I’ve seen *counts on fingers* four stabbings in my time, mostly fairly minor nicks to the belly and chest tissue, backed up with defensive injuries to the hands and forearms.
This is the story of the one that wasn’t.
We were sitting in the station gazing longingly at the birthday cake of one of the Technicians, we’d all been at her party a few nights previously, but this was the day.
“It’s too nice! I can’t ruin it!” she insisted “And I don’t want to cut the cute teddy on the top.”
The phone rang, myself and my host paramedic were up, we left them to their confectionery conundrum.
The incident was a young soldier on leave who’d had a disagreement with someone in the pub, on returning home he found that his debating partner had followed him and he was promptly chibbed in the gut with a breadknife whilst standing in his mother’s kitchen.
On arriving with the paramedic I was shadowing that night we found the lad on the floor, understandably howling, family pressing on his wound with bath towels for all they were worth. The paramedic, “L”, grabbed control of the situation immediately “Right, is the person with the knife still here?”
The family had barely answered in the negative before she was directing me to clear the kitchen while she dropped to her knees next to the leaker on the lino.
Lifting up his sodden teeshirt revealed a wicked, jagged edged hole above his navel, whipping a dressing out from her pocket she applied pressure and machine-gunned off a list of equipment she wanted from the vehicle “Entonox and two bags of fluids, GO!”
I was on my feet, snaking through the crowd of shuddering relatives and assembled cops in the front garden, their faces lit by the blue-green screens of their shoulder mounted radios.
Out to the vehicle, dig in the box, SHIT, where are the fluids? Fluids…fluids…ah! In the warmer, kept at blood temperature so as not to affect the patient’s core temperature when they’re run through, got it. I grabbed the heavy Entonox cylinder and two bags from the warmer, grimacing at their texture, warm as blood, leaden and soft in my hands.
Back into the kitchen and I get taught my first real-life lesson in pain management. All my classroom training has said “Pain is bad, it should be avoided.” but that was it, simply a niceity for your patient, we were told, don’t worry about pain if there are other aspects that concern you, such as their breathing, bleeding or blood pressure.
What had never been pushed home was that pain AFFECTS these things, as was ably illustrated right here, right now. With every scream and shudder that came from the patient, his breathing became harder and shallower, blood poured from the wound and butchered lumps of fat and tissue pushed to the surface, peeking out, spongey and pale in the dim light that emanated from under the kitchen cabinets.
“Get him on that.” said L, nodding at the Entonox, “I’m going to get a line in and give him these fluids…”
“Right mate” I began “This is just gas and air, ok? Like they give pregnant women. It’ll make you feel a bit woozy, but it should take the edge off the pain for you. Take the valve in your hand, hold it in your mouth and suck hard whenever you feel you need it, right?”
He nods, eyes twisted tight and wraps his lips round the mouthpiece, sucking greedily at the cold, sweet gases.
Within a minute he’d relaxed, the screams had abated, the bleeding eased, the wound became a simple dark hole in his belly, rather than the Hammer Horror extra it had previously been.
“Pass me the giving set.” murmured L.
“The what?”
“The giving set, for the fluids.”
“I, ummmm, I don’t know….”
She whipped her head back and forth, “There’s not one here, did you bring one from the car?”
“No! You didn’t say, I don’t know what they are.”
“RIght, we’re going to need one, it’s a long tube that connects to the fluid bags, there’ll be some in the warmer. Quick as you can, right?”
Again, on my feet, open the door and walk into a WPC on her way in.
“LTP?”
“Huh?”
“LTP?”
A nugget of information comes into focus in my memory, she’s asking if he’s “Likely To Prove”, fatal, that is, she wants to know if she’s investigating assault or murder.
I’m in no position to make that sort of decision, I blow out my cheeks.
“Couldn’t say, I’m afraid, can we talk to you once he’s transported?” and with that, I’m on my way for the elusive giving set.
Back in the kitchen with the missing equipment one of the bags of fluid pour into the young man’s veins, a large pad is soaked in sterile water and laid onto the wound and he’s wrapped in cling film, a sterile and self-adhesive container for his belly. The fluids start to run low.
“Are you wanting the other bag, L?”
“Nope, can’t use it, it’s glucose solution, I needed saline.”
“Ah, sorry…”
“Never mind, let’s get this guy ready.”
We sit him in a chair, wrap him in a blanket and roll him out the door where he’s passed onto a receiving crew with an ambulance, no space in the back of the Rapid Response Vehicle to move patients.
We hang around, L gives her details to the police, I chat to the family, reassuring them of the level of care their son is receiving. His mother is frantic, begging L for directions to the hospital, she wants to be with her boy.
I take her husband aside.
“Mate, I realise this is a difficult time, but you can’t let your wife drive like this, she’s in too much shock. Your lad’ll be fine in the meantime, can I leave her with you? She needs a cuppa and a sit down, just to get her breath and keep the head before she gets in the car.”
“Shouldn’t we be going to the hospital?”
“Frankly, if you let her drive in the state she’s in? You’ll need another ambulance before the night’s out, it’s not worth it.”
“Right, right, ok, yeah…”
Back in the vehicle I relay to L what I said to hubby, but she cuts me short,
“I heard you.”
“But you were talking to the cop.”
“Yeah, but I was listening to you.”
“Oh. Sorry I flapped back there, I just wasn’t on the ball.”
“Don’t worry about it, I’ve been waiting for it.”
“Sorry?”
“Well, you’ve been out with me now, what, 3 times? Probably done 15, 18 jobs together?”
“Uh-huh.”
“I’ve been pushing you harder and harder on each one, I knew at some point I’d reach a level at which you couldn’t perform.”
Once we returned to the station, we reran the shout together, going over exactly what I’d missed, which equipment I’d been ignorant of, how the bags of fluids were labelled( “The glucose shouldn’t be in the warmer anyway, it knackers it, but I still expect you to read the labels.”) and a variety of other minor points.
We left the garage and moved to the mess room, where the cake discussion continued to rage on.
“Good shout?”
“Stabbing.”
“Oooh, pish, or proper job?”
“Proper job.”
Birthday girl stands up, knife in hand.
“Well, when in Rome, right? Cake anyone?”
and down went the blade, right into Teddy’s gut.
Next year? We should get her one of these.