MajAx

A major accident is one where the resources required outstrip those that are available. I have attended one such incident a few years ago somewhere in the center of Ireland.

The incident which we came across saw a car end up off the road in a ditch facing back in the direction it had been coming from. The local volunteer Fire Brigade were on scene several of whom were trained as First Responders.

Access to the scene is slightly akward but the Fire Brigade lads have been hard at work and have cut back the hedge out of the way and put down one of their ladders to give us reasonably safe access to get in to examine and treat the injured people. The chief fire officer gave me a quick briefing informing me that there was 5 people in the car and that they were making preparations for cutting out the people in the car.

I climbed down the ladder guided by one of the firefighters who was making sure I didnt break my neck in the gully at the bottom of the ladder. The good news was that the initial assessment did not show any unconscious parties but did have two potential serious injuries in the form of a suspected fractured femur and a complaint of chest pain from the older patient in the vehicle. The remaining three in the back seats had one complaint of neck pain between the three of them and a sore knee both on the same person.

Very quickly a plan of action was put together involving removing the side pillars and roof from the car to improve the access for removing the 5 patients. It was agreed that all would be removed on spinal boards and 5 ambulances were required. This information was referred back to ambulance control by the chief fire officer. While waiting for the ambulances to arrive I recruited one of the firefighter first responders to help me examine the patients with his responsibility being the three relatively uninjured patients in the back and the two in the front being my responsibility.

Thanfully the first ambulance arrived pretty quickly, althought it felt like hours, and the plan of action relayed to them which they agreed with. Things started to happen rapidly after that with empty spinal boards and KEDs being sent down the ladder and occupied boards and KEDs being sent back up the ladder.

All five patients were quickly extricated from the car with a minimum of fuss and transferred to the ambulances for onward movement to the A&E which was just over an hours drive away. With all five ambulances gone a tidy up of the site revealed that two of their paramedic bags had been left behind, Ooooopsie, needless to say we rang up ambulance control and agreed to meet up with one of the ambulances to give them back their bags.

What I can remember taking away from this incident was there was no difficulty in communications everyone knew exactly what they were doing. A plan of action was agreed and rapidly communicated onto additional arriving crews and personnel and worked through to its ultimate conclusion which was at the end of the day to get 5 injured people to hospital with a minimum of fuss.

Scout First Aid Teams

Over the years in addition to being a scout leader I have attended many scout camps and Jamborees providing first aid cover to the participants. At the Jamborees I worked with three Scout First Aid Teams out of the many that exist in Ireland and the UK. These are the Fat Fellows Fellowship (Ireland), Eastbourne District Scouts First Aid Team and the Cambridge Scouts First Aid Team.

We have worked together so far at Norjam 2001, Irish Jamboree 2008 and Kent Jamboree 2009. At each of the three events it was very obvious to me that all of the members were dedicated to their role and worked together as well if not better than a professional hospital based team. Why better you ask?, a hospital based team does not have to deal with mud and rain and floods (those that were at the Irish Jamboree of 2008 may recall me pleading over the radio for rescue saying the only way out was swimming!, needless to say we swam!).

For me the crowning point of the teams professionalism came during the Kent Jamboree in 2009 when the Fat Fellows and the Eastbourne District Scouts First Aid team came together for the second time in a year and on the day that our resident doctor was unavailable due to work committments. That day became the busiest day for the team with four ambulances being called and arriving on the two separate sites within the same 30 minute period. It is a testimonial to the professionalism of the staff that none of the ambulances went to the wrong patient. The poor Community First Responder that did turn up could do little more than report back to Ambulance Control as we already had Technicians and Nurses on site at the incidents!.

The good news is that the Eastbourne District Scouts First Aid Team have recently replaced their ambulance with a newer one to ensure that they do not get caught out by the London Congestion Charges while covering events in the areas bounded by the convestion charges etc.

There are many of these Scout First Aid teams around the country but I can only speak for the ones that I have been with and I am very impressed by them. I look forward to spending a lot more time with them when I am in the UK doing the course and beyond.

If you have any interest in joining any of the teams please contact them! They are a great bunch of lads and lassies especially when the water pistols come out.....

Attention seekers....

With less than 5 weeks to go before I start my Ambulance Tech course I have been looking back at many of the cases I have treated over the years.

The most common "incident" that I came across was the attention seeking patient who had nothing medical wrong with them but more often than not having just had a row with their friends. Two incidents that stand out from over the years both happened at nightclubs and one involved a female patient and the other a male patient.

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The first incident involved the male and occurred after the club was finished for the night and most of the crowds dispersed. There was two of us on that night and we were talking with the doormen inside the club before heading home when someone ran in the door screaming that there was a collapse outside. The two of us went outside followed by some of the door staff to ensure our safety to find a young male lying down on the ground.

The initial assessment is carried out by the other medic on with me who determined that they were breathing just unresponsive. I told him to put him into the recovery position upon which he grips the patient by the shoulder and hip and pulls him over, it was at this stage that i noticed his right leg lifting up neatly and being brought over so that id didnt bang onto the ground with no support by anything underneath!. On closer inspection his eyelids were fluttering in an attempt to keep them closed and his "fits" that he was now having did not involve his head hitting the ground! I attempted to get a response from him, pointing out to him that I knew he was faking, but he did not respond at all.

A Dublin Fire Brigade Ambulance arrived shortly afterwards and the first thing they said was "He's faking isn't he". They then took him off our hands having not been able to get him to respond to them either.

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The second incident involved a female who was part of a private party in the bar next to the club who "collapsed" beside the nightclub. I was called out to have a look at her as she was fitting. The first thing I noticed about her "fit" was that like the male patient above her head was stopping short of hitting the ground. I got her friends to stay quiet and I spoke quietly to her say that I knew she was faking and to stop and sit up. She did stop fitting but as soon as her friends started calling out that she was fine and was going to be ok etc she started "fitting" again. At this point her skirt was rising up her thighs and I could see her underwear and said to her "You might want to stop doing that now love as I can see your knickers", these words had the desired effect and she stopped straight away.

After two more episodes of this thankfully a Dublin Fire Brigade Ambulance arrived and she then had another "fit", I gave my handover to the arriving Paramedics and demonstrated my miraculous fit stopping skills by reminding the girl I could see her knickers again!. They too couldnt get her to see sense and took her to hospital.

Please note I would have covered her if I had spare blankets or a coat which i didnt have at the time!

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These are only two of many similar incidents I have come across over many years of treating people at events and elsewhere. What they all do not seem to care about or realise is that the resources of the Ambulance Services and the A&E departments are finite and have to be diverted to watching them because they are "unconscious" which in a genuine case is a life threatning condition.

For those that arent transported to hospital it is also a frustration to the medics treating them on the side of the street or at an event that their time is wasted dealing with this individual who is just out to get attention. Despite this frustration they are still treated with respect and to the same standard of another genuine patient.

Start of it all

Hi folks

This is the first of many posts that I will be putting onto this blog charting my next few months and years training as an Ambulance Tech in the UK.

More to be posted later, maybe, if I get the chance.