JAWS of life not needed?

Wow, I knew it had been a while since I updated, but I didn't realize just how long it's been. Life's been hectic as usual, and my mind has been in other places and on other things. Life at work has become, well, let's just say it's been more like a job lately.

I went on a training ride a few days ago with the bike team, 10 miles later I could barely walk straight. There's another ride in a couple days, if I can get out of the station for a few hours I'll go. Our big training class is less than 2 weeks away, we'll learn how to ride up and down stairs, jump curbs, weave through pedestrian traffic, and whatever else they decide to cram into our minds.

I ran a pretty bad MVC since the last journal update. I wasn't even dispatched to the call originally. We were finishing up paperwork at a minor MVC when we saw 3 or 4 police cars hauling ass from the precinct towards our station. A few minutes later we went in service and decided to roll on past the station to see if we could find what was going on. My partner called the batallion chief and let him know we had a visual on the scene and would go ahead and respond.

Coming down the street, we saw 2 cars, 2 fire trucks, and 5-6 cop cars. The drivers of both cars were still inside their vehicles, this is 10 minutes after the first unit went onscene. Since we had a third-rider, her and my partner went to the sedan, and I took the SUV.

First of all, the SUV was flipped onto the driver's side, it was also facing the exact same direction as the other car. One of the guys from my station was in the SUV and the patient was standing on her door with her torso between the front seats, looking straight at us. He needed something to cover her with so I grabbed the fire blanket off my truck and brought it to him. By this time, the other rescue was onscene so I went and set up a couple bags of ringers for him. ***Lactated Ringer's is similar to Saline, but is much better for a trauma patient***

Heading to join my partners, I realized this was going to be difficult and take some time. The patient was pinned between the seat and the steering wheel (which was broken), the front tire was pushed so far back, it was nearly under her. To top it all off, you could clearly see the passenger-side airbag had deployed, but not the driver's...My guess is that she was pinned onto the steering wheel faster than the air-bag could deploy.

Looking quickly around, I see my partner hand his turnout coat and helmet to our rider so she could safely hold c-spine from the backseat of the car. It made me think, and I went and got my coat also (I already had my helmet on). Since they managed to get her door open, I ended up using my leg to brace the woman into the car while the Quint crew prepared to start the extrication.

My partner was beside me looking to start an IV and looked up at our captain who was just standing there, "Capt, we need to fly her."

"Uh, well, umm, I don't think so, umm, no."

????????????????????????????????????  The main criteria that would call for a helicopter is prolonged extrication of 15 minutes or more. They were onscene 10 minutes when we got there...WHAT (if anything) are you ThInKiNg?!?!?!? It didn't help any that the patient was somewhat combative.

Turning to the Quint's captain (who is hard to convince that the sky's blue) we asked him, "Do we need a bird? Tell him we need a bird."

He looked straight at our capt "She needs a bird."

Once the batallion chief got onscene, he originally said no bird, barely 5 minutes later he changed his mind. Of course, now the weather has supposedly grounded the helicopters.

Back to the extrication process.... Once everything was set up, the posts were cut and the roof of the car rolled back. Since our rider was not an employee and was not trained in rescue and extrication, I took her place in the back seat. The next step was to roll the dash off the woman and get her out. This was easier said than done. The car was crushed around her and placing the ram where it wouldn't slip was difficult. A few minutes later, the dash was rolled and the woman removed to a backboard.

Once inside the rescue unit, it was an absolute flurry of activity. All her clothes were removed, an IV established (she removed the one that was started in the car), broken bones splinted, and a 3-lead ECG. What showed up on the ECG was amazing. Her ST segment was depressed, indicating she was having an MI or heart attack. Now we've really upped the anty.

She continued to be somewhat combative enroute to the hospital. Since we never did get the helicopter, she got a very quick ride...What we like to joke about as a diesel drip.

At the hospital, we passed her off to the ER staff and would decon the ambulance for a few minutes, then go see how she was doing. The first thing they did was knock her out and get her intubated. At one point when we went inside, her X-rays were back. She had broken her left wrist, right ankle and femur, dislocated her right hip to the rear, and shattered her pelvis in at least 4 places. Moments later, she coded. The hospital staff worked her for 30 minutes before pronouncing her.

It may not have made a difference if she would have been flown in vs. ground transport, but she would've been at the hospital about 12 minutes sooner. From first dispatch to extrication, it took around 35 minutes to get the woman out of her car. Over double the standard based in our protocol that would require a helicopter. All I can do is pray for her family and hope that things will go better next time a call like this comes out.

Take care....

 

Oh, and after this call, it is cemented into my mind that my captain is 100% incompetent as a paramedic. I would not want him to touch me if anything ever happened to me, no matter how severe.