Monday, August 27, 2012

Lady Luck

It never fails to amaze me how some people involved in serious motorvehicle accidents manage to escape relatively unharmed.

I have lost count of the number of accidents I have been called to where the vehicle was wrecked but the patient was somehow pretty much injury free.

The very first one involved a car that somehow went off the road into a ditch, coming to a sudden halt at the bank at the end of the ditch in a head on collision. The driver was knocked out and flung sideways. When I looked in the drivers compartment the steering wheel was up against the seat. He would have likely died from chest injuries. Instead he somehow got flung sideways out of the way!

More recently I went to a van with 7 passengers which rolled on a country road. One of the passengers had a hand injury but the rest walked away pretty much unharmed. No head injuries, no c spine injuries. Nothing!

Anotherone involved a driver who most likely fell asleep at the wheel and rolled his car on a bend on another country road.

When I pulled up the car was upside down and his legs were poking out from the passengers door. I immediately thought this was going to be a fatal but as I walked over to the car he wiggled out and stood up  He had been looking for his mobile phone!! Once again he was unharmed and refused to come with us so he went to the police station for a breath test instead!!

Yes Lady luck was shining on these people.

Sunday, August 26, 2012

Everything is going to be ok

I just watched an episode of Rescue 1 which follows a rescue helicopter crew to jobs. The Advanced Paramedic had responded to pick up a rugby player with a suspected neck injury. The patient had been packaged onto a stretcher with stiff neck in place. He was lying there with a worried look on his face.

The Advanced paramedic leaned over him and put a hand on him and uttered those magic words. "Everything is going to be ok"

He went on to explain what had happened, why they had packaged him that way and what was going to happen next. 

Why am I making a big deal about this?

Because I have been a patient and I know how terrifying it is lying there imagining all the terrible things that you think is happening or going to happen to you. Your lack of knowledge or understanding, even as a clinician, results in you thinking the very worse and fear can really overtake you.

Hearing those words of absolute reassurance that everything is going to be ok from the ER doctor simply melted away all my fear.

As paramedics we often attend the same types of jobs over and over again. Chest pain patients for example become a routine call out for many of us, yet for most of these patients it is their first ever cardiac event and something that is probably very terrifying. Its hard not to think the worst possible scenraio when your heart is the source of your illness. Even worse, there is a general misconception that heart attack=cardiac arrest/death (which is only sometimes true!)

Yet how many of these routine patients do we attend to and forget to include in our standard treatment regime some simple reassurance of the patient that everything is going to be ok?

It is probably one of the single most effective parts of our treatments. Alleviating fear reduces heart rates which in turn reduces myocardial oxygen demand so not only does it have psychological effects, it also has positive physiological effects.

Now it may well be true that the patient is very ill and my deteriorate but the fact is, while they are in our care we have all the tools to help them, so for the patients benefit everything will be ok and they need to know this.

So next time you attend that patient and are busy sticking IV's in them, hooking them up to your monitor, taking their blood pressure and sticking an oxygen mask on their face, dont forget those magic words.....everything is going to be ok. Trust me, your patient will thank you for it.