Louise Rosson has been a registered paramedic for eight years with the East of England Ambulance Service NHS Trust (EEAST). Not only is she now a critical care paramedic (CCP) and air operations supervisor working for Essex and Herts Air Ambulance charity, but she volunteers her time responding for Suffolk Accident Rescue Service (SARS) in her community.
Louise and her critical care colleagues treat are dispatched to hundreds of patients every year who are seriously injured or in a life-threatening condition. Many of these are critically injured people who have been involved in a road traffic collision (RTC) on one of the region’s roads.
“From frontline duties on the ambulances to responding solo and as part of a team providing enhanced critical care, I have had more and more exposure to many road traffic collisions ranging from no or minor injury, up to life-changing and fatal incidents,” says Lou. “The role I currently play within the ambulance service and charities results in my increased exposure to these incidents, often on a daily basis.”
And so the call begins…
As the piercing tone of the emergency activation phone rings at the air ambulance base, Lou’s senses are already heightened even before she picks up the call. The surge of adrenaline begins to prepare her muscles and mind for the incident she is about to attend.
“We are only passed minimal information at this time,” Lou says. “The focus is getting to the address, locating the incident and identifying a suitable, safe place to land. The doctor and I gather up our many bags as the helicopter rotas slow to a stop. With our personal protection equipment donned we head to the incident.”
Lou explains that sometimes from the overhead they get an idea what’s to come, meaning that as they can see more of the scene, it can be clearer what’s happened and what they face: “As pre-hospital clinicians, we pay immediate attention to the mechanisms involved. The damage to the vehicles or obstacles involved, the distance objects have moved or casualties have been thrown, analysing the bending of metal or breaking of trees and understanding the energy that has passed through this scene as it lay so still now. This is called ‘reading the scene’ and it is very important for our assessment of the casualties involved and predicting their injuries.”
Critical care teams are sometimes confronted with many patients, and their immediate actions are briefly assessment of all casualties to prioritise their injuries and treatments. This can be harder to do at some incidents than others when all patients are seriously injured or life-threatened and when children are involved. Lou says: “The rapid assessment of a patient takes skill, knowledge and experience. We are not just looking for broken bones but also assessing for suspected internal injuries which can and do mean that a patient’s life begins to slip away before our eyes.
So has seeing this kind of devastating changed Louise’s awareness? You bet.
“Despite the time of day, the weather, the car, the driver, the outcomes can be so unpredictable and devastating, “she says “I adapt the way I drive because of what I have seen. Please adapt your driving – once the accident has happened, it is our job to try to save you. It is your job to drive safely.”
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