Processing the killing...
So what did you do last weekend?
Ah....
As we drove past a parked car a man straightened up and grabbed his throat shouting "Oh my God I've been stabbed!" A blonde girl (later transpired to be his sister) screamed "Help he's been stabbed" as we drove around the corner. I turned over my shoulder but already they were out of sight. Sat pulled the car over " do you need to..." "yeah I think I need to have a look and make sure he is OK" I jumped out of the car and ran around the corner, passing a black man sat in a car looking wide eyed at me. He had short cropped hair, pale latte skin and a smooth complexion and I think he might have been wearing a v neck tshirt or shirt. I couldn't see his hands. I can't have looked at him for more than 3 seconds as I ran past towards the other chap. His sister was screaming at him as I caught up with them "Oh my god stay with me David stay with me" His pupils were wide and staring and he was making laboured slightly gurgling breathing noises, his hand still clasped to the side of his neck. He almost looked past me as I approached. I can't remember if I asked or he just started to sink to the floor at that point, but the next thing is I am helping him lie down and moving his hand away from his neck to see what is going on. I remember his sister is in the way and I'm thinking I need her to get her head out of the way so I can assess this man. There isn't much blood but the wound is deep. At this point a fireman arrives. "Quick put pressure on it, we're going to have to do CPR" 'Hang on' I think I need to find a pulse and he's still breathing at the moment.' But the fireman gives him a couple of breaths anyway. The man groans slightly but barely resists and I realise he is already starting to lose his airway and his consciousness. He has his hand over the mans neck so I can't really feel for neck pulses. I try to feel for a pulse femorally and radially and there aren't any. So I start chest compressions. I get to 15 and the fireman wants to breathe. Its 30 to 2 now so I carry on and tell the fireman to breathe. He does. We carry on. It seems like an hour goes by but after only a few minutes a paramedic arrives - but he is off duty was just passing. But he gets out and helps with the chest compressions. I am relieved as I am tired and cold, and for some reason topless. I think I took my t-shirt off thinking we would need something to staunch the flow of blood but there just wasn't any. I help the fireman now, maintaining the head tilt and jaw thrust while he respires for the man. Finally the ambulance crew arrive and a guedell is in the man's mouth with a bag valve mask over his face. It is only 4 minutes since he went down I realise as I start to explain to the crew what has happened. They ask me if I am medically qualified and I reply that I am a junior doctor at the County Hospital...I realise sheepishly that I have not identified myself as such either to the man on the ground or anyone else. The crew are struggling to get access as we continue on the CPR. So we move him over to get at the other arm. And they're in..fluids to resuscitate him. Meanwhile pads are on the mans chest and...we only have p waves. The paramedic is already giving adrenalin and atropine and they are continuing CPR while I am holding the airway for the bag valve masking...what am I missing, why has this man got no output...the algorithm is not even in my head right now...I'm supposed to be a doctor why can't I figure out what we should do? The paramedic is asking me if he should put in an airway - yes of course, put one in he will need it if he makes it to the county OK. I help him tie it in place and then put the stethoscope in his ears so he can hear that both lungs are inflating because his hands are tied...wierd the things you think of doing when your brain is not working. And then he is being taken into the ambulance. I ask them as they are getting ready to transfer if there is anything more I can do to help them...but they obviously have it covered...my hands are sticky, covered in the man's blood. I wonder up the street in a daze and some bystanders who have come out of the house look at me. I apologise and ask if I can use their bathroom to wash my hands. " Of course come in, but please take off your shoes". Odd how familiar requests are somehow comforting. I am dimly aware of walking through a beautiful flat on thick soft carpet and into a plush bathroom - I recoil and don't want to touch anything but the man is gentle and insistent and opens the tap for me putting soap on my hands. He hands me a towel and I am walking to the door again, apologising. As I reach the street again a bystander asks me if I helped the victim. He asks me if I cracked the mans ribs, because he has heard that happens in CPR. I say I think I probably did but that it is the least of his problems. The man asks me again did I hear them crack or just feel them...what a bizarre question, I can't remember if I had the presence to ignore it or if I half replied as I walked away. WHere are Sat and Gill now....lots of angry upset people everywhere with police everywhere now...need to get out of here...need to get away from here.
Ah....
As we drove past a parked car a man straightened up and grabbed his throat shouting "Oh my God I've been stabbed!" A blonde girl (later transpired to be his sister) screamed "Help he's been stabbed" as we drove around the corner. I turned over my shoulder but already they were out of sight. Sat pulled the car over " do you need to..." "yeah I think I need to have a look and make sure he is OK" I jumped out of the car and ran around the corner, passing a black man sat in a car looking wide eyed at me. He had short cropped hair, pale latte skin and a smooth complexion and I think he might have been wearing a v neck tshirt or shirt. I couldn't see his hands. I can't have looked at him for more than 3 seconds as I ran past towards the other chap. His sister was screaming at him as I caught up with them "Oh my god stay with me David stay with me" His pupils were wide and staring and he was making laboured slightly gurgling breathing noises, his hand still clasped to the side of his neck. He almost looked past me as I approached. I can't remember if I asked or he just started to sink to the floor at that point, but the next thing is I am helping him lie down and moving his hand away from his neck to see what is going on. I remember his sister is in the way and I'm thinking I need her to get her head out of the way so I can assess this man. There isn't much blood but the wound is deep. At this point a fireman arrives. "Quick put pressure on it, we're going to have to do CPR" 'Hang on' I think I need to find a pulse and he's still breathing at the moment.' But the fireman gives him a couple of breaths anyway. The man groans slightly but barely resists and I realise he is already starting to lose his airway and his consciousness. He has his hand over the mans neck so I can't really feel for neck pulses. I try to feel for a pulse femorally and radially and there aren't any. So I start chest compressions. I get to 15 and the fireman wants to breathe. Its 30 to 2 now so I carry on and tell the fireman to breathe. He does. We carry on. It seems like an hour goes by but after only a few minutes a paramedic arrives - but he is off duty was just passing. But he gets out and helps with the chest compressions. I am relieved as I am tired and cold, and for some reason topless. I think I took my t-shirt off thinking we would need something to staunch the flow of blood but there just wasn't any. I help the fireman now, maintaining the head tilt and jaw thrust while he respires for the man. Finally the ambulance crew arrive and a guedell is in the man's mouth with a bag valve mask over his face. It is only 4 minutes since he went down I realise as I start to explain to the crew what has happened. They ask me if I am medically qualified and I reply that I am a junior doctor at the County Hospital...I realise sheepishly that I have not identified myself as such either to the man on the ground or anyone else. The crew are struggling to get access as we continue on the CPR. So we move him over to get at the other arm. And they're in..fluids to resuscitate him. Meanwhile pads are on the mans chest and...we only have p waves. The paramedic is already giving adrenalin and atropine and they are continuing CPR while I am holding the airway for the bag valve masking...what am I missing, why has this man got no output...the algorithm is not even in my head right now...I'm supposed to be a doctor why can't I figure out what we should do? The paramedic is asking me if he should put in an airway - yes of course, put one in he will need it if he makes it to the county OK. I help him tie it in place and then put the stethoscope in his ears so he can hear that both lungs are inflating because his hands are tied...wierd the things you think of doing when your brain is not working. And then he is being taken into the ambulance. I ask them as they are getting ready to transfer if there is anything more I can do to help them...but they obviously have it covered...my hands are sticky, covered in the man's blood. I wonder up the street in a daze and some bystanders who have come out of the house look at me. I apologise and ask if I can use their bathroom to wash my hands. " Of course come in, but please take off your shoes". Odd how familiar requests are somehow comforting. I am dimly aware of walking through a beautiful flat on thick soft carpet and into a plush bathroom - I recoil and don't want to touch anything but the man is gentle and insistent and opens the tap for me putting soap on my hands. He hands me a towel and I am walking to the door again, apologising. As I reach the street again a bystander asks me if I helped the victim. He asks me if I cracked the mans ribs, because he has heard that happens in CPR. I say I think I probably did but that it is the least of his problems. The man asks me again did I hear them crack or just feel them...what a bizarre question, I can't remember if I had the presence to ignore it or if I half replied as I walked away. WHere are Sat and Gill now....lots of angry upset people everywhere with police everywhere now...need to get out of here...need to get away from here.
posted by Duncan at 12:13 am
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