Memoirs of an Emergency Nurse Read Free Page B

facial flap and suctioned when necessary.
    Her blonde hair was matted with blood and her nose had been bleeding. Sharp shards of glass were stuck in the creases of her clothes and around her C spine collar. Another nurse, Matt, and I began swiftly cutting her clothes off while the doctors looked frantically for any veins they could give analgesia through.
    Too late. The patient was already in shock and her veins had hidden away deep in her skin. It was 11pm on a winter’s night and it seemed, from the evidence of the alcohol on her breath that she had been out drinking for a while. We needed venous access now, no time to mess around.              
    Matt got out a femoral artery kit. As we couldn’t find any venous access in her peripheral veins, we would have to access a main artery near the groin area so we could give the girl pain relief and sedatives. The girl continued to scream and writhe on the trolley with no change in her response to pain or verbal commands. The doctor punctured her femoral artery pushing a catheter into the artery and carefully stitched it tightly to her skin. By this time, the woman had been wriggling uncontrollably on the spinal board and was half off it, with her head still taped to the top. She was approximately 100kg in size and not in a fit mental state to cooperate.
    The primary survey indicated little as the patient was so distressed she responded to neither verbal or painful stimuli but continued screaming and writhing about on the spinal board. I went to the top of the bed and tried to reassure her by talking close to her head, which was when I noticed that she had blood coming from her right ear.
    I informed the doctors and we determined it wasn’t from her bloody face but indeed from inside her ear. Alarm bells rang in everyone’s head as we all thought the same thing.  Blood in her ear could indicate two things; base of skull fracture, which was highly likely after the force of her impact, or she may be haemorrhaging from her brain. If she had been wearing a seatbelt, she would have remained inside the car; but, unfortunately, her head may have received a massive impact and we suspected a basal skull fracture. If she kept moving around, she risked injuring her spine more.  She could not understand our instructions through either being intoxicated or the head injury.
    The paramedic doors sounded their familiar bell and the resuscitation room doors were opened by paramedics with the next patient from the same car accident. The first patient was in the hands of the doctors and as we were short staffed, I moved to meet the second team of paramedics and patient and asked for the history while I was changing gloves. This was the driver f rom the same vehicle. He had been travelling approximately 70mph; lost control of the vehicle and hit the central reservation on the motorway.  This patient was also immobilised on a spinal board and a C spine collar was in place. The primary survey process began again. Airway, C spine, Breathing, Circulation. This young man was able to speak to me although he was shaken up and asking about his friends. This was a good sign but I was on edge, looking for hidden signs of injury, any discolouration of his skin, obvious wounds and bone deformities. This was the driver and his major impact was with the steering wheel. He had pain in his chest, but looked a good colour and was more distressed by his friend’s screams from the next cubicle. I cut away just his top, enabling access to veins and getting a good look for signs of injury. I attached ECG leads to his chest and took the vital signs while a doctor took over and assessed his condition.
    The resuscitation room was now a hub of people; the police were outside, there were nurses in and out of the doors and doctors of different specialities waiting their turn to assess the patients. Radiographers patiently waited for doctors to finish vital medical care before venturing in to X-ray the