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Sir, keep looking at me. I'm from the ambulance service.
My colleague is going to come into the car to take your head.
The first course of action is safety.
That's to myself, to my colleagues and to the patient.
So safety is our paramount concern.
After we've done the safety aspects,
we then approach the vehicle, talk to the patients,
make sure they keep looking straight out of the window
and someone will get in behind to support the head.
Jim, I want to rapidly assess you
to find any internal bleeding or any life-threatening injuries.
The first priority when assessing a patient that's been exposed to trauma
would be to ensure that their airway, breathing and circulation
are all intact and functioning.
The first thing is checking the airway,
ensure that the airway is clear, open and will remain clear and open.
Secondly would be breathing.
Ensure that the patient is breathing, so that's rapid chest auscultation,
that's listening to the patient's chest with a stethoscope
to ensure air entry into both lungs.
Thirdly, circulation to establish their pulses
and to see whether they're bleeding from any external or internal sites.
Feel your abdomen, Jim. Tell me if it hurts.
Okay, sir, just once more.
Okay, sir.
He's very tender on his right abdomen.
I'm going to check your hips, sir.
Check your femurs, your big, long bones.
Lovely. Any pain in the top part of your legs?
Just the bottom.
Okay, you've got an obvious open tib and fib on the right-hand side.
Andy, this is a time critical.
Internal haemorrhaging in his abdomen.
I'm going to request a second vehicle.
Jim, I won't be a moment.
The golden hour in the role of the paramedic
is the first 60 minutes from the time of an incident
to the time of the patient receiving definitive care.
It's usually inside a hospital.
From the paramedic's perspective
they would look for the platinum ten minutes.
The platinum ten minutes is from arrival on scene
to actually loading the patient for transport to hospital.
Within that ten minutes, that's where they identify key things
around life-threatening conditions,
focusing simply on airway, breathing and circulation.