‘Male run over’. Hmm, this could mean anything from a glancing blow from a slow moving car, to a high speed collision with an unsuspecting pedestrian. This call turned out to be somewhat in the middle. On approaching the scene after a 15 minute journey we were met with the sight of police cars and flashing blue lights, and a crowd gathered in a circle in the middle of the road. Police officers were controlling the traffic and trying to control the crowd. Slipping into my hi-vis jacket I made my way over to the figure lying in the road. Hearing his rather loud verbalising I experienced some relief. I prefer a shouting patient to a very quiet one. Well, most of the time! He was being abusive to those around him. This, I considered, could be due to; pain, head injury, drug or alcohol intoxication. I crouched down to speak to him and it was immediately obvious from his breath that alcohol was indeed a factor.
Someone had kindly covered him in a blanket. He was complaining of leg pain. I lifted the blanket and without further exposure glanced at my crewmate, we nodded in silent agreement. ’Yep, that’s a mid-shaft fractured femur’ was the telepathic message between us. His leg was at the silliest angle I’d ever seen, that’s for sure. ”My femur is gone” he shouted. ’No shit’ I thought. We established he had no neck or back pain but given the mechanism of injury and the possibility his leg pain was masking any other pain we planned on fully immobilising him. He, however, wasn’t so keen and was being somewhat uncooperative. A police officer was telling him off for swearing at us and this actually seemed to calm him down. He occasionally apologised to us but would then immediately insult us again. He was given pain relief before we attempted to move him, and I had cut his trousers to expose his leg. The thigh area was very swollen, indicating internal bleeding and there was also a deformity to his lower leg, suggesting a fractured tibia and fibula. Ouch!
A paramedic in an rrv (rapid response vehicle) together with his student paramedic arrived to give us a hand. We agreed to roll him onto the spinal board first, hoping this move would naturally straighten out his leg, rather than us straightening it. It worked and I could feel a good pedal pulse. We splinted his leg, strapped him to the board, and transferred him onto the ambulance on the stretcher. All the while being shouted and sworn at.
As he’d had morphine I was relegated to driver, and my paramedic crewmate stayed in the back of the ambulance. Judging by the abuse being hurled at him, I’d had a lucky escape! From the ambulance cab I shouted through to my colleague ‘Alright in the back?’, and the response was a grunt followed by ‘Yes fine’. With a knowing grin I drove off. The patient remained aggressive and tested the patience of my colleague for the whole 30 minute journey into hospital. Just as well he was strapped to the spinal board, not that he would have been capable of much movement with his leg injuries!
