“There’s been reports of a casualty across the road. I’m going to be staying here for better comms.”

We all nod and head off. I grab the radio I’ve got and call in to get a radio check and I’ve barely finished when we find our casualty. A 7 year old girl with breathing difficulties. We’re on it like a shot, oxygen and a nebuliser mask out, I’m on to control to get some backup, Mum is upset and panicing. No air ambulance available and the nebulised salbutamol is having little effect. There’s no county ambulance either and our vehicle has a puncture. There’s a quick conversation – I arrived at this incident in my own vehicle, we’ll transport mum and daughter in that. We’re moving, rapidly through the trees whe the radio comes to life – there’s an ambulance en route to us now…

We’re still packing up and debriefing from that job when the radio comes to life again. “We’ve had a call nearby for a young child that’s fallen, no parents, friends have raised the alarm but are not with her.” We look at each other and we’re off again, this time I’ve got the purple gloves on my hands as we head through clouds of gnats. We find her next to a few old logs which she’d been climbing on. She’s 9 years old and looks quite healthy. She’s complaining of a bump on her forehead and a painful ankle. I talk to her, practice my new skill – talking with kids. I’m not good at it and I’ve been practicing. She responds well, I’m on a winner. I check her over carefully and she reports a painful neck. She’s talking to me and I’m adding up her GCS in my head as she tells me she’s feeling sleepy. GCS of 15, she’s alert and responsive…wait what?

She’s feeling sleepy.

Despite the warm summer evening and the gnats crawling all over me, my attention is focused on her as I slip my hands onto her neck and hold her head still. I look at the stump she fell off – 2 feet? 3 feet? A colleague takes over her C-spine management as I get oxygen going – but she doesn’t like the mask on her fact. She’s content to hold it near her mouth and breathe the cold gas though. We package her up and move her down to the road to be met by a county ambulance. I’m all smiles and chatty and she’s responding well.

We haven’t even started the debrief when somone runs up to us. “Come quickly, it’s my friend – he fell off the stile, I think he’s hurt!” We head down, shaking our heads and find a gentleman lying on rocks next to a river. He’s fallen some 2m and is complaining of a lack of sensation in his legs.

Fuck.

I’m running this incident as my colleagues deal with first aid. I request backup from Ambulance control to be told that there’s no land ambulance available. They check on a helicopter for me as we request more people and more equipment. Our landrover pulls up, blue lights flashing and cars slow down on their way past, their occupants staring at a blue-shirted throng of rescuers arranging to move this man onto a stretcher from one of the most awkward positions I’ve ever seen. It’s not long before he’s on a stretcher and moving. We look at the fence – it’s in our way. Bolt croppers are called for and the fence is ready to become a casualty of this incident.

“Ok, hold it there folks.” A voice calls from behind me and the ‘casualty’ pulls his collar and spinal management kit off.

“That collar’s really uncomfortable.” He says, rubbing his neck. I turn around and find ‘mum’ and our two previous casualties grinning behind me. The exercise is over and we’re talking amongst ourselves about how it went. There’s lessons to be learned – there are always lessons to be learned. But we have three people who are alive and kicking (in the scenarios) because of the care we gave them.

As we head back to base I’m thinking that I’m glad I got to practice on children tonight. I’m rusty in dealing with children, but I seem to be getting the hang of it. I shudder as I think of the moment when my casualty told me she was feeling sleepy and know that I’m better prepared for the next one. Chances are, the next one won’t be practice.

It’s quiet at the nursing home. We’re led to a room somewhere in the building- the place is a rabbit warren. “She’s very violent.” someone says. Joy. I head in and start talking to her. She looks confused and doesn’t register my questions. I’m just starting to gather the details when the crew arrive. Her right leg is obviously shorter than the left and rotated outwards – classic symptoms of a broken femur.

While we’re helping, the phone rings. It’s control – are we available? We take the details of another call - 6 year old child with breathing difficulties.

I’m more awake for this one and head across town. I get there as the ambulance is pulling up and jump out to assist. When we get inside it’s painfully obvious that this poor boy is having a severe asthma attack. The crew get some Salbutamol going with a nebuliser mask with oxygen. His respiratory rate is at 32 breaths per minute, and his oxygen saturation is down to 83% – both indicators that this kid is very ill. Packing their kit up quickly, the boy is swept up into the arms of a paramedic and taken out to the ambulance. Minutes later, we watch as the ambulance heads off to hospital, blue lights flashing.

I head back to my car and toddle off home, knowing that by the morning, these calls will seem like dreams to me. I just hope I get a decent lie in after this.