Beware the flower pots!

So this was a job,

C/t - 62 y/o male, fallen, intoxicated, unable to feel hands.

O/a - Pt found outside on concrete patio in a supine position, (it's about 2200hrs and cold) he states he has been out here for over 30 min before he could raise the Girlfriends attention.

O/e - Pt conscious, alert, intoxicated by admission and smells like a brewery, orientated to Dd/Mm/Yy, hypothermic at 35.3 tympanic and centrally well perfused. (Site layout - pt is lying at the bottom of about six steps that lead up from the patio to the street level. there are lots of pot plants on each end of the steps with 4-5 broken on the second step. There is a very skittish dog running around)

Pt states, the dog tripped him, he fell onto the pots, rolled to the patio and could not feel both legs or left hand/arm. Movement was seen in all limbs but not purposeful and no grip strength in hand.

Pt's only visible injury is a very small laceration 1cm above his left eyebrow.

Of course full spinal precautions are taken (we have motor & sensory deficit).
Extrication with assistance from G/f and a code 3 passed to the receiving hospital.

Mechanism is really very low (height wise),
Alcohol on board, always a danger as it hides injury and pain,
The biggie's are the deficits. I saw the pt cross his legs but when asked he didn't feel it or know that he had. I saw movement and wagging of the ankles as well as the left arm move but not the hand.

Eight hour later,

The pt is still in the Resuc bay collared, still with deficit although he could straighten a bent knee he couldn't bend it from straight??? There has been a brief episode of Priapism! Never a good sign if your thinking spinal and X-ray showed no fracture or fault.

Side note Blood Alcohol Level over .2 ( .05 is the legal limit to drive in Australia). Now I had to leave for my Nan's funeral and did not get to follow up the next shift.

From other officers who did that for me the pt was suffering a Spinal Cord Compression Injury caused by a haematoma most likely from the impact with the irregular edges of one of the terracotta pot plants.

There was no Spinal Column deformity and the swelling was monitored and self resolved.

From this we learn,

1) Never judge or dismiss the intoxicated person.
2) Keep an open mind.
3) You will never get bunged for following your protocols and procedure for a patient.
4) BUT YOU WILL GET CRUCIFIED IF YOU DON"T DO ENOUGH!!!!!!!!!!!!!!!!
5) Everyone is sick and enjoy the opportunity to play with stuff.

Now the proof reader says that I should explain some of the terms used above but I think I'll leave them for you to look up or alternatively you can ask me.



Be careful out there and I'll see you at the Big One.

Taz