24 Hours in A&E

12-year-old Tulsi is airlifted to St George's after falling from a cliff near her home in Hastings, seventy miles away. She has a head injury and is designated as a ‘Code Red’, meaning she’s bleeding badly. Emergency doctors have put her into an induced coma. Clinical director Phil orders urgent CT scans as soon as Tulsi arrives so he can assess the extent of her injuries. They reveal that she has a subdural haematoma – a clot of blood within the head which is expanding, putting pressure on her brain. Tulsi needs emergency brain surgery. “If that pressure builds up and the brain is squashed, it can stop the patient breathing,” says Dr Phil. “Your worry is that, even if you do get the clot out and the child survives, that she may have residual brain dysfunction or injury.” 39-year-old bus driver Adam is rushed to A&E after his motorbike collided with a car in south west London on his way home from work. Adam has a very obvious and painful leg injury, but consultant Rhys is concerned that there might be something less visible, but more life-threatening. “Coming off a motorbike at high speed, they could be injured anywhere,” says Dr Rhys. “Sometimes it's not the leg that I'm most worried about, it's the things like, inside his chest or is there anything going on in his abdomen or his pelvis or his head?” CT scans reveal that Adam has fractured his wrist and some of the bones in his spine. He also has bruised lungs and an injury to his kidney. And he faces lengthy emergency surgery to fix his badly broken leg and a long period of rehabilitation. Meanwhile 70-year-old retired mechanic Ron has come to St George’s after getting his hand caught between two vehicles while helping a friends fix their car. He’s been brought in by his girlfriend, bus driver Jackie. Doctors suspect he may have broken some bones. “We went to bed that night and didn't think much of it,” says Jackie. “When we got up in the morning, looked like someone had got hold of a rubber glove and blown it up!”