Scissors

She's 65. She's in a bad way. She's lying on the floor, moaning incoherently, with blood from her left ear, and her left eye swollen shut. Her arm is bent at a funny angle as well, but that's not bothering me now. What's more concerning is her head injury. I look at the car: the windscreen has been hit hard from the outside, and is now mostly in the car, on the passenger side. Thank goodness there was only the driver in the car, when it hit the lady as she crossed the road, iPod headphones bought for her by her granddaughter for christmas drowning out any extraneous noises.

The HEMS crew arrive shortly after me. They are in the car, it being night-time (oh, and it's raining - again!!!). I confer briefly with the HEMS doc, who is happy for me to run this one, and happy to take the patient for me to St Mary's Hospital. I am on call for my own hospital tonight, so can't be going on any road trips...

I call for assistance to stabilise the patient: scissors to cut up each trouser leg and across each sleeve, a cannula in the uninjured arm, blood pressure and other vital signs.

She's a bit more awake now, calling out, and asking for her mother. She's very confused and agitated, so will still need tubing before transfer.

The HEMS team do things a bit differently from me. They set everything out very neatly and ordered, whereas I have a tendency to unzip my bag and turn it upside down. And then there's the checklist. Before I tube a patient, I have a look around and make sure I can see the bits I might need. The HEMS crew have a laminated sheet, with a list of equipment, drugs and personnel, which is called out, much like the checklist before flying an airplane.

Please don't get me wrong: I agree in principle with the idea of a checklist, but it's just not me.

I call out the items on the list, and receive a "Check!" from the paramedic assisting me. I take a breath in, inject the drugs and insert the laryngoscope. Easy view! The tube goes in, we secure the tube, and the patient is wheeled into the back of the ambulance. 5 minutes later, the ambulance is off, with the HEMS doctor inside.

I look around at the mess that is left: discarded packets, gauze, blood from her head wound, and the tuff-cut scissors I used to cut the patient's trousers. I look around - no more ambulance crew here. I feel strangely deflated, giving over the patient to the HEMS crew and not being able to complete the job through to the hospital.

But at least I've gained a pair of scissors.