How Evil Can Help

I'm 'third manning' at the moment, which is a way of easing me back into work. I'm a third person on an ambulance, which means I get to see how other people work.
We were called to a man who had been pushed over following an arguement over payment at a shop. The man (the customer) was sitting on the floor wailing and shouting as our patients who feel aggrieved often do.

My mate attempted to get a history from the patient, but he refused to talk to us. He would talk to his friend, but not to the ambulance crew who were trying to help him. He was being generally obstructive.

We gathered, from other people, that he had a painful leg – he didn't tell us this himself, he just ranted about how he wanted the person who had pushed him over arrested.

So, without being able to get a verbal history my mate decided that he would physically examine him – so he got out his scissors and cut the trousers off of the patient so that he could examine the injured leg. The patient still refused to talk to us, he was too busy trying to get the other man 'nicked'.

I mean – he'd been pushed over, he was hardly going to hurt himself in anything but a most minor way…

Except that his femur – the strongest bone in the body had snapped.

We have no idea how this could happen in a middleaged man with no other illnesses and (after the x-ray) no sign of pathological bone disease. It's the sort of job that you pick the person up off the floor, dust them off and they refuse to go to hospital.

So we got him into the back of the ambulance to discover that the traction splint that we would normally use was missing a small, but vitally important, bit.

So I got the job of hanging on his leg providing traction while my mate gave him some excellent painkillers and *his* crewmate drove us into hospital.

The hospital was impressed as well.

It's a good job my mate decided to be 'evil' and cut his trouser legs off. The patient didn't have an accident history to suggest a broken bone, the patient themself didn't suggest a broken bone and we could have quite happily taken to lifting him off the floor.

There is a reason why we don't cut the clothes off everyone who falls over, it costs them money, it's very cold at the moment and it's frankly undignified. But now I'm wondering if I need to start stripping everyone I come across…

14 thoughts on “How Evil Can Help”

  1. Saeger splint – and you are correct about the missing bit.I'm also very dubious about putting it on anything that isn't obviously a mid-shaft. In this case…well… lets just say that out patient had an interesting new joint in a place that wasn't near his hip.

    I think that in more than four years in the LAS it's the first time I've put it on in anger, but then I'm the fella who gets the 'no injury' calls.

    (Although I did see a crew on a TV programme stick it on a #NOF… Sat screaming at the telly…)

  2. Superb!We did give painkillers, but even if we didn't the traction (while painful putting it on) would result in less pain and a lot less injury.

  3. He He gotta love the Themur. Strongest bone, contains lots of blood and over all useful bone. Has anyone here ever tried applying traction without Entonox or painkiller. Just wondering what the effects are. Other than patients fist in Attendants Face

  4. “But now I'm wondering if I need to start stripping everyone I come across… “Waits for the saucy comments! ๐Ÿ™‚

  5. Looking at some of the people I come across I wouldn't consider it. This morning I was on top of some scaffolding in the freezing cold, talking to the builder who is short, wide, hairy and old with a gut overhanging his trousers. The thought of stripping him….. er no, let's not go there.

  6. I'd say that traction without any kind of pain control would be generally better than not using traction. Applying traction to the leg and preventing the shattered bone ends from rubbing together will (should) cause less pain (and stop a lot of mangling from taking place). Just don't let go !

  7. I've never tried applying traction without painkiller but I had it applied to me (I broke my femur when I was 11 – has to have it re-set 3 times, only got painkiller in the ambulance – when they re-did it in hosptial they did it without. What happens is a nurse gets to hold you down while the 2 fattest doctors pull on your leg & your mum faints in the corner. Oh, and it hurts. Quite a lot.

  8. Giggles, laughs, drifts off into rescue fantasy featuring current honey. And don't think I'M the one whose jeans are ruined!

  9. Pain is forgotten, ask any mum. But a broken femur left untreated can cripple that person for life.Whereas a broken lemur is just a small furry guy, with big eyes and a defeated smile, wishing he'd opted out of the poker game before the stakes got too high….

  10. We all have opinions about the Trac3 – most of them unprintable (like the one about the vehicles we used to have where you couldn't close the rear doors if you had applied a Trac3!)Having been told – from Day1 – that I must NOT use the damn' thing unless I have positively identified a midshaft of femur fracture (and also not being gifted with X-ray vision), I have spent an entire career (as have many others) avoiding the thing like the plague, and using a Vac or Box Splint instead.

    This, of course, also leads to a lifetime of turning up at A&E with your next patient and having Sister point to the radiograph currently on the light box (which, of course, shows a classic, laterally displaced, midshaft of femur fracture) whilst smugly saying “You really should have used a traction splint on that, you know.”

    The grinding sound is not crepitus – it is my teeth – because I know, equally well, that- were I ever to take the plunge and actually use the ruddy thing – my next lecture from Sister (at the light box once more) would inevitably be on the folly of electing to use (really, my dear!) a Trac3 on what was obviously a frac NOF.

    It's not just hindsight that gives you 20/20 vision – radiography does it too.

    So, once again, my congrats on using the thing in anger. Pity it didn't work !

    (Do I get a prize if my guess that it was the ankle/foot strap that was missing proves correct?)

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