Unlike in America, UK paramedics are completely seperate from the Fire Service (apart from some of us sharing a building). We work together fairly frequently on certain types of jobs, but we only have a limited knowledge of each others service and skills. As an attempt to become more efficient when working together, our local Fire Brigades have recently began to offer the opportunity for two paramedics to attend their yearly refresher RTC (Road traffic collision) courses.
I was fortunate enough to get a place on a recent course and ended up having a very informative and very enjoyable day.
Our attendance on the course has two main goals;
1) to further our knowledge on the Fire Brigades options and capabilities for extrication of a casualty trapped in a vehicle
2) to provide expertise and advice on casualty management and trauma care for the Fire Fighters attending the course.
The first part of the day was classroom based where I learnt about the technical part of cutting up a car and the inherent dangers always present, such as undeployed airbags and seat belt tensioner charges etc. This was a good opportunity to get involved in discussions with the firemen and sparked a couple of very lively discussions.
After coffee I had my first opportunity to be a “casualty” and got extricated from a vehicle.
Luckily this was a training car and already had it’s roof removed so no cutting was needed. It was, however a tad embarrasing when the fire crew had placed me on a spinal board and were ready to lift me up and out of the car:
“ready lads?……1, 2, 3,…..LIFT!…….Jesus Christ!, how much do you weigh?????”
They managed to get me out on the second attempt when they were prepared for the weight of lifting me (I’m just heavy boned!)
Once out, there was a debrief where the Firemen first discussed technical issues, then it was over to me to feed back and make any comments on their casualty management. Again, we all had open and frank discussions and lessons were learnt on both sides.
On to the afternoon and the full vehicle extrication exercise.
I was asked to climb into the car on its side, pinned between the overturned car and the container. I was left to my own devices to come up with a scenario of injuries. One of my colleagues who came with me for the day climbed into the other car and we waited for the arrival of the crew.
Whilst waiting I had time to try and picture how frightening this must be for a real patient! I could feel my heart rate increase and got a little bit edgy whilst I was curled up in a ball in the footwell of the front passenger seat, even though I knew that if I wanted I could just get up and pull myself out. I cant imagine how it would feel to be in that situation when you are bleeding, trapped and severely injured. It must be truley terrifying.
A couple of minutes into the exercise the first Fire truck turned up. I could here them all decamp and go to check the first vehicle. They quickly found my mate and stabalised his car and prepared to start extricating him.
5 minutes passed, and I was still waiting. eventually one of the instructers prompted the station officer to do a thorough check of the scene to ensure there were no other casualties. Soon after I heard him shout ” Lads, theres another one in here”!
I was shortly joined by John, the casualty officer on the crew. He quickly did a primary trauma survey to ascertain my injuries. I thought it would be a good idea to be unconscious, until I heard them decide it was now an emergency extrication and they were just going to drag me out!
I then made a miraculous recovery and regained consciousness. What follwed was a very interesting but cramped process with the crews cutting away at the back of the car to try and maximise any space to allow them to gain access to me and remove me from the vehicle whilst protecting my C-spine by keeping me immobilised as far as possible.
All in all it took 50 minutes for me to be removed from the vehicle. It could and would have been far quicker if my “condition” was unstable and I was at risk of “dying”. but I found it far more interesting to be in the car for the full time.
Once I had been removed, I was again part of the debrief and discussions, giving information and advice on what “medical” considerations could have been improved upon (although these were actually very minimal)
The day then came to an end. I had an extremely enjoyable day. Historically there has always been times when the Fire Service and the Ambulance service have not seen eye to eye. There are times when even though both services are acting in the best interest of the patient, toes can be trodden on, things can be said at a scene which have long lasting reprocussions on the relationships between the two services. These sort of days are valuable in addressing these long standing issues and informing both sides of the immensly valuable contibution both have to give.
I now feel far more informed about the capabilites of the Fire and Rescue service and work much more closely and efficeintly as a result of the course. I would encourage any paramedics, technicians, EMTs etc to try and find one of these courses and get a place on it. It certainly helps see an RTC from the other side (both that of a patient and the Fire Brigade)