RTC with no 'C'

We are ruining on blues down the motorway, the traffic is thankfully not too bad, even though it is around 5pm on a weekday.

My crew mate pushes the Ambulance to it's limit and we manage a 'sensible' 85mph with the wind behind us! The 4.5t vehicle does not have the performance of a saloon car, so once we get it up to speed, it is all about maintaining the momentum. What we do not need is a brain dead company car driver, not looking in their mirrors and pulling in front of us..........on go the brakes, out into our lane comes the 3 Series!. Every one is moving into the two left hand lanes and Mr Unaware has found his lane a little crowded, so why not use the bizarrely empty fast lane?

I hit the bullhorn repeatedly and he jumps back into the middle lane, we have now lost 15mph and have no hope of gaining the momentum back for the next few miles as the motorway climbs a hill.

I know the Road Traffic Collision (not allowed to say Road Traffic Accident anymore, as this implies no blame) is coming up soon and I keep an eye out for the tell tale line of brake lights in the distance that signal everyone is trying to get a look at what is happening, to break the monotony of their everyday, commute home.

The Traffic Officer is flagging us down to the hard shoulder, we are the first crew on scene, with just 3 police cars also in attendance.

After the usual round of hello's and 'what have we got 'ere' jokes with the Police, I look down the embankment to see the car 40 feet down, lying at about 45 degrees on the drivers side. Time to put into practice the one of the many skills, again they did not get around to teaching us at school, mountaineering with 30lb ruck sac and oxygen cylinder.

On reaching the vehicle, I find one patient, awake and chatting to a Police Officer and looking a little pale, understandable I suppose, considering the shock of the accident. Yes I called it an 'accident' as he did not appear to have had a collision with anything! Just left the motorway at 70mph and dropped 40ft off a bank.

Quick trauma assessment;

A - Airway good, he is a little white but does have good colour
B - Breathing, seems to be doing that OK
C - Circulation, no obvious blood loss or bleeding
D - Disability - where's the pain? and what are your injuries?

As soon as he says the magical words 'my neck hurts' he has to be immobilised, completely and the car has to be effectively taken away from around him, so he can be extracted without actually moving his head or back in any way. This is where the Fire Brigade bring in all the cool toys and we stay and play.

Do you have any pain?

My neck hurts!

Bloody marvelous, let the games begin!

My crew mate clambers into the back to take hold of his head from behind, to start the process of making sure he is immobilised. I am the attendant for this job but she is far more experienced that me but that does not matter, I need to learn and she gets in the car and lets me run the scene and coordinate impending extraction from the car, up the embankment to the Ambulance.

Love her, she's great.

We then conduct a full secondary survey on the patient and conclude, tenderness and pain in C3 and C4 vertebrae, potentially 1 broken rib and a right side tenderness to the thoracic region, probably from the airbag impact. Not life threatening but the spinal pain means our job is to ensure this guy can walk at the end of this ordeal.

The Fire Brigade arrive on scene and we have ladders and ropes placed down the embankment to ease access and I talk to the Fire commander to brief him on what we have and what I want to happen.

'1 casualty, male in his 30's left the motorway at 70mph and ended up here, no impact with stationary object evident, air bags deployed, vitals stable, broken rib left side, no respiratory impairment, ?C3 & C4 spinal damage, no other injuries present. I need the vehicle stabilised, the roof removed for access and an extraction plan to get him up that embankment once we have him immobilised him on a spinal board. He is not time critical.'

I love this job! Where else to do get to say that in everyday life!

The commander gets the crews to work and comes back to me with 2 options. I go tell the patient what will happen and inform my crew mate.

Right mate, this is what is going to happen. We are going to get you out of this vehicle, keeping you as still as possible to minimise any damage to your spine. It is going to take a while so just relax and let us work. Fire crews have arrived and will be working on the vehicle to help get you out. We will be placing you on a board and strapping you down to ensure you do not move then we have 2 options to get you up to the Ambulance. One is hand to hand up the embankment, the other is a large platform gets lowered to the car and we strap you underneath and hoist you up to the motorway.

'You are joking about option 2?' he asks

No and it sounds like fun, so that will be my choice! Do you have any questions?

'Is my car a right off?'

Well it does not look too bad from here but the Fire Brigade are about to turn it into a convertible for you, so that we can get you out. It will be pretty much knackered from there I am afraid.

The job went great and the huge crane platform was cool to see in action, the communication between the services was good and the patient was safely delivered to hospital 2 hrs later.