Skull Traction Memories

Mr Ravichanrdran was on the phone.He seemed rather worried.

"Can you take a newly injured C2/3 from A&E....she's a fall down the stairs?" he asked carefully

We had the staff, and we had the bed, so the admission of a patient without any paralysis, on the surface seemed pretty routine.

 (For everyone's information a high C2 fracture is what is commonly called the "hangman's fracture because when is occurs the spinal cord can be totally transected causing a paralysis that stops every muscle group below the level of the injury from working  including the patient's ability to breath)

The initial treatment for someone with a severe fracture dislocation of their neck is often the insertion of a somewhat barbaric looking contraption called  gardener wells skull traction. This is screwed directly into the skull and provides a way of applying an opposing traction to the fracture site, It is an effective method of maintaining spinal alignment , reducing pain and can effectively prevent any further neurological damage.)

"Has the patient got traction on?" I asked our consultant.

"Yes," he said, " I have just put it on", he then hesitated for a moment and added " she is also, unfortunately eight and half months pregnant"

An hour later, as senior nurse on the unit, I had taken possession of this unfortunate woman, who was indeed not only massively pregnant, but incredibly confused due to the toxic effect of some medication she had been taking. 

Immediately I felt out of my depth

A confused patient on skull traction is a nightmare, for compliance with strict, calm bedrest is vital for further injury and paralysis not to occur. This woman was pulling at her traction, her hair and the bed in an effort to get up she was incapable of any rational thought and had no idea that. further damage to her neck, could have resulted in her literally dying on the spot.

I did , the only thing I could have done, I climbed onto the bed and held the woman down at the same time as one of the staff nurses ran for medical help.

By the time, a consultant had turned up, the woman had pulled out big lumps of my hair, but was still safely on the bed, and by the time the obstetrician and midwife marched into the room my uniform epaulets had been ripped off and my arms were scratched to buggery.

The patient then kicked the obstetrician hard in the chest, and she flew, shrieking like a chicken through the bedside curtains with her white coat flapping. 

The whole thing was getting  all rather surreal

Then ,I started to get just a little unprofessional at the group of doctors whispering at the foot of the patient's bed.

"FOR FUCK'S SAKE CAN ONE OF YOU DOOOOO SOMETHING!" I hissed

It was then that the midwife tapped me on the shoulder and with a slightly worried look she whispered, something that I really didnt want to hear........

"Oh Bollocks......I think she's in labour"

Then...thankfully, I woke up.

It's a long, long time since I have experienced such a vivid  work based dream.

And it is fourteen years since that woman was admitted to my ward

As far as I know, the woman is now still walking , healthy and intact in the community

Her daughter will now be a stroppy teenager