This picture made me choke on my tea – thanks Ewan.  Click on the picture for more great work from the costumers who made this replica.

There has been a bit of bad news, in that my new crewmate won’t be returning to work until much later in the year.  I’m thinking of putting some plans in motion to get me a temporary crewmate.  Obviously I’ll let you know here how it all works out.

I did three jobs last night and all of them are ‘blogworthy’, here is the first of them.

It was actually the second job of the night – we were sent out of our area for a ‘Pedestrian Vs Car’.  Often these are ‘nothing’ jobs, the person isn’t badly injured simply because there are very few roads where a car can get up the sort of speed to cause serious injury.  Then I had a look on our mapping terminal and which road it was.

“Bugger”, I said to my crewmate, “could be a nasty one…”.

We got there quickly and found an FRU already on scene along with some police, one of the officers was holding the patient’s neck as still as possible.  The patient was writhing around the floor in a mixture of fear and agony.  The FRU paramedic looked rather relieved to see us.

As I jumped out of the ambulance he came over and told me that it was a hit and run, that she’d been thrown some distance and that she had an open fracture of her arm.

An ‘open fracture’ is where a bone has been broken and is sticking out of the skin.  There is always a worry about infection in these sorts of injuries, we also worry about nerve and blood vessel damage – it is a serious injury.

My first concern however was to protect her from any other injuries – specifically any neck or back injuries, and then to get her off the cold dark road and into the warm and well lit ambulance.  Then we would ‘scoop and run’ to the hospital which was less than three minutes down the road.

First things first – I told my crewmate to get our scoop stretcher and trolley bed off the back of the ambulance, then I grabbed a cervical collar and, taking control of the patient’s head, placed it around her neck.  It is here that I’m glad of my hospital experience, as she was wearing a necklace that I took off before putting on the collar – you can’t x-ray a neck that has a necklace on it, and once the collar is on then any necklace is that much harder to remove.

While I was doing this the paramedic was putting a temporary dressing on the patient’s fracture, so while I was holding the patient’s head I started to talk to her.  She didn’t remember anything about the accident, and she kept repeating herself.  While this can be normal after a traumatic event, it always makes me consider that she may have received a brain injury as a result of either hitting the car, or hitting the floor.

I was certain that we weren’t going to ‘stay and play’ at all.

We strapped her to our scoop, lifted her onto the trolley and then put the trolley in the back of the ambulance.  We could have put needles into her, filled her with fluid, given her pain relief – but with the closeness of the hospital I thought that the best thing for her would be out of my ambulance as quickly as possible.

In her confused state the patient kept wanting to poke at her broken arm, so the journey to hospital was mainly taken up by my holding her (working) hand while standing over her so I could talk to her in a vain effort to try and keep her calm.

Soon we were relaxing at the hospital having handed the patient over to the resus team.  Speaking to the FRU paramedic, he had been returning to his station after an equipment failure when someone had jumped out at him and shouted that the patient had been hit by a car.  As he put it, “four months on the FRU and the most interesting job I get is the one I get waved down for when I have no kit in the motor”.

My crewmate asked me later if I missed A&E nursing.  While generally I don’t (because, like this job 80% of it is ‘crap’, but it’s crap that is hard work), I do miss a ‘nice’ trauma sometimes – because my first thought is to get the patient into hospital I don’t often get the chance to use my trauma nursing skills.

But then again – I do now get to drive the wrong way down the road.