Knee Trouble

Back to work with the rather enjoyable 18:00 to 01:00 shift, where you tend to get lots of drunks, and very few serious cases that require me to do some actual work.
However, you do occasionally come across a job that is tricky, not because I worry about the patients illness, but instead for reasons that to the non-ambulance person are hard to understand.

Our first job of the day was one of those very jobs. The call we were given was 13 year old female with a dislocated knee. Nice and easy I hear you say, but lots of minor problems can build up to make a job less than ideal.

We arrived on scene and found a patient who had a rather obvious dislocated knee – just imagine your kneecap shifted two inches to the left, so much so that it casts a shadow on the rest of your leg. Simple enough to deal with – if you are feeling brave you can slide it back into place yourself, or go the more recommended route which is to take them into hospital and let the doctors fiddle with it.

Then the problems started piling up – To start with there were no adults present, just another (unrelated) teenager, neither the patient or this other teenager were what exactly call brain surgeons. We aren't supposed to deal with children without an adult present, but what else can you do in those circumstances? Her father had been called, but he was travelling from another hospital where he had been undergoing outpatient treatment. So we had to decide if it was 'safe' for us to take the patient to hospital – we use something called 'Gillick competency', but it's always a bit of a gamble on our part.

The patient had fell from her bunkbed – so her friends (who had run off) had lifted her back onto the top bunk. She was screaming in pain (which is fair enough I suppose), and wouldn't let us near her. This little problem was solved by giving her a lot of Entonox, known to some people as 'laughing gas'. After enough of this stuff she started laughing and we essentially 'grabbed' her off the bed.

Now she refused to sit in the carry chair, but because we were upstairs she needed to go in it. After a lot of persuasion, and a lot of her screaming very close to our ears, we managed to get her to sit down – this had the rather excellent side effect of popping the kneecap back in place.

This would normally mean that the amount of pain goes down by a lot – but this girl has a touch of 'hospital phobia', so she continued screaming.

While screaming she was also arguing with the teenager who was with her, telling him that he needed to come to hospital with her – but he was refusing because “How am I gonna get back home?”. I must admit I really wanted to tell him to walk it, because the hospital was only about 1000 yards away. But despite her pleading with him, he wasn't for budging – he set his burberry baseball cap square on his head and refused. I don't think she is going to be too happy at him next time she sees him.

Once that arguement had run it's course (and my crewmate and I managed to stop laughing), we had to get the patient downstairs – this was made more difficult by a sideboard that was in the upper hallway bay the stairs. To counter this problem, we had to lift her completely over the bannister – luckily she was a lightweight, and my crewmate and I are both strapping, good looking *cough* men.

We saw her later in hospital, having a plaster cast put on her leg, so that the kneecap wouldn't slip out of place. She was much happier and surrounded by her parents. She even managed to give us a smile – which, in the end, made the job worthwhile.

So this is what we occasionally have to deal with, not so much the life threatening stuff, but more the 'silly little things' that can make an 'easy' job, much trickier.

4 thoughts on “Knee Trouble”

  1. Soft as soap.I think it is because of her age, and because it's “The Season of Death” (all those new A&E SHO's come out of school). She had a fracture clinic appointment the next day, so it'd probably be removed then, by an amused registrar.

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