I often bemoaned the fact that I tend not to get sent to many jobs involving ‘trauma’. If you’ve been stabbed, I’ll be down the road picking up a maternataxi. If you’ve fallen out of a second floor window, I’ll be one street over dealing with the sleeping drunk. And if you’ve thrown yourself under a tube train, I’ll be one stop down dealing with the twisted ankle.
So the smallest little traumatic injury makes me happy.
We were sent to a fifty year old man who had fallen. We made our way up the stairs to the gentleman’s bedroom and saw him lying on his bed with a woman in a nursing uniform crying her eyes out. The patient had indeed fallen, his foot was the main injury.
The patient normally wears a caliper on his foot, due to nerve damage from having polio as a child. He had fallen and the caliper had caused the toes of his right foot to bend upwards. He had split the skin on the underside of his foot where the toes meet the body of the foot, and he had probably broken something.
The woman in the nursing uniform (who turned out the be the patients wife), told us that at least one toe had been dislocated, and that the patient had twisted it back into shape himself.
He was, unsurprisingly, in a lot of pain.
First, we got the patient some pain relief, some Entonox. The Paramedic I was with was going to give him something stronger, but the patients pain completely disappeared with the ‘laughing gas’.
We then bandaged his foot, and placed it in a vacuum splint. This is pretty much a sand filled bag, that becomes rigid when you suck the air out of it. They are very handy when dealing with injuries in awkward areas. I don’t get to use them often, but when I’ve needed one, they are perfect.
We then had to, very carefully, carry the patient down the stairs.
All the time the patient was thanking us for looking after his pain, and for helping him get to hospital. He was a genuinely nice man, and his wife was nice as well. It was a good job, in that we were able to help someone who needed help and while we needed to put our thinking caps on as to how best to get the patient out of the house the job went smoothly.
I spoke to him later in hospital – he’d managed to break three toes and one of the bones in his foot, his wife was still with him, and once again they thanked us (and let us know that the Entonox was a better pain-killer than anything the hospital gave them).
It put me in a good frame of mind for the rest of the day.
8 thoughts on “Gassed And Splinted”
And the nurse's uniform? Bona fide or sex toy?
It is so-o nice when you can do your job, isn't it?
Good point Lesley.Good one Tom
This tale and the mention of dislocation that resided therein reminded me of my own dalliance with dislocation three weeks ago yesterday and if I may I'd like to briefly recount it to the reading public and ask 2, if not more, questions.I play rugby ( I live in the North so it's Rugby League). During a game three weeks ago yesterday a 19 stone man collided with my upright left leg causing it's knee to severely dislocate. I can only describe the sensation as utter and total howling agony far worse than any physical pain I had ever encountered up to that point. I haven't got a photograph but my patella (kneecap for you peasants) was pointing 90 degrees west of where God intended it to. A bird's eye view would have given the impression of a mastectomy given the hole that existed where my kneecap should have.
About 20 minutes of lying on the floor late the ambulance arrived, put me on a stretcher (such fun when they move you around) and whisked me off to Bolton Hospital where the knee was popped back into place amidst extreme pain. My left leg now lives in what is termed a cricket pad brace rendering it unbendable. I am on crutches and have 3 more weeks to go on them. I'm in considerable danger of going insane and have been forced to renew my subscription to Sky Sports to help break the tedium. I'm even re-reading Foucault's Pendulum.
So, my questions are thus:
1) How far up the leg pain scale is a severe dislocation of the knee? When it first occured I thought it was a break, plain and simple. People with more experience of leg injuries than I reckon a break is less painful and a dislocation altogether more of a hassle. Can this be true?
2) It is approximately a 7 mile trip from where the injury occured to Bolton Hospital. Is it normal to devour an entire cannister of gas and air before we'd got within 2 miles of A&E?
I know what you mean when you state it was 'a good job'. They don't have to be life treatening or time critical to make you feel you have made a difference. Get rid of the pain and the majority of injuries can be tolerated. We dont have vacuum splints up north and just had training in a Sager splint. Another oh it's the end of the tax year and we haven't spent enough so lets go out and buy each vehicle a splint without telling the staff! Hoorah! As for the rugby players disclocated knee – Question one – 10/10 and Question 2 – Yes!
From experience, I'd say a break can be almost painless – the only time I've ever been a customer of the Ambulance Service was a couple of years ago when I slipped on the stairs at home, only three steps from the bottom, landed a bit awkwardly and thought I'd sprained my ankle, so I hobbled to the front room and took my boot off to inspect the damage. This was when I noticed my foot shouldn't have been at that angle, and called 999 on my mobile. Then the realisation of “how was the ambulance crew going to get in?” so I crawleed to the front door and found the major problem was that following a burglary ten years earlier I was in the habit of shutting a bolt near the top of the door — trying to reach that was the only time in the whole experience that I was in pain. It's not easy trying to reach a bolt nearly 6' up when you've got a broken leg! Then back to the bottom of the stairs to await the arrival of the paramedic (round here they don't send an ambulance round in cases like this until it's confirmed that it's needed). I don't bolt the door any more, I'd rather be burgled than go through that again!Anyway, thanks to not having had any breakfast that morning, about four hours later I was in theatre getting a plate, seven bolts and a couple of pins put in to reattach the bottom of my right tibia and fibula, which had broken just above the ankle, followed by a week experiencing the (very good) hospitality of Leighton Hospital, Crewe (even if one of their nurses was subsequently jailed for sending several patients she considered to be “bed blockers” to meet their Maker). I can honestly say that apart from the episode opening my front door, I didn't experience any pain at all.
You know don't you that only those in emergency service would understand why you'd be happy for a good trauma case?
Loved the contra-indication of 'Nutter' for Entonox on the linked page