Bloody Trolley

The radio squawked into life, “Can anyone assist with an emergency call in Alice street?”

We were around five miles away and there were three ambulance stations between us and the call, obviously everyone else was further West than us or already busy on their own calls.

“Sod it”, I said to my crewmate, “It'll be fun for you to have a decent run on blue lights…”

So we made our way there as quickly as we could in the traffic that seems to come from nowhere at 11pm in East London.

As we approached the scene we saw our FRU already on scene along with a van full of police. My heart sank, I knew that this wasn't going to be a simple job as I could see the police stringing the 'Do Not Cross' tape around where our patient was lying. The locals, as usual, were ignoring the tape, the police were getting exasperated.

Jumping from the ambulance I headed over to the patient. Our FRU paramedic was leaning over the patient's head and as he straightened to greet me I saw that the patient's head was… well… mushed.

He had huge swellings around his eyes and head, he was semi-conscious and covered with blood and vomit.

“Apparently”. our FRU told me, “he's been hit once with a lump of wood”.

Looking at his head I wondered why, if he'd only been hit once, it was such a strange shape.

“OK”, I said, “We aren't going to hang about, lets run him to hospital”.

There was some commotion as his drunk friend gave his story, in fractured English, to a police officer while more locals ignored the police tape which was cordoning off the crime scene. I needed to know how many times the patient had been hit, as it would change my treatment of him. His friend was adamant, he was only hit the once and his face normally looked misshapen. It wasn't outside the realms of possibility that our patient was just… ugly.

As we lifted the patient onto the trolley he let forth a long stream of vomit, my boots were merely splashed.

In the light of the rear of the ambulance I could take a closer look at our patient – he did have a very lumpy head along with plenty of 'soft tissue injuries' to the face. One eye was swelling up and he was still leaking blood from a large cut on his scalp. He was still semi-conscious and I made the decision to 'blue' him into hospital.

But which hospital? If I was sure he had a brain injury then I could take him a couple of extra miles to a unit with a neurology unit, but, if his drowsiness was as a result of alcohol (and we had been told that he had been drinking a lot) then the much closer local unit was a better bet. In the end I decided on the closer unit, they would be better able to assess him and if needed could easily transfer him to the hospital with the neurology unit.

So, after making sure that he hadn't been stabbed or shot (not..ahem…unknown in East London), we started towards the hospital.

The police officer who travelled with us asked if our patient's injuries were life threatening, I could only reply that it was a possibility but he'd have to wait until the hospital ran some more tests.

It was only as we were pulling into the hospital that I noticed one of his pupils was getting larger where previously they had been equal – this is not a good sign as it is an indicator of a serious head injury, it's normally quite a late sign though and he didn't look that neurologically impaired. Still it was too late to change our destination. During the transport he had turned his head to vomit on the floor (and this is the picture at the top of this post), and on arriving at the hospital did the same on the lift of the ambulance.

Straight into resus and I gave my handover to the doctor in charge – the team descended on him and, after booking the patient in, we left to begin the long, smelly and mucky task of cleaning out the back of the ambulance (and changing my now spattered uniform).

We went back to the hospital later to find out what had happened to our patient – after exhaustive tests it was found that his facial bones had been broken in

several places and he had a fractured skull – his friend had obviously been lying when he told us that he had been hit only the once. The reason why the patient's pupil had started to change was because the optic nerve had been damaged, there was a strong chance that he would lose the sight in the affected eye.

Thankfully I'd made the right decision, after CT scans it was determined that there had been no brain injury and that the reason he was so 'out of it' was because of the alcohol he had drunk over the night.

It later transpired that the beating was in part due to the 'inter-tribal' warfare that often takes to the street of London. Country 'A' hates Country 'B', and so they decide to beat each other up. The ambulance service and A&E departments along with the police are the lucky souls who get to pick up those pieces.

OK, I have now run out of stories to write about, so I hope I get something 'interesting' in the next four days… Also I now have an empty Inbox, so if you have sent me an email and expected an answer then it's been lost somewhere.

29 thoughts on “Battered”

  1. Flying home today after a weekend break in London – I felt educated by Reynolds about the inner workings of the LAS. Being 'on the inside' at home makes you want to be in the thick of it when you see an ambulance go whizzing by (quite frequently it seems). Too bad I was here a week before your meetup ! Are you working Christmas, Tom ?

  2. Yes, very messy indeed. I haven't visited RoR for a while and don't remember you being quite so graphic – sort of ambu porn.

  3. I heard once, although I can't remember where and I don't know if it's true, that the “chopped carrots” are little pieces of stomach lining.

  4. Geez, poor guy, Man's capacity for violence to fellow man never ceases to amaze me.A quick question, any idea why he vomited up the blood? I've been thinking about it and can't come up with anything, I don't know. 🙁

  5. It's equally feasible that he had merely been drinking cider and black (possibly mixed with Pernod)……….Mind you, it's not a very “butch” drink I guess.

    Still, “butch” isn't something I would call beating ten bells out of another human being for no readily-justifiable reason other than “You're in the Wrong tribe and I'm in the Right one!”.

    No – not “butch” but “butchery”……..


  6. This patient had facial trauma so he could have swollowed his own blood from the inside of his mouth. I have found that patients that swallow their own blood do not like it to sit in there stomach for too long so the body does what comes naturally and rejects it (vomits). This is from my own experience as I have been to a fair bit of facial trauma.As well blood mixed with alcohol can also give the apperance of there being more ingested than there actually was.

    There are many reasons but I find this to be the most common.

  7. Broken facial bones => bleeding into the nasal cavity => trickles down the throat, swallowed by reflex.I once had a tooth extracted that just would NOT stop bleeding – not a lot just a trickle. But it meant I was spitting blood every few minutes. That's fine when you're awake but, as I discovered, once you fall asleep you start swallowing the stuff. After about 30 minutes I woke up and projectile vomited half digested blood everywhere. This guy must have been vomiting faster than that because the blood looks quite fresh – leave it in your gut a bit longer and it looks like coffee grounds when it comes up.

    P.S. If you ever do vomit 'coffee grounds' and you don't have a good cause for knowing where the blood is coming from – like you've swallowed blood from a nose bleed etc. – call for one of Tom's taxis ASAP.

  8. Thanks for the answers guys, I thought about bleeding internally into the stomach, but discounted that because it was given as a head injury.

  9. Just shows what happens when we have the multiracial society thrust upon us. I don't recall voting for it or seeing it in any manifesto.

  10. All I can tihnk about is the line from Dads Army where Cpl. Jones says to Cpt. Mainwaring “And there was Blood Everywhere”. LoL. Makes for interesting reading Tom. Just out of interest, what was his on scene GCS and what did it go down to at hand over?

  11. “If you ever do vomit 'coffee grounds' and you don't have a good cause for knowing where the blood is coming from – like you've swallowed blood from a nose bleed etc. – call for one of Tom's taxis ASAP.”Oooh, I had that about ten years ago from a serious head injury, I fell downstairs and was bleeding from one ear, broken wrist and far too concussed to even think about big white taxis, and I recovered okay in the end – but I always wondered what it was?

  12. Goes to show how we need to tighten up our immigration policy. I would support a system of “probation” whereby anyone committing an offence like assault / affray within the first 5 years of being here was deported.

  13. Can I ask a clinical question? Well, I'm going to! Did you collar & board him? My last lot of training suggested that any above-neck trauma indicated a collar (this was training delivered by an LAS FRU driver from a well-known station in East/Central London!). Just wondering….

  14. Aren't there rules and regulations for patients coughing blood, especially over the crew etc? I'm thinking about AIDS here.

  15. In the ideal world then yes, I would have. However on scene this can cause more trouble than it solves.In this case the patient wouldn't tolerate having the collar on and struggled to remove it. If we had 'forced' it on him it had the potential to do more harm than if we just soft supported the neck (which is what we did).

    So sometimes – if you let them lay still, it can be better than trying to hold them down.

  16. If I remember right (and this is from my very poor memory) he was E3V2M6 on scene and dropped to E2V2M5 as we pulled up to the hospital.

  17. There are no chopped carrots in it. Amazing – even my dog manages to get some of those in his vom, and I don't feed him carrots…..

  18. A technical comment from one who has his priorities right – you don't seem to have uncovered wheelchair/incubator clamp rails in the floor of your motor. So you won't have all the fun of trying to fish all the nasty squeamy bits out. Who's a lucky boy, then?

  19. Yes – and it makes me happy.(We just fed a jetwash through the driver's window and blasted the whole of the ambulance to give it a good clean).

  20. DiD you drink any of the blood this time Tom. I remeber a few years ago, I got poked with a contaminated Sharp and had to spend the next 4 hours in A+E.He had quite a good GCS score for someone who had those injuries. Owwww well. Did you find out how hes doing. Has he lost the site in his eye?

  21. Wow, all I can say is, if that's true then back in my cider drinking days I'd have been like a hollowed out canoe, as I did quite a lot of puking!I don't think they are with my mutt, he's been all checked out and based on the way his tummy bleached one of my socks when he ate it and regurgitated it (don't ask) it's probably the bleaching effect of stomach acid on random stuff… I do also realise I sound obsessed with carrots these last half dozen posts, like some insane bunny-girl gone wrong, so will shut up now.

    An unrelated I'm seeing a pal tonight so can't make the blog pub thing but hope everyone who goes has a super time and doesn't end up as a character in Tom's blog! :o)

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