Trauma Doctors Respond to a Multi-Vehicle Pileup | Trauma Investigators Full Episode

do is try and firstly find out how many patients are involved these multi-car accidents often have patients with serious injuries need to try and work out where are the patients in relation to the crash all right car versus car approximately about 45 miles an hour total impact yeah three other people this guy apparently has been unconscious okay uh for about the last 25 minutes all right when you open his eyes if they're just if it was a roll back to me sir all right all right supposedly through other working wounded if i have a quick look here will you just eyeball the other three the local ambulance team is also on site and have stabilized the patient are you needing the extrication can i just have a is he actually trapped right okay um just checking yeah do you mind if i just have a look at him hi fella how are you are you all right the driver is a university student 25 year old jerome he was heading home from college at the time of the crash hello fellas hold his eyes closed he feels really warm he's not cold and clammy when i move his arm he actually has tone in his arm when i open his eyes they don't feel flaccid have the seatbelt retention has worked has the patient been protected this airbag's gone off and that airbag's gone off so he's got a good radial and everything yeah we'll just take all this away it'll speed it up okay let's just get this oxygen mask on it the patient is not responding he's not responding to painful stimuli or verbal stimuli which technically is unconscious but i think he's slightly not quite that unconscious he's more frightened and scared that's why his eyes are closed and he's not talking to us but anyway we're going to get him out of the car in a controlled way um so we don't damage his spine and then we're going to have another look at him do you think the seat will move or not okay so look we'll just go for a simple right so who's leading so you're leading are you okay it's very difficult when patients are not talking to you they're not speaking they're not moving their eyes and they're not moving technically that's a low glasgow coma score three which is profoundly unconscious but he had tone in his face when i tried to look in his eyes there was a little bit of resistance to lifting his eyelids all of those suggest to me that he actually is more aware than he's letting off this guy is he um he's not gcs3 tonight um he's lighter than that his blood pressure's normal his heart rate's normal so he looks okay okay have we got the board all ready sorry do we can't we just get him up and out yeah we won't get him up like that why not do more damage no no i'm happy just lift him straight up put it over he won't do him any harm if he can't do this we're just going to drag him out the side take me two minutes we'll get him out in two minutes you can't lift him up on there he's right come on let's just get him out let's put him at the side there's no reason why he shouldn't be out by now so just put the ford in under his thumb here now let's lift his bum onto there and fold him down onto his right hand side ready one two three are we the middle for okay all right quick as we can let's just get him skinned to scoop yeah do you want to take this head we're just going to roll him roll so there's there's actually no external signs of trauma is there anyway i think from our point of view this isn't life-threatening no no not at all i'm not life-changing either what the extent of the injuries people at this stage i don't i don't think he's got any oh really yeah i can't identify anything at this stage not my technology he tries to unearth clues as to what has happened this car it isn't uh quite a head-on there is some impact to the front of the vehicle here whilst it looks superficially quite bad actually the real solid structures of the cars are not deformed in any way but the combination of the seat belt the airbags and the deformation of the vehicle at the front have helped protect them so what looks like a nasty crash actually those forces haven't been transmitted to him and i think he's going to be all right we pride ourselves in trying to find out what has happened to our patients and it is really important to find out what's happened to your patient because when you know what's happened then you can predict what injuries they might have his orbs are completely normal i think he can go to kingston jurong uninjured but clearly traumatized by the incident is going to be taken to a local hospital to recover he was discharged later that night london's air ambulance is on call for life-threatening emergencies every day you've been hit by a lorry every new patient each new trauma the great challenge of emergency medicine is the fact that we don't know what's coming through the door and that's when i think a lot of emergency physicians get a real buzz so where's your pain the doctors use their training literally he wouldn't survive under a social operation [Music] hospital dr anne weaver is awaiting her next investigative challenge we've got a call from the ambulance service to say there's a 28 year old male who's been involved in a red traffic accident i don't know whether he's a pedestrian or what apparently he's got a head injury an injury to his left shoulder and it's slightly down on his level of consciousness and that he's confused as far as we know so we've got the trauma team ready and we'll see what we've got hello hello sir my name's ann i'm one of the doctors are you getting the idea yes 28 he's been hit by a car uh he was in the middle of the road car travelling at approximately 30 miles an hour he's hit the bonnet hit the windscreen no bullseye landed in the road the drivers got out helped him to the side of the road he cannot remember anything that's happened um so query loc he's got about a two to three inch laceration to the back of his head no c spawn tenderness can um complaining of pain in his left knee and his left shoulder has no memory of today he doesn't know what the date is very repetitive keeps asking where he is over and over again great thanks very much okay three people either side ready slip is closed down if they're not completely cut being hit by a car at 30 miles an hour so ab could have injuries anywhere on his body to his lower limbs pelvis rib fractures internal injuries to his liver spleen or his lungs and he obviously could have a head injury or spinal injury so the possibilities are wide at the moment do you remember anything shakira's central clavicle on the left and the right are normal no sign of bruising on the lateral chest walls no evidence of crepitus or pain on palpation of the ribcage he's got a good radial pulse yeah it's over an hour since soweb was injured hello how are you doing uh not really good because i hardly remember anything you can't remember anything don't worry about not remembering it it's probably a sign that you have had a bang to the head and you might have been knocked out and that you can't remember it well what we've been told partly by the driver who i think got out to help you think you were crossing the road and you were hit by a car going about 30 miles an hour crossing the road without any light i don't know you don't remember that at all don't worry okay it might come back to you okay this forgetfulness is a clear clue for anne the things we're worried about is he's repeating questions and asking for the same information which makes us think maybe he has got a little bit of bruising to his brain so we're still concerned about his head along with head injuries zoeb might well have damage to other parts of his body the driver reported that he hit the car bonnet the windscreen and then the road surgeon is checking him over no pain in the health no any pain here a bit i can't feel anything it's not really any pain here no any pain on when i do this where about on top of it really top of the knee that's fine which x-rays do you want left shoulder right hand and left knee okay along with the additional x-rays ann is keen to get sohb to the ct scanner so she can see what is happening inside his head chin on that little shelf yeah we're going to the scanner yes you did hey here okay yeah i've also been here before no just today i mean a few minutes ago i came and said hello all right all right just keep your chin on there perfect okay right he gives a hand in the scanner all right are you all right you don't have to help us slide the ct scanner is one of the best investigative tools at anne's disposal he's moving all of his arms and legs i'm not worried about spinal cord injury but we want to make sure he hasn't got a skull fractures b to see if there's any bleeding inside his brain it's either causing pressure on the brain or that it's like a little bruise inside the brain the images from this machine could reveal vital clues as to what is causing soab's amnesia if it is a bleed it could save his life serbs had a big impact he's been hit at 30 miles an hour he's asking me the same questions and he doesn't recognize me i'm worried that he has got a significant brain injury okay thank you here i think you might have seen me somewhere else have you been into hospital before behind you you're not sure i don't work at new room no roland yes yeah and won't know any more about soweb's injuries until the results of the scans are back delta alpha 7-7 okay we're going to shoot in we're gonna turn left so that's going to be the rvp where the ambulance services are meeting because we haven't seen declared yet yeah here we go so we're meeting uh what we call a rendezvous point with the ambulance service the police because someone is alleged to have been shot the police will have to go in first and declare that this scene is safe for us so we're going to meet here and get some further instructions from the control room so i'm just going to jump out and have a chat with this uh paramedic are they okay steve so we're at the rvp the ambulance is here on vassal road so we're just waiting to go ahead now yeah from the police i don't think they've actually found the incident yet what's happening at the moment is that the armed response police units are driving around to different addresses that they've been given for where this incident has happened it's getting that time when you're not quite sometimes sometimes people who have been shot will move from one address to another so they have their uh their incident on one address and perhaps they run away to another one and then report their injuries not quite sure what's going on behind the scenes but there are people searching for us to get to the right place here new rvp sydney road junction stockholm park prison if i'll spin it around you'll follow me out the trauma doctors venture into these potentially volatile situations to save lives we're at a rendezvous point with non-armed response police officers who are looking to secure the scene so we're always a little bit careful here because obviously although we're with the police we never assume that that makes us safe necessarily gareth has now been on the road for 27 minutes most important thing where someone's been seriously injured from a shooting is time the longer it takes us to get to the address the longer the clock is ticking for which is not good when somebody's badly injured so i'm hoping that the patient here isn't badly injured if there's bleeding from any of the major organs we would need to be there now to try and help with that and also to get the patient onto the hospital as quickly as possible delta alpha seven seven okay thanks thanks thanks steve bye-bye bye nobody in the address nobody all right cool thank you very much cheers so we've been told uh by the police officers that this is a hoax call which is a shame given the number of police resources and ambulance resources and so on that are here it does make you angry because ambulances aren't 10 a penny and there could be an old lady around the corner that needs someone who's lying on the floor um so we try not to make judgments but if you make a hoax call to the ambulance service the risk is that one of your family might be the next one that doesn't get the ambulance or the doctor or the paramedic or the police officer that they need hit the bonnet hit the windscreen he's repeating questions yes you did wasn't here before i'm worried that he has got a significant brain injury at the royal london it is just 47 minutes since soweb was first admitted and he is still confused and repetitive when it comes to head injuries we're trying to work out whether someone's behaviour is due to their head injury or whether it's just their personality or the fact that they're just nervous they're in hospital and they've been injured the ct scans of soweb's neck and spine are ready for analysis i'm just looking at a ct scan carefully there's a couple of bits on his cervical spine on his neck i think they're probably old but he's got a couple of little chips off some of the bones in his neck i might have done something before his spine looks fine and his head does as well i'm just gonna have another look [Music] this looks okay which is great news for him tiny bruise or confusion can cause concussion the good news is that the most worrying injuries a bleed on the brain or a skull fracture can be ruled out by the scans he is still not quite right though um so we're going to be keeping him in hospital tonight we'll keep him on the a e ward just to make sure everything settles down and that he feels better tomorrow morning so now we're just going to wait for his x-rays of his shoulder and his knees and his hand to make sure we don't miss any minor injuries it could have been a lot worse i mean if the driver was going at 30 miles per hour 30 miles an hour is very fast for a car to hit your human body and depending on which bit of you gets hit or which bit of the car you hit um you know if it caught him on his side and he caught his spleen or his liver or something like that it could have been a very different story so yeah he is a lucky man in a medical emergency speeds [Music] able to accelerate [Music] [Music] response unit which can get a senior doctor out to provide i think we want to be going up here in the pru today [Music] someone has called an ambulance for a patient complaining of chest pain caffeine could be anything from a cold muscle having lifted something in an awkward fashion to a full-blown past that and there is a myriad of things in between that it could be so it's not going to be the first left i think it's going to be the second leg the worst case scenario would be the best scenario it'll be something quite simple that we will be able to diagnose and reassure them and we save an ambulance for the next chest pain it is a heart attack there's a man on the chair there i think i've seen the patients to identify and treat the problem hello so is the main problem pain in your back or your chest ned back it's your back yeah can you just point to where it is and this pain came on when you were walking three days ago three days ago and then it suddenly just got worse now did it yeah then it was known yeah the pain is just in his back suggests this isn't a heart attack the way he seems to be stuck we need to be sure this isn't a prolapsed disc prolapsed disc is an incredibly serious problem if we don't get the diagnosis right he could be paralyzed and what about your arms and your legs how do they feel normal they're look i think what we need to do is we need to try and get you somewhere where i can look at you properly okay do you want to have a look around we need to get into a place where we can examine properly and perhaps give them some pain pain relief sorry sorry sorry can you bend that elbow that's good just need to see your back if that's all right so this pain is here that's right this side here gareth is looking for clues as to whether this could be a prolapsed disc the staff is complaining of back pain there are problems with the spine we have where a disc can suddenly rupture or move slip disc that can be a really big problem compress many of the nerves in the back [Music] the nerves to all of the legs and the bowel and the bladder start to be compromised and that can leave you paralyzed and incontinent the muscles in the back are nearly really tender and in spasm that's what's giving him the pain i think the muscles are absolutely rigid like this listen i'm going to put a quick drip in your hand here i'm going to give you some strong painkillers i want to try and get you in place where you can sit up properly you can see he looks a little bit more relaxed all right he's just pushed himself back in his chair now gareth needs to rule out both a prolapsed disc and a heart attack heart rate 93 i think that's because he's in pain are you happy with it yes yeah yeah if your staffer didn't have a heart attack may you show up on the ecg okay this is good they're hard no problems do you feel a bit woozy yeah okay it feels like a couple of pints of beer it hitting the spot obviously the you know the painkiller has several effects obviously it takes away his pain but it also takes the degree of the anxiety around the pain away when someone's in a lot of pain they're not keen on answering questions when did you last have a um a wee when you went and toiled you've done that today yeah no problem okay this is a good sign as the bladder can stop working properly with a prolapsed disc gareth is confident this problem is purely muscular and nothing more sinister so it's this muscle here that was the problem yeah and now it's it was in spasm but it's it's out of spasm now it's important with this problem that you move your back even though it's a bit sore every hour stretch it it'll avoid this going back into the spasm mustafa we've managed to keep out of hospital and save an ambulance rob has just walked him back to his house which is you know i think a bit of a result considering the man that you saw at the very beginning where in normal circumstances that would have ended up in a 999 ambulance had gone to hospital waited in the emergency department seen me if i was working happy to be working there you know this way we've avoided all of that waste within minutes of returning to the physician response vehicle the next call comes in go heavy details and cardio roger onway we've now been diverted off for someone that's believed to be in cardiac arrest which means their heart is stopped which means we need to get there as quickly as possible when someone's heart has stopped you've effectively got about three or four minutes if the temperature of the patient is the normal body temperature so we've got three or four minutes to get there and try and restore the pulse every uh literal seconds after that the chances of recovery are falling away dramatically okay go straight go straight every second counts okay this is our left gate getting a senior doctor with specialist equipment to a patient quickly can dramatically improve survival rates for cardiac arrests that's good okay should we not get involved yeah ross thank you for that and uh when you speak to charlie saying thank you okay so we've just been stood down on the way to that job um information from the crew on scene suggests that the patient's been without a pulse been dead for quite some time so and they're not trying to resuscitate the patient [Music] at the royal london hospital [Music] they're unconscious at the moment we think about things like overdoses strokes those sorts of things [Music] we'll get much more information once the patient comes through the door okay let's get ready guys 54 year old emmerich works in patient transport he has collapsed and fallen down on coverages whilst all right sir okay okay right what's happened tramps he had been complaining to his crew mate all day that he had a headache right his blood pressure was coming up then subsequently was taking an elderly patient off the back of the vehicle and then he crumpled and collapsed onto the floor yeah a small tremor in his left left hand we got there his gcs was still um about three it slowly came up to seven his eyes have been rolling in these all right okay emmerich mr campbell mr campbell can you open your eyes for us how are you doing so you're in the hospital we're going to look after you all right well done with the high blood pressure and the tremor i wonder if this could be some sort of seizure or maybe an infection or a stroke i need to do multiple investigations at the same time have we got a drip or you mentioned it that's okay i can do that that's fine no problem so mr campbell seems to have a sudden event where he's collapsed to the ground and initially just before that he was saying that he had a headache and that he was worried that his blood pressure had gone up which is quite significant the main thing that we're worried about here is that mr campbell might have had a bleeding episode into his brain or a stroke emmerich's reported high blood pressure makes him a potential stroke [Music] whatever the cause gareth needs to get to the bottom of it fast it's normal we've had some blood tests back already and that shows that all the salts in the blood and the hemoglobin level at the sugar level are all normal which is good but obviously that doesn't give us anything to treat at the moment so we're so keen to get into the ct scanner as soon as we can 170 over 98 it's just high but not too high the blood test results suggested and isn't an overdose emeric however is still deeply unconscious if this is a stroke every second counts if i check if the scanner is ready we've got an unconscious person can't we're going into the second scanner let's go this needs to be done pretty quickly the ct scanner the ultimate diagnostic tool will help gareth to narrow down his search okay mr campbell mr campbell i'm just going to lie you down a little bit flange go a stroke or a bleed on the brain can have catastrophic consequences if left untreated okay mr campbell so nice and still for us well done [Music] level of consciousness has stayed very low so i'm still very worried about that sometimes people can collapse like this after having a seizure and then the level of consciousness is very low but comes up quite quickly but mr campbell's case he's remained more or less completely unconscious since he's been with us can i just check while we're here that we don't need to do a ctn if this is a stroke there could be some bleeding into his brain or there could be a clot blocking one of the blood vessels his level of consciousness still isn't right though this is a bit of a puzzle the ct scan is complete and the good news is that the patient has finally started to regain consciousness if hold it there can you hold it okay it's a gamble can you feel it when i rub you here is that sore which pain is worse is it the back pain or the chest pain or the head pain which is the worse where's the pain show me where it is where is it in your back which part of your back show me where it is the chest one is this the worst pain and what and the back as well okay with his patient finally responding and conscious gareth can assess the all-important scan results if there is a clot on emirates brain or bleeding inside his skull these images will reveal it and on a first look through the scan pictures there isn't anything as as catastrophic as we thought there might be so we were thinking that there there might have been some bleeding and i can't see any bleeding so it's quite good news that mr campbell hasn't had a bleed into his brain or a stroke he's still not feeling very well and he's still got a headache so there are a few other tests that we need to do here but it's unusual to be as sleepy as mr campbell was when he came in so i think what we have to do now is to put all the tests together do some further x-rays and then see if we can work out what this event was but it's all a little bit unusual at the moment got a call from the ambulance service to say there's a 28 year old male hit the bonnet hit the windscreen i can't remember anything he's repeating questions what's in here before you want to make sure he hasn't got skull fractures but this looks okay 30 miles an hour is very fast for a car to hit your human body he is a lucky man have you been into hospital before behind you you're not sure i don't work at noon [Music] that was three months ago he still has no memory of the accident itself or his first few hours at the hospital the first thing i remember after having my consciousness is just seeing my friends beside them the only question i was asking what happened what happened and i don't remember anything at all the experience wasn't that bad because the bed was comfy soweb was discharged from hospital the day after his admittance both his scans and the x-rays were clear so he was lucky to escape with bruising rather than anything more serious literally after 10 days i had to go to my work it was hard and the knee injuries was affecting me a lot because you had to walk the memories are fine the knees got recovered as well it's just the shoulders are still giving a bit pain the left shoulder the accident has certainly left its mark the thing which has happened to me it could have been my last day it could have been my last day and so it's a awakening for me so i just wanted to take a step forward the accident reminds me of that life is short so you got to do what you got to do and what you plan for the moment you think of it so you shouldn't wait his plan now is to travel and see the world next month we plan to go to see the great wall of china i always wish to see the seven wonders of the world really every time so i think it's the time to start can you open your eyes for us mr campbell might have had a stroke or a seizure we're going into the scanner let's go this needs to be done quickly no no no listen hold it here can you hold it level of consciousness has stayed very low isn't anything as catastrophic as we thought there might be a little bit unusual at the moment he remains a bit of a mystery actually we were really worried about him when he came in and all the test results that have come back show that everything was normal so he remains a bit of a mystery and one of these people that's had a funny turn that we we can't really explain when he was first admitted to hospital emmerich remained deeply unconscious for almost an hour before finally starting to respond emery emrick emery first thing i could remember was i think i had someone calling my name i'm emmerich so nice and still for us well done mr campbell can you feel that when i robbed you here obviously it was all a bit scary but i was hearing some reassuring voices hey emrick are you all right can you hear me can you hear me where's the pain show me where it is i was feeling very disorientated show me where it is i was thinking is it how people feel when they die you know i was having all sorts of things and i thought maybe i was some point i thought probably i was losing my mind because i was thinking what am i doing here what is this place and what has happened it is now three and a half months since emmerich collapsed and after numerous tests and scans he has recently been given the medical all clear i was in hospital for almost 10 days and all these monitors put in and there were 24-hour machines and all this test being done there was no abnormalities detected which still leaves me well very confused by the same time i'm very thankful i'm pleased to say that he's doing really well actually he's recovered fully so we always try and give something a name but unfortunately you can't always find a name for all of the things that you want and rather than making something up to make us feel better sometimes it's better to say didn't know what was going on but we've ruled out all of the all of the serious things [Music] having been given the all clear regarding any serious health issue emery can soon return to work i definitely feel very very lucky making me more aware of the value of life and health i'm trying to lose weight not to eat much fatty foods and then start to go jogging and exercising i think it's the way forward because the health is the best thing you can have money you can have everything if you have poor health i mean you can never enjoy this thing so um i'm going to put that as a priority to put my health first in this case things have worked out where we thought things were going to be quite bad and they turned out to be okay so we're pleased in that case you know i've seen the way the nurses work the ambulance team the doctors you know and their love and compassion and devotion has really let me not to take things for granted you know and obviously all these things cost money as well so i mean i would like you know as a good citizen as well to pay my own back to society [Music] we're all very privileged to work for the service it is the most amazing job in the world i think that we're able to help people who need us and day after day the work goes on someone's fallen underneath the train you've been hit by a lorry since it was formed as a charity in 1989 london's air ambulance has carried out 28 000 life-saving missions i'm lucky really good job guys well done team should be really happy with that my job is unique because we're on call for 20 million people we're going to help you each year around 2 000 desperately ill people are given the emergency treatment they need websites looks like it's got a break in it i was scared every week more lives are saved open your eyes pretty good isn't it you pop your head in there thank you so much thank you we're always trying to provide the best possible care for our patients so you

Channel: Trauma Investigators

Views: 583,479

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

Id: GscCAK1URHA

Length: 41min 53sec (2513 seconds)

Published: Mon Jan 11 2016