had a disagreement with a mate. He seemed to have no neurological injury, he was speaking normally, his reactions were normal and his mobility had not changed. The knife could easily have punctured his frontal lobe and caused bleeding inside his skull.
He was sat in a cubicle and was assessed by the doctor. There seemed to be no signs of injury caused by the knife and it seemed to be stuck into the skull bone rather than piercing his brain. He was able to walk, so a nurse accompanied him to x-ray, making sure he didn’t bump into anything and embed the knife any further. He walked down as if nothing was unusual. It was the medical staff reactions that were the unusual thing in this situation. The nursing staff and medical staff crowded around the x-ray light box to look at this man's x-rays. They revealed the knife was millimetres away from his brain. He was so lucky. If he was to shake his head around, the knife could easily pierce his brain.
After having the all clear from the doctor and a look at the x-rays himself, the procedure to remove the knife began. The man lay flat on the cubicle trolley. With his head supported in place, the doctor pulled the knife out with force. It was embedded in his skull and it took a few attempts at pulling to release it. The doctor got it out on the third attempt, nearly hitting the wall behind him with the momentum and force it took. The doctor then sutured the wound to prevent infection getting into the site and informed him of what to look out for to prevent infection. Stitches were to be removed in 10 days by his GP. The man was appreciative of the help and asked to have his kitchen knife back. The doctor gave back the man’s property and he left in good spirits, feeling like it was his lucky day.
Drugs
We often had regular intravenous drug users attend emergency after overdosing. Often paramedics would bring them into the department, having administered Narcan, a drug that reverses the effect of opiates. They would often last less than half an hour in the department before making a hasty exit.
On one occasion, a person spent no longer than five minutes in the department. He was given Narcan by the paramedics and just after being assessed by the nursing staff, he woke up, jumped off the emergency trolley and started to run out of the department. He saw a window of opportunity through the waiting room door and ran through the crowds of people waiting patiently, nearly knocking a few over, and outside into the daylight.
A few of us walked out of the department to see how far he would get. We found him on the grass outside of emergency, laid out flat, unconscious again. Narcan has a very short half-life and the waking effects only last for a short period of time. We scooped him up and returned him to the trolley he had just ran away from andensured he was safe to sleep off the rest of his heroin overdose.
Alcohol
A teenager had been drinking alcohol in the local park when he became unresponsive and, despite his friend slapping his face with full force, he would not respond. His friends called an ambulance and he was brought into emergency. The teenager was given immediate treatment by the paramedics.
When he was brought in, paramedics had already placed a Geudel airway in his mouth to keep his tongue from falling backward and blocking his airway. He also had a cannula in his right forearm and a litre of fluid attached. The paramedics wheeled him in on a trolley, his long hair draped over his sweaty face, his breath reeked of alcohol with every deep breath he blew out and he had vomit stains on his t-shirt. His skin was cold from being out in the night air with not much warmth or protection. The paramedics lined up the two trolleys together and unfastened the teenager’s seatbelt. Removing the blanket, they rolled him over onto the emergency trolley and placed the blanket back over his body.
His Glasgow Coma Score was nine out of fifteen. Fifteen would be fully conscious with no
He was sat in a cubicle and was assessed by the doctor. There seemed to be no signs of injury caused by the knife and it seemed to be stuck into the skull bone rather than piercing his brain. He was able to walk, so a nurse accompanied him to x-ray, making sure he didn’t bump into anything and embed the knife any further. He walked down as if nothing was unusual. It was the medical staff reactions that were the unusual thing in this situation. The nursing staff and medical staff crowded around the x-ray light box to look at this man's x-rays. They revealed the knife was millimetres away from his brain. He was so lucky. If he was to shake his head around, the knife could easily pierce his brain.
After having the all clear from the doctor and a look at the x-rays himself, the procedure to remove the knife began. The man lay flat on the cubicle trolley. With his head supported in place, the doctor pulled the knife out with force. It was embedded in his skull and it took a few attempts at pulling to release it. The doctor got it out on the third attempt, nearly hitting the wall behind him with the momentum and force it took. The doctor then sutured the wound to prevent infection getting into the site and informed him of what to look out for to prevent infection. Stitches were to be removed in 10 days by his GP. The man was appreciative of the help and asked to have his kitchen knife back. The doctor gave back the man’s property and he left in good spirits, feeling like it was his lucky day.
Drugs
We often had regular intravenous drug users attend emergency after overdosing. Often paramedics would bring them into the department, having administered Narcan, a drug that reverses the effect of opiates. They would often last less than half an hour in the department before making a hasty exit.
On one occasion, a person spent no longer than five minutes in the department. He was given Narcan by the paramedics and just after being assessed by the nursing staff, he woke up, jumped off the emergency trolley and started to run out of the department. He saw a window of opportunity through the waiting room door and ran through the crowds of people waiting patiently, nearly knocking a few over, and outside into the daylight.
A few of us walked out of the department to see how far he would get. We found him on the grass outside of emergency, laid out flat, unconscious again. Narcan has a very short half-life and the waking effects only last for a short period of time. We scooped him up and returned him to the trolley he had just ran away from andensured he was safe to sleep off the rest of his heroin overdose.
Alcohol
A teenager had been drinking alcohol in the local park when he became unresponsive and, despite his friend slapping his face with full force, he would not respond. His friends called an ambulance and he was brought into emergency. The teenager was given immediate treatment by the paramedics.
When he was brought in, paramedics had already placed a Geudel airway in his mouth to keep his tongue from falling backward and blocking his airway. He also had a cannula in his right forearm and a litre of fluid attached. The paramedics wheeled him in on a trolley, his long hair draped over his sweaty face, his breath reeked of alcohol with every deep breath he blew out and he had vomit stains on his t-shirt. His skin was cold from being out in the night air with not much warmth or protection. The paramedics lined up the two trolleys together and unfastened the teenager’s seatbelt. Removing the blanket, they rolled him over onto the emergency trolley and placed the blanket back over his body.
His Glasgow Coma Score was nine out of fifteen. Fifteen would be fully conscious with no
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