Need to hire a cycle, help or advice on a new bike or a repair then give me a call on 077468 60023 email:firstname.lastname@example.org We might only have a bike shack but we can sort most things. Need a Transceiver or ski's then I can supply Ortovox and Movement Ski's and some other brands at very competitive prices. I am a professional member of the American Avalanche Association and work as a ski patroler and rescuer providing professional training including UK Trainer for RECCO
Wednesday, 22 January 2020
A reminder of blood and tears
Having spent yesterday formatting and upgrading Fiona's desktop to Windows 7 from XP I took some files off including some with stuff I didn't deem important and had thought long gone but Fiona obviously thought was worth keeping. I am glad she did as there's a host of pictures and documents I had binned off my own various computers years ago. Some pictures of patient care and some letters including my HPC revalidation as a Professional Paramedic from 2005/6. Section G7. Quite a reminder of the level of care in tricky places I used to provide never mind the A/E work, Ambulance and theatre electives. "the busiest mountain rescue team in Scotland" was maybe true back then but not now as Lochaber MRT hold that title. Here's some mountain stuff cut and pasted from the scanned version:
I was quite good at sticking sharps in folk in tricky places
Section G7 Report
Description of areas of professional practice
Three Patient Histories
work for the busiest mountain rescue team in Scotland, Glencoe Mountain Rescue
which is a voluntary service similar to the RNLI. We are funded by the Highland Constabulary
(Police) and uniquely by the Scottish Executive (Parliament). I am insured for medical duties including
invasive skills by the Highland Constabulary (Police) and when treating a
patient will have been called to do so by the Police.
number of trauma victims and ill patients treated by me practicing for the
above rescue service ranges from 26 to 50 per annum. My duties includes
the initial rescue response tailored to
the injury or illness, logistical organisation for completion of the rescue
task, scene safety of the patient, and rapid assessment and critical
interventions at the scene.
My duties also include liaison with other search
and rescue agencies to carry out the primary role of Glencoe Mountain Rescue
which is to find, treat as appropriate, and stabilise patients for onward
transport via rescue techniques to hospital.
The medical aspect of rescue provided by me would include:
safety, history of the present complaint or injury, primary survey,
resuscitation according to UK Resuscitation council guidelines, splinting and
packaging and providing adequate analgesia.As an example of clinical skills I will provide three examples of
patients treated by me:
Narrative: 19/02/05 While en route in blizzard
conditions to evacuate the body of a fallen mountaineer in a remote location, a
rescuer was seen falling over 400ft on hard neve (hard snow).
Scene : Safe as fallen
mountaineer landed on less steep ground
Initial assessment: Airway with “C” spine control, Patient Alert
and Vocalising and Responding to Pain. Breathing rate 12/20 and pulse rate less
than 100bpm. Rapid body survey indicated only one chief complaint which was a
badly deformed and broken ankle which was exposed and examined for distal
circulation which was absent. Cold was an issue as it was -6c and wind was
40/80 knots so protecting the limb from cold injury was also priority. SAMPLE
Treatment provided: The
patient was cannulated by me with a 18g Safelon cannula in the antecubital
vein. Cyclimorph 15 was drawn up and diluted in 10mls of sterile water (1.5mg
per ml) and slowly injected using a visual analogue scale (VAS) to gauge effect
from the patient. When a therapeutic
effect and adequate analgesia was achieved which in this case was 4 the ankle
was pulled by me and circulation returned.
A rigid vacuum splint was applied.
The patient was put in a warm pre heated casualty bag
Rescue: The patient was
evacuated for 3 hours via a circuitous route to avoid avalanche traps until a
SAR helicopter was able to come in and uplift him to the Belford DGH.
Outcome: Transfer by road after initial assessment to
regional orthopaedic unit for pins and plates and patient is now fully mobile
and recovered. Total rescue time 11
Narrative:22/06/05 while instructing students on an MEL course an
instructor stepped back off a ledge and fell “bouncing” 60ft into a
gully/watercourse (Lady’s Gully)
Scene : Steep but made
safe. Patient lying in water and unresponsive
Initial assessment: Airway,“C” spine control and jaw thrust. Breathing inadequate SAO2 at 80% so initial resuscitation by BVM and then
return of consciousness to GCS circa 11 (aVPu) and SAO2 96% with spontaneous
respirations and adequate tidal volume. Breathing 12/20 and pulse 90bpm. Obvious bleeding from scalp wounds but no
other external bleeds found during rapid body survey. Conscious level
alternating between AVPu and aVPu. Body check revealed tender left side thorax
with good breath sounds and lumbar spine pain. SAMPLE history unremarkable.
Core temp 36c by tympanic thermometer.
Treatment provided: O2 at
15l/min (SAO2 100%), Cervical Collar, The patient was cannulated by me with a
16g Safelon cannula in the antecubital vein flushed to keep open. Patient packaged good lung down in modified
recovery position (WEMS guidelines) even though no obvious lung injury - in a formed vacuum mattress and casualty bag
Rescue: The patient was
evacuated immediately after packaging by SAR helicopter which arrived 2 hours
Outcome: I accompanied
patient to local DGH for handover where he continued to improve. No fractures or life threats found. Admitted for observation for 2 days while
obvious concussion resolved adequately for release. Patient 6 months on still has memory problems
which are slowly resolving. Post traumatic psychological injury regarding
“trusting himself” not yet resolved.
Narrative:29/12/05 a Lady of
57 years running down mountain path to a bridge in the dark goes over the side
into a deep gorge 15mins walk from main A82 road. Husband phones 999 via mobile
immediately and local police collect me and other team colleagues called out
via radio net
Scene : Patient found
below 60 ft drop face down in water with bubbles from mouth. Other rescuers arrive and we pull her onto
large slimy water worn boulders at side.
Initial assessment: Airway,“C” spine control and attempted jaw
thrust. Breathing absent
Treatment provided: Initial
BVM unsuccessful as head jammed among large rocks with no flat ground
around. Vocal cords not visible via
laryngoscope so I elected to intubate using a 37f Combitube Airway. Successful esophageal intubation visible by
chest rise and good breath sounds. Ventilations by colleague via BVM and
catheter mount. Patient had been in cold
winter water for 35 mins. and no signs of circulation. Defib attached and slow sinus rhythm with
ectopics observed. Patient core 32c but not accurate as water in ear
which affects the tympanic thermometer.
Rapid body check revealed no obvious sings of external bleeding but
history suggested internal injury and bleeds.
Packaged with spinal precautions and
attached to defib in casualty bag. Rope raise to path and stretcher to
awaiting road ambulance. En route to road patient goes into VF and one shock
results in RSC. 10 mins later goes into VF again and 3 shocks as per UK
Resuscitation guidelines for special circumstances delivered as patient trauma
vs. hypothermia victim. CPR and delivery
to road ambulance with no further shocks.
Rescue: The patient was
evacuated immediately as “load and go” -
as far as is possible in a technical rescue situation
Outcome: Patient blue lighted
to local DGH where pronounced life extinct due to traumatic injuries.
hope that the above actual case histories show some of the range of
professional practice regarding my work for the Police as medical officer to
Glencoe Mountain Rescue.