X-ray of the neck : Photo by Andrew Ciscel

As I mentioned yesterday, my crewmate is, I don't know, sunbathing topless on a French beach or something, so I have brand-new people to work with. And there are a lot of brand new people coming out of training school ready to be scarred for life educated by myself.

Working with someone fresh out of training school is normally quite enjoyable - I can show off, while they can tell me how whatever I'm doing isn't part of current educational theory on pre-hospital care. It's a win-win situation.

The first job I had with the shiny new recruit was a woman who'd fallen downstairs - often a nice and easy job and, as I blue-lighted us towards it, I checked up on what my crewmate knew about such things. As it was she wasn't confident about clinically clearing a neck injury, so I thought this would be a good chance to show her how it is done.

Our patient had fallen the entire length of the stairway, about thirteen steps rolling head over heels down them. She was complaining of neck and shoulder pain but had got herself up off the floor to sit on the sofa.

I'd gone over the finer points of clinically clearing a neck on the way to the patient, so what was left was for me to actually feel down the neck to see if there was any bony tenderness.

Down the bones of the neck I felt - C1, C2, C3, C4, C.... Oh dear, judging by the way she yelped in pain she seems to have a rather sore neck at the level of C5.

A really nice patient (and family) and we were going to have to truss her up like a turkey in order to make sure that her suspected neck injury didn't get any worse.

So that is exactly what we did, c-spine collar, strapped down and as smooth a ride into hospital as I could manage.

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We returned to the hospital a little later and they confirmed that our patient did indeed have a broken neck, it was just then a question of if they were going to treat it conservatively (with a collar), or if she would need surgery.

"You see", said the doctor to me as I asked about our patient, "anyone with a bony pain in the neck needs to be collared".

I didn't bother explaining that this is exactly why we had brought her in strapped down and with her neck immobilised.

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I don't know why, but my regular crewmate and I don't do 'trauma' - but as soon as one of us goes on holiday the other is left having more trauma in those few days than we would otherwise have all year.