The Last Journey

Oh how I hate these kinds of jobs. Hangings never go well. The patient usually is in a very bad way and they are often at home, found by family members, which adds to the intense emotion of an already tense situation. So, I am very wary of this job. Also, the fact that I haven't been out on a call for many weeks doesn't diminish my concerns. I mentally run through the contents of my bag. Did I replenish the drugs after my last call? Do I have enough syringes? Are the batteries in my laryngoscopes still live? There is nothing I can do about these things now, as I drive into the car park to a block of flats near to where I live. This is not a particularly selubrious area, and I am comforted by the number of blue lights and police vehicles I can see parked up. I jump out and grab my gear.

Ok, number 63. Where is number 63? It's dark, and despite the presence of what looks like most of the emergency services in London, I can't see a living soul. Oh,a nd surprise, surprise: it's raining.

Erm, what now? I tried a tentative "Hello?", but got nowhere. Then, from a balcony above, I hear some murmuring. This sounds promising. I move towards the stairs leading up, and see, in very small type, the words "15-63". I start making my way up the stairs.

Now, for those of you who don't know me, I don't really do stairs. Lifts are good, escalators I can cope with. But not stairs. And not this many. And not with a 25kg bag on my back and a 5kg monitor in my hand. But, this building doesn't look like there is going to be a lift. Or escalators.

I stumble on to the 4th floor, and call out again, rather breathlessly. This time, I am answered, and ushered into a tiny hallway, and my first glimpse of Jake.

Jake is lying on the floor underneath a loft hatch. He is being held down by two policemen, whuile the boys in green tend to him. He is agitated, and has the marks of a noose around his neck. He has, according to his flatmate, fallen from the loft, with a rope around his neck. The rope held him for mere seconds, before he fell the last remaining feet, to land in this tight space between front door and the bedroom.

I think quickly: he is currently maintaining his airway, but is very agitated. He has clearly suffered some hypoxia (lack of oxygen) making his brain not function properly. He needs intubating and ventilating, and getting to a trauma centre.

We are 4 floors up. If I tube him now, it will be incredibly difficult to keep ventilating him all the way down the stairs. The likelihood is that any brain injury from his hypoxia will only be made worse by the journey down the stairs, not better.

So, we need to get him down awake. But he's not the most cooperative of gentlemen. Not at the moment, anyway. He's moving all his limbs, the lower ones quite agressively, so he hasn't broken his neck. But we still need to be very careful in how we move him.

I decide that he needs to come down awake, and we strap him to a scoop stretcher, before making the precarious journey down with him. Well, when I say "we", I mean the ambulance crew. I go on ahead to set up my equipment and drugs for the inevitable intubation when they bring him down.

It's a good 15 minute journey down the stairs, and I am completely set up by the time they bring Jake down to me. I need to reassess him, just so that I have a baseline set of observations. Pulse, 96. Blood pressure, 130/75. Oxygen saturations, 98%. Glasgow Coma Score, 15. Sorry? Let's just check that. Yep, he is fully conscious. Hmm. I decide that tubing this one may be a little more than he needs. I'm not sure how he could have improved so dramatically in such a short space of time, but I'm not arguing.

He still has had a major insult, and needs to go to a Major Trauma Centre. It would be inappropriate to ignore the low GCS initially, nor the mechanism of injury. I look at my watch: 22:30, T-1. T being the day that my local Major Trauma Centre opens its doors 24 hours a day. Yes, tomorrow at 8am, I can go to my local at any time of the day or night with my patients. Not tonight, tomorrow. Tonight I'm off to the Royal London. That's a looooong way. Over 45 minutes. Still, I have no choice.

What I do have a choice in is how I get there. The patient is going in the back of the ambulance. I'm not happy to have the crew take him there all on their own, not on a 45 minute journey with a man who, 15 minutes ago, had a GCS of 6. But, if I travel in the back with them, then someone will have to somehow get me back to my car. However, if I follow in my car, I can still jump out and help if they run into trouble en route, yet I will have my car available to drive back immediately.

Decision made, we package the patient securely, and I start on my last journey to the Royal London.

Puddle

It's raining. I guess that's normal. What's not normal is that I am underneath a 4X4 looking after a young lady who was hit by aforementioned 4x4, and is currently lying on her left side, completely under the car. She's fully conscious, and tells me what happened. She was walking across the road, when she saw a car slide towards her. She ran, slipped in a puddle, then watched in horror as the car came inexorably towards her, then over her. She closed her eyes and waited for the end.

The end didn't come, and now she lies there, while the fire crew use hydraulic lifting gear to raise the 4x4 off of her, and while I lie next to her, in a puddle of rainwater, putting a cannula into her vein to give her enough pain-killing medication to allow the ambulance crew and I to move her on to a board and drag her out. My discomfort, that of the water seeping inexorably through my flight suit and my trousers, is nothing compared to her pain from her fractured pelvis.

Eventually she is out, and we get her to the hospital to be checked out. I make a mental note to myself to get my suit cleaned, and waterproofed at the same time.

Flying!

He loves driving. He's quite good at it, actually, having been driving for well over 6 months. He can handle his car with ease. So what if he drives a bit fast sometimes. He can cope. He never drinks and drives. That would be silly.

He's out with his mates. His girlfriend is driving her car, and is in front of him at the moment. She can't drive properly. She sticks to the speed limit. It's 2'oclock in the morning - what's the point of a 30mph speed limit. After all, it's not as though there is anyone else on the road.

Ok, time to show her just how to drive!! No room on the right, so have to undercut on the left. Drop back a bit to give some accelleration space, then floor it, and onto the pavement.

He hits the concrete bollard at well over 50mph. The bollard is partially uprooted, and ends up at a 30 degree angle, just perfect to act as a take-off ramp.

The car sails through the air, at a height of 2 metres, and comes to rest on the roof of a Volvo S60 (band new, from the look of the plates) that was parked in the owner's driveway.

I arrive to see 4 young lads walking around, somewhat dazed by what has occurred. None have any significant injuries. Not one. The girlfriend doesn't look happy, and I wonder, as I drive away, whether the only thing that has been broken in this accident, (apart from the unfortunate S60) is the relationship.

I go home, so pleased that my teenage son isn't like the others. Oh, and that he can't afford the car insurance, so won't be driving any more.

Bad Boy

I am a bad boy! I have been told off, by my friends, by my father, by the paramedics who work with me. I complain about not going on any jobs, and then, when I do, I don't write any blog entries about the jobs I do go on.

The only ones who really matter are you, Constant Reader. I have let you all down, by neglecting my duties as a Blogger.

I could tell you about how busy the Hospital has been over Christmas. I could tell you about the lack of staff, leading to me working more hours than there are. But, the bottom line is that I haven't written. And that has to be rectified.

I will try, try very hard, to keep the writing going. There has been a hiatus (more of a huge hole!) but I will make all endeavours to bridge the gap.

To be really honest, I miss the release that I get from writing. I feel emptier as a result of not writing.

So, without any further ado....

The Essentials

Ah, Monday mornings!! How I love my Monday mornings! You see, I don't go to work until 4pm on a Monday, so for me it's a continuation of my weekend, just without the noise of 5 smaller people.

It's a dressing gown morning for me. Mrs RRD has been up at the crack of dawn to take Princess and Micro2 to the bus stop, and I am enjoying a hot cup of tea and some 'us' time, while we work out what to do with our day together.

The ringing of my 'phone sends a small shiver of anticipation through my bones: yes, the screen reads "Unknown." Control seem to have got the message that I am still alive, and this is a call to a trapped RTC nearby.

"Want to come with?" I enquire of Mrs RRD. She acknowledges that this might be fun, and I rush upstairs to get dressed.

As I run down the stairs she is passing in the opposite direction! "Get into your suit and program the SatNav," she suggests, "while I get my essentials."

Thirty seconds later, the engine running, the SatNav all ready and the lights flashing, Mrs RRD jumps in beside me; flask of tea, book and make-up bag at the ready.

As I ease out of the drive, the 'phone rings again. I answer on BlueTooth (before anyone says anything!!): "Can we cancel you down on that job: no-one trapped or injured." We climb out and continue our day.

Jaded??

Some of you eagle-eyed readers may have noticed that I haven't posted for a while. Why? Well, mainly because I haven't had anything to write about. I haven't been on holiday (apart from a weekend in Holland - more about that in a moment), just haven't been called out to anything. Nothing. Sure, there have been some serious incidents in my area; someone falling out of a tree and landing on his head, a couple of fatal accidents on my stretch of the motorway. But no calls.

You may be wondering why. Well, so am I. I call the Desk regularly, they thank me very much for letting them know that they can call, day or night, and get me running. But they don't. I ring and ask them about the call the night before, and no-one can tell me why I didn't get a call. So, I begin to wonder: have I upset someone? Nope, I'm just out of the radar.

Cut to this weekend: a great break in Holland with the whole family, visiting more family. Let me tell you something; 8 children between the ages of 16 months and 17 years in one house isn't conducive to sleep!! We get back at just before midnight from the airport. The kids are tired. The adults are tired. The phone rings as I open the door to the house. Yep, nothing for almost 2 months, and then a call at midnight on the day I get back from holiday.

It's a call for assistance to a man who has rolled his car and is now deeply unconscious. Sounds reasonable. And yet I am looking for excuses not to go. This is so unlike me. How far away is it? Oh, that would take me at least 30 minutes to get there - they shouldn't wait for me, just scoop and run.

This isn't like me at all!! Whatever the distance, wherever the call, I would normally be out of the door like a rat out of an aqueduct!! But not this time. I know I have just got back from holiday, but it was only a weekend, and I'm not that tired. And I have been complaining bitterly about not being called. I get off the 'phone wondering what has happened to me, why I am feeling so jaded for the first time about driving out at all times of the day and night.


And then the 'phone rings again. Control tells me that the crew are running to the local with the patient, and I breathe a sigh of relief. But they continue: can I run to an alcoholic who has fallen and hit his head? It's a close one this time, so I shrug my shoulders, jump into my suit and drive off to pick up the pieces of an overindulgence at the pub.

A Night Out

Why is MrsRRD nudging me? Surely it can't be time to get up already? No, it's my 'phone. I'm so sleepy that even the dulcet tones of the drum solo from "In The Air Tonight" have failed to penetrate my dreams. No wonder: I had already had one call tonight, and only been asleep for a couple of hours. Fortunately, MrsRRD is awake enough to remind me that my jump suit and boots are in a pile on the floor of the bedroom, or I would have had a bit of a shock when I got down to my car and found them absent.

A few minutes later, SatNav programmed, I shake my head repeatedly to get rid of the last vestiges of sleep, and start my journey.

The car is on 4 wheels. That's always a good start. I see the airbags have deployed. That's not bad. The windscreen has a spiderweb pattern of cracks on the driver's side, the centre of which is pushed out alarmingly. You and I both know what made that mark - yes, Constant Reader, the classic sign of a bullseye, made when the driver's head impacts at speed with the windscreen. Not so good. Not good at all.

I survey the scene for patients. There's a woman, looking ok, with a piece of gauze on her chin. She's walking around, so she can wait. There's a young chap, looking very much the worse for wear, but from an alcohol point of view, rather than injury - at least that what it seems at the moment. He is jawing away in his phone, and the police seem very interested in him.

Ok, to the car. There is a young man being extricated on a spine board through the passenger door. He has a deep gash on his head, and looks as though he has a broken femur. I presume that this is the driver, who is being brought out this way because it was easier, but, when I question the ambulance crew, it turns out this is the passenger. The driver is the rather drunk chap, who is wandering around in the company of the boys in blue! Hmmm.

I check the passenger out - he is in a lot of pain, and will need stitches galore to repair the scalping he has had, but will be ok.

Wait a minute! This is the passenger! Not the driver. But it was the driver's side that had the bullseye in the windscreen. I rush over to the car to check the position of steering wheel, just in case I have got this wrong. Nope, wheel on right, with pedals underneath. So, man who has bullseyed the windscreen is - somewhere.

I have a chat with one of the officers. Apparently, the police have taken him away into custody. (Crazily, my mind repeats a sleep deprived litany, "Rhubarb and custardy, rhubarb and custardy!"). I try to get my mind round this one. Has anyone medical seen this chap? Nope. Well, you'll just have to bring him back, then. Boys in blue not too pleased about this turn of events, but agree that they were probably a little hasty in dragging him off to the cells.

I hang around scene as he is returned. It doesn't take me long to examine him and find he is completely uninjured, save for a probable fractured toe. I relay this information to the waiting police.

"What??" he exclaims. "I've broken my toe?????!!!! Will they have to operate??".

It took all my restraint not to drag him over to his friend, lying in the ambulance, a laceration you could keep a bottle of WKD in, and show him what he had done.

I go home, and eventually fall into a troubled sleep, with dreams of car crashes and damaged teenagers.