Tag Archive | Collared and Boarded

A Bit of Excitement

Rugby Goal

Image by Márcio Cabral de Moura, on Flickr (see Flickr page for license)

(Aside: The prose in this is a bit rough, but I can’t quite work out how to fix it so it’ll have to stay that way…)

I have just spent a weekend doing rugby duties. All the players were under 18, Saturday’s lot about 16, Sunday’s between 9 and 12.

The first day was simple enough. One person who had been booted in the chest and was in some pain. He might have broken a rib, we’re not quite sure, but even if he had there was nothing we could do for him. Even if we sent him to hospital, they wouldn’t do a lot (or so a doctor friend tells me).  He was otherwise fit and well, so we suggested pain killers (which he declined) and then he wondered off.

Sunday was a bit different. This time there was only two of us (instead of four adults, a youth member and an ambulance).  We started the day by getting lost, and heading completely the wrong way. We confused one driver by going around a mini-roundabout multiple times until we got our bearings.  Fortunately we still arrived in good time, and settled down on a cold, windy pitch to try to keep an eye on four or five games at once.

The first load of patients were simple enough, standard rugby injuries (bruised hands, heads and the like), though we did get three one after another, keeping us busy for a while.

Then it went dead, we had a very nice burger for lunch, and sat back down outside in what was improving weather.  Quietly, knocking on wood the entire time, we thought we’d had our rush and would coast until the end with the odd cut.

Then a boy walked up, saying that his neck hurt and he couldn’t really straighten it.  When we took a look at the back of his neck, the pain was mostly near the middle. Possibly muscular, but definitely too near the bone for my liking.  I asked my colleague to hold his head (to stop it moving), and I got ready to call an ambulance.

Then another boy turned up with a properly dislocated little finger. I am already on the phone to the ambulance service, so I just mention he’s here, and try to get on with the call.

At this point, someone claiming to be a doctor turned up, and wanted to put the finger back in place. This is against our protocol (we consider that a job for the hospital, in case surgery is needed), and I couldn’t be certain that they were a doctor, so I asked them to wait, as an ambulance is on its way.  Naturally they ignore me, then after demanding tape from my kit, and thoroughly disrupting my conversation with the ambulance call-taker, they demand paracetamol (which I refuse to give them without my own assessment, because I have to write-up that it’s given, and I didn’t think the ‘doctor’ would hang around long enough to fill out my paperwork), and promptly vanished (suspicion proven).

I’ll point out now that I put ‘doctor’ in quotes only because I couldn’t prove they were indeed a doctor, I don’t like taking people’s word for it (particularly when they’re a random bystander. What if they were a doctor of physics or something!), and because of the speed with which they disappeared. Not once did they stop to check on the poor boy whose neck we were trying to hold still (a coach did put her two-pennies-worth in by criticising my colleagues method of holding the head, which was correct, but we ignored her). I thought they had a duty of care!

When I was done with the ambulance call, and my colleague’s arms started seizing, it was my turn to hold the head.  This also freed him up to placate the other boy, and then deal with the two new patients who chose that moment to turn up with thankfully minor injuries.

The ambulance didn’t take too long to arrive (hurrah!), and when I handed over to the ambulance crew, they agreed that we should be careful and grabbed their long board (aka a spinal board).  We now had to put the poor boy through a standing take-down.

For those that haven’t seen or experienced a standing take-down, it is where the long board is placed behind a standing patient, they lean against it, and both are slowly lowered to the vertical. It is a highly unnerving maneuver, requiring quite a bit of trust on the part of the patient, as for the first couple of degrees the patient can feel as if they’re falling with nothing behind them.

My job was to hold his head, and after a bit of shifting to avoid trying to lower him through a tent pole, and to make sure I could keep my hold, we got him to the floor. Now I don’t like this process at all, to the degree that I refuse to have it done to me during training. Needless to say, this brave boy put me completely to shame, taking it in his stride.  After a strategic slide up the board, on my command (I had the head, so I was in charge… eek!) and the judicious application of head blocks and straps, he was safe and secure and ready to go.

During this entire process, my colleague had worked through each of the other patients, clearing each one in turn and leaving nothing left for us to do for the rest of the day (thankfully).

I’ve never done anything like this for real before, and it’s taught me a few things about spinal management, including good places to put hands and how to hold the head during a three-man standing take down. While I wouldn’t wish such an injury on anyone, and hopefully the boy wasn’t seriously injured, I am pleased I was able to get involved, and it was definitely good experience.  It has also maintained my enthusiasm to finish my ambulance training (whenever the second course comes around), when I can learn to do all of this properly for myself.

Now I just have to write this up for my portfolio…


Busy Again

Yet again, I seem to have got myself booked up several weeks in advance.

Last weekend, I was off to play casualty again for BigPara. It was assessment weekend, so plenty of scenarios to keep me and my fellow casualty busy. Saturday, after an interesting session on Emergency Child Birth, I spent the day getting collared and boarded. Nothing new there.

Except there was a difference this time. I had ‘damaged’ myself up a narrow flight of stairs. This meant that, had the scenario run it’s full course, the crew would have had to carry me down the stairs. There is only one way that could have been done: on a board, feet first.

Luckily for me, they didn’t have to take it that far.  Unfortunately, BigPara still had to be sure they would have succeeded. This basically meant that they had to lift the long board up to the vertical.  With me strapped to it.  Or more accurately, suspended from the straps.  That was an interesting experience.

Next day, I was the resus patient.  Cue one CVA, also known as a Stroke. In my case, this was heralded by Expressive Dysphasia, where I had great difficulty with spoken language, and an inability to control my left arm. These are two classic signs of a stroke. If you live in the UK, you’ve almost certainly seen the adverts for FAST, a protocol to help identify a stroke (if you haven’t, I can’t recommend reading that web page enough).  I ticked two of the boxes, Speech and Arms.  Oddly enough, once the crew knew what was going on, I was quickly hustled out of the room I was in.

Unfortunately for them, I arrested just as they arrived at their ambulance. How inconvenient of me ;). One resuscitation attempt later, and I was done (or is that done for).

Last weekend was fun, but next weekend has the potential of being better.

I have applied to join our cyclists, and the training is happening this weekend. If I manage to get one of the five places on the course (eek!) I could be learning to cycle around with a ridiculous amount of gear on one of our amazing push bikes :D. If you hadn’t guessed, I’m a little excited, and a lot nervous.

I suspect the rest of the week is going to include me compulsively checking my emails, hoping for a response.

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