"There's an RTC a few miles out, they need a doctor."
Callie Edwards looked up from the patient file she had been reading and looked towards the registrar who had just been on the trauma phone, the red phone, as they called it. Any major incident that happened, they were telephoned and warned ahead, so that they could prepare as they needed.
"I don't mind going," Callie said, depositing the patient file on the desk. "I've just discharged my last patient and I'm at a loose end."
"Go on then, grab your uniform and head out, there's an ambulance out front waiting for you. Good luck."
Rushing towards the cupboard where they kept the coveralls for such occasions, Callie grabbed a pair and shoved them on over her shirt and trousers, exchanging her heels for a pair of steel toe capped boots. Picking up a helmet that had the word doctor written across it, she tucked it under her arm and deposited her shoes in the staff room on the way out. They would be safe there.
"Morning Callie. Looks like a busy one," Ian, a senior paramedic commented as Callie swung herself into the passenger seat of the ambulance.
"Hey, I'm just happy to be out of the department for once," Callie laughed. "Things like this are rare and I'm more than happy to be getting involved."
"As you wish Doc, as you wish." Ian replied, waiting until Callie had buckled her seatbelt before switching on the siren.
"What have you heard about it?" She asked, looking out the window in amazement. The cars in front of the ambulance seemed to part like the Red Sea and it truly was a sight. Usually she was the one who was moving out of the way, not the one in the ambulance. She decided she quite enjoyed it.
"Multi vehicle RTC, two ambo's already on the scene as well as police and fire crew. We've managed to extricate the majority of the casualties and they've already been taken to the nearest trauma centre. We have one vehicle that has slid down the cliff face. They're hanging on a ledge and fire crew are trying to figure out how to get the casualties out. As far as we can tell there are two adults in the car, a man and a woman. They're both in a pretty bad way but the woman is conscious at least. That's the last I heard. We'll be there in a few minutes."
Callie nodded, reaching for a pair of blue surgical gloves, waiting until they arrived to snap them on. It sounded a bad situation all right. She desperately hoped there was something she could do. She did not like to lose patients if it was avoidable. Seeing the flashing lights, adrenaline pumped its way into her body, making her heart race. She could do this. Things would be okay.
Jumping from the ambulance, Callie picked up her kit bag and slung it onto her shoulder, running to where a group of paramedics and fire crew were huddled, making a quick introduction and surveying the scene that lay before her. Devastation was the closest word she could summon to describe what had happened here. From what she gathered from the snippets of information she could glean, a lorry had lost control and overturned, crushing one car before jack knifing and throwing another over the cliff. They had managed to rescue those that were in the first car and the driver of the lorry, but the vehicle that had been thrown from the cliff was teetering dangerously from the narrow ledge that they had miraculously landed on.
"We can't get down to them to pull them back up, we just don't have the equipment," one fireman commented, his voice sombre and morose. "HEMS are busy with a major incident a few hundred miles north and there's no one we can call that is available to help."
"Is there anyone we know that does?" Callie asked desperately, looking down the cliff face. It was a tricky situation all right, one that she wasn't sure they could solve.
The group shook their heads. There was nothing they could do.
"Hang on, I was listening to the radio on the way to work this morning. There's a rescue organisation that help out in things like this. They helped out in that disaster with the Fireflash, remember?"
One of the firemen nodded, a young lad of barely twenty. "I remember. International Rescue, right?"
Callie nodded. "Apparently you can call them on any radio frequency. Maybe they could help?"
There was a general nod of assent and fumbling for the radios.
"You call them, I'm going down to help those that are trapped."
"Callie that's not a good idea. That thing could slide over at any moment." Ian said, his face lined with concern.
"I don't care Ian, they need a doctor." Callie lifted her kit bag and asked for a guide rope that would lower her down the cliff face. She was placed in a harness and gently lowered down until she reached the ledge, undoing the clips and letting the firemen pull the rope back up.
"Call International Rescue!" She shouted up to them.
One of the men gave her a thumbs up and Callie nodded to herself, peering into the car. Ian was right, it was a mess. Leaning into the car, Callie encountered a male and female, both early thirties. The woman was awake and stared at her, terror in her eyes and tear tracks down her face.
"My name is Callie, I'm a doctor. I'm here to help you. Were you knocked unconscious at all?"
The woman nodded slowly. "I woke up a few minutes ago but Andrew hasn't woken up yet," she whispered, her voice hoarse with emotion and the dust that had risen when the car had landed. The tears started again, slowly sliding down her cheeks.
"Alright, it'll be alright. Help is on the way." Or she hoped, at least. "What's your name?" Callie asked, trying to keep the woman talking.
"I'm Angela. We were on our way to pick up our son from school. What will happen to him?" Her voice rose with emotion and Callie carefully reached through the car to take her hand.
"When we get you out of here we'll contact his school, okay? Just try to keep still, you might have hurt your neck or back. I'm going to assess Andrew quickly, okay? It'll only take me a minute and it will really help."
"Okay." Angela agreed. The crying had stopped for now, but Angela was very pale and clearly traumatised. With any luck they would both be airlifted out soon. Reaching across to Andrew, Callie called out to him, trying to see if he would wake. No luck.
"Alright Angela, I'm going to do something called a trapezium squeeze, to see if Andrew will wake up. It won't hurt, it will just give him a surprise." Okay, so that was a minor lie. It would hurt him, but it was necessary. Callie didn't want to traumatise Angela any further. Placing her hands either side of his shoulders, Callie squeezed his trapezius muscles, hoping for a response. There was none.
There was no other way, Callie would have to climb into the car. It was the only way that she could get to them both and assess their injuries.
"I'm coming in now, okay? Just hold very still and I can help you both. I just need to radio up to the fire crew and let them know what is happening."
Angela nodded and Callie pulled her radio from the holder just below her right shoulder.
"M2605 to mobile base, can you hear me?"
"Mobile base to M2605, coming in loud and clear Callie. What's going on down there?"
"Female, name of Angela. Approximately early thirties, A on AVPU and GCS fifteen. Was knocked out for a considerable length of time but is coherent and orientated to time, place and event. I haven't assessed her injuries yet. Male, mid to late thirties, U on AVPU, GCS eight. I haven't been able to assess him yet either. I can't do it out here. I'm going to have to go in."
"Are you sure? The vehicle isn't stable and help won't arrive for a little while yet."
"You got through then?" Callie ignored the question. In truth, she wasn't sure. She was taking a risk even being down there, let alone actually climbing into the unstable vehicle.
"They'll be here in about half an hour."
"Well I'd best get going then. Out."
Cutting the radio, Callie slipped off her kit bag and passed it to Angela awkwardly, before clambering in through the back window, which had been smashed in the fall. She went slowly, breathing deeply, trying to calm her beating heart. This was craziness. What was she doing? Saving lives, that's what you signed up for, isn't it? Do no harm? Remember that oath? Her subconscious told her. Still, this was taking that oath a little too seriously. Callie ignored the broken glass that was biting into her legs as she crawled in, trying to ignore the ominous creaking noises coming from the vehicle. Callie hummed an old tune to herself, trying to block it all out. Making it to the back seats, she let out a sigh of relief. She was safe. For now, at least.
"Alright Angela, I'm here now. I'm right behind your seat. Help is coming and it will be here soon, okay? We just need to get you patched up as much as we can before that happens. We don't want them to think I've been sat here relaxing, do we?"
Angela let out a weak chuckle and Callie took that as a good sign. She opened her kit bag and looked over all the equipment she had. It wasn't much but it was a start.
"Right, I need you to tell me where it hurts, okay?"
"My leg, it's my leg."
"Okay Angela, it's okay. We'll get that sorted, okay?"
Callie looked over her briefly, performing a primary survey. Her breathing was fine, apart from a little shallow, but that was simply to do with panic, her pulse fast but regular, which Callie put down to pain and fear.
"Angela," Callie deliberately used her name frequently. It was something to do with it grounding people, hearing their name relaxed most people. Callie couldn't remember the exact logistics of it, but it seemed to work. "Angela, I need you to try and calm down, alright? Deep breaths for me."
Angela looked frightened and Callie put a comforting hand on her shoulder.
"Trust me."
Angela looked unconvinced but her breathing slowed and it allowed Callie to assess her properly. Reaching for her stethoscope and pen torch, she shone the light in her eyes quickly, muttering to herself as she did so.
"Pupils equal and reactive at two millimetres. Bilateral chest expansion, no wheezing, crackling or stridor. Does your chest hurt anywhere Angela?"
"No," she muttered, focusing on her breathing.
"Okay, I'm just going to have a little feel of your chest, okay? Stay nice and still for me."
"No paradoxical movement, crepitus or flail chest."
"Is that good?"
Callie nodded. "It's very good. It means that there's no damage to your chest and ribs. That's a good thing. Does your leg still hurt?"
Angela went to nod and Callie put a hand under her chin to stop her. "Remember, you need to stay still. I'm going to give you something for the pain in now, okay? Do you have any allergies?"
Angela replied in the negative and Callie wiped the back of Angela's hand with an alcohol wipe, preparing a cannula so that she could give her morphine to ease the pain and ondansetron to stop the nausea . Her leg was clearly fractured, but there was nothing much Callie could do in the limited space.
"That should start working soon. Just hold tight. I'm going to look at Andrew now, okay?"
He had a rather nasty head injury and was bleeding from his ears. That was not a good sign. It was a sign of cerebral haemorrhage, bleeding in the brain. Before she could do anything else, the radio crackled into life.
"This is International Rescue here. Do you read me?"
"I read you, strength niner, over."
"Good. I'm about to arrive and my colleague will be arriving with some machinery to help you get out of there very soon. How are you holding up down there?"
The voice was male, with a soothing, almost melodic tone. Callie found herself relaxing slightly, knowing that they were about to be rescued. They needed help quickly.
"Not too badly. We seem stable enough for now but we have injuries. They're pretty nasty."
"We'll get you out of there in no time."
Callie let out a sigh of relief. Andrew needed to be airlifted to a hospital and Angela would need to have her leg splinted. She wasn't able to see the leg but was fairly sure it was a break. If it was serious, she needed attention quickly, before any lasting damage was caused.
"I'll be operating on this frequency so try to keep it clear if you can."
"I just need to radio my colleagues to let them know what to expect."
"That's okay, you do that and by the time you're finished we'll be there. Thunderbird One out."
Callie turned to Angela and pasted on a smile. "We'll be out of here soon. I'm just going to do a few things to help Andrew out. I'm going to give him some oxygen but I want to make sure that he can breathe properly first, so I'm going to put something in his mouth. It will stop him choking on his tongue."
Callie opened up her kit bag, pulling out an orange airway adjunct. She hadn't used one of these in years, preferring to intubate her patients, but that wasn't something she could do in her current position and Andrew was maintaining his own airway for the time being. No, an oropharyngeal airway would be fine. She explained to Angela what she was doing as she was doing it, ensuring that Angela would remain calm throughout the process. Once Callie inserted the adjunct, she reached for her oxygen bag and put a non-rebreather mask carefully over Andrew's face. If he deteriorated further, she would have to breathe for him, but for now, this would do.
She radioed up to the fire crew to prepare for their rescue, warning them of Andrew's condition, whilst not trying to frighten Angela. It was a long few minutes before help arrived and it dragged. There was nothing more that Callie could do, as both casualties were as stable as she could make them with her supplies being as limited as they were.
Callie tried to make conversation with Angela to pass the time and keep her calm and still, but Angela was getting agitated. She wanted out and the pain, though minimised, was still there. Callie continued to reassure her that they would be freed soon and that Andrew would be fine (there was no guarantee but she knew that bad news was not a good idea), as would their son.
"This is International Rescue again, do you read me?"
"Loud and clear International Rescue. What's going on?"
"I've just arrived, I'm with the fire crew. My brother Virgil is bringing some electromagnets to lift the car clear of the ledge. He's due to arrive any minute now. Have there been any changes since the last time we spoke?"
Callie shook her head before she realised he couldn't see her. "No changes, but we do need to get out of here quickly. There are serious injuries that require urgent treatment."
"Roger that. We'll get you out of there soon. Just hold tight. I'll radio again when he arrives."
The call was cut and Callie took Angela's hand to calm her down.
