"93 year old female, fall"

We pulled up outside and were beckoned towards the house by the concerned neighbour who had found her on the floor.
"She's been there for 12 hours, bless her. She's in the downstairs toilet."
Poor thing. I headed round the hallway to where she was and what I saw shocked even me. I just starred for a few seconds and made the following observations.
- That shouldn't be facing that way!
- That shouldn't be up there!
- That shouldn't be that colour!
- How in God's name are we going to get her out?!?
So, with or without medical knowledge we all have a grasp of human anatomy. We all know, therefore, that the foot has no place anywhere near the shoulder. We also know that it shouldn't be blue. THAT is what was facing us! Not only was her leg so badly twisted / fractured / dislocated, but her other leg was wrapped round the toilet and her arm was stuck behind some pipes. It was like a contortionist meets a Rubiks cube + injuries.
We immediately asked for more hands. No way would 2 of us be able to get her out of there. She apologised for wasting our time! If only she could have met our last patient who was drunk in the street and full of venom. (In fact the way he was spitting resembled a venomous snake!) I started her on Entonox while we tried to assemble some kind of plan. Unfortunately, like most other bizarre jobs, this ISN'T in the books! A couple of FRUs arrived and joined in the "ooohh's" and "eeeek's" and "ouch's". We decided it was going to be best to free the limbs that would be 'easily' freed, get some IV access, load her up with morphine, get her out with the bad leg still in that ghastly position, and then finally straighten her leg. Simple!

The doorway wasn't wide enough for us to be able to lift her in the position she was in and carry her out. The room wasn't wide enough to realistically straighten her leg inside and then get her out so some more head scratching occurred! It was decided that a rescue board would be slid down to us. We'd lift her off the floor a few inches whilst the board was slid underneath. Then, we'd carefully slide her along the length of the board, through the doorway and into the hallway. It worked a charm! Now for the leg. After another dose of morphine and plenty of Entonox we went for it, slowly. I felt a vile click as her knee cap moved about but now her leg was straight (ish). By 'straight' I'm not taking into account that her foot was still facing the wrong way. The fracture dislocation of the ankle was going to be left for the hospital to deal with. We secured it into a vacuum splint, continued with pain relief and got her out and off to hospital as quickly as possible.

Very rarely do I see injuries that make my stomach turn and it isn't often that I look at someone and literally don't know where to start! People manage to fall and get stuck in some of the most incredible positions! I really don't know how. I just hope I'm never unfortunate enough to do anything similar. I can't even comprehend the pain. It doesn't bear thinking about!
I just love love love reading your blog!! I've share it with a few people and they are buzzing from it as well!! Another fantastically written piece! Can't wait for the next one.
ReplyDeleteMyke :)
Ouuchh-eeeeeee! That should have come with a cringe factor warning! lol. Poor poor lady.
ReplyDeleteOh poor lady. I'm so glad that there are paramedics with the training and experience to help her and others.
ReplyDeleteYe gods! That made me wince reading it!!
ReplyDeleteyou do a brilliant job keep it up just love reading the blog
ReplyDelete