Sunday, June 3, 2012

That lights and siren

I don't like to be in an ambulance. It makes me nauseated. Before this, I was in the ambulance to send cases especially when I was in medical and surgical posting. But this time, I have to attend cases and bring the patient to hospital.

During my very first ambulance call, I was so afraid to face it though we had gone through BLS and BTLS courses. I was not so sure what am I afraid of; maybe it was the usual feeling for the first timer. If possible, I'd like to change it with somebody else. But, my best friend kept giving me motivation, encouraged me to face it as there is nothing to be afraid of; just do it accordingly and reassured me that the MAs are experienced enough to face the situations. He also told me to manage the situation and don't let ourselves be influenced by the situation.

I went to work that night with mixed feeling; I was excited but at the same time I was so afraid. I did not have a good sleep that evening though I was tired with cases in red zone that morning. Things went well in the first hour of working; attending patients in yellow zone as usual - but patients kept coming that night; we had no enough hands. I was glad in the first place when my friend; who was at the end of the posting offered himself to go for ambulance call if there was any trauma case - I was more than happy to give him the chance.

Everything started at 11 o'clock; when I was called by the MA to attend an MVA case near Carefour Seremban. I was trying to find my friend but I could not spot him anywhere. So, I just went out for the case. I could not describe my feeling in the ambulance. I told myself that I have to stay calm and be ready; I could only read selawat and bismillah throughout the journey.

It was a bad traffic on the way to the scene as the it was the main road to Senawang, plus it was Saturday night! There were already at least 2 JPAM ambulances at the scene while we arrived. The accident was between a car vs car. A car from the opposite direction was skidded at the traffic light, flew to the road heading to Senawang and hit a car before turned over and landed in a drain. Just imagine how bad was it as there was a 3 lane - road for each direction. There were 3 victims in the car; the driver, the front passenger and the back passenger. The back passenger was thrown from car and passed away.

The first victim we met was a family who did not sustain any external injury; they were in great shock, un expecting anything to happen on their way back home from a kenduri. One of our MA took care of the family and brought them to the ambulance. We searched for another victim - he was sitting beside a drain and screaming in great pain and maybe for a great fear; no obvious deep external wound. We let the JPAM staffs took care of the victim as the airway, breathing and circulation were secured. I attended a patient in one of the JPAM ambulance; he was alert, conscious with GCS 15/15, ABC was secured but his left lower limb was splinted as deformity was noted. And to my surprise, he was one of my hospital staff  in surgical ward! He was stable with IV drip in progress prepared by the JPAM staff. The only thing that was not completed was cervical collar and I asked them to apply it though he did not complain of any neck pain. I accompanied this patient to hospital (in JPAM ambulance). I did not find the dead victim as they may have rushed him to hospital earlier.

I triaged all the victims I met to yellow zone. Unfortunately, the second victim needed to be up graded to red zone for chest tube after primary survey as subcutaneous emphysema was noted. The red zone was like a war zone with CPR was going on with few other asthmatic patients on the bay.

While I was helping with the patient, another ambulance call came in - and again trauma case. It was a call by the public as they found a gentleman lying on road beside his motorbike. "He must be drunken!" said
my MA. We rushed to the scene. This time, I had no time to get worried or trying to comfort myself. The adrenaline rush dictated everything. There was an elderly Indian gentleman lying on road beside his motorbike with a strong alcohol smell! I did things accordingly. Red zone was informed about this case which need intubation; I did not intubate in the ambulance as the hospital was just nearby. We rushed the patient to red zone as we arrived and everything was ready. The patient was safely intubated but unfortunately our CT scan was broken down and we needed to bag him to Mawar Hospital for CT brain. While the patient was intubated, I was called again for another case!

This time was a case of acute exacerbation of bronchial asthma; we received the call from an elderly Malay lady who has been having asthmatic attack for the past 3 days but was relieved with Salbutamol inhaler. She had no transport to hospital and stayed with her son who was still young; I assumed he was around a 12-year-old kid. It was another headache to find the house in the middle of night. I nauseated in the ambulance especially when we passed through the bumpers in the housing areas. It took quite sometimes before we could find the house. I was lucky as my MA was well trained. We gave nebulized AVN to the patient and rushed to hospital; and I still nauseated and leaned my head against the wall with my eyes half -opened monitoring the patient - ensuring the vital signs are stable.

I triaged this patient to red zone and helped out with the patient as red zone was busy that night. And...another ambulance call came in; trauma case - again!

That was during my very first ambulance call. Now, I have no more palpitation or worry for the call because I know Allah is always with me and He always send good people for me. Thanks to my friend for your encouraging words. In fact, I don't mind to take the call if offered by my colleagues because of the experience that I'll gain from it. Sadly, the motion sickness doesn't fade away.

Ya Allah, please ease my way to help those in need. Please grant me patience and passion to deal with them. Please grant me patience, patience and patience. Ameen.

71200 Seremban

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