Guest blogger: Bro

Some of you might remember my adventure on the 101 a few months ago as my brother investigated the scene of a freeway accident. Now he is back as a guest blogger, telling one of his many amazing stories from his days as an EMT.

I'm not going to give this story a big intro, as it surely speaks for itself, but I will say that after reading it, I went home and gave my Spooney an extra big squeeze. I take too many things for granted, I think. And I'm probably not the only one.

Bro:

I replayed a moment today… one and a half seconds from 14 years ago. Then like a television show flashback I ran the tape from beginning to the end surrounding that 1.5 seconds.

I was an EMT, getting into the burnout phase, I was now a squad Captain and didn’t do much hands-on patient care, mostly dealt with the big picture; the scene, the crew, the patient, and anything that would hurt us. You also kept a list of variables in your head: how far out were paramedics, what the flight time to the trauma center was, how many rescue trucks would be needed and just which direction actually lead to the nearest hospital.

On this night I arrived on scene in the command car just as 3683 (ambulance, “83”) announced their arrival over the radio, I keyed right after announcing 3685 (my vehicle, “85”) with 3680 (me) on scene. I saw the pole, I saw the wires, the vehicle torn almost in half, the one headlight already half dim but eerily still lit. The car was white, the patient was a woman and she was half out of the car with what looked like a bystander attending her.

The crew got the stretcher, board, collars, and other paraphernalia with their normal efficiency; someone touching a patient was unusual enough (and potentially hazardous to the patient) that I went pretty much straight to the patient rather than standing back as an IC (Incident Commander) typically does. The person that was bracing the patient’s head looked up and announced he was a doctor, I waited to see whether this doctor understood what was going on and about to happen, I have had optometrists, general practitioners, dentists and gynecologists tell me they were doctors and get oh so close to assuming patient care. (a bad thing unless they are a doc that understands emergency care and is going to make the trip to the hospital as a doc cannot turn over care to a lesser trained person once they start treatment)

He briefly reported: unconscious on arrival, definite head trauma and he was maintaining an airway. I looked down and he was doing the right thing, something called a modified jaw thrust which is how you hold the airway open for someone with possible neck and head injuries. He immediately handed over care as an EMT took stabilization and didn’t try to say more. I believe he understood that no matter what he said, we had to check for ourselves, we are trained to get facts firsthand, too much at stake for hearsay.

The Lieutenant was now standing beside me. I had watched her check the scene as I had done myself, I have been known to grab the back of this Lt’s helmet to rock her head back and the eyes up to whatever the wires are doing overhead. After once or twice it had become an automatic reaction with her and the memory also helped me to not forget to look myself.

The Lt. was Cathy, a young woman that played the giggling blond co-ed part to a tee, and was very competent… you could count on her to not lose a bump of composure, though she sometimes forgot her helmet. She stepped forward to take control of the patient and the EMT’s. I stepped back to watch. I had good training; I was trained to train, to not always be the one in the front so that others can learn while there is a margin of safety.

I stepped to her side: “what’s missing?” as the EMT’s were just starting to do a simultaneous evaluate and package. “Airway…” she started to reply and turn and see me offering one. I kept certain things in my turnout coat and a medium sized Oro-Pharyngeal airway was one of them. It’s automatic to assume that if someone was working a patient that they would have put one in if they had one, which the bystander did not.

I stepped back again. We would be on the road before the medics would arrive; the patient was definitely a “head” and also had massive blunt trauma to the midsection. She was dying.

In less than 5-8 minutes the rig was readying to pull out; there was a sense of movement with vehicles being put into drive with feet still on brake pedals, and the swaths of light started to shut off; first the take-downs on the side of the rig, then the middle doors close and finally one door then the other in the back, pulling the light back within as they shut.

The shadow outlines of the crew moving around within the rig testified to the continued activity as now the scene became just a wrecked car… now hard to distinguish in the dark with red lights playing off every surface in sight. I started a final walk-around and approached the other vehicle that had been near the scene, though not part of it. A bearded young man sat in the middle sliding door of a panel van crying.

I approached and looked at him.

“She’s pregnant” was all he said.

It was this next one and a half seconds that I played back in my head today, and it was from the “I wonder what he saw as he looked at me” point of view. He would have seen someone fix their gaze on him, a moment of complete concentration with otherwise no expression as I evaluated him, his state of mind, his physical condition/surroundings and whether he would really know this. I ran the equation; Yes? No? Truth? Would more information make a difference in treatment over the next 10 minutes?

In answer to this moment in time I keyed the mike in my hand and in a quiet voice stated “83… bystander states patient is pregnant”.

A second later a noise and an “…k..” came over the radio and I could feel the activity in the rig in that one second of radio noise as the Lt. answered.

I looked back and he and I had nothing else to say to each other based on where each of us was at that moment on that New Jersey night.

He sat and cried, I believe he knew what this was; he wasn’t chasing crazily after the ambulance as someone does when they are groping desperately for hope, he just sat and cried.

He was the father of the unborn child I had learned in that one and half seconds.

I turned back to the wreck and noticed that the headlight was just the dimmest of glows, now a dim orange glow of filament, a penetrating sadness in that thought that the life draining out of the patient was mimicked by the dying light of the headlight in a pile of twisted metal.

The tow truck pulled up as I finished some paperwork, killed the dome light and put it in gear.

“Central…3685, 3600 available” in that quiet radio voice that we practice so that we are calm even when we aren’t.

“….85…. patient is coding…” I remember hearing, again a snapshot of a siren in the background and activity over the carrier waves. I would have replied “…k…” though I don’t remember doing it. At that moment the crew would be performing CPR as the woman’s heart had stopped.

I imagined that the headlight would have gone completely dark just about that time.