I write my first blog post from Chipping Norton First Aid Unit. If you’ve not heard of either, Chipping Norton (affectionately known as ‘Chippy’ locally) is a market town in West Oxfordshire. And a First Aid Unit is exactly what it says in the title: it’s a small unit that can treat a wide variety of problems from cuts and sprains to minor infections. It was set up by a much loved and respected colleague, Gary Toohey, to provide out-of-hours first aid cover to the local area as well as relieve the stresses within the Emergency Departments (ED) at the nearby hospitals. Many people attend ED when they could be treated just as well (and probably quicker) at a first aid unit, or a minor injuries unit. There is, however, a key difference here: first aid units do not have X-ray support, whereas most minor injury units do.
This unit is relatively small, with a desk overlooking the car park (and viewing any potential visitors), cupboards and a dressing trolley lining one wall, with an examination couch at the back. However, we stock everything and anything required to treat minor ailments and injuries. Additionally, since we’re a rural community service, we have on the odd occasion provided the first steps in treatment for those experiencing heart attacks, severely broken bones and even delivered babies – although thankfully, there is a maternity suite upstairs!
Either way, we are a busy little unit manned by one Specialist Paramedic (and sometimes an accompanying student) at a time. On the first weekend in April, that was me. I’ve been a specialist paramedic for four years this year and really do enjoy my job. Working in unscheduled care, similar to the nature of any emergency or healthcare service, you’re never really sure who you might meet, what you might see and where you might go. If only these four walls of the unit could talk…!
I am currently two and a half hours into my weekend shift, and have so far seen three patients: a child with a minor ear infection; an elderly lady who required a dressing change for her sore leg ulcers; and a young male who had cut his thumb during some woodwork. What I love about this particular service we run within SCAS is not only the clinical variety I encounter each day, but that feeling of making a real difference. We can review the child later in the week if their ear infection gets worse, which helps alleviate mums’ anxiety and means we can catch any deterioration quickly. I have redressed the elderly lady’s leg ulcers several times before, and it really is satisfying to see that they are getting better and her mobility is improving – from something as simple as cleansing and redressing a wound! Treating the young man’s laceration also means his wound can be closed in a timely manner, preventing infection among other things, and also meant he didn’t have to wait too long to be seen. It’s not just the difference in the local community; it also makes a difference to the wider health services – alleviating pressure for my colleagues in emergency departments as well as within general practice. Oh! That’s the bell! Outside I can see a teenager in football kit hobbling towards the unit, with one ankle in a bandage. I ought to open the door to our fourth patient of the morning!
Eight hours later….
It has been busy today! Following my four patients this morning (the teenager had a rather bruised ankle from a heroic tackle that won his team the match), I have since seen:
- 3 year old with a high temperature
- 20 year with a subungual haematoma (bleeding under the nailbed)
- 43 year old who had crushed his thumb in the car door- he will be seen by the plastics team at the John Radcliffe Hospital in Oxford tomorrow morning
- 68 year old with vertigo
- An 11 year old with a soft tissue injury to his knee (another football injury, this time requiring an X-ray at the local minor injuries unit)
- 52 year old with an ear infection, who didn’t require antibiotics
- 72 year old with mental ill-health, who required additional social support
- 26 year old who had been bitten by a dog
- 36 year old who required a dressing change (ongoing management for burns from three weeks ago)
- 10 month old with a milk rash
- 49 year old with urinary tract (water) infection. After testing her urine, I was able to give her some antibiotics to get rid of her infection.
There has definitely been some variety! That’s the beauty of this unit, as well as never knowing what or who you might see next, the breadth of conditions we can help out with is really quite vast. I think that’s largely because my background as a paramedic (being autonomous and having to rule out the worst-case-scenario) has really helped me develop how I think about conditions. Plus additional training to be able to identify and treat minor injuries and illnesses really means this unit can just about deal with anything! The other benefit is, if there’s something I’m not sure about, we have a good network of referral routes. So if we can’t treat within the unit, we can help find someone who can. For instance, the gentleman who had trapped his thumb; he had a laceration through his nail as well as a possible fracture. I referred him for an X-ray at a nearby minor injury unit and also organised a review for him within a team who specialise in repairs of wounds or injuries in complex or essential places. I would say a thumb is pretty essential for most things!
So, after a busy day it’s time to restock the dressing trolley, clean the surfaces and the rest of the room, and generally prepare the unit for the morning. I might even have time for some tea; I think I deserve a cuppa!