Ive just been reading a post over at ‘life under the lights’ where CK writes about a job where he really had to think laterally about how to manage his patient. Click here to go and have a read, its a really interesting post!
It got me to thinking though. I firmly believe that some of the most important lessons I have learned since I joined the service in 2000, have come from experienced paramedics and advanced technicians who have come up with really good ideas for some really difficult situations.
One that springs straight to mind is a job I went to as a relatively new advanced technician.
Simon and I were called to a house for a 8 month old child who had rolled off the top bunk of a set of bunk beds and had landed head first onto a wooden floor. There was an apparent initial loss of consciousness, but when we arrived baby was screaming its little head off.
Going back to training school and looking at the mechanism of injury, the kinematics involved in the fall, and the anatomical differences of a baby from an adult, the textbooks would tell you to collar and board the baby due to the risk of spinal injury. However, as we all know this is a virtual impossibility with a conscious baby and would probably increase the risk of damage and injury from the baby struggling against the restraints.
Another conventional way to handle it is to get mum to immobilise the child in the ‘best possible way’ in her arms – hoping that once the baby settles, she will remain in a the neutral position that you have instructed mum to try and get her into.
Simon however came up with a different idea. One which I still use today if presented with a similar circumstance.
We carry full body vacuum splints which we sometimes use for major trauma/possible spinal injury/pelvic injury etc. It is more comfortable than the traditional spinal board and in the case of limb trauma along with spinal trauma, its a quick one fix, whole body immobilisation device. This would of course be HUGE for a little 8 month old baby girl.
Simon instructs me to go and get a leg vac splint.
As I return to the patient with the splint and suction pump, I realise what he is going to do!
We lie the baby girl on the vac splint and gently shape it to her outline and hug it close to her head as we suck the air out of it making it go rigid. Because it is small enough to virtually be the same size as the baby, mum actually carries it on her whilst she lies on the stretcher which helps to keep baby placid during the journey.
As I came out of the A&E department once I had handed the baby over to the waiting team, all I could say to Simon was:
“What a Fab idea!!, that worked really well!”
What pearls of wisdom have been handed down to you over the years, to help in those rare situations when the ‘normal approach’ just doesnt work? Leave a comment and let us know. We all might learn something!