Reflective Piece 1
Using Gibbs model, this first reflective piece recalls an experience in which I responded to an incident of major trauma as part of a two person ambulance crew, after an elderly lady had been struck as a pedestrian by a motor vehicle. Besides myself in attendance there were three of my colleagues: an emergency medical technician, a Rapid Response Vehicle (RRV) paramedic, a consultant paramedic, numerous police officers, and a large number of bystanders, including the vehicles’ driver. Upon arrival it was a chaotic scene. A road block was in place, yet the scene was still in full view of over a hundred bystanders, many of whom were intent on voicing their opinions on the treatment of a significantly injured patient, creating an intimidating atmosphere. While our focus remained on patient management, it was difficult to gather scene information and history from varying sources, leading to some confusion over occurrences. There were further interruptions to the focus from communications from the Emergency Operations Centre (EOC) requesting an initial scene report, despite this already being passed to the RRV contact by the first responder, the RRV paramedic.
Although it was regained swiftly, it was difficult with the staggered arrival of senior colleagues to maintain operational focus and control. Upon reflection post incident, the patient received full and appropriate care, however there were moments when this focus was lost as priorities of action became muddied as more clinicians arrived and the team dynamics changed, compounded by ineffective communication pathways with the EOC. The patient ultimately received full and rapid interventions, but perhaps a smoother operation might have yielded better information gathered first hand from bystanders and witnesses. Furthermore a firmer grasp of trauma pathways and contacts might have allowed for the erasure of small moments of conflict or indecision. Where the incident concluded ultimately well, I draw the conclusion that firmer awareness of specific drug protocols and better liaison with trauma contacts more immediately available would have improved the expediency at which we treated our patient. As a result I have revisited local and national drug protocols, as well as ensuring contact details for the local trauma cell are immediately accessible on my person.
Although it was regained swiftly, it was difficult with the staggered arrival of senior colleagues to maintain operational focus and control. Upon reflection post incident, the patient received full and appropriate care, however there were moments when this focus was lost as priorities of action became muddied as more clinicians arrived and the team dynamics changed, compounded by ineffective communication pathways with the EOC. The patient ultimately received full and rapid interventions, but perhaps a smoother operation might have yielded better information gathered first hand from bystanders and witnesses. Furthermore a firmer grasp of trauma pathways and contacts might have allowed for the erasure of small moments of conflict or indecision. Where the incident concluded ultimately well, I draw the conclusion that firmer awareness of specific drug protocols and better liaison with trauma contacts more immediately available would have improved the expediency at which we treated our patient. As a result I have revisited local and national drug protocols, as well as ensuring contact details for the local trauma cell are immediately accessible on my person.