The Complete Blood, Sweat and Tea. Tom Reynolds

the woman was sitting in a chair (having had a C-spine collar applied) with her head supported by a BASICS doctor (a doctor who volunteers to respond to calls in the community).

      This woman, who should have been dead, had a 1-inch cut on the top of her head.

      … And that was it.

      The brick had hit her on the head, then had hit the floor with such force that it had shattered. Yet, here she was with no injury other than complaining of the cut being painful. There was no loss of consciousness, but we treated her as if she had a neck injury, purely because of the ‘mechanism of injury’. It’s been a while since I’ve had to do a ‘standing take-down’ (where you get a standing patient onto a spinal board by placing it against their back and laying it flat with them on it) but it all went smoothly, the doctor travelled with us and was a pleasure to work with.

      Although she was 39 the woman actually looked like she was in her early twenties – perhaps she has some witchy super powers? Either way she was discharged later in the day.

      She was exceptionally lucky – if you can call getting beaned by a brick ‘lucky’.

      

Crunch … Crunch … Crunch … Masked Symptoms

      I discovered yet another reason to avoid alcohol, namely that it can mask the symptoms of otherwise obvious illnesses and injuries.

      We got called to a 60-year-old man who had fallen in the street: as it was 2 a.m. we could guess that alcohol was involved. When we arrived on scene the patient was standing against a wall very much the worse for drink. Admitting he was an alcoholic he told us that he had tripped over and now his right leg hurt. While he was standing there I gave him a quick examination, he had no bony tenderness and was able to bear his weight on his leg. He could feel his toes wriggling in his shoe and there was no obvious deformity to the leg. We helped him walk the few steps to the ambulance, but he was unable to manage the stairs at the back of the ambulance so we put him in our carry-chair and lifted him into the ambulance. Further examination showed little else of note; his pulse was a tad on the high side but otherwise his blood pressure and other observations were well within normal limits.

      We transported him to hospital, where the nurse gave him a quick examination, essentially repeating the examination I’d given him in the field, and she sent him out to the waiting room.

      When we returned to the hospital a little later we were told that he had a fractured neck of femur – essentially he’d broken his hip.

      He was so drunk that he felt little pain, and for various reasons none of the normal signs of a broken hip were present. Luckily, I’d documented that I’d examined for the possibility of this type of fracture and found negative signs all the way along, so should he complain (which I doubt he would do) both I and the admitting nurse would be covered.

      So … don’t drink, or you may find yourself walking around on a broken leg.

      Now I’m off to sleep. Two very long night shifts and I’m ready to collapse.

      It’s one of the main differences between A&E nursing and ambulance work – in an A&E department you have good lights, can undress the patient and can put them on an examination table. In ambulance work you can find yourself down dark, unlit streets, in the rain and with the patient lodged under a car. I did feel a little bad about this patient, mind you …

      

An Excellent Bad Day

      Have you noticed how much I talk about being tired or needing sleep? The benefits of shift work …

      First off, I’m bloody knackered, frazzled, chin-strapped, and generally tired. If I ramble just poke me in the ribs with a stick.

      Today was both bloody awful and rather good fun, which despite sounding like the ramblings of a madman is a perfectly sane way to describe today, although I’ll be glad for it to be over.

      The day started badly: I woke 3 minutes before my alarm was due to go off so I turned it off and woke for the second time 10 minutes before my shift was about to begin. I didn’t get much sleep last night so I suspect my body overruled my brain to give me an extra 50 minutes of sleep.

      Luckily, when I wake up with an adrenaline jolt like that I can get washed, dressed and speed through the streets of Newham like an Olympic sprinter on methamphetamine.

      Turning up at the station I found out that my regular crewmate was ill, and instead a ‘Team Leader’ was being sent to work with me. Team Leaders are on the lowest rung of management: they are the people who are supposed to keep the troops in trim, and so spend considerable time moaning about the speed at which we get to jobs, and the poor quality of our paperwork. I’m of the belief that if management don’t know about me, I can’t get in any trouble, so working with a new Team Leader was something I was less than happy with.

      I had barely gotten to say hello to ‘Team Leader’ than we got our first call of the day, a ‘Suspended’ (cardiac arrest) a couple of miles from station. Manoeuvring a big yellow taxi through rush-hour traffic is no fun at the best of times, but as I was driving I gave it my best shot – we got to the scene shortly after our First Responder who was already bagging and giving CPR to an obese woman in her eighties. As we were in one of the new yellow ambulances I lowered the tail lift, got the trolley out and nearly ruptured myself lifting the patient onto the trolley bed. Rolling her out to the street, we got her on the tail lift and raising it, rolled her into the back of the ambulance. All that was left was for me to raise the tail lift the rest of the way and rush to hospital.

      You may notice that I spent some time discussing the tail lift; this is because as I went to lift it, the hydraulics failed and it was stuck, sticking 7 feet out from the rear of the ambulance at a height of about 4 feet from the floor.

      I gave it a kick, a shake and then resigned myself to manually lifting the bloody thing up, all while the crying relatives were watching me pumping the manual handle like an idiot. Finally, it was raised to the closed position, so I made my way rapidly to hospital while ‘Team Leader’ and ‘First Responder’ worked on the patient in the back. I’ll not mention the road closure that forced me to make a painfully wide detour, but otherwise we reached the hospital with some speed where the woman was, unsurprisingly, declared deceased.

      After a quick tidy-up of the back of the ambulance (which after a cardiac arrest always looks like a bomb site) we got a job to an ‘unwell child’. The 15-month-old child was indeed unwell, although not life-threateningly so. The assessment was made harder by the mother having very poor English and the child having ‘Development Delay’, which encompasses a multitude of syndromes and genetic/biological causes.

      The next job was a transfer from the local maternity department to a maternity department in another county. This is a hospital that I had no idea how to get to (the details of why there was a need for transport are too boring to go into; also, I think I might say something about the mother I’d regret in the morning). I set our travel computer to give me directions to the hospital and we set off. The journey was supposed to be 9.8 miles, but after following the computer’s directions to the letter we had travelled 37 miles along rather crowded motorways.

      We had taken 30 minutes longer than we had planned. It’s the last time I trust that bloody machine. ‘Team Leader’ was not happy about the computer but we laughed it off.

      The next job was a simple maternity which we drove into the London Hospital. This was fine until I managed to drive into another ambulance when trying to leave the hospital. No damage to my ambulance, and minor damage to the other, but as my first accident in over 18 months, it was obvious that it would happen when ‘Team Leader’ was sitting next to me …

      Returning to fill in the accident paperwork, Control asked us to attend to another call – this time it