To celebrate the publishing of the 2nd edition of Sunny Whitfield’s best selling book, “Here Hold My Drink and Watch This – Tales from the lighter side of paramedicine, adventure and life," we have been granted permission to publish the below excerpt. The book now has a new cover and includes a previously deleted chapter. All proceeds are still funding safe water projects in India and Nepal. Please enjoy.
Is that a dog in your ambulance?
I was asleep at the station of a remote town where I was providing operational cover for a run of eight shifts. Since I had logged in to my car two days earlier, I had not turned the wheel. In other words, I had not been dispatched in over forty hours. The town sustained a population of about three hundred people and the closest hospital was about one hundred and fifty kilometres away. This meant that when a new paramedic was in town, everybody knew about it. I had been in the local bakery earlier that day and greeted by a heavily pregnant young girl. She had jokingly said that she hoped she would not see me this week as she was due in three weeks. Should have touched wood!
Now my sleep was rudely interrupted by the incessant beeping of the pager followed by the ringing of my work phone that all spelled, “The bakery girl is in labour.” I cursed to myself for my shitty luck. Babies can be complicated, especially in a remote area with no support. Sure, enough the pager read that a twenty two year old girl was thirty-seven weeks pregnant and bleeding. My heart sank. This didn’t sound like a delivery at all. This sounded like something more complex.
The address was only a few hundred metres from the station, so I was on scene fairly quickly. The front door was already open, and I moved inside where I was greeted by a panicked older woman and the bakery girl. The bakery girl was standing with a torrential vaginal bleed. Being somewhat caught off guard and still trying to wake up, I took a moment to process the gravity of what was occurring. “Are you in labour?” I asked her.
“No I am not having any contractions. I just started bleeding,” she squealed with horror. If I lay her down here to control the bleed, we could be waiting a very long time for support so with microseconds to make a decision I decided that if she was on her feet, she could get in the truck. With no assistance she was inside and on the stretcher. I quickly assessed the bleed and it was bad. I grabbed a trauma pad and asked the older lady now climbing into the ambulance to hold it on the bleed and apply pressure. I then raised her legs and grabbed the radio.
Following my urgent sit-rep, I was advised that there were no helicopters available as all were on other taskings. The closest unit to me was one hundred and fifty kilometres away on call. This meant that the backup unit would be delayed. I inserted a big bore cannula in her arm and got a base line set of vitals. She was tachycardic, and tachypnoeaic. And I had to calm her down to try reducing the flow of blood.
The poor girl was not worried for herself but worried for her baby and just wanted reassurance that her baby was ok, the very thing I could not give her. But I also needed someone to drive the ambulance. The old lady was just too emotional to be trusted driving so she was not an option. I thought about ringing the local police station but as I moved to my cab to make the call, Larry the local fire captain came walking past. No shoes, no shirt, walking his blue heeler. “Larry” I called. “Get over here mate. I need a driver urgently.”
“Is Nancy ok?” he asked. All the locals knew each other so there was no point in denying I had young Nancy from the bakery and her mother in the back.
“No mate she is not. I need you to log in with your fire staff number and get us heading south.” Larry uttered something to me, but I was already back inside the ambulance running some more observations. I figured that if it was important, he would come in and repeat it.
I was relieved when Larry climbed in the cab, logged in and started driving. On the way in, young Nancy began to deteriorate, her heart rate went higher, her respiratory rate went higher, and her blood pressure began to drop. She was looking rather pale and nothing I could do would reassure her that her baby was ok. It was apparent to me that she was suffering a condition known as placental previa where the placenta drops in front of the birth canal prior to birth, but there is nothing paramedics can do for this condition except recognise it and get the patient to surgery. Forty minutes later an ambulance raced past us and I realised it was the backup crew, they must have been driving very fast.
Larry pulled over to allow the backup officer to get in. The other officer was Flip, an intensive care specialist and the right person to be sent. He repositioned Nancy on another trauma pad and I watched in amazement as he isolated the baby’s heartbeat from the mother’s. It was some stellar prehospital care to watch. He could reassure her that the baby was ok for now and Nancy relaxed a little. We continued to slow the bleed whilst heading to hospital. At the hospital we wheeled Nancy straight through emergency up to the maternity wards where she underwent an emergency caesarean section. After hearing that Nancy and her baby were doing well, I went back downstairs to reset my truck.
Outside I was feeling a bit of a come down. My senses had been pinging for over three hours. The smell of blood, Larry’s driving, and the whole situation had come to a satisfactory culmination and now I was feeling rather good about the case. As I walked outside, I could see Whippet pacing. Whippet was a grumpy old manager who had been in the job too long, but I liked Whippet. He was harsh, fair but blunt, straight to the point. Young paramedics were terrified of him. But not me, especially not today. Did he see what we just did?
I waltz outside to bask in my own glory and receive copious amounts of praise from Whippet, but the look on Flip’s face said I was not in a safe spot. “Sunny, is that a fucking dog in your ambulance?” Whippet growled. “
Whaaaat?” I stammered. I quickly ran to the front of the ambulance and sure enough there was a dog on the front seat, chewing on the steering wheel. Larry came out and his smile disappeared. All I could do was laugh and Whippet marched inside shaking his head. “Sorry mate I tried to tell you,” offered a sheepish Larry. “I couldn’t just tie her up mate, we were gonna be gone for hours.”
We sat in silence as I was forced to refuel in town with a dog hanging out the ambulance window. People were staring. The drive back was a two hour journey, so I was happy for the company, including the dog. However, less than an hour into the trip, both Larry and dog were snoring.
About thirty minutes from home we were diverted to a car crash on the main highway. As the only paramedic in a three hundred kilometre radius, I had to respond, regardless of how tired I was, but Larry was now wide eyed and ready. We heard a sit-rep from the local cop, Trevor, to say that he was on scene with a male patient who was entrapped by his foot only, and that the rest of the fire crew (minus Larry) were also responding. Another fifteen minutes down the road a fragmented sit-rep came through the radio and I did a double take. “Either they said a yak is best or cardiac arrest.” We were in a radio black spot for the rest of the journey but when we arrived, I pulled the ambulance up behind the fire truck to see Trevor the cop doing CPR. The patient had their foot stuck in the wreckage, but Trevor had manhandled his torso to the ground where he could begin chest compressions. The two other firefighters were in the process of applying a defibrillator as I moved down the embankment. There were quality compressions being provided and the defib applied by the firefighters was not recommending a shock. For me this meant the patient was either in pulseless electrical activity (PEA) or asystole. With quality compression being provided by Trevor, I moved to decompress his chest bilaterally and then returned to manage his airway. I asked the fire rescue guys if they could free the man’s foot to allow us a bit better access. When they freed his foot, a severe laceration was identified. He had unfortunately expired gently and rapidly whilst talking to Trevor, bleeding out into his door jam where no one could notice the loss of blood. I called the arrest off and we packed our gear. It was silent again driving Larry home. In one shift we had brought a new life into the world and another life had departed, and I still had a dog in the cab.
The life of a paramedic is a challenging one. You work during the night. You work during the day. You meet young people. You meet old people. You work in the rain. You work in the sun. No day is the same. A few weeks prior, during a night shift my partner and I were assaulted on our first job of the night. The young perpetrator was arrested on scene and we departed. By the end of the same night we were at a nursing home to assist a ninety-four year old woman with dementia. Right when I least expected it, she sucker punched me right in the jaw. It caught me off guard and off balance; however, unlike the assault at the beginning of the shift, this was somehow funny. Whilst I was picking myself up off the ground, my partner Billy was hysterically laughing. One shift, two assaults, but one is criminal, and one is funny. How can you make sense of that? How could one assault be serious, and one assault be amusing? Sometimes nothing made sense in the ambulance and all we could do was laugh or cry.