Tuesday, 15 September 2009

Fun in the Back of an Ambulance!

His name is Chris, and he is 12 years old. He's been out for a bike ride today, wearing appropriate protective gear. He has a helmet on, and elbow and knee protectors. Unfortunately, these will only do so much when you ride straight out of an alleyway into a busy road. He's been clipped by a car, and on my arrival is lying in the road. According to his mum, who is with him before the ambulance arrived, he was out cold for a few minutes, but seems to be ok now.

I have a look at him: he's awake and talking, his pulse is strong and regular, but he does have a bump on the back of his head. He has a few abrasions, but seems to have got off lightly, considering.

I have a chat to the crew: we are about 15 minutes away from the local A&E, and I feel it's probably best to ride in the back with Chris and his mum, just in case. After all, he was "out cold" after the accident.

As we are travelling to the hospital, I am chatting to mum about BASICS, and what we do. She used to be a nurse, so she is quite interested in what I do. I keep a close eye on Chris all the time: he is quiet, but responding appropriately to questions, and his observations are fine.

About 10 minutes away from the hospital: I notice that Chris is a lot quieter. He is still responding, but just monosyllabic. Hmm. I'm getting a bit worried about this, and I let mum know that I will be asking the hospital to get a Trauma Team ready, "just routine precautions, nothing to worry about." Phone call made, I am also less communicative, watching Chris carefully.

About 5 minutes away from the hospital: Chris is hardly talking at all now. My heartrate is higher than his, as I quietly, calmly, start drawing up some drugs, "just in case, nothing to worry about, Mum." My call to the front of "are we nearly there yet?" is meant seriously.

About 3 minutes away from the hospital: Chris is looking over to his right. This is baaad. We're not going to make it. I will him to keep in there, just for another couple of minutes, but I realise that time is running out. I quietly unzip my intubation bag, "just to be safe, nothing to worry about, Mum."

About 2 minutes away from the hospital: I turn to mum, just to reassure her. I see the look of horror on her face, and know that time is out!! "He's fitting!" she screams at me. I turn back to my patient, to see a full-blown, tonic-clonic seizure. His body arches and strains against the straps, and his face takes on the blue shade of cyanosis.

"Stop the vehicle," I call, and ask Mum to step outside while I sort out Chris, "Just to get him a bit stable, nothing to worry about!" I'm not very convincing at this point.

Withing 30 seconds of his fit beginning we have anaesthetised him, and secured his airway. With no other injuries, we are able to carry on the journey to the hospital, far more uneventfully than before. Mum is sitting next to me again, and I am reminding her about extradural and subdural haemorrhage, as well as intracranial contusion. I remind her that, as Chris was fully conscious before we left, and that as we had terminated his fit and maintained good oxygenation for all but half a minute or so, his prognosis is excellent.

Arriving at the hospital, I hand over to the team, then wait with mum for the CT results - a small contusion, no need for surgery.

2 days later, Chris is woken up and extubated. 2 weeks later he is back at school.


  1. "Just in case," indeed. Thank you for this story, and all the others. I've just read all of your blog in one sitting. I am captivated by your writing; not only with the stories, but with the humanity with which you carry out your mission in life. Thank you.

  2. I so wish you had been there when my lovely Mum sustained a head injury, she would still be here now had she had the care of someone like you. It comforts me that others peoples loved ones have you when they need expert help the most. I just wish the impossible that you could be everywhere! Never, ever underestimate the huge, huge difference that you make to so many ordinary peoples lives. You are the best Sir and more needed and precious than you could ever know. I am in awe of your humbleness and compassion, thank you - so small a phrase but heartfelt. Thank you, love Lois x

  3. Lois, your words have touched me. I am undeserving of your comments. So many people spend so many hours of their lives selflessly giving to others. I don't feel that I am in the same camp, as I do what I do because I love it all.

    I am sorry your mother didn't survive. I am sure the ambulance paramedics did all they could to save her - some, as you have seen from my blog - are beyond anyone's help.

    Keep reading, keep smiling. RRD

  4. You are not undeserving of my comments. I am glad that you do what you do because you love it all. That's lovely because it means that you give it your all and you care - you are compassionate to others in a time of great need. Sadly the A&E Dr that spoke to my brother showed no compassion or concern for my brother. Fortunately a Nurse heard the brutal and dismissive way in which he addressed my brother and told him what had happened to my Mum and where she had been moved to It really does make a huge difference when a Dr shows compassion you can never really know how much difference you make. My Mum didn't have a Dr to give the critical care needed prior to her arival in A&E but it comforts me that there are people like you that can give that care and make that difference. Please don't underestimate what you do, i would give anything for you to have cared for my Mum and my family. You give people a chance that they don't otherwise have, and that comforts me in the midst of the awfulness of it all you give hope. Please know that you are very, very precious and that the care and support that you give and the difference that you make is huge. You could never know how much, it is too big, beyond that which words can say. You are the best! thank you, love Lois x