Open Mouth, Insert Foot

"It'll be the idiot trying to get out of being lifted"

We received the message that the patient had been injured during a shoplifting incident in a well known supermarket in the centre of the concrete jungle.

We arrive outside to find the RRU there before us holding down the fort. The store had put up a screen in one corner of the entrance to shield the patient from the many shoppers rubber-necking to get a look at the action.

I turn the corner to see a young man lay on the ground. But instead of the civilian outfit and handcuffs I'd been expecting I was faced with a manager of the supermarket. The git doing the shoplifting had got away.

"Alright Delboy*? Whats the script?"

Delboy nods his head in the direction of the patients lower leg which is being supported by a blanket.

I look at the leg. The foot is facing an unnatural direction, the joint is not the ankle but a newly created one about 4 inches further up. At this point the bone can be seen micrometres from piercing through the thin layer of skin around the patients tibia.

Now, part of our training involves learning to be calm, collected and diplomatic in the face of things most people flap around. We are trained to be the voice of reason and reassurance to our patients. We see these things all the time so they do not faze us.

So my reaction to the patient and his predicament in front of me.

"Oh Crap!"

Now, dear reader, you are probably thinking "she said this to herself, in her head, surely. Our Louise is far too professional to have said it out loud".

Wrong! I said it out loud, with the appropriate facial expression to instill no confidence in my patient whatsoever!

A hasty apology and promise to get some pain killers is mumbled as I embarrassingly shuffle out to the motor red faced to get the Gas 'n' Air.

A little later we are transferring our patient into the ambulance, he is merrily high on a combination of entonox and morphine, his leg is now in the correct position supported in a splint. I have apologised for my initial reaction, he informs me that he had a pretty good idea it was bad from his mate going green when he saw it so my outburst wasn't a big surprise.

"So I'll just get a cast on and be home this afternoon then?"
"Hell no, your going to surgery this afternoon, mate"

His face drops, he was convinced a simple cast would be the solution. I had, for the second time in the last hour, burst his bubble and put my foot in it.

"Sorry" I offer sheepishly as I offer him the entonox again.

I really should engage my brain before opening my gob at times!