The events of 22nd May 2017

The Manchester Bombing

The events of 22nd May 2017

I have been pondering the events of this night for a year now, and certain aspects haven’t escaped me. It’s not something that happens every day. Had these individual injuries been standalone incidents there would have been nothing too out of the ordinary, though still traumatic injuries. But the event itself as a whole is what makes it a completely different beast.

Me and my colleague Jade were on shift together out of Central Manchester, and we were ready for a good shift. We set out on the night shift of the 22nd, and can only say we were called out to a number of jobs that seriously did not require an emergency ambulance. I can’t recall the job we received in Middleton, but I do remember leaving the patient at home. A call came over the radio, which sounded serious mentioning central Manchester and that some major incident had gone off, we remained clueless as to the true nature of the event and continued to assist our patient with receiving the appropriate care.

Big news!

As we headed back towards Manchester, we were hit with a job for an 18-year-old with belly ache. When you receive messages like this, you do become a little cynical as to why this is indeed an emergency call, especially at that age, not that you provide any less care. We began our journey towards the address provided. Within a couple of minutes, we received a call from control. ‘Are you able to head towards a major incident in Manchester please?’. ‘Not a problem, we’ll make our way there now.’ I responded. As we began our journey the job came through on our screen, title ‘Explosion’. Both of us were gobsmacked, I immediately text to confirm, as sometimes we receive the title of the message by accident. It was confirmed fairly quickly by control, and a further message with Manchester Arena box office in the text.

We began our journey in to Central Manchester and the Arena, completely unsure of what we would be faced with. We eventually arrived in the centre, and were being directed by police in the road. We headed down past the arena, negotiating a range of marked and unmarked police cars that had been abandoned everywhere. We eventually turned the corner at the road up towards the entrance of Manchester Victoria, and it was awash with blue lights. Ambulances and police cars dumped on all available kerb space. So we felt obliged to do exactly the same, unsure of protocol, and all training of vehicle positioning during a major incident from well over a year ago, not even reach the forefront of the mind at all.

Gathering what we thought we needed we headed towards the Manchester Victoria station. Immediately we noticed crews taking a lot more than us. I returned to get more kit, only to head back two more times. A policeman approached me at one point during these return journeys for kit and asked about a girl who had approached him saying she didn’t have her insulin.  In the grand scheme of the events we would push this down to walking wounded (P3). This is common practice during triage, she had only forgotten her insulin, and heading to the P3 station they would check her sugar levels and offer advice/treatment as required. I proceeded towards the door to meet back up with my crew mate. Both of us stood in a queue waiting for permission to head in to our assigned patient.

In no time we were at the front, with a HART Paramedic managing the front door. He was a big lad, almost had the appearance of a bouncer. I asked him if he was ok, to which he responded ‘I’m absolutely shitting myself, I want to be in there really, helping.’ I felt for him, as he had received all his major incident training for such situations, and was at present being a door man. A role that was definitely needed as to control the flow of crews, but I understood his desire to help.

In we went following a ‘two pipper’, also formally known as a Senior Paramedic or Assistant Operations Manager. We arrived at our patient, she looked like she was on her way in to shock. We cracked on checking injuries and observations. There was an obvious injury in the neck, caused by a bolt or something similar, and her observations were all over the place. A doctor was also assisting us, of which I assume he had been off duty. I continued to dress the wound and check for further injuries. The atmosphere was extremely noisy, as patients were brought from the arena, but the bulk of the noise was from a man who came with the patient. He was very irritating and was providing little assistance or actual benefit to the patient. I asked if he could leave as he was distracting our care, he refused. Quite hard in such a situation, and the police were unable to remove him at this point, as they were obviously busy with a number of things.

We were eventually given a green light to load our patient on to the ambulance. My heart was racing, and I was still a little unsure of what I was doing. Eventually it was all clear. We got on to an unfamiliar ambulance, and were quickly informed that we would be heading to our designated hospital. Thankfully streets were fairly clear as we made our way there. We were the first patients I believe at this hospital. Jade made her handover to the crowd of nursing staff and doctors, whilst I busily tidied the vehicle and located replacement scoop stretchers and straps. I was confident that we would be asked to head back, and I therefore decided to grab an extra scoop and set of straps in anticipation that kit may be starting to dwindle.

We got ourselves back in to the vehicle, and sure enough as we cleared we were asked if we would like to return to the scene. We both agreed that we would be ok to do so, and headed off. It was a weird sensation heading back in, but we knew what to expect this time.

On arrival, we took charge of a patient with lower limb injuries sustained from the shrapnel. The lower left leg had been box splinted and bandaged. The leg swelling was pretty serious. As we moved the lady from the event fencing on to a scoop and on to the bed, it was evident that this woman had still not received enough pain relief. She’d already had Ketamine and something else of which I cannot remember. As we headed outside, we let a doctor know, who quickly assessed her and established that she would be ok for another dose of ketamine. The doctor informed us that she would likely become vacant, and then quite shouty. I wasn’t quite sure what he meant by this, but I was going to find out.

The queue for the ambulances had grown significantly since the first patient, and most were serious injuries. Our patient was definitely a serious injury, but had been relegated by many others. This allowed us to monitor her and assist neighbouring crews with their patients as required. This was when our patient appeared to stop breathing. She was looking straight up in to the sky, and I couldn’t see any rise and fall in her chest with the poor lighting. I got close to her to assess her breathing, and could just see air movement in her nostrils and chest. I must have been about a foot from her face, when she demonstrated what ‘shouty’ sounds like. At that moment, I am pretty sure no one has ever made me jump out of my skin quite like that. She shouted for few what felt like minutes until the ketamine affects died down. Note to self, ‘ketamine makes people vacant and shouty’.

During our assessment, we had to reapply the box splint, and in doing so we also reapplied a dressing to the serious wounds on her leg. I am sure many of my colleagues have dealt with serious limb injuries before, but this was my first. And this was definitely going to be one that the surgeons would be tested on. It was a right mess. The foot was in good order, but the calf was about 3 times it’s normal size.

We eventually got the thumbs up for a trip to our designated hospital. Arriving at the hospital the staff got the patient sorted out, and on the movement of the patient to the bed I removed ours to the corridor to ready again, a nurse who was lovely, asked if we would like a brew and a biscuit. This was amazing and received with gratefulness.  We knew that the last of the patients were being cared for and that we would be heading back for a debrief, so we admittedly appreciated the brew and biscuit. But then again, we also missed our lunch break, not that I don’t think either of us felt particularly hungry at all.  We headed back in to Central Station for our debrief, utterly diminished of energy and still heavily processing the events of the evening.

After the debrief we headed back to our station, near the Etihad Stadium.  I mentioned to Jade that I reckon it might be a good idea to clean the vehicle top to toe and just chat about everything that we felt we had to chat about.  We got back to station about 4am-ish and begun cleaning.  We chatted everything out whilst cleaning everything methodically for the next crew.  It was very therapeutic, and I felt like it took some weight off my shoulders having that discussion with Jade.  The cleaning itself was the right kind of monotony that I personally required.  I couldn’t be anymore grateful to have had such a great crew mate as Jade, I felt like we got on so well outside of this incident, it just went well.

Ongoing reflection

It was a serious event which requires a lot of personal reflection. I am writing this blog as it has been sat in my head for a year now. And sometimes it revisits me at random times of the day and night. Thankfully it isn’t affecting anything in my life at present, but wanted to write this to attempt to avoid that happening.

During that night a lot happened and I know that had all those jobs been independent jobs, in our everyday work, they would have gone far differently. The situation in which we were immersed was chaotic but organised, noisy but clear communication, lots of healthcare professionals and trust, and everyone involved regardless of input was helpful, supportive and caring. I didn’t want to be in such a situation ever, but I am proud that I could help where I did.  I was pleased to have had a crew mate who I was friends with and is happy to listen when I fancy a chat, that is priceless.

I have no images for this post, as I honestly didn’t know what to put.  I have plenty of images in my head, but not one photo on the internet can come close.  Plus, I do not think it is all that appropriate, as the above and all other stories and reports speak for themselves.

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