Multiple Trauma And Floppy Children

One of the ‘problems’ with working on the Rapid Response unit is, because you are so ‘rapid’, you can often find yourself first, and only, responder on a job where you would much rather have a large number of ambulance crews.

I’m thinking specifically of the RRU who was first, and only, paramedic on the scene of the recent London bombings.

I got sent on a job to one of our main roads, given as ‘car vs bus’, I thought that it couldn’t be too bad, as the speed of traffic on that stretch of road is about 4mph.

The police have already gotten the area taped off, and there is minor damage to the front of the bus.

Sitting some way away, nudged up against a shop, is a blue car.  The first thing that hits me is that there is no way that an impact that does such little damage to a bus, spins a car through 180 degrees and throws it against a shop.

(I later realise that what has probably happened, is that that the bus has clipped the car – the driver has then hit the accelerator and driven over the kerb, ending up ramming the shop).

“Hi”, says a friendly policewoman, “there is a full term pregnant adult female with a head injury, a baby that she was carrying on her lap and six other children, none of which had seatbelts on”.

“Gaa!”, I mumble.

I get onto Control, “I’m going to need at least three ambulances”.


I go to check on the woman – she is pregnant, wasn’t wearing her seatbelt and ‘bullseyed’ the windscreen.  She has the world’s tiniest cut to her head, and minor stomach cramps.

To ‘bullseye’ a windscreen, the head hits the glass and causes a distinctive ringed crack pattern.  There is often hair left in the glass.

A quick examination, and I’m happy she hasn’t broken her neck, and actually not that badly injured.  There is nothing much to do with her.

A very quick look over the multitude of children standing around shows a swollen lip on one of them, but probably nothing serious.

A female police officer is holding the 18 month baby, “I keep stroking his cheek and he keeps waking up and crying”, she tells me.

I take a closer look…seems a bit pale.

He also looks a bit ‘floppy’.

I stroke his cheek.

Not a flicker.



My salvation then comes around the corner.  An ambulance.  A lovely big, yellow, blue flashing lights and sirens ambulance.  An ambulance that can take this child away from me and into hospital where he needs to be.

The police officer and I jog over to the ambulance and I give the quickest hand-over to a crew ever1.  They take one look at the child and ‘blue’ it into the hospital.  (I later find out that the child was faking it all, and was absolutely fine).

I then have to examine each of the kids to make sure that they aren’t hiding any serious injuries, which thankfully they aren’t.  I then recheck the mother of the toddler, explain why her child has gone to hospital without her, and try to keep her calm.  While doing this I’m also trying to chat up one of the female police officers (but she’s having none of it).

So I’m kept a bit busy.

I’m also being watched by an increasing crowd of people, who aren’t impressed by the power of police tape, and so want to wander over and offer advice.  The police do a good job of shooing these people away, but it is a bit Canute trying to hold back the sea.

Thankfully, there were no serious injuries (although if I had the kit, I’d have liked to have immobilised everyone involved), and the other ambulances soon turned up to ferry away the patients.

My paperwork consisted of one report form with “Multiple patients” written on it, and a description of what I’d seen and done.   

Then I went back to station, had a cup of tea and then got sent on a job on the edge of my patch, described as “12 year old female, collapse”…


1.Apart from the time my handover was a disdainful, “the patient has a verruca”.2

2.Incidentally, also the shortest triage note I ever wrote when an A&E nurse.

21 thoughts on “Multiple Trauma And Floppy Children”

  1. Boy, is she in trouble… as the adult driving she is responsible for making sure all passengers under 18 are fully seated and wearing seatbelts. and will probably get fined for each one not belted, and get done for overloading as well….As a taxi driver who has done many school runs, it astounds me that even though there have been many sdverts and tv ads about wearing seatbelts, these mothers (and some fathers) insist on packing as many children into the car as possible for the school run….. then you have a school bus crash and the uproar an be heard for miles… why no seat belts? why 3 to a seat (fit for 2) why? etc etc …. then the same people quite happily stuff 7 or 8 kids into the car.

    the mind boggles….

    on another (slightly) unrelated note, we have a festival here at the minute, and you usually have floats… now… some smart arse has now brought up the subject of health and safety on what is after all, a 40 foot trailer on a lorry with numerous unseated and unsecured humans running about on the things….

    never mind they have been doing this for years with no injury, but, after one lorry braked suddenly (its air brakes locked) and sent 18 kids flying, it looks like you can kiss goodbye to random floats at festivals soon…

  2. 18-month-old baby faking it?! That sounds advanced. I'd love to hear the excuses it'll be able to come up with for handing its homework in late. Does this happen a lot?

  3. They know I don't like them, so they pretend to be ill, and five minutes later they are laughing and giggling with a paediatric nurse who is wondering why I 'blued' the kid in…It also happens with parents – kiddy stops breathing and turns blue, I turn up and they are happily playing with their favourite toy.

    Little sods, the lot of them.

    (In reality, kids tend to get sick quick, and then either dies quickly, or get better quickly. Annoying, but it's why I tend not to take chances with kids when they actually do look ill).

  4. That is unbelievable! I wonder if the police attempt to educate the mother on little matters like seat belts?Pat

  5. Well, I think after “X” amount of time being pregnant, you are exempt from legally needing to wear a seatbelt, and as far as I know the law for rear seat passengers is that belts should be worn if fitted…I may be wrong on the last bit.

    The police were however very interested in a normal 4 door car carrying 9 people though, and at one point I did see the driver getting a little angry with the police…

  6. with seven children and an eighth on the way, there's probably not much time for little things like that! It's enough of a military-precision-operation trying to get just one or two kids into a car!

  7. In fact, there is no exemption for pregnant women. :PChildren must be properly restrained, whether in the front or the rear (there are very few exemptions to this).

  8. “nudged up against a shop, is a blue car.” bloody lucky it were not into the R. Tems or R. Lee. Dah! [it only happens to others] . No seat belts, car nudged in a corner mudguard , go spinning and then see bodies go flying to the four winds.

  9. Tom left us hanging with: Then I went back to station, had a cup of tea and then got sent on a job on the edge of my patch, described as 12 year old female, collapseFollowup on that, please…?

  10. a floppy baby is one that has an apparent lack of muscle tone. Reynolds may have intended it to mean something else, but on this side of the pond that is the accepted meaning. I've been reading for a few months, and love all the posts.Ben from Texas

  11. Exactly, when kids get sick – really sick, they go floppy. This is a big warning sign that things are not going well for the kid.

  12. I looked after an 18month old in hospital, she craved attention.. so”if I lye here and hold my breath for long enough my SP02 will drop and alarms will sound…..”

    “if alarms sound I get many many people comeing to play with me”

    “lets hold our breath, then giggle when lots of people turn up”

  13. Clearly I'm not very bright; if I'd thought about it, I'd've remembered you hadn't been back to work since “bad job”. I always read things in chronological order (regardless of how many posts have been made since the last time I checked in), so I just assumed – foolishly as it turns out – that “multiple trauma” took place *after* “bad job”, not before.Sorry…make that plane next time, 'kay?    ;-P

  14. “Multiple trauma” *did* take place after “bad job”. The whole point is that “bad job” involved going to a “12 year-old female, collapsed” who later died. Then on Tom's first day back at work after that, he again got a call to “12 year-old female, collapsed”, which was somewhat uncanny. That's why the post was left hanging on that point. Makes for good writing. Clear now?! Doh.

  15. Nope, I had it right.   ;-p   “Multiple trauma” preceded “bad job”, and Tom was just being extremely clever, as is his wont.

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