Friday 3 February 2012

Slow motion

"RTC Car vs Pedestrian 'Running Call'"

The 8 minute target is much talked about and discussed at length. The government require us to be on scene within 7 minutes and 59 seconds of a 999 call being connected should it be categorised as a Cat A call. Cat A basically means immediately life threatening and as thus Cat A calls are generally cardiac arrests, unconscious, chest pain, seizure, major trauma and any medical condition where death is a possibility. Obviously, this is open to interpretation and based entirely on the information given by the caller. Regardless of what the job is we try to get there as quick as possible. During the drive to any job, the attendant in particular goes through in their mind what exactly what they will possibly be walking into, what kit they will need and what the protocols and guidelines are if the job is 'as given'. These few minutes of composure are extremely important for the jobs where a life hangs in a balance but more often than not it's all a worry about nothing. That's the job. For me, doing without those few minutes is where I'm taken out of my comfort zone. You learn very quickly what is and what isn't second nature and as a crew you have to rely on each other to do the right thing.

As per usual, as is customary on a relatively quiet weekday morning, we were sat outside Costa coffee getting our caffeine fix. The day had been pretty uneventful and we were just watching the world go by waiting for a job. We were at the far end of the high street, the road clear of shops ahead of us and clear of traffic. The next 10 seconds occurred in slow motion. A woman, on her own, came into my view running / jogging up the side road about 20 meters away. As she approached the main road she appeared to look diagonally across in our direction to check for cars and continued into the road. Everything slowed down even further, as each step she made went by a maroon Ford escort inched closer and closer to her. We were the only ones who knew what was about to happen and we were powerless to stop it. The car struck her, she went no higher than 6 feet in the air and span like a Catherine wheel. She landed on the bonnet to a screech of brakes. The car ground to a halt and she was catapulted forward off the car about 30 feet and lay motionless on the floor. Still in slow motion we watched the car door open, out stepped the driver, 3-4 pedestrians from both sides of the road ran to her aid. Forget 8 minutes, we had 8 seconds until we'd be on scene. 

The passers by started to place her in the recovery position, my crew mate sounded the horn and I waved frantically for them to stop. They did. I jumped out and went straight to her head. Her face was covered in blood and grazes. To my surprise she opened her eyes and started crying. That's a good sign! My crew mate came over loaded up like a pack horse. He didn't know she was alive and talking so had unloaded everything he could carry, all the bags, the collars, the suction and the paramedic bag. While he was staggering over I pressed 'priority' on the radio on my belt. I just shouted 'Running Call, RTC Car vs Ped, HEMS required'. I knew we'd need HEMS because both of the legs were pointing in the wrong direction. We began assessing her, albeit in the wrong order. Witnessing it had taken our composure away! Despite her obvious leg injury and a nasty gash on her forehead she appeared stable. We gave her Morphine which didn't really help but it was a start. We wanted something inside her as  the fractures would need reducing. We cut off her clothes keeping her as covered as possible. Her left leg was broken and were unable to late a pedal pulse in her left foot. We needed to pull the fracture so after explaining what was going to happen and some lugs of Entonox my crew mate straightened her left leg. She screamed but after a few seconds felt more comfortable. We put both her legs in splints and started patching up her head injuries.

Twenty minutes after calling HEMS arrived. To be fair we had done everything. All her injuries had been assessed, treated, dressed and splinted. The passers by had been a great help and all we needed HEMS for was more pain relief and someone to pass the responsibility on to. They obliged and drugged her up ready for transport. Strangely, if we had had the 8 minute drive to scene I doubt we would have requested them but we panicked. Having to deal with trauma when you've seen it happen puts a different slant on it and you approach it with more frantic severity than you would otherwise. If we'd arrived and a witness told us the lady had been hit at 40mph, spun at least 3 times in the air, landed on the bonnet and then shot forward 20ft and rolled on the floor, we would hear it as 20mph, spun once and fell to the floor. Generally people embellish, not through malice or a need to lie but because everything is exaggerated when a monumental event occurs before your eyes. I'm sure it wasn't as bad as I remember it but we are only human. 

This lady was lucky, a broken leg, a dislocated knee, 6 stitches in her forehead and a fair bit of bruising.  It could have been so much worse. This all occurred though through a moment of stupidity. A moment where she didn't think, and we all do it. We all forget to put our seat belt on at some point, answer our phone when driving, look at something on the pavement, cross the road 20ft from a crossing, run into a road because when you looked 5 seconds ago it was clear. We just do stupid things we know we shouldn't. From when we learn to walk and talk we are constantly told to Stop, Look and Listen or Look Left, Look Right, Look Left again. Our patient knew that. Why didn't she? Because she didn't! Has she learnt her lesson? Yes! Will she do it again? More than likely.......

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