Why We Do It Patient Stories I will never be able to thank DSAA’s clinical team enough On 23rd May at approximately 6.30pm, I was riding my motorcycle with my friend on the B3157 between Swyre and Abbotsbury in Dorset. Unfortunately, I misjudged a corner on a blind brow and collided with two oncoming cars. Travelling at approximately 50-60mph, the impact caused me to somersault into the air and I crashed into the road with full force. Isuffered catastrophic damage to my left arm and shoulder, broke my humerus, severed an artery and a nerve, dislocated my elbow and I broke two ribs which punctured my lung. When the air ambulance team arrived, my friend who had been riding with me was using a blast dressing to suppress my arterial bleeding. I was very lucky, as I was also being assisted by three members of the public who had stopped to help and fortunately, were all medically trained. I am led to believe that the air ambulance team performed a blood transfusion as I had lost six pints of blood and they also induced me at the scene because I was becoming increasingly agitated. I have no recollection of being lifted onto the stretcher or into the helicopter, which then flew me to Southmead Hospital in Bristol. Surgeons at the hospital then operated on me for five hours to save my arm and my life. After my operation, I was transferred to the Intensive Care Unit for two days and spent a further six days on the ward recovering. Several months of physio treatment followed and I required more surgery in December to graft the median nerve and release the ulnar nerve in my arm. Thankfully, my arm is stronger now, but it is still far from normal. I have limited feeling in much of my lower arm and hand, my bicep does not function properly and I cannot use my left hand yet as I have no grip. I wanted to repay the air ambulance team for saving my life, so I ran a half marathon to cover the cost of a mission and raised £3,067 (including gift aid). I will never be able to thank DSAA’s clinical team enough and hope to be reunited with them one day once the COVID-19 pandemic is over. VIEW FROM THE CREW:We arrived at the incident location via air and were met by the ambulance crews who were treating James at the roadside. On examination, it was clear to us that James was very unwell, therefore our priority was to quickly establish the extent of his injuries and to formulate a treatment plan based upon our findings. Upon assessment, we found that James had sustained significant arm and chest injuries and had lost a considerable amount of blood as a result. We continued to provide direct pressure to his wounds using trauma bandages and haemostatic gauze, as well as administeringantibiotics and tranexamic acid (a drug used to reduce bleeding). We also started a blood transfusion using fresh frozen plasma to begin with. James was becoming increasingly agitated and distressed while in our care, which we suspected was most likely a result of the amount of pain he was in. Despite already administering strong intravenous analgesia, we decided to give James a sedation dose of Ketamine so that he would not be able to feel us repositioning his left arm back into normal alignment. This procedure worked well, however once the sedatory effects of the Ketamine had worn off, James became agitated once again. At this point, we felt that the kindest option was to put James to sleep. After briefing the team and preparing our equipment, we undertooka pre-hospital emergency anaesthesia (PHEA). A PHEA involves administering a combination of drugs that provide analgesia, sedation and muscle paralysis in order to facilitate the placement of a breathing tube into the patient’s trachea, so that we can support their breathing from this point onwards. Following this, we performed a thoracostomy; by making an incision through the chest wall to allow for the release of air and/or blood from the chest cavity. James had a pelvic binder in situ and was carefully packaged inside a warming blanket, before we made the short trip down the road to meet our pilot at the helicopter. We secured James safely onto the helicopter stretcher, connected him to the ventilator and continued infusing further blood products en route to the Major Trauma Centre, where the trauma team were awaiting our arrival. Our thanks go out to our ambulance colleagues, the police officers and bystanders at the scene, who all helped to care for James on the day. It is fantastic to hear that James is doing well and we wish him all the very best following his recent surgery and onward recovery. Thank you so much for raising over £3,000 for DSAA! It is truly amazing what James has achieved since the accident and words cannot express our sincere gratitude for his kind donation.