> 1. How long was the entrapment in total?
Just under 2 hours
> 2. Did you use analgesia at any stage and, if so, what?
Yes; we used nalbuphine (and he was not in a great deal of pain, whatever Fireman Sam claimed) as we had absolutely no access
to his face at all and I was concerned about vomiting into his helmet and of course losing his airway. He had excellent pain relief
with that. At first we had no idea how severe his injuries were, and it was not until he was out that we realised he had a femoral
fracture.
> These are simply curiosities. The crux of this enquiry relates to the
> cervical spine immobilisation. I noticed that the motorcycle helmet
> remained
> on throughout the extrication and even onto the long board.
>
> My understanding of the current best practice (in the presence of a
> clear
> airway) is controlled removal of the helmet at the first practical
> opportunity but certainly before laying supine. The forward flexion of
> the
> c-spine caused by the 4 - 5 cm of helmet over the occiput prevents
> neutral
> alignment of the spine. Manual in-line immobilisation was well
> demonstrated
> and consistent by all!
> Was the footage broadcast a result of TV editing, organised chaos in a
> difficult situation or am I missing data on spine positioning?
>
> I would be interested in your retrospective thoughts.
The problem was that he was on his side, and the only way that he could be extricated without risk of worsening injuries (we
didn't know about) was to slide the spine board in from the back of the bike and glide and rotate him onto it. His head remained
totally out of reach until the very end of the extrication from under the trailer, so we were unable to remove his helmet until after he
was out and already on the board. As you say, ideally you get it off as soon as possible, but it is extremely unusual to have a
biker trapped in this fashion - normally they are simply lying on the side of the road, and you can approach the problem in a more
logical fashion. As with all these things, the rules are there to be broken.
I was very disappointed with the programme compared to Chopper Coppers; I looked odd and bloated in the 999 pictures, and in
retrospect it was a mistake to wear my jump suit. They made me sit in this curious slouched fashion and that compounded it! Ah
well.
Best wishes,
Rowley Cottingham
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