Fall From Tree
I did a shift on an ambulance recently – I’ve been meaning to since I went on the FRU to keep my hand in working as a crew.
One of the calls was to a local park and was given as a 14 year old boy had fallen out of a tree and had a leg injury, possibly broken.
We arrived at the park, and were shown to where our patient was half laying, propping himself up on one elbow.
Daniel had been climbing a tree. A big tree. He had managed to get about 20 feet off the ground before his luck ran out, and a branch he’d grabbed onto broke off, causing him to fall feet first onto the ground. His left leg was bent at a funny angle just above his ankle, dismissing any thoughts that the leg was possibly broken. It was definitely broken, and more than likely both the bones in his lower leg.
I started to give him Entonox – the pain killing gas given to women in labour. This is usually very good for pain relief, begins to work after only a couple of minutes, but doesn’t mask any pain because the effects wear off very quickly when the patient stops taking it. While I was doing this, Martin, my crewmate, went to fetch the necessary equipment for moving the patient.
The Entonox didn’t have the desired effect this time – it doesn’t work on everyone so I wasn’t worried. Martin put a needle in Daniel's arm and gave him some morphine instead, with the comment “There you go – you can now say you’re the first person in your class to say you’ve had a class A drug legally!” That brought a smile to his face. We left it a few minutes to give the morphine time to work, then asked Daniel if the pain had eased at all. He said no, but I think it must have taken the edge off because we were able to get him to roll onto his back and straightened his leg so we could put it in a splint, and although he cried out in pain, it wasn’t as bad as I was anticipating – but we couldn’t just leave him there.
I cut the laces of his trainers, slipped his shoe off, and cut his sock off to prevent unnecessary movement of his leg. I felt his foot, which was warm, and I found a good strong pulse on the top of his foot. This was really good. With the shape Daniel's leg was still in, and the pale colour in his foot, I wasn’t sure if he’d still have circulation – the pulse and the warm foot proved he had good circulation to his foot. I drew a cross on his foot where the pulse was to show the hospital staff I’d found it. We do this because it can sometimes be quite difficult to find a pulse in the foot and often takes a bit of poking around before you find it.
Even though Daniel wasn’t complaining of any neck or back pain and nothing felt out of place there, we collared and boarded him due to the fact that he’d fallen a long way and the chance that the pain in his leg could distract his attention from any neck or back pain.
We “blued” him in to hospital because even with the morphine, we were having a problem controlling his pain. The hospital had decided that due to the long fall and the high potential for serious injury from it, they would assemble a trauma team, and I handed over to the gathering of doctors and nurses waiting to greet us.
It turns out that his only injury was the breaking of the two bones in the lower leg – the tibia (shin bone) and the fibula, which is the small bone that sits behind the tibia and assists with the walking motion in the lower leg.
He’s a lucky lad, but I bet he won’t be climbing tall trees again in a hurry!
One of the calls was to a local park and was given as a 14 year old boy had fallen out of a tree and had a leg injury, possibly broken.
We arrived at the park, and were shown to where our patient was half laying, propping himself up on one elbow.
Daniel had been climbing a tree. A big tree. He had managed to get about 20 feet off the ground before his luck ran out, and a branch he’d grabbed onto broke off, causing him to fall feet first onto the ground. His left leg was bent at a funny angle just above his ankle, dismissing any thoughts that the leg was possibly broken. It was definitely broken, and more than likely both the bones in his lower leg.
I started to give him Entonox – the pain killing gas given to women in labour. This is usually very good for pain relief, begins to work after only a couple of minutes, but doesn’t mask any pain because the effects wear off very quickly when the patient stops taking it. While I was doing this, Martin, my crewmate, went to fetch the necessary equipment for moving the patient.
The Entonox didn’t have the desired effect this time – it doesn’t work on everyone so I wasn’t worried. Martin put a needle in Daniel's arm and gave him some morphine instead, with the comment “There you go – you can now say you’re the first person in your class to say you’ve had a class A drug legally!” That brought a smile to his face. We left it a few minutes to give the morphine time to work, then asked Daniel if the pain had eased at all. He said no, but I think it must have taken the edge off because we were able to get him to roll onto his back and straightened his leg so we could put it in a splint, and although he cried out in pain, it wasn’t as bad as I was anticipating – but we couldn’t just leave him there.
I cut the laces of his trainers, slipped his shoe off, and cut his sock off to prevent unnecessary movement of his leg. I felt his foot, which was warm, and I found a good strong pulse on the top of his foot. This was really good. With the shape Daniel's leg was still in, and the pale colour in his foot, I wasn’t sure if he’d still have circulation – the pulse and the warm foot proved he had good circulation to his foot. I drew a cross on his foot where the pulse was to show the hospital staff I’d found it. We do this because it can sometimes be quite difficult to find a pulse in the foot and often takes a bit of poking around before you find it.
Even though Daniel wasn’t complaining of any neck or back pain and nothing felt out of place there, we collared and boarded him due to the fact that he’d fallen a long way and the chance that the pain in his leg could distract his attention from any neck or back pain.
We “blued” him in to hospital because even with the morphine, we were having a problem controlling his pain. The hospital had decided that due to the long fall and the high potential for serious injury from it, they would assemble a trauma team, and I handed over to the gathering of doctors and nurses waiting to greet us.
It turns out that his only injury was the breaking of the two bones in the lower leg – the tibia (shin bone) and the fibula, which is the small bone that sits behind the tibia and assists with the walking motion in the lower leg.
He’s a lucky lad, but I bet he won’t be climbing tall trees again in a hurry!
written on the PRF by Steve at 10:45 pm
3 Comments:
Interesting.
60 + years ago, I fell 48 feet onto a cinder path, at midnight,[that I remember, wondering what in heck?] Gorgeous night , that I remember, then the next thing I remember was geting off the operating room table onto a gurney for a ward plastered from hip to big toe, had no morphine for the pain ? I was unconcious for approx five hours.
The Point being, I now still walk at 5 + mph, lived a good life, so this young feller should be up and having the time of his life,soon chasing the ball and climbing trees and doing gym , sports of all types soon, jumping out of planes, doing the ton on Motor cycle etc.. But It is good that there be this kind of service, then it be some old rattle trap to the hospital 30 miles away and very dim Head lights.
2nd point do not sleep walk.
60 + years ago, I fell 48 feet onto a cinder path, at midnight,[that I remember, wondering what in heck?] Gorgeous night , that I remember, then the next thing I remember was geting off the operating room table onto a gurney for a ward plastered from hip to big toe, had no morphine for the pain ? I was unconcious for approx five hours.
The Point being, I now still walk at 5 + mph, lived a good life, so this young feller should be up and having the time of his life,soon chasing the ball and climbing trees and doing gym , sports of all types soon, jumping out of planes, doing the ton on Motor cycle etc.. But It is good that there be this kind of service, then it be some old rattle trap to the hospital 30 miles away and very dim Head lights.
2nd point do not sleep walk
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