Oh that's got to hurt

Well I was working 7-7 day shift at a neighbouring station today and it was your run of the mill calls, elderly patients who had fallen and possibly fractured their hips etc.

Well all that was to change, at 1330hrs we get the do do do doop noise as we are pulling into Livi to give the outside of the Ambulance a quick clean, so pulling back out of the wash bay we are heading out of the station lights and sirens going to a call at a local industrial estate for a 'Male hit by sheet metal' we arrive to be waved in the direction of the patient, who is lying on the floor beside a very large machine, in obvious pain, but still fully conscious.

I am driving for this half of the shift so my partner goes to assess the patient whilst I gather some extra information from the patients colleagues. My partner shouts to get another crew with a paramedic for pain relief, I head back and gather some further equipment and call up to the EMDC at the same time requesting the second 'paramedic' crew and head back.

Our patient is given entonox for the pain before we even begin touching him, but we can see that this will not work that well and hope that the second crew are not that far from us.

Now the patient is a male in his 30's who has been working at a machine when some sheet metal struck him in both the legs just above his ankles, this caused one of them to snap and the other leg ended up being fractured (#) and the foot was rotated 180 degrees, causing the bones in that leg to tear through the skin.....

The 'paramedic' crew arrived and gave the patient more stronger pain relief, set up fluids because of the blood loss and shock and we then had to gently move the fractured ankle into box splint so that we could then move this leg off the one underneath which was the rotated open fracture (more serious due to the possibility of loosing the foot if the blood supply is restricted beyond the site of the injury).

Once we had the # ankle supported and moved out the way we could then see the full extent of the injury and begin to manipulate it back into line (we had to remember and turn it the right way!!), now the feeling of crepitus is not a nice one and I have only felt it once before, but today I was supporting this limb as my colleagues applied traction above and below and we all turned together, straightening the patients knee out and making sure the foot was pointing in the same direction as his knee, my hands were under the fracture, holding on the sterile dressings to control the bleeding and supporing the bones and I can honestly say if you want to feel crepitus then get some chicken bones, snap them and then rub them together in your hands!!

Once our both the legs were stabilised and the patient was feeling the effects of the pain relief medication he was lifted onto the trolley bed in the Ambulance and the 'paramedic' crew transported him to hospital, leaving me and my colleague to tidy and re-stock our vehicle and reponse bag because we found out that the 'paramedic' had used all our equipment! Thanks mate!

Oh well I guess that the patient will now be lying in a hospital bed, possibly following surgery today and looking forward to a fairly lenghty recovery process, well at least we managed to do something good for a change :)