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Life Medical Thursday Doors

Emergency

BASICS isn’t basic. The British ASsociation of Immediate Care (BASICS) is an organisation which trains volunteer health workers to provide healthcare assistance in support of the emergency services.

Last weekend, I did a three-day BASICS residential course dealing with a wide range of emergencies, from car crashes to falls, heart attacks to carbon monoxide poisoning, electrocution to stabbings.

The course was intense. It began at 8.30am and continued till 7.30pm, with some sessions taking place outdoors as Storm Ciara threatened. It was very cold and windy. “Typical weather, good practice for you,” said the instructor.” All we need now is some rain.”

The organisers encouraged us to bring personal protective equipment, and some participants looked cool in their high visibility gear. All I had was a suit of orange overalls, handed down from my father. He used to be a postman, so instead of “paramedic” or “emergency doctor”, the label on my chest spelled out “Royal Mail”. The organiser told me that this was a first.

A fireman gave us practical instructions on how to get people out of a smashed up car. I think he enjoyed sharing his gory tales of derring-do. I had no idea how many airbags a modern vehicle contains, and what damage they can do when they go off as you are struggling to get someone out of a wreck. He referred to extraction implements as “toys”. I will keep my Kevlar gloves and eye protection specs in the glove compartment of my car.

The practical tests were interesting. I had to deal with someone who had been burned and blown up at a fireworks display, a lad who had been smashed in the face by a thug wielding a baseball bat, a pedestrian hit the bull bars on the front of a 4×4 and an elderly man who collapsed in the newsagents. My colleagues on the course were brilliant actors.

For the last seven years, I’ve dealt with emergencies in “resource poor environments”, often without oxygen, defibrillators and drugs. For 25 years before that I worked as a general practitioner in primary care. So the last time I put paddles on a chest and shocked a patient’s heart back to a normal rhythm was 34 years ago in North Devon District Hospital. In 2020, the standard equipment which “first responders” keep in the boot of their car is more sophisticated than the kit I was using in hospital in 1986. It was a vertical learning curve. But I passed the exam.

Now I’m a lot more skilled at managing critically ill patients away from hospital. I can use a Kendrick splint to stabilise a femoral fracture. I can remove a motorcyclist’s helmet safely. I even feel confident cutting a hole in the cricothyroid membrane. I might even be competent to assist paramedics if I come across a road traffic accident. *Basks in warm glow*

Cold, bright morning, close to the River Soar, Leicester
Where the old Bowstring Bridge used to be. The Pump and Tap is now the Queen Elizabeth II Diamond Jubilee Leisure Centre

Early on Monday morning, I swam 40 lengths at the local sports centre, showered and was just putting on my underpants when I heard a scream from the pool. “HELP!”

The new training kicked in so my mind did not go blank with panic. “First assess the scene, it will tell you what injuries you are likely to find.” Swimming pool? Drowning or cervical spine injury from diving in at the shallow end. Think – where’s the oxygen? Is there a defib? But I know they have an extraction board. I didn’t expect to be called upon to use my new skills so soon.

I peeled off my pants and wriggled back into my wet swimming costume, tucking myself in as I slithered out of the changing area. “Remember, your own safety is the most important. Don’t slip and fall, becoming a second casualty,” I said to myself.

I knew something wasn’t right when I saw the life guard still sitting on her high chair at the poolside. No one seemed to be bothered. No one seemed to have been injured. It was just a life saving class. I breathed a sigh of relief and looked plaintively at the life guard. She waved two upright thumbs at me and said, “See you at aquarobics on Wednesday!”

The climbing wall. Just waiting for someone to fall off while I am swimming.

By Dr Alfred Prunesquallor

Maverick doctor with 40 years experience, I reduced my NHS commitment in 2013. I am now enjoying being free lance, working where I am needed overseas. Now I am working in the UK helping with the current coronavirus pandemic.

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