A little look at the excitement of the weekend, through the eyes and fingers of the Derby Medics. Friday - 08/08/14 Friday was an eventful day for Medic 1 and one particular rider. Medic 1 was stationed at HS5 when, at 1720 there was a call to us from Derby HQ, that there was a rider with possible concussion at HS4. We were mobile at 1725 and travelled 35km along dirt tracks and uneven countryside to arrive at HS4 at 1810. We found the rider laying flat on his back in a ger, where he told us that he was just in canter when the horse manoeuvred awkwardly and he fell off, hitting the right side of his head on the ground. He wasn’t knocked out and took a few moments to compose himself. He walked the remainder to the urtuu where he started to develop a headache with dizziness. Sarah felt down his cervical spine which the patient said was very painful. He also said that he had altered sensation to his fingers, so we immediately placed a cervical spine hard collar onto the rider to protect is neck from further damage. Deborah used the ‘Reach Back’ service offered by Prometheus, to discuss the case with an on-call doctor back in the UK. It worked well, with contact back from a doctor within twenty minutes of request. After about two and a half hours, we heard back that the SOS Clinic would send a helicopter for the rider in the morning, so we bedded down for the night, nursing the rider and ensuring he was comfortable. We heard the helicopter approach and were not surprised by the appearance of an EC145 helicopter, with a doctor and nurse on board. The SOS Clinic does not do things by halves. The helicopter generated a lot of interest from what seemed like the entire province of herders who suddenly appeared from nowhere, but were keen to help us load the rider onto the aircraft who was fully immobilised with cervical spine protection. As we made sure the rider was loaded safely and ready to go, we wished him luck and told we’d see him soon. The mouse helps the lion. Or not. Saturday - 09/08/14 Horse station 10 was eventful. The previous night James and I had been monitoring and treating a rider who had developed signs of urinary sepsis and dehydration. I was woken at 6.10am by a rider who had been sharing his ger calling from outside the tent that our patient was feeling worse and shivering all over. The thermometer was reading 34.7 and he would not let me examine his abdomen at all due to the severe pain. This was really a tipping point in his progress, and it looked unlikely that he would be riding out later that day. So, after discussing with the rider we arranged for a casualty evacuation (casevac) to hospital. On the road we came across a heavily laden truck, stuck at a jaunty angle in the mud. The truck driver and his young son were keen for some help, and our driver helpfully obliged. In spite of several attempts to pull him out with our Landcruiser, the truck wasn’t budging. We had to carry on leaving the man to hope a larger rescue vehicle would happen by.... Sunday - 10/08/14 After receiving the all clear to move on from our ‘standby point’ yesterday evening we moved through two horse stations to finally reach horse station 13. Morning consultation with the locals (usually a blood pressure check and some reassurance) was interrupted with a satellite phone call from HQ, about a help request from a rider approximately 55km away. Fortunately, a vet on scene was able to stand us down. During one of the many ‘herder health checks’ Sheila saw an interesting case of a man in his 60’s complaining of numbness in his little finger on his right hand which he has had for 20+ years. The man was generally well and fit for his age but it was noted he had significant muscle wastage in his right hand. When asked through Dari, our interpreter if he had ever had an injury to his right arm, shoulder or neck that may account for the suspected nerve damage he simply replied “I have worked with horses all my life!”
Posted on: Mon, 11 Aug 2014 13:17:03 +0000
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