Do you think you hit an artery instead?

“Ok, mind out, sharps . . .”

A Tech 4 took the sharps needle from me and deposited it into my little sharps bin attached to my bag.

I’d blown the vein . . . which was annoying really, as it was huge, like a hose pipe.  So confident was I about getting it in I’d gone straight for a size 16 cannula – a big one.  But, our patient was suffering exacerbation of his and wasn’t in a particularly good way.  As such, he was sat in a tripod position desperately trying to force air both in and out of his lungs.  This, of course, made him highly agitated and was the sole cause for my failure in cannulating . . . well, that’s my excuse anyway.

We already had a nebuliser on and wanted to just go – but our patient was in that little grey area of agitation which makes them refuse to move and gives them just enough strength to fight anything you do . . . so, we had to stay and play.  For a short while at least.

The other medic compressed a bundle of tissue on the little hole I’d made in their arm after removing the failed cannula.  Instantly, the blood soaked through and was almost pouring down the patient’s arm.  We quickly removed it and put another more compact dressing onto it and pressed harder.   This too, quickly became saturated.

“Do you think you hit an artery instead?”  The medic tried to ask under her breath.  Thankfully our patient spoke poor English and was otherwise preoccupied with trying to stay alive to pay attention to our conversation.

“No way man!  His vein was huge!”  But then doubt started to kick in.  It only takes one thing to set it off – and this was it.  The wound was bleeding . . . lots!  So, maybe I did hit an artery . . . but I couldn’t have, no way.  I felt myself going red.

I glanced over and over it until – click!  The proverbial light bulb switched on.  The tourniquet!!!  I’d left it on.  So, after quickly removing this from the upper arm we were able to subdue the bleeding and crack on with getting another vein and treating our patient with some drugs.

Soon, our patient was calmed enough that he ventured into the carry chair and allowed us to transport him to the ambulance.  Here, we made him comfortable and rechecked his observations.

As the blood pressure was being taken I suddenly noticed a large wet red patch gathering on his crotch.  As I stepped in closer to see what it was a fine jet of blood hit my arm and trousers.  It was then I noticed the constant squirting blood coming from the cannula wound I’d gone for.  The original dressing had dropped off ages ago in all the excitement and now, the BP cuff had caused so much pressure, it had blown the clot and made it bleed again.

After placing a finger on the fountainous wound and taking off the BP cuff we all exchanged a few giggles and apologised to the patient.  He smiled back and rolled his eyes – thank god, he was on our side.

Eventually, the patient was blued into the local hospital.  I followed in the car so that I felt like I was doing something useful.  And, after the Ambulance crew handed over to the Doctor in resuss the nurses all set about the patient putting leads and probes on.  And before we could say or do anything, one nurse had placed a tourniquet above the original wound and . . . . . blown the wound right open again.

“Yeh, that’s the one I missed . . . sorry”  Giving this vital piece of information after she reopened the wound was really helpful.

Out poured the blood again, all down the patient’s arm.  And as we turned to leave, we saw the patient glance at his arm, then at us.  He rolled his eyes, shook his head slowly and started to chuckle before waving us goodbye.

Binder

 

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“Chronic Obstructive Pulmonary Disease”.  A generic term used for a long term illness associated with the lungs – eg, Asthma, Emphysema, Bronchitis etc.  Patients with COPD usually present with difficulty in breathing (DIB) and are a high percentage of our call-outs.  Smoking is a massive influence to this condition – I reckon if we could take the general public round with us sometimes to visit the folk who are COPD due to smoking, it would probably turn things around.

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