Monday 23 September 2013

Into The Mixing Pot

WARNING: If you are squeamish, read no further. You won't like it!

"32 year old male, arm stuck in mixer, bleeding"

Oooohhh, bit of trauma! Love it! Yes, I'm morbid but I can't help it. I don't want anyone to be shot, stabbed, run over, have limbs cut off or fall from buildings, BUT, if people do, then I want to be the first there and I will quietly revel in the glory of it to myself whilst sporting my very serious 'emergency face'. Anyway, surely if you were seriously injured you'd want a paramedic who loves trauma and doesn't flap?! That's sound logic in my head anyway!

So, the patient. I was on the FRU and pulled up outside the building site in question. I was greeted by a large group of men frantically waving. I put on my hi-vis, my hard hat (yes, we have hard hats and yes, they look ridiculous) and followed them in. A couple of them  looked rather pale. 

"I hope you've got a strong stomach, his arm is fucked."

Well, at least he's not beating around the bush. They led me up some scaffolding stairs and carried all my bags for me. Makes a nice change! On the second floor was a man with his arm in a machine. He was surprisingly calm. The machine was some kind of mixer with blades in, what for exactly I'm still not sure. What I was sure about was a) his arm was inside it, b) there was a worrying amount of blood and c) despite his calm demeanour, he was white as a sheep. I asked for torches inside the machine to have a close look. He'd managed to pull most of his arm out and from what I could see, he was only trapped by his sleeve. I tentatively cut bits of his sleeve until suddenly his arm became free. I then told him to look away as I cut his sleeve off. 

As I did, one of his mates vomited. Not the most comforting thing for him to see, or me! I insisted he did NOT look at his arm. I wanted him conscious if at all possible! Now, his arm...... The guy's original description was pretty accurate. This was the first time I'd seen a completely de-gloved forearm and it wasn't pleasant. Flesh, muscle, fat all mangled and twisted. Large areas of bone exposed and his hand was a total mess. (I called for HEMS immediately and said I needed the ambulance NOW!) Blood was coming from what appeared to be everywhere so I applied a tourniquet. Until now he hadn't been in much pain. It was all numb. Well, the scream he let out as I tightened, and tightened and tightened the tourniquet was gut wrenching. I won't repeat the words he called me. I let it slide! Just as the bleeding stopped he passed out. 

We got him on the floor and I arranged his arm to be supported upright while I dressed what I could. Apart from the guy who was recovering from his vomiting incident, the rest were amazing. They couldn't do enough to help me and that makes jobs like this infinitely easier. The extensive wound dressing and non-adhesive dressings were placed over his arm and I bound it all together. I then remembered to write the '15:37 T' on his forehead in black pen. We were told to do this if you put a tourniquet on so it is never overlooked at hospital. His arm is now dying and that tourniquet needs to come off at the earliest opportunity. 

I managed to get a line in him and starting giving him fluids as the noise of the chopper blared out above us. The patient was awake again and talking. Turns out his wedding ring fell off and as he tried to grab it his hand went in too far. He kept asking how his arm was and I kept ignoring him. I didn't know what to say. His mate answered for me.

"Seriously buddy, you may have to start wanking with your other hand!"

Everyone laughed. It is amazing what a soothing effect humour can have on a situation. Through all the chaos and horror that was around, a joke can still be made and that probably helped more than any of the drugs we could give. Everyone knew his arm was bad, he knew his arm was bad, but the people who knew him best, knew he didn't need to be told that.

Within minutes the orange jumpsuits appeared! I love it when the grown ups arrive. I couldn't give anything as his blood pressure was too low and as the adrenaline started wearing off and the pain was getting worse he needed proper drugs! Cue the Ketamine! Still without an ambulance we used the HEMS scoop, strapped him in and carried him down. He was being given units of blood on the way. 

We loaded him on to the chopper and off they flew. I was left, covered in blood, and dust, to do the paperwork. I trundled back to my car and on cue the ambulance arrived. I didn't know  whether to laugh or cry! I did know I needed a shower! 

De-gloved forearm! Awesome! One for the scrap book!


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