Medics Rush a Man to Hospital After a Three-Storey Fall | Trauma Investigators Full Episode

hi how are you doing all right i'm gareth this is steve hello in a bit of an awkward place come from the top apparently if he's come from the top of that then that could be quite serious i can't see anything that would have broken his fall on the way down it looks like he's coming to a sudden start has quite a big impact how are you doing all right this is good hello john i'll bring the top of his face there yeah each pulse is a hundred no problem and it's quite pain as well john just to say hello my name is gareth i'm one of the doctors okay we're gonna help you with your pain as well now all right okay we're gonna get you nice and warm the guys are doing a great job his blood pressure is relatively low he's also very pale i am really worried that he's bleeding from somewhere we're going to help you all right the first thing we need to do is get you out of this little confined area okay [Music] but if they're to save john's life it's a risk they have to make do we need some painkillers before we move i think we do the main bit to support is going to be his middle bit so lift him out onto the scoop stretcher yep okay is everyone okay okay should we go straight into the ambulance the sedative is starting to affect your memory i don't know what's going on you're unwell you feel a bit frightened because the painkillers are very strong as well okay i don't know what's happening yeah so what we'll do is go in cut clothes off have another look i think it's just going to be painkillers splinting the pelvis and and running down to the london help me help me good man what is me doing you're doing well this is just a drug [Applause] have you still got any pain anywhere john he could have landed directly on his back and broken his back i'm also concerned about all of the bones between his feet and his back they're all vulnerable here including the pelvic bone which could also be fractured and with pelvic bone fractures you sometimes get some bleeding which can be severe so is everyone happy with the plan guys so collar and blocks will keep him as analgesed as we can until we get down to the london i don't think we need to give him an anaesthetic at the moment but we could change that plan if we need to um i think we can manage his pain pelvic splint off to the right london but we're just going to have these around your head to stop you moving whilst you're traveling yeah we're good we're good to go thanks guys you're perfect john's injuries are potentially life-threatening they need to get into the specialist trauma team of the royal london monster as quickly as possible [Music] the elite squad of former doctors from london's air ambulance deal with the capital's most serious emergency years of training have turned them into medical investigators they look for the clues and search for evidence that can lead them to the right diagnosis and saves patients lives [Music] the latest patient being rocked into the royal london hospital is 23 year old john he's fallen off a ladder and has potentially life-threatening injuries [Music] we've got a hems patients being brought in who's a 20 year old male he's been falling about 30 feet um and has had a hypotensive period so worried about blood loss and they suspect pelvic injury which would certainly be a common cause of major blood loss uk happy patients arriving so if we just make some spacements coming on this side please so everybody this is a gentleman in his 20s called john he was at the top of a three-story building on a ladder when he fell from the top of the bottom landed on his back when we got there gcs-15 that complained of a lot of lumbar back pain looking very pale and so from the top down he's he's got a head injury with a laceration to the left frontal region he's um fully ketamine ketamine eyes on the moment he had 150 milligrams of ketamine for pain in his back hence his gcs at the moment is about four but okay his natural gts is 14 yeah lots of back pain and posterior pelvic pain he was moving his legs normally on scene and was a summary of 4 30 feet with back injury and head injury all right thank you lovely thanks um you're happy with the airway at the moment okay and then lulu if you can carry on with the primary survey please he's fallen from three floors onto the ground and some people don't survive that he's already had a low blood pressure recorded and that makes me concerned that he is bleeding he's also like to have spinal fractures i know he's got a head injury that could easily progress and become a big problem also hello there healing up your eyes for me hello you're just in the resource room okay hello john hi there john can you squeeze my fingers john that's it fantastic bilateral transmitted upper airway sounds equal layer entry bilaterally no bruising over the chest that i can see stats of 99 good volume central pulse weak volume peripheral pulse fuse to the hands john is certainly at risk of having a pelvic fracture with a pelvic fracture with all the blood vessels that run over the pelvis is that internal bleeding associated with that is very likely and difficult to detect okay so if we can get another line in some bloods off and pelvis x-ray so the chest x-ray looks pretty normal there's really no sign of any bleeding or any uh injury to the lungs or the chest wall which is consistent with the clinical examination there wasn't really any sign of that it was below the waist really that was more concerned about so let's have a look at his pelvis x-ray so the pelvis is asymmetrical so it's wider here on the left than it is on the right it also can be because the pelvis has been disrupted and is not uh intact in its ring-like shape which it should be um and then the second abnormality is that the uh there's a lucency running through the pubic symphysis here which is a fracture although it doesn't look like a major fracture the fact that there is a fracture there makes me worried that the pelvis itself is more disruptive than we can see okay we're good to go to cet i think it's not just john's pelvis simon is concerned about he needs to find out if jon has damaged his spine if he has there is a danger he could be paralyzed slide one slide ready brace slide what's going on what we're gonna do is get a little x-ray of your neck now to check it's okay really what is going on what's going on is you're in hospital because you had a fall okay and they gave you a drug to make you sleepy because you're in quite a bit of pain to start with right cersei i don't have no idea i know i know that's what the drug does can you can he oh my oh john john john i can't remember yesterday no that's that's part of the effect of the drug that you're giving i'm panicking it's all right you're fine it's okay okay they need clear seaty images of john's spine and pelvis but with the sedative wearing off it's proving impossible can i bring him out for a minute help me john you're fine i'm gonna bring it don't panic right listen john hello my name's simon i'm one of the doctors do you remember me from earlier on hi okay well i'm one of the doctors who's looking after you it's important you keep nice and still for the scan just for a few minutes and then we'll get you out of here okay why why am i here just because you had an accident you had a fall and you felt quite a height so we wanted to have a look at the x-rays and scans of you see if there's anything broken just keep nice and still for a minute right despite our best attempt to reassure him it's gonna be very difficult for him to keep still whilst he has this scan done so um really i haven't got any other alternative than to give him some more sedation so that he's uh able to lie still for the scan at least thank you just keep going okay so we're going to get hold of emma for you okay i'm crossing my fingers and toes hoping he doesn't move [Music] two and a half thousand images so far it might take a little while to look at them all simon can now see the full extent of the damage to john's pelvis as is often the case that the factory is much more visibly extensive on the ct than it was apparent on the x-ray so he's got actually quite a um quite a significant pelvic fracture with some bleeding and a cluster blood that's formed around the fracture and actually you can see that the breathing is still continuing at the time of the ct scan so which explains why his blood pressure was a bit on the low side john's back in recess and the effects of the drugs have finally gone off i'm a bit uncomfortable my lower back hurts quite a lot but i mean i'm okay that does me some morphine i remember being up on the ladder and being kind of dragged off but then after that i don't i don't remember falling no i didn't know what was going on i had no idea what had happened i had to be told what happened and then even now the memories are still extremely vague what i told you earlier is what i think happened but i can't be for sure because it just happened so fast simon's now got the scans of john's spine it's got a fracture of his lumbar spine the uh cause of his pain uh 5'432 so his second lumbar vertebrae on the vertebral body is uh being compressed uh and there's lost a bit of its normal height in fact to one side it's it's potentially unstable so the main thing now is his spinal cord was working because his legs grossly anyway then his legs are moving um he's not being made paraplegic by any spinal cord injuries we need to preserve the function of his spinal cord and not to let anything happen that could cause an injury to his spinal cord john's admitted to the trauma ward so he can be monitored only time will tell whether or not the damage to his spine is life-changing [Music] london's air ambulance has been called out to an emergency in southeast london [Music] an elderly man has been knocked down elderly people involved in these [Music] the air circumstances has permission to land all over greater london right is this road i think sometimes mate we've just been sent to an accident at the end of this road can you give us a lift is that all right thank you thank you thank you very much it's straight down the road to the roundabout it just means we'll be in a better state when we get there yeah especially thank you so much your style says coming guys hello how are you right yeah this is peter it's an elderly gentleman he's crossing the road just here skip lori's just going past we think it's clipped him in his head this accident happened about 30 minutes ago now 88 year old peter was on his way to the post office when the truck hit him you know what's happened oh yeah you've been hit by a lorry we're gonna help you okay what's your name what's your name darling he's clearly agitated he's not answering questions appropriately i'm worried that he has got a bleed inside his brain if his blood pressure is high it can make a bleed in the brain worse little scratch okay so guys if someone can hold his other hand do you mind coming back thank you just hold that hand no he's right on there thank you brilliant good stuff all done have you had a blood pressure [Music] so he's going to go a little yeah relax peter stay still guys have you got a dressing handy oh yeah okay yeah i've got them now that's right how are you doing we're going to allow you down pretty hard okay let's get us this place out have we got a blanket to cover the rest of him i think from an agitation point of view um we have to worry that he's got a decent head injury don't worry but um yeah okay let's have a look pupils okay they're equal hemorrhages yeah okay that's new yeah okay he's got lots of blood around his teeth so okay let's skip laura's hitting his head to pull to the floor or if you see his head after it okay i think in view the fact he was annotated and that we couldn't manage him without the dazzle i think we should probably put him off to sleep and then take him to an mtc as well as his head's container you're all happy with that as a plan okay [Music] this is going to be an rsi and carry back to war london right back to 100 heart rate 93. giving peter an anesthetic is a risk i could make things worse by lowering his blood pressure or dropping his oxygen levels but i am worried about him having a brain injury i think this is the best course of action okay there's loads of blood okay but i can see [Music] let's put the collar on and then if we drive around we're going to get to the aircraft but in the mountain we'll do a quick inr check yes thanks with peter now intubated and stabilized the ambulance takes them back to the helicopter there is a risk doing this to people who are older but actually this is in his best interest at the moment that we're able to control these things for him and get a good quick ct scan and if necessary he might need newer surgery the nearest hospital is 25 minutes peter may have a bleed on the brain which could kill him [Music] and needs to well done just to let you know we're bringing you a patient by air he's an elderly man who's a pedestrian who's been hit by a skip lorry he was he had reduced gts and particularly agitated she's had an rsi he appears to have sort of limb injuries but predominantly head injury will be with you in about 15 minutes is [Music] and see a young ladies come in with quite sort of sudden dramatic onset of dizziness hi i'm simon wilsham consulting a e so what actually happened to you today um i was there driving and just all of a sudden i started feeling dizzy i had to go to st so i managed to park in space and i managed to get downstairs into the actual supermarket and then i just felt really dizzy and lightheaded when you say you felt dizzy just tell me exactly what you were seeing and feeling at that time it felt like everything was moving around that you know if you come off of the merry-go-round when you're little there must be the 30 or 40 different causes of dizziness the most serious of those include things like brain tumors bleeding within the brain so it's quite tricky to know which way we're going with this so what i'd like to do is just examine you have a look in your eyes with so many possible causes for annette's dizziness simon needs to find some clues fast it's going to ask you to put your hands out in front of you to hold them steady take my hand squeeze my fingers tight and go back and forth as quick as you can i'm going to move my finger to make it more difficult as well okay so a little bit unsteady there a little bit a little bit okay just the reflex on the right knee jerk is just slightly reduced compared to the left side tell me if you see double at all there is there are some just some subtle abnormal movements of your eyes when we do that okay yeah is that when you stop all of a sudden i almost feel as if my eyes want to continue moving right yeah there is some slightly abnormal movement of her eyes these could be caused by an abnormality of the middle ear or with part of the brain that deals with balance and got any family history is a bit of dizziness my mum had problems with her eyes and she had to have a brain scan because they thought that there was problems with the nerves there and then it came about that she had a large aneurysm there okay which has been successfully recoiled okay whilst my mum was waiting for the operation her older sister actually had a stroke and she that they found out that she had an aneurysm that actually burned and another sister actually found out that she had an aneurysm because of the the history you've got in the family i think it's pretty worth doing a ct scan okay i'll see a little bit so we've got a couple of abnormal findings which don't particularly fit together in my mind to give me an answer but there's enough to make me think i need to go looking a bit further for anything potentially serious when my mum found out she had the aneurysm it was a complete shock to the whole family because essentially you know when she found out that how big it was she was told basically she's a ticking time bomb if you've got an aneurysm there then it's best to know about it before it causes you any problems at that stage you can prevent someone who might potentially go on to have a catastrophic uh bleed inside their brain and cause them long-term disability or even death with such a strong family history of aneurysms simon decides to take a net for a ct scan if she does have one and it's ruptured she would explain her symptoms there's nothing that sort of is leaping out as is obviously abnormal um which is good so i certainly can't see any signs of any bleeding around the brain or within the brain that shouldn't be that would obviously be abnormal so it's answered some questions and that there isn't any sign of any bleeding or any tumor but it doesn't actually tell us if there is an aneurysm there or not which is another question that i have so your ct scan i mean i had a look at it and it does it looks normal okay so that's obviously reassuring yeah um i think with your family history we want to be absolutely certain there isn't anything um any surveillance sitting there to cause problems in the future simon still doesn't have an answer the next step is to get a far more detailed mra scan and see if that reveals anything an elite team of trauma doctors cover the 607 square miles of greater london either by land or air they're on call saving lives 24 hours a day [Music] dr ann weaver is on her way back to the royal london hospital with peter an elderly man with a serious head injury so we've got the helicopter coming with one of the possible care consultants dr weaver with an elderly gentleman who's been hit by a skip lorry i haven't got a full list of his injuries but he's been intubated and ventilated so he's probably pretty badly injured the whole point of the helicopter is that patient should arrive stable there's a process where the helicopter team can tell us if they're unstable which is the code red process and he specifically said this isn't a code red which means she's been able to stabilize him on the scene which means the next bit for us is to find out what his interests are and if it's something that is time critical that we need to operate on malik needs to establish whether peter has a bleed on the brain if he does it could be fatal if he's stable yeah um we're probably going to go straight to ct okay this is peter brooks we think he's in his 70s to 80s about quarter past 12 he was hit through the pedestrian hit by a skit lorry he was agitated with the london ambulance service unable to tolerate oxygen or collar his injuries from top to toe i've got obvious head injury with wound on his right side of his cheek and some facial bruising chest is clear on examination chest wall impact abdomen soft and pelvis symmetrical um he had a full dose anaesthetic with fentanyl ketamine and rock uranium um so in summary pedestrian hit by skip lorry presumed head injury thank you so much if you just wait let's get the scoop we'll get the scoop out then you do that [Music] he's been hit by a skip lorry that will have caused a massive energy transfer he can have injuries to brain spine soft organs i'm worried that he could have internal bleeding significant injuries in a 28 year old let alone 88 year olds will do a primary survey once to get the scoop out of the candidates they're obviously injury his blood pressure that we're going to leave what's the last blood pressure you have um good we've had good blood pressure 200 pr and we've had high ones the pre-hospital team has stabilized him so he's got a good blood pressure he's got a normal heart rate there's no signs of internal bleeding so the priority is working out if there is an operation that's needed particularly in his head so he's been in seven minutes we're just going ct now we're gonna go to ct with what we've got bring a canon with you because we can scan his head with just the one then flop so let's just go all the clues point to a serious bleed on the brain there's no time for other x-rays they need to get peter to ct now to find out exactly what's happening daughter's coming the hospitals managed to contact peter's two daughters he's normally a fit healthy independent 88 year old who still runs his own business and looks after his wife i hope the scan doesn't show an intercranial hemorrhage if he's got anything that will need him to be ventilated for a long period of time aged 88 he's likely to have a very difficult time [Music] so if you look at his scan there are two bits to it there's an area here of contusion and subarachnoid bleeding which will cause some brain swelling in the future over the next 12-24 hours and if you were to rescan him in 24 hours this would look significantly worse but then there's also something called subject there's a very thin rim of blood that's sort of going up across his brain underneath his skull on the right hand side and the question is whether that's going to carry on bleeding or whether it's going to stop if it carries on bleeding it can cause pressure inside the brain it's it's really difficult because if you're 28 and that gets bigger you take it out if you're 70 and that gets bigger you take it out 75 80 85 at some point the operation itself will kill you and at what point we reach that isn't completely clear but at 88 probably he wouldn't survive in your social operation peter's injuries are so serious the accident may well become a criminal investigation so the police are always interested in the level or the severity of injury of the patient because it determines their response on scene so it determines what type of investigation they do so they use a phrase life-threatening life-changing to determine what response they put into a scene so that police was asking me if this is still life-threatening which it is [Music] an elderly gentleman who's had a bad accident it's very difficult this stage to predict how he's going to do peter was a flight engineer in bomber command during the second world war only time will tell whether peter will survive this battle [Music] response the service also runs a physician response [Music] which gets doctors out to patients we're going to kings cross station for a patient who is is very cardiac arrest i don't have any more at this stage [Applause] [Music] is there anybody that knows exactly where this patient is and if there is can someone take us to it please excuse me guys please sorry all right off to you man all right guys anybody doesn't need to be in here we need to actually hop out we need to create a bit of space in here guys thanks sorry 74 year old warner was in cardiac arrest the paramedics have got his heart going but his pulse is very weak and his heart could stop again at any time so how long has this been going for now before i got in here i'd already given him one shot 15 minutes brilliant so he's had five six shots in total well done with the access he's got a grey over there it's just becoming weaker he's gone he's just gone yeah we'll shock him again warner's heart is failing again we really need to get uh this patient out of ventricular fibrillation he's critically ill he's at risk of having significant brain damage from lack of flow to the brain yep straight for shock okay shocking shock delivered lovely thank you all right some of the stuff yeah no right let's get him on the other side then i'm gonna get the aicd after seven shots warner's heart still isn't beating properly glenn's hoping an auto pulse a device designed to give precise chest compressions will help all right shock again please okay shocking okay has he got a pulse i just want somebody to keep his fingers on a cardio pulses please sink cardiovert just assisting events stand clear guys ready yep sorry sir you seem to feel that which is in some ways a good thing he's localizing the pain so we're in a lot better situation than we were five ten i'll minutes ago bolts back radial pulse back is it yeah it's got femoral he's got a feminine pulse okay so plan from here lee same again onto the stretcher good work guys that's the way okay i've spoken to the london chest we need to blue call it in on the way but the patient's going to the cath lab so let's get him to the ambulance i've got one ecg along the short of it easy i don't know any details a 60 plus year old gentleman who presented to one of the guards unwell vomiting and then arrested in front of it the next 24 hours will be crucial just all of a sudden started feeling dizzy squeeze my fingers tight my mum she had a large aneurysm there okay your family history we want to be absolutely certain there isn't any surveillance sitting there the ct scan of annette's brain is normal which leaves simon without a diagnosis he needs to do more tests what experience has taught me is that unfortunately things don't always fall into place as you hope they might do to give you an answer when you examine someone and particularly with people who present with neurological problems today annette's back at the hospital for further investigation [Music] i see my job mainly is ruling out most of the time serious diseases and serious illnesses but occasionally you find someone saying really serious and potentially something which we could prevent someone could come to harm annette is having an mra scan it will show up the blood vessels in her brain and reveal whether she does have a potentially life-threatening aneurysm okay honest i want you to keep really still it's about 10 minutes long it's estimated up to 8 000 people die from a ruptured brain aneurysm each year in the uk if an aneurysm is the cause of annette's dizzy spell then discovering it now might well save her life okay that's you john you're going to come out now [Music] the results are in so these are really amazingly detailed pictures which are showing uh there's a network of blood vessels that are supplying the brain i'm looking for any sort of abnormal swellings or out pouchings of these vessels particularly around the base of the brain here where they're quite common that was the major concern with such a strong family history um that it was caused by an aneurysm that was waiting there to pop but there's no sign of that so it's great we're pretty much then left with the less serious stuff which is things like viruses which can affect the middle ear or uh even sort of bits of grit that gets um stuck in the um the balance organs that help me tell you which way up you are um so and those things can cause very severe symptoms but they're not going to endanger her life three direct members of her family have had cerebral aneurysms so i'm sure she'd be very relieved to find that she hasn't got an aneurysm waiting to pop there we're going to a patient who is very cardiac arrest straightforward warner spent 10 days in hospital he was fitted with a device which will kickstart his heart if it goes out of rhythm again he was really sick and he had such a long time of cpr before he got there but his cpa was really really good quality which you know obviously gave him a better chance but i must admit if i really really think about it i'm really quite surprised at how well he's done and i'm really really pleased i think the team should be really happy warner was repatriated to his home in france where he's making a good recovery he recently celebrated his 75th birthday got a fracture of his spine because we need not to let anything happen that could cause an injury to his spinal cord john john that was 11 weeks ago i don't remember it happening i don't you know one minute i was up at the top of the ladder and then the next minute i'm in hospital it's my dad he had um he fell off a roof as well so he was cleaning out the gutters on my old house and he felt he only felt two stories it wasn't as impressive as me knowing you know finding out that i had you know injured my spine you automatically i well i automatically linked that to being you know i'm going to be in a wheelchair for the rest of my life and then finding out that i had injured my wrist you know being a guitarist of so many years i you know i use it every day basically and not knowing if i'm going to be able to do what i love to do you know being a musician it was yeah it was quite it was horrifying now i feel like it's been given back to me so i'm gonna grab it and basically do everything i can to make it a reality for me you've been hit by a lorry we have to worry that he's got a decent head injury don't worry he's an elderly man who's a pedestrian who's been hit by a skip lorry will be with you in about 15 minutes it's three weeks since the accident although peter is still in hospital he has made a remarkable recovery we thought you had a bleed you know we thought you had a serious brain injury so getting you to the hospital in the surgery i don't know what was wrong with me because i i've no memory of it whatsoever i feel a bit scatterbrained although you didn't need to have an operation on your head your brain has still been shaken a little bit and it takes time for that you're much better than you were even when i saw you a few weeks ago yeah you do really well you do amazingly well i was completely upside down when i got here i'm an independent person or had been well dad's main carer for my mum um so that's been very difficult the first thing when he saw my mum he went sorry darling i'm sorry i'm not at home to look after you and you gave her a wink i know you won't remember that you gotta get yourself well somehow to justify the trouble that's been spent on you when it comes down to it i have a black hole all the way up here i didn't do that no no did i you take care thank you so you

Channel: Trauma Investigators

Views: 605,387

Keywords: Trauma Investigators, Nurses, Doctors, Paramedics, Reality, Channel 5, Patients, Emergency, Trauma, Full Episodes, Investigations, Hospital, UK, London, Surgeons, Medical, Investigators

Id: NoLjUWpI1MU

Length: 41min 9sec (2469 seconds)

Published: Mon Jan 11 2016