GD

Chaos.
Smashed glass.
Fuel all over the place.
Unconscious, probably drunk driver.
Lots and lots of bystanders who all come rushing out.

*****
I'm always amused by the fact that when attending the scene of a serious RTA, as this one was, there are people who still insist on waving frantically to show the ambulance where to go. I mean, do you really think I can't see the upside down car with the steam pouring out of it? I know, I know they're only trying to help, so I shouldn't really complain, but still. It's weird.
One of the bystanders, we'll call him GD (the reasons will become clear shortly), comes over to tell me proudly that he and one other person dragged / assisted the driver out of the upside-down car, and after a few seconds of drunken yelling and thrashing about, he collapsed into an unconscious heap, where I found him.

GD then stands watching me and talking to me as if I'm his best friend. I complete an initial assessment, sort out a collar, some oxygen, do some basic obs, and assess for any immediately life-threatening injuries. None are apparent. Had he not have been drunk, this would never have happened, but the fact that he was, probably saved his life. Ironic really.

The whole of the local fire department turn up, and look sorely disappointed when the car wasn't on fire as had been originally reported. Apparently. They're closely followed by the ambulance. We package our drunk friend, who's starting to come round a little. Frankly, it was easier when he was unconscious and wasn't claiming to be one of several Hollywood heroes whilst fighting everybody off.

The ambulance leaves, and as I start my paperwork, I'm left watching the fire brigade turn the car back onto its wheels and then sweep up the mess. A voice behind me startles me a little, and I turn round to see GD standing there, proud as a peacock. "You don't remember me, do you?," he says. "You were at my house six weeks ago!"

I search the recesses of my brain but in the chaos can't place him at all. He must have seen the blank look on my face. "You were at my house", he adds, "for something completely different. Just as messy, though. Don't you remember? You delivered my... "

"Grandson!" we both said, simultaneously.

I'd delivered his grandson not two months previous, in the house right by the scene of the crash. I knew the house looked familiar.

"Don't you remember? I floated round the house yelling to everyone on the street: I'm a GrandDad! I'm a GrandDad!"

Cue huge grin.

Oh yes, GD. I do remember.

Sleep is Overrated

This is what happens when you sleep.

Admittedly, not when you're in your own bed, but at the wheel of a truck.

Not recommended.

Although, seeing that as we rounded the corner made sure I was wide awake.

Told you sleep is overrated.

A Tale of Two Bloggers

All I can see in the distance is a set of hazard lights, emitting an intermittent orange glow against the dark background of the night. Maybe this RTC won't be quite as given - trapped and unconscious - but as I approach at a rapid pace I can see that the hazard is not the car with the lights flashing, but a car facing the wrong way, lying on its side, perched up against a street light.
At four o'clock in the morning there's very little traffic, very little life about. The world sleeps as I do my small bit to keep it safe and well. The call rate to the ambulance service drops, but so do the number of available ambulances. I know I may be on my own for a while. I stop by the car, take one look at it and its unfortunate occupant, and call for help. I need everyone. Fire Brigade, police, at least one ambulance and a Basics doctor. This patient could need a lot of help, and quickly.
I’m fast asleep, having just finished a late shift in the A&E. How weird, then, that I can hear the drum solo from “In The Air Tonight!” Wait a minute, that’s my ‘phone, Ambulance Control. I blearily answer it, and accept a job nearby – car overturned, entrapment and unconscious.
I climb into the car through the boot, hoping that my assessment of its safety was correct and that the kerb would hold the car from tipping further. The patient was clearly unrestrained, lying with his head on the passenger window against the road, and his legs wrapped around the steering wheel. His breathing is a little slow, which concerns me but just putting an oxygen mask on him is a struggle. He tries to fight me off, making me think that this could be anything from a diabetic coma, to alcohol, to a serious head injury.
The journey is uneventful, and I pass the police barricade a few minutes after leaving home. It usually takes a little while for me to wake up fully, but the sight of the car on its side, facing the wrong way, and the lamp post knocked down, is like a splash of cold water. This doesn’t look good. I jump out of the car and grab my pack – anything else I will come back for. I jog round to the car, and am directed to the rear.
The Fire crews turn up first, and I ask about taking out the windscreen, but that would apparently take some time. I need him out quicker, but have no way to move him and no where to move him to. As I'm still fighting to get a primary set of observations done, three pairs of legs appear at the back of the car, two of them green belonging to the crew, and one of the pairs of legs orange. I recognise the voices and thank everyone who needed thanking for them turning up in a hurry. The orange pair of legs belongs to RRD, and I was fairly certain that when I'd asked for a Basics doctor, it would be him that I woke from his slumbers as I knew I was on his patch. At least now I could share my thoughts and decisions.
I peer in through the hatchback of the car, and see a familiar face – Ben! Excellent! This is going to be entertaining, if nothing else. He quickly appraises me of the situation – an unrestrained driver, was deeply unconscious, now has a GCS of around 8. Difficult to get access to the patient, no obs done. We discuss what options we have; peel the roof down or bring out through the back. I want this man out here, so I suggest to Ben that he tries to wind the seat back down, so that we can bodily drag him out. I wander over to the Fire Chief, and let him know what we are doing. He doesn’t look best pleased – I guess he was looking forward to some cutting, but offers all assistance with lifting etc that we might need. I go back to the boot of the car, to see Ben struggling vainly with the seat controls. “Got a problem?” I ask. He just grimaces, reaches under the patient, and the seat magically drifts back, giving the crew room to get him out. I leave them to it, and go and set up for the inevitable intubation.
We extricated the patient out the car the same way I'd climbed in, through the boot, and onto a rescue board. He was still trying to fight back. By now I could smell the alcohol, but still couldn't rule out that his behaviour was due to a head injury, and we treated as such. RRD knocked him out, intubated him, and made sure that our transfer to the hospital would be as event free as possible.
I watch as, first Ben and then the patient, are born(e) from the back of the car, the patient on a spine board. The crew wheeled him into position, near my kit dump, and we start to cut through all his clothes, so that I can make a formal assessment of his injuries. Ben is set the task of getting iv access. I check him over, head to toe, and find little else wrong with him, apart from the obvious – he is eyes closed, occasional groans and localising to pain. Glasgow Coma Score is therefore… anyone?? 8. of course!! I’ve got the kit ready, the team are ready, Ben gives the drugs, and the tube is in. We get him on to the vehicle, and I ask Ben to travel with us.
I travelled with them, abandoning my car at the scene and remaining in charge of the patient's ventilations as we did the breathing for him.
The journey is uneventful, and the three of us in the rear chat about stuff – other jobs we have done, BASICS, the state of the country, that sort of thing. All the while, we are closely monitoring the patient for signs of deterioration, of which there are none. We get to LocalNeuro, and hand over the patient, with some playful banter about whose IV access is better, Ben’s or mine (mine, of course)
All that remained was the tidy-up, paperwork, NHS tea in paper cups, and to get back to my car and return to base for the end of my shift. Maybe, if I asked really, really nicely, RRD would take me back in his cool car...
And then it’s all done. It’s early in the morning, and there’s a bit of paperwork and a lot of clearing up to do. We stand around, drinking our tea, before I offer Ben a lift back to his car.

Note to Self

You'd think that over the years, and after the previous post, you'd have learnt your lesson.

Don't say out loud what you're thinking.

It's damned likely to happen.

Twice.

So, if you feel the need to say to the The Mrs just before you leave for work that you feel like there's a big job out there tonight, don't. Just don't.

Even if it does mean you get to wake up certain people in the middle of the night.

Thus endeth the Note to Self.

Training School

I was new at the time. Very new. Not even two months out of training school. It was a time when I was keen, eager, and very very scared. I arrived at the station at least half an hour before the shift, which I still do to this day, just to make sure everything that I may need for the shift is available and ready for use on the ambulance. Obviously still keen and eager.

Ten minutes later my crew mate for the day arrived. I introduced myself and told her that I was new, and would need all the help I could get. She asked if there was anything in particular that I was nervous about, anything that I really wanted to see, that she'd see what she could arrange. I didn't really believe it, but I did mention that I'd not yet been to a cardiac arrest call. I'd practised the scenario endlessly in training school. Everyone seemed to die there. All the scenarios seemed to end in cardiac arrest.

Asthma attack scenario? Cardiac arrest.

RTA scenario? Traumatic cardiac arrest.

Pregnancy/Labour scenario? Double cardiac arrest.

Drug overdose scenario? Self inflicted cardiac arrest.

And the scenarios would always be as difficult and unlikely as possible. "Worst Case Scenario" the trainers would call it. We all took it with a pinch of salt, they were just so far-fetched.

In a broken down lift.

A crane at full height.

Stuck behind a toilet.

In the middle of a muddy building site.

On and on it went. Weeks of "people dying". If that was the real world, I wasn't so sure I was ready for it. The real world, however, was anything but constant cardiac arrest calls. Six weeks on the road, and I hadn't seen it or had to deal with it once. So I told Anne about it. She laughed and told me that the chances were slim. It was a day shift, and people tended to die at night.

Those were the days before we had computer dispatch on the ambulances. The calls would come off a printer, and the Control Room would call the station to find out who was to be the next crew out. I can still hear the distinctive whirr of that printer and find that if I ever hear it anywhere else, I instinctively expect to hear a phone ring.

We'd been out on a couple of calls and had managed to get back to station. There was nothing to challenge my knowledge yet. But now, we were the next crew out. I sat anxiously waiting for something to happen. Eventually, the blue piece of paper appeared at the top of the printer, and the phone made me jump half out my skin. This was it. My turn. And for some reason I had butterflies in my stomach. I looked at the piece of paper and saw that we were on our way to a man in his 40s with difficulty breathing. In the special instructions section there was a line about the patient being in a "hard hat" area on a building site. Could be interesting.

Half way there, we get a call on the radio: "ETA request from the scene. Patient deteriorating".

"We're approx 5 minutes away."

"Thanks, we'll let them know."

Anne presses the accelerator a little closer to the floor, the engine screams in response, but the ambulance doesn't seem to move any quicker. Two minutes later, the radio operator calls over the noise of the engine. "Update from the scene. They're on the 3rd floor of a building site. Stairs still unsafe. Ladders in use. Patient turning blue." Leave the important bit until last, why don't you?

"ETA two minutes. Thanks."

Accelerating makes no difference other than the noise, so we will the ambulance to go a little faster.

As we're no more than half a mile away, the radio chirps in once more. "Patient now in cardiac arrest!" I expected panic to set in, for the shakes to take over, for my brain to freeze. None of that happened. It was as if I'd been programmed for just this moment. The adrenaline rush was incredible. In my head I'd made a detailed list of what equipment to take, how we'd get to the patient, how we'd get him down again, and what else needed doing. All this before I'd even got out of the ambulance.

We arrived to find that our patient, had been carried down one floor by the other builders. Now at least we only had stairs to contend with, and no ladders. Two of the builders had started CPR whilst the others looked on anxiously. Anne and I took over and with the oxygen we were giving him his colour started to improve. The defibrillator looked at the chaotic heart rhythm and decided that it needed to be shocked back to life. Shocks, CPR, Shocks, CPR. We were in hard hats, covered up to our knees in mud, on the second floor of a building site, surrounded by exposed beams and electrical cables, with a 100kg patient. A real "worst case scenario".

Moving him to the ambulance was much easier than expected, thanks to several pairs of builders hands helping us carry him. The ambulance visibly sank by several inches and audibly groaned its complaint as the group of 4 ambulance staff, 6 builders and one patient either climbed in or were loaded into the back.

We continued our attempts all the way to hospital where the staff took over. They knew Anne and the other crew, but I was a new face. I overheard one of them ask Anne who the "new guy" was.

"Oh" she said. "He's a bit like this job. Come straight out of Training School."

Cen-Tree

I have an ex-crewmate, Jim, who, when frustrated with the job and its ensuing politics, would threaten to go and work for the council as a lawn-mower. No, not as the machine, but as the operator of one. No grief, out in the open air, music blaring. What more could you ask for?

*****

Al, a local-council gardener for several years, loved his job. It wasn't taxing, he loved the open air, loved working at his own pace, loved listening to his music. No managers, no hassles, never home late. Just him, and the flora and fauna of the local area. Today was his turn on Daisy, the industrial-sized ride-on lawn mower. Daisy was used when the big jobs needed doing. Parks, large verges, anywhere that a normal sized machine would take days to complete, Daisy could do the job in a fraction of the time. Daisy's twin, Belle, was also sent out on the mission, piloted by Sue.

The weather forecast had promised a bright sunny day and for once had delivered on its promise. Al and Sue were thrilled. They moved from place to place, leaving behind them the scent of freshly cut grass whenever they journeyed on. Daisy and Belle were in their element. With Sue and Al chatting throughout, the morning flew by, and as the midday sun began beating down, they found a shady area that needed cutting too. A wide grass verge with several large trees dotted around.

Sue went left, and Al, right. He'd just remembered a funny story he was going to tell her and turned round to call out. Two seconds. That's all it took. Two seconds looking in the wrong direction. Sue barely had the time to scream: "AL! LOOK OUT!!!!"

Al turned round to face the front again, just in time to see the huge branch. Most trees would be proud to have that branch as their trunk, but on this tree it was just a branch. Perpendicular to the tree-trunk, parallel to the ground, and about six feet above it. Daisy was about four foot high. Al sitting down another two. He took the full impact straight in the face. Ten miles an hour isn't fast when you're surrounded by a tonne and a half of metal, but it's lightning speed if your face meets a tree and has no protection at all.

When we arrive, Daisy is the other side of the tree, with Al a crumpled heap on the floor. There's blood everywhere. I take a few seconds to assess and work out what's going on, in which time, Jim, my crewmate suggests that immobilisation may be a good idea. I wholeheartedly agree, and curse myself for not thinking of it immediately too. Right, brain back into gear. Trauma. ABCs.

Airway - clear at the moment, but some bleeding in the mouth. Unknown source. Regular reassessment required.

Breathing - yes. At the moment. Clear chest, no funny noises, no missing sounds.

Circulation - yes. At the moment. Several areas of blood loss, none that are obviously too heavy.

Disability - Sue's unsure if he lost consciousness, but thinks that he did. At the moment, he's conscious but very confused and a little agitated.

I'm still worried about Al's airway. We need to immobilise him on a board, with a neck brace, on his back. And there's something bleeding in his mouth. Not at all ideal. Ideally I'd like to have the patient knocked out and intubated. That would ensure that his airway and breathing are secure and I could deal with the other problems.

I ask for HEMS. They're unavailable. (Not once, in my whole career so far, have they come when I've called them. I've done calls with HEMS, when other people have asked for them, but never when I have. Either they've been busy, had no helicopter, or a myriad of other excuses. Once, they even crashed when they were on route to me. Before you scan old newspapers for news of a HEMS chopper crash, they were coming in the car. But still, it must be some sort of conspiracy...)

I ask for a BASICS doctor. The nearest one is at least 40 minutes away.

We're ten minutes at most from the nearest A&E, not one known for its trauma care. The nearest Trauma Centre is an extra twenty minutes drive away. Al has an airway problem, so we don't really have a choice. We package Al, load him into the ambulance, warn the local A&E that we're on the way, and apply diesel. Jim's driving, which is a good thing, as he's a much faster and smoother driver than I am. On route I constantly suction the blood from Al's oral cavity. I have flashbacks to the dental surgery. Not a good thing.

His observations remain stable. A quick look shows that he's lost several teeth, probably fractured his jaw and eye-socket, possibly fractured his skull. As his face took the full force whilst Daisy kept going, we had to suspect a serious spinal injury too. When we arrive at the hospital, there's a full trauma team to meet us. I'm impressed. They obviously understood the significance of the injuries that we'd tried to relate over the radio. Al's handed over to the team, and I never find out what happened to him after that.

Whilst we're cleaning all the blood, mud, and carnage we'd left in the ambulance, Jim mentions that he's not so sure about his alternative career path after all. I'm not surprised.

*****

PS. This is my 100th blog post. My century entry. What started out as a little bit of a trial run, has turned into something that has taken over my life! I'm shocked I've made it this far, and honoured that I seem to have captured the interest of so many people. I hope I keep going for a long while yet, and I hope you keep coming back. But in the meantime - thank you.

She

Apologies in advance. This is likely to be a rant. I may write it in one go, not bother re-reading or editing, and I might, if I remember, just spell-check it once. Because, in case you hadn't gathered from several of my previous posts, or in case you're new, kids, in my view, take priority. They need looking after. They need to be cared for. They need attention.

They need to be kept safe.

*****

"How dare you move my children?" She screams like a madwoman. She's running round in the middle of the road, tearing at the bandage that we've placed on what's left of her ear and throwing it to the floor in fury. Immobilising her is out of the question.

"My children are my life. I wouldn't do anything to hurt them!" She's restrained by police while we have the unenviable task of cutting her children out the car and immobilising them on spinal boards.

"Don't you dare touch them! I've done nothing wrong! I'm a good mother! A safe driver! You're hurting them. You're gonna take them away!" Damned right. They're going to the hospital so they can put them back together.

It takes all my self-restraint not to answer her back. This is all her fault in the first place. These children, who she so vehemently claims she would never hurt, are now being scared to death by the fire-brigade who have to cut them out of the ruins of the car. It's her fault. She's the cause. This is the effect.

Another maniacal scream follows.

"YOU DON'T CARE ABOUT MY CHILDREN! YOU'RE TRYING TO KILL THEM!" And I can hardly take it any more. In the recesses of my mind, my self-restraint gives way to my red-headed temper and I tell her what I think.

If only you hadn't have loaded your car with a 2 metre long heavy box that was placed between your children.

If only you hadn't have had that can of beer sitting next to you.

If only you weren't concentrating on eating the hot chips that were in your lap while you were driving.

And if only you'd have actually placed your kids on proper seats and strapped them in.

Then maybe I'd struggle a little less with your claim that they are your primary concern. Maybe I'd stop thinking that actually, the person who was really trying to kill them, was you. Their mother. I don't mean to, but I can't help thinking it. She's no mother.

She had her ear practically torn off by the box as it flew through the windscreen. It could have been one of her kids.

She's lost control of the car, either through drinking or eating whilst at the wheel.

She's lost the right to tell me what's best for her kids.

She's lost the right to tell me my job. I need to do my job. I feel like I need to do her job too.

She's almost, very nearly lost a hell of a lot more.

She almost lost her kids.

Inspiration

Every so often I get asked where I get the ideas for my blog. And every so often I get asked why I ever became a paramedic.

********************

Late Saturday night on a dark, twisty, road. The family car is returning its cargo of parents and their three children from a family gathering in a small village, way off the beaten track. The road twists its way back and forth through the undulating countryside. If it wasn't pitch black, the breathtaking scenery all around would show its true desert colours. The road cuts through the sand and rocks on either side with a high-sided cliff one side, and a sheer drop the other. The blind bends hide unseen hazards. The family continues its journey home, totally oblivious to the imminent danger hiding round the very next corner.

The kids in the back are asking the all-time favourite question of "Are we nearly there yet". Ben, the eldest, all of seven years old, is half asleep. Moments before his eyelids give in to the lead weights that are hanging off them, he looks up out the front windscreen, just in time to see the truck coming towards the car, on the wrong side of the road. There's no time for any avoidance manoeuvre, and even if there was, the choice is either hit the rock face, or fall off the edge of the cliff.

The impact was instantaneous, the noise deafening, the damage to the car catastrophic. And then silence. The loudest silence ever. The dust settles, the debris is scattered all over the road, the family is in total shock. Ben is disorientated, confused, dazed. A dull cry comes from his left hand side, and he looks across to see that his brother and sister both seem OK. One of them is on the floor between the seats, the other is lying on the seat itself. He looks at his mum for answers, and finds only more questions. He looks at his dad for an explanation, but finds that just like dad's front teeth, the explanation is missing.

Blood and tears flow freely. A few minutes later an ambulance arrives. It's a military ambulance, and the sight of soldiers confuses Ben even further. They're there because the nearest point of civilisation is an army base, and their medical centre was the first to get the call about the crash. They explain that they're doctors, nurses, paramedics, it's a blur of flashing lights, of people and equipment. They do their best to calm everyone down, to gain the trust of adults and children alike. Ben's initial terror starts to subside once he realises that these soldiers are here on a peaceful mission. They're here to help. Other ambulances arrive, more paramedics, civilian ones this time. The family is divided amongst them to be treated and transported.

********************

I don't remember any more. I was only seven, after all.

********************

Every so often the scene gets replayed in a recurrent dream, when the insomnia finally gives in to exhaustion and a fitful sleep takes over. I guess, in the recesses of my mind, this is why I became a paramedic. I guess, despite the fact that it took me a long time to realise it, that these amazing people were, and still are, my true inspiration.

Who's Law?

In the back of my car is a bag. Only a small bag, with only a few bits in it, just enough for me to provide some sort of basic assistance if I ever come across something. I have a bad habit of doing so. I know if it's there that there's a much better chance that I won't need it.

In the back of my wife's car is no such bag. On the rare occasions that we swap cars (hers has more seats and therefore easier to transport more small, noisy people), I swap the bag over too. I like knowing that it's there. It's my comfort blanket. Today was one of those rare swap occasions. Except that I forgot the bag. About 3 miles from home, car full of large and small people, all noisy, I remembered it. Not being the swearing type (apart from the fact that my kids were in the car so I couldn't even if I wanted to), I muttered lots of gibberish, cursed my stupidity, and repeatedly told myself that I bet I come across something.

Two minutes further up the road there's a traffic jam. I crawl around the blind bend to see the first signs of glass and debris all over the road. Then the police cars. Then the mangled Ford with a large Range Rover shaped dent in it. I KNEW IT! I JUST KNEW IT! The one time I forget the bag, and I'm gonna need it! As there's nowhere safe to stop just yet, I keep crawling with the traffic. I get a little closer, and just there, hidden behind the tall hedge, hidden just well enough and just long enough to scare me, is the ambulance. No need for the bag. Lucky. I get to my destination and breathe a sigh of relief that despite my stupidity, my little bag still wasn't required.

On the way home, very near the scene of the RTA, is a car stopped by the side of the road. In front of it is a bicycle lying at a strange angle, and two women standing comforting each other. Neither is injured, so no need for the bag again. Lucky again.

But next time I swap cars, I'll make sure I remember it, because you-know-who's law only rarely takes a break...

Another Epidemic...

There seems to be an epidemic in the country at the moment, and I don't mean any type of flu. It seems that there has been a spate of hit-and-run accidents in the news recently. It may be that after my recent call I have become a little more sensitised to seeing these things in the news, or it may be that there really has been a sudden increase.

There are, on average, ten people killed every day on Britain's roads. And nothing seems to be bringing down that number. But more worryingly, those involved seem to be becoming more callous. I don't profess for one moment that I have the answers to either of these problems. Some suggestions maybe. Having lived in various different countries over the years, I've seen how different places try to deal with the same problem, with varying degrees of success. One of the ideas I've seen, rather than using shock tactics, is using reality.

At the end of every day a list is released. It includes the number of accidents that have occurred, the number of people injured (including degree of injury), and most importantly the number of those killed. This list is then published in the national press. Every day. It appears on TV news. On the internet. On the radio. Every day. Slowly but surely the tide seems to be turning. There seems to be a shift in public awareness.

Here, the fatalities make the local news at best. RTA's with major injuries don't even do that unless the Motorway's been shut for several hours, and then it only makes the traffic reports. We need to do something to drag ourselves out of our apathy and callousness.

Send those who are responsible for serious RTA's for a week's work and observation to a rehabilitation centre where the victims of their actions are trying to piece their lives back together. Show them the reality of their crimes.

Reality is often scarier than fiction. Maybe we all need a dose of reality to help rid us of another epidemic.

Fast food?

The scene: My local restaurant / take away

The time : Judging by the noises my stomach's making - Dinner Time

Number of people I recognise: Zero (Not unusual for me to survey the scene. I'm suspicious by nature. Very unusual to spot no-one I know)

"You're a paramedic, aren't you?" says the stranger as he taps me on the shoulder. An ominous question if ever I've heard one. I'm not in uniform either, so there's no clue to my identity. I fear a question on athlete's foot, or tennis elbow, or worse... But I'm certain I don't know this person, so I suspect that it's not something quite that trivial. I risk it. "Yes I am..."

"And you went to a car crash on the North Circular Road didn't you?"

"I'm sorry, sir, but I've been to far too many car crashes on the A406. It's notorious for them". I try to concentrate on my food order. Undeterred, the gentleman, probably in his late 50's, went on to describe an RTA that I'll never forget.

_________________________________

The car was stopped in the inside lane with it's hazard lights on after breaking down. The car that used to be a family-sized car looked like a Smart car. In the boot of the car was a large truck. Not the normal thing you tend to carry around in your boot. By the side of the car was a baby seat, with baby still inside, screaming. In the front passenger seat was the driver, who was completely trapped. The reason she was in the passenger seat was because she'd somehow foreseen the imminent danger and had very quickly unbuckled the car-seat and literally thrown the baby out the car before the impact. (I believe that miracles occur all around us, all the time. We just need to open our eyes more...)

Babies screaming is usually, strangely enough, a good sign for a paramedic. As, sometimes, is a screaming adult. But this time the adult was silent. Becky probably in her mid to late 20's, wasn't moving, wasn't talking, yelling, or doing anything. Other than breathing. Very very quickly, but breathing nonetheless. The extrication was time-consuming and difficult. The Fire Brigade cut the already destroyed car into even smaller chunks, and we were able to eventually move Becky out the car. She was strapped to a back-board to ensure her back was kept straight, and had her head and neck immobilised to prevent any spinal or nerve damage occurring or worsening.

In this sort of condition, there is little time to worry about other injuries, but we noticed that she also had a broken arm, broken leg and we had to worry about internal injuries as well. Once Becky was in the ambulance we took her to the nearest trauma centre, along with the screaming baby. Just before pulling into the hospital Becky opened her eyes. She was completely confused, and her instant reaction was one of horror. She wanted to know where her baby was, and if the baby was ok. We showed her the baby, and the weight of the world seemed to lift off her shoulders. She even managed a smile. We handed over our now-no-longer unconscious patient to the hospital team, and went about the mundane tasks of paperwork and tidying up the ambulance before leaving the hospital.

As the hospital is not one to which I regularly take patients, I had no way of following up her progress.

_________________________________

"Were you one of the paramedics at that crash?"

"Yes, sir, I was. But I don't remember you being there"

"You wouldn't, because I wasn't there. But my daughter Becky was, and she recognised you as soon as you walked in. She's sitting over there at the table. She finally left hospital yesterday, and we're having a family dinner to celebrate! She wants to thank you in person, and wants to know if you'll come over to our table?"

Three months after the crash in which she saved her own baby's life and nearly lost her own, she was able to go out for a family dinner to celebrate her recovery.

We very rarely get to follow up on our patients, and it's even more rare to meet up with them, so it was an exceptional moment for both patient and paramedic. "Thank you. So, so much" said Becky. Her eyes welled up with tears and she gave me a hug that seemed to convey all the anger, confusion, frustration, sadness and eventual joy of the past few months, in just one moment.

And all I wanted was some fast food for dinner...