Don’t use that, it’s shit!

When people get on with each other in this line of work, the jobs can go well.  If however, the patient ultimately dies it can be argued that it doesn’t matter how you all got on, the result was still the same.  No matter what the outcome is though, as ambulance clinicians, we need to be able to move on, learn positively from the things we do so that we can attend future jobs with (at least) the same skill and determination as before.  By working with a person you don’t get on with its easy to have that review process clouded by the single thought that the job might just of gone a bit better if only you weren’t working with such a dick head.

__________________      __________________      __________________

I sat munching on a piece of toast in the mess room.  A partly completed PRF lay in front of me.  To my right was a mug of tea, to my left a plate of toast and in front were several sheets of kitchen roll upon which were two used rubber gloves encased in congealed blood.  Partly obscured by the this, hieroglyphical pen scrawls were strewn over them providing important data from the last job.

The mess room was alive with the banter that follows interesting jobs and the topic at this stage was how my crew mate had brought an egotistical power mad medic down to earth mid job . . .

The job had come down as “20 year old female – bike vs vehicle” – Amber 2″.  Most of time this is usually a benign incident with scratches and bruises but today was going to be a little more than that.  As we approached the scene in our truck we could suddenly sense the tension and panic in the air.  There’s no easy way of describing that funny sensation of how you can just tell something is bad . . . very bad.

A traffic cop was first on scene and his face said it all before he even opened his mouth.  He was terrified.

Traffic Cop:     “She’s stopped breathing!!!”

Before I’d even stopped the ambulance my crew mate had jumped out and was doing chest compressions.  The patient was young, female and had just been run over by a skip lorry.

As I ran over it became very clear that her airway was becoming obstructed as a ‘pink blancmange’ like fountain of fluid started erupting from her mouth and spilling over her face.  Kneeling beside her head I grabbed the manual suction unit from the response bag and started making a futile effort to clear her mouth as it spilled out.  Trying to support her head was like attempting to hold a conker on a length of string, the wrong way up – her neck was irrefutably shattered.

And at that point a motorbike medic arrived.  Charging over he could clearly see what I was doing was pointless and pushed me out of the way.

Bike Medic:    “Don’t use that, its shit!  Go get the proper suction unit – now!!”

I’d only been out a few weeks and was now a bag of gibbering nerves.  So, yanking the suction unit away from the ambulance I ran back and attempted to use it.

Bike Medic:    “NO!  Not like that!  GIVE IT HERE!!!  Get on the airway – now!”

He barked an order at the Policeman to also help with the airway.  There was so much pink blood everywhere it was difficult getting the mask to seal over her face.  Whilst we struggled the Bike Medic continued with the suction.  Not content with that job he moved round and proffered the unit to me.

Bike Medic:    “Move round here and do this!!!  NO!!  Like this!!”

He grabbed my hands to make me do it properly.  None of it was going in – it wasn’t making any sense now and all I wanted to do was curl up underneath the ambulance and disappear.  This was turning out to be an utter nightmare.

Bike Medic:    “Once its clear, get straight back onto bagging!”

He turned to my crew mate, who’d been watching all this quietly.

Bike Medic:    “You!  Get those pads on her chest and – !!”
Crew Mate:     “Please!”
Bike Medic:    ” . . . . . sorry, its the Army talking in m-”
Crew Mate:     “Well, you’re not in the Army now are you!”
Bike Medic:    ” . . . . . . .”

I caught a glance from my crew mate.  She gave me a wink and then suddenly I was back in control.  And from that point forward we started working better as a team.  HEMS eventually arrived a few minutes later and were able to perform advanced techniques like .

But despite all our best efforts the patient was sadly pronounced dead at scene.  Her injuries were just too multiple and severe.  We covered her up with a couple of our blankets and let the police deal with things thereafter.

It was when I was putting things back in the ambulance that I wondered where my crew mate was.  I eventually found her sat in the back of a police car comforting the driver of the lorry.  He was in bits – his demeanour went in a constant circle of moods.  First asking (no one in particular) why the patient did what they did, then getting angry with bikers in general and then building the aggression to a crescendo where he’d finally break down in tears.  Silence would ensue and then he’d repeat it all again.

Witnesses had said it wasn’t his fault.  And by all accounts there wasn’t much we could do for him but take him to hospital to be checked over.  Talking with the driver’s colleagues later they said he’d probably never drive again.

We also checked on the Policeman first on scene.  He was shook up but fine – his superiors stood him down for the rest of the day and sent him home.

As for us – we returned to base to complete our paperwork and grab a cup of tea and some toast.  Our gloves had all the relevant information on them so we placed them on some kitchen roll and cracked on with it all.  The black humour of the mess room reigned supreme and before long we were joking and laughing about how my crew mate rescued me from the nasty evil Bike Medic.  I thanked her personally afterwards too – and typically, she just laughed it off.

Whilst back at station, Control phoned a few times asking if we were ready to accept jobs as they were holding calls.  Eventually we pressed the “Green Mobile” button our MDT and inevitably a job came down straight away – “20 year old male, abdominal pain”.

And as for the Bike Medic? – well, I’d never seen him before and I’ve not seen him since.  Its easy to dismiss his behaviour as bullish and arrogant but I understand he was also quite new and was possibly defecating himself in equal volumes as I was.  And in fairness to him, he calmed down after he was confronted.  So, as I’ve said, when people get on in this line of work, jobs tend to go well – regardless of the outcome.

Binder

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bilateral thoracostomies are where an incision into the chest wall either side of the patient is made to gain access to the lungs therein.  Usually done as a ‘prophylactic’ treatment of a tension pneumothorax or a haemothorax  Best performed under clean hospital conditions but done “on the road” in emergencies when the patient has suffered a traumatic cardiac arrest.  This is the time when a doctor to “loses” their keys.

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