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They were born for the second time

Lucia Filípková
Language: English
Country: Slovakia
Typology: health care professionals
Text:
Jakub was brought along with his friend to the nearest hospital by an ambulance after a car accident. Their car flew off the road, flipped several times downhill and after 27 meters landed on the roof. Later they both learnt the car ended up in a junkyard as irreparable. It took them a long time until they managed to crawl out of the overturned and destroyed car, climb up the hill and call for help. Then Jakub’s friend lost her consciousness. Jakub is a 19 year old responsible trained yound man who is preparing for a professional paramedic career. He has wide ranging knowledge and skills about situations like he survived that day. Both Jakub and his friend were examined in the hospital and both were kept there for observation for suspicion of possible consequences of the car accident. Jakub was more worried about his friend and if she will be fine than about himself. Then he was informed by the doctor that the CT examination could not rule out a possible fresh bleeding in brain or an older scar and it will be necessary to check him up during the night. Jakub was only slowly realizing what really happened and what could had happened. Some parts of the accident he could not recall. For example, he did not know how he got out of the safety belt on the passenger seat to the back seat. On the other hand, he remembers very strongly the CD player switched for a radio which played a song with a chorus of: „ We live only once, right now, rigt here“ and he could not concentrate. He was helplessly banging on the radio but both he and his friend failed to turn it off. He has cut legs because before they climbed the hill up he gave his shoes to his friend who could not find her high heels in the car and he did not want her to go barefeet. He had to go back to the car because the cell phone for calling help stayed there, even though he knew the gasoline car could explode after a rollover. He knew how to administer the first aid to his friend when she lost her consciousness and he called an ambulance. Jakub had a strong believe that as a future paramedic he should handle this sort of situations and therefore he was confused from his strong feelings and insecurity as well as his physical reactions and flashbacks which he could not control. The nurse calmly administers psychological first aid every hour along with the check up of the neurological symptoms. OBJECTIVES: Help Jakub manage the first night after a serious accident, check possible changes of neurological symptoms, inform the doctor when necessary, provide psychological after trauma first aid, normalize surviving and responses. MEANS AND STRATEGY: Regular check ups of the overall condition for suspicion of the brain hemorrhage based on the CT scan. The nurse explained to Jakub in an open interview the necessity of the regular checking of the neurological symptoms and the response of his pupils every hour and therefore the need to wake him up. When his breath got fast and he looked scared after the first light flash in his eyes, she asked him what was happening. He replied that the whole experience had come back in a moment, as if he was rolling in the car again and the lights were illuminating the surrounding environment according to the car movements. The body feelings came back as well, as if he were there and his whole body hurt him. The nurse explained to Jakub how brain behaves right after such life threatening experience, that so called flashbacks is a normal way the brain tries to process and integrate with such strong experience. She assured Jakub that all his feelings and reactions are a normal response to an abnormal situation and dread him because he has not experienced them yet. After the checking and lightening the eyes she always helped Jakub to calm down his breathing, helped him realize he was safe and stayed with him until he fell asleep again. CONCLUSIONS: Jakub managed necessary hourly check ups which were inducing flashbacks. After the third one he was able to fall back asleep within a few minutes. Brain hemorrhage diagnosis was ruled out. In the morning Jakub said the most helpful were understanding of what was going on with him and awareness of nurse’s genuine care in him no longer being frightened.


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