We were heading back to the station after chilling in the nice sunshine by the beach when the call came in. It sounded nothing more than a lift assist. We pulled our vehicle onto the drive and was lead to the back of the house by our patient’s husband. I was about to turn down the stairs towards the basement when her husband turned the opposite direction. Hmmm…I thought we were going inside the house, but no, instead we found our elderly patient on the concrete floor lying on her back. She didn’t seem too agitated at the moment.
Me: “What happened?”
Pt: “I fell from the ladder, second rung.”
I looked at the nearby ladder, second rung looked to be about two feet.
Me: “Did you hit your head at all?”
Pt: “Oh no…but my hip really hurts.”
I saw her clutching at her hip the best she could. It was clear she couldn’t sit up. She had her legs bent at about ninety degrees. I examined the hip, but found no gross deformity, or angulation, she had nice strong pedal pulses. It must’ve been me and my partner’s beautiful looks or perhaps our presence that seemed to put our patient more at ease. After a while though, I noticed my patient’s face wrinkle up…and as far as I’m aware, no one had leaked gas, the air was still nice and fresh.
Pt: “Ohhh!! It’s starting to hurt now…it didn’t earlier.”
Me: “It might be the adrenaline leaving you…”
I looked at her grimace and didn’t want to tell her what I had to say next.
Me: “Unfortunately, we have to straighten out your leg in order to get you to the hospital, it’s going to hurt.”
She made a whimpering sound. Her pain was genuine and I felt bad that I had to inflict more pain on her. It was impossible to straighten her leg without giving her entonox (laughing gas). I held her leg, one hand on her shin, the other on her thigh as I tried to re-align her leg as gently as I could. She yelped out in pain and was shuddering.
Me: “You’re doing great, keep on taking those deep breaths of gas.”
I sounded calm and soothing, but inside I cringed from her cries of pain. I continued to pull on her leg, gently but firmly.
Me: “We’re almost there, half way…try and relax your muscles.”
I massaged her hamstrings to get her to relax. They were super tight as she flexed her muscles from the pain. It felt like eternity, although I’m sure it didn’t last more than a minute or two, when I finally got her leg straightened enough to splint.
In the back of the ambulance I started an IV, although I had no idea how I got the line in with the vein looking rather empty and fragile. Everything was smooth sailing, she was quite comfortable once the leg was splinted, I’m sure the entonox also helped. The call was a good call, although next time I’d prefer to play the role of relieving pain rather than inflicting pain.
Before I left the ER, I dropped by my patient’s bed and wished her all the best. She smiled and thanked me for my help. I left with a smile, that was a good way to end the day.