked off, I should be alright with just a reflective jacket. I carry one of these in the boot as well, usually for observers who ride out with me. So I pull it out and put my arm in to the sleeve. It won't go in!! What I haven't yet mentioned is that I am not as slim as I would like. This jacket is not for me, not my size, and definitely not going to fit!

Ok, enough mucking about. It's civvies for this one, and let's hope there's no pools of blood on the floor for me to kneel in.

I go over to the patient with my kit. She is calling out, "John, John!" I talk to her; she is fairly coherent, and tells me John is her husband. She is able to tell me that she remembers walking out of the church and crossing the road, when she was hit by a car. Not unconscious, then! There is a lady, also in civvies, putting a venflon in the patient. I introduce myself, and she tells me she is an off-duty A&E doc. Fair enough, the more the merrier. I leave her to the intravenous access, and carry on with my assessment:

Airway - talking, so that's ok

Breathing - same as airway. But, she is complaining of severe right shoulder pain - that might indicate an injury to her chest on that side. Have to have a closer look in a bit.

Circulation - she has a good, steady, strong pulse. But, she is complaining of severe pain in her left hip, so she might have a fractured pelvis. You can bleed all of your blood volume into one of those, so better be careful there. She's having her iv line sited, so, again, need to have a closer look shortly.

Disability - she is fully conscious, but a bit drowsy, and quite repetitive. She has some blood from a head wound (another pair of trousers ruined...) but is moving all four limbs. She will need a CT scan when she gets to hospital.

One can get a lot of information from looking at the scene. I quickly check out the car. There is a dent in the front passenger side bumper, and a large starring of the windscreen - what is known in the trade as a bullseye. So, I now know how she was hit. She impacted with her left hip on the bumper, and the right side of her head / shoulder on the windscreen. The bonnet is unmarked - there was little or no impact of her body on this part of the car. Oh, and then she was thrown to the ground.

She is scooped on to a stretcher, me doing an equal part in the lifting, and taken in to the ambulance. A second look reveals a definite pelvis fracture, a fracture of her shoulder and a probable femoral fracture. We shouldn't muck about with this one. The elderly do not tolerate blood loss as well as younger patients, and she is at risk of decompensating if we don't get her to definitive care. I won't be doing anything more with her - we are only minutes away from GoodHospital, and I can follow in my car, ready to jump out if there is a problem.

We arrive at GH, and I hand over her care.


  1. Another interesting and well written post thanks RRD.

    How often do you get called out? Is it the traditional nothing for weeks then 3 times in a day type of scenario or does it seem fairly steady.

    With regards to your kids loving riding in your car, is it marked up at all or is it all covert lighting etc?

  2. Thank you, Mart, hope you continue to enjoy what I have to offer. Yes, my call-outs vary considerably. I had 3 last night, and may not hear anything for another 3 weeks. And, yes, my car is all marked up - have a look at my next post for some comments about it, and the fun I get up to...