Monday, 10 June 2013

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

57 comments:

  1. later that morning, the woman was transferred to our small theatre and an emergency caesarean was performed. she was transferred sedated and ventilated to ITU and the baby was send to scubu.
    a few days later, the patient was transferred back to us, vague but complying with her care.... the baby returned to the ward c/o grandmother
    hey ho

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  2. "Then...thankfully I woke up."?
    Just like all those horror films, now rather hackneyed, which start off in high drama, but with what turns out to be a dream - leaving us feeling relieved yet oddly disappointed.
    And I'd been hoping to read of your grand finale knight-in-shining-armour coming-to-the-maiden's-rescue (though hardly a 'maiden' in this case)! Oh well. Seems it'll have to wait a little longer for you to do your Sir Lancelot.

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    1. It was a true story ray.......

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    2. Yes, J.G. My reaction reads rather more flippant than I'd intended. Sorry. Not something anyone would wish to go through - as either yourself or the patient, or indeed the then baby..

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  3. God that's a gruesome looking object! Fortunately the worst I ever had, spinal-traction-wise, was a Milwaukee brace. (If you don't count three spinal ops - but I slept through them.) And never anything higher than about T4.

    I'm glad the woman was OK - not sure you get brownie points for helping to bring a stroppy teenager into the world ;)

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  4. bad enough to go through that once and then make it twice through a dream!

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  5. whew!!! you had me going there for a bit John...happy all has turned out well for the woman and her daughter..."all's well that ends well"!!! have a good Monday :)

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  6. That was stressful reading....I can't imagine having actually been there! Phew.

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  7. My hair was falling OUT reading that. Good God!!!

    Although I do have to laugh at the description of the Dr's standing around whispering and not helping and your "plea" for help. Just last week I verbalized what was in my head with an outloud "Go, Go, GO!!!" spoken rather forcefully to a Doc. Thought for sure my butt was going to get spanked for that one but no comment was made.

    You live the most interesting life, John.

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  8. Ouch, ouch and ouch again.

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  9. ...seeing you on top of a woman just doesn't seem to fit.

    Is that contraption called a halo (in laymens' terms) or is that something entirely different?

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    Replies
    1. A halo goes around the head and is usually screwed in at four points

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  10. Frightening...glad that dream was over! I have never had a desire to work in health care unless it would involve rocking the newborns...:)

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  11. What a nightmare. I hope she doesn't have similar dreams of that time.

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  12. I wonder why you had that dream now? A bad day at work?
    Jane

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  13. Not funny, but funny anyway. The dream must have been an amalgamation of all the difficult things you have to put up with as you endeavour to look after your fellow man (or woman). You are a grand chap, John, a grand chap. Why? Because you stay on the job whether it be when you are awake or when you are asleep!

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  14. You'd make a good script writer, John. Bloody spellbound, wasn't I? Till you woke up. At least you've still got your hair. And I have learnt what to do and how to behave should I ever desire you to lie next to me.

    U

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  15. Good Lord John you had me holding my breath and sitting on the edge of my seat. No wonder that experience haunts you in dreams.

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  16. Heavens; I'm panting.

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  17. Blimey!! Just reading it has left me exhausted!

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  18. Good lord, that looks like something out of the torture chamber...glad the lady in question survived and as you say has a stroppy teenager in tow!

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    1. They do look barbaric.. But often they make the patients much more comfortable

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  19. Brilliantly told John - sounds a bit painful to me (for all concerned)!

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  20. My God, John! Did you eat too many scotch eggs before bed or what? That's one hell of a nightmare! I'm glad the woman made it fine, but I think it has scarred you for life!

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    1. I suspect it was the pathology programmes I was watching last night

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  21. Goodness! I thought software-writing nightmares were bad. No contest.

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  22. Wow, surreal, all that drama and you hung in there regardlessly.
    I've had a story or two like that, but with animals not people. I once had to sit atop a cow in labor, whilst my vet performed a very difficult breach delivery.
    I awoke in the middle of the night last night, and guess what were my first thoughts ?
    "I wonder if John the Dogs arse got better".....
    Go figure !!
    ~Jo

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    1. The power of my arse jo!

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  23. That sounds like a painfully vivid dream John. That makes my disconcerting dreams sound timid!!

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  24. Well you pretty much saved that womans life, enough said.

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  25. I've had a couple nights filled with nightmares recently. They seriously disturb my sleep.

    Love,
    Janie

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  26. Bloody hell - I'm glad I didn't know about the C3 thing when I had my C1 fracture. Because of the spinal fractures, I never really thought about the neck and just got on with wearing the silly brace thing. What a hideous dream John....I'm sorry I laughed. x

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  27. Oh, you had me holding my breath.

    Glad that the real life patient survived.

    Nurses are miracle workers in so many ways.

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  28. OMG and I thought that my dream about writing my needs for a resurrected next life on a filing card was vivid! Ok you win.

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  29. John, that was more of a nightmare than a dream.

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  30. its amazing how the past can come into your present, just when you are unawares, and shock you into a standstill.

    I think thats called ptsd, John.

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  31. See John.... that's why I resisted all attempts in my 20's to send me to nursing school! Traumatising to say the least! Glad it all turned out alright though, despite me thinking it had all turned to... as you say, Bollocks.

    Jo in NZ

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  32. Nurses are a special breed unto themselves!! And thank god for that! What would we do without them?!

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  33. I call these "work-mares!" When your job/profession involves life and death, little scars are left on the psyche no matter how well you handle the crisis at the time. That said, I 'retired' 5 years ago and still have one now and then. I get up, make a cup of tea to calm down and regain my composure, then try to sleep again. It's a tough job but someone has to do it! (or so said my Mother)

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  34. Oh Lord, you took my breath away with that story.

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  35. Oh, Lord, that must have been a nightmare! Back then, I mean, not the dream. You could escape it by waking up now; back then, it must have been quite a hair-raising (hair-losing?) experience.

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  36. Wow John you do tell some of the most amazing stories. My life is dull as dishwater in comparison!

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  37. Thank heavens for those in life-and-death situations who take charge and get the job done ... a mind-boggling situation, for sure. Hardly seems fair you'd have to relive it in your dreams as well.

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  38. I wonder what stroppy teen is really like ? Great post John x

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  39. Looking after animals must seem a doddle after all that!!!

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  40. I thought having my appendics, or is it appendix out half way through a pregnancy was bad enough. Happy to say we had a daughter 4 monthes later, who grew to be a stroppy teenager,is now married with two boys; according to son-in-law she can still be stroppy at times, can't think where she gets it from!

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  41. Thank you for commenting Penelope
    I adore your name by he way

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    1. Thank you, have been reading and enjoying your blog for ages. Have only just found out how to post a comment, so no doubt you will be hearing from me again

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  42. Ruptured aortic aneurysm, nursed him for days while he clung to life by a thread. I couldn't believe it when I saw him alive and well in the middle of Marks and Spencers. Poor guy was terrified. Probably quietly trying to buy a scotch egg. Not expecting a strange female to start sobbing over him with arms outstretched in an embrace. Totally forgot he was unconscious the whole time I knew him.

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    Replies
    1. Hahaha! Hilarious, Susan!

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    2. Lol...made me smile sue xx

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  43. To live that once is bad enough but to have to go through it again ....... truly a nightmare!!

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  44. Ah the memories........

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