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Choices

The pager goes off, the sound of call to duty. We run for the ambulance and hit the road with the sound of the radio crackling the information of the call that lies ahead. Siren screaming, lights flashing, traffic moving out of the way we head for the highway. The radio dispatcher tells of a multiple vehicle accident just ahead, about 3 miles. We prepare ourselves for the inevitable scene that will confront us. Guts churning, adrenaline pumping, minds racing over protocols of what to do we speed toward the unknown. Merging onto the three lane highway we get our first glimpse of what we are about to be immersed in. Death and destruction lie ahead.

We first come upon a small car with the front end all crashed in, bits and pieces of cars strewn about the road, then realize there is more, much more. Some hundred yards down the highway sits a van sideways and Vega wagon pointing our direction in the middle of the road. We call for more ambulances and see that one of our quick response teams has arrived at the first car, we are waved on down the road to the second site. Arriving there I see one woman lying on the ground next to the van, another inside with a man holding her head. To my right is the Vega. One man still sitting in his seat with seat belt on. Only, the seat is between the door and the front windshield post and he is hanging over the front right fender. His seat had been ripped from the floor with him in it. The door had bowed out from the windshield post due to the impact of his body. He has agonal respiration's (death breathing). The driver is half in and half out the driver door, dead. As the only paramedic on scene my first job is to sort the bodies, rate for who lives and who gets treated first or who gets no treatment. I have to make all decisions, it's my responsibility.

The poor fellow hanging over the fender is to get no treatment as he cannot be salvaged. Life Flight is called, a helicopter coming from some 60 miles away as the crow flies. Other ambulances begin to arrive. My assessment of the woman lying on the ground shows that she has clicks and gurgles under her right clavicle (collar bone). It's clear her diaphragm is ruptured and her bowels have been pushed into her chest. She is immediately loaded into the first available ambulance and transported by ground some 30 miles away to the nearest hospital. I turn my attention to the driver of the van. She is trapped inside, screaming bloody murder, hands and arms waving about, clearly combative. The bystander who is holding her head wants me to take his place. It's clear he wants out of his situation. I tell him to stay put and to continue to hold her head.

My rescue crew arrives and tell them we need a dash lift and full extrication of the lady in the van. Word comes that the police had been trying to catch these two in the Vega from some 40 miles. They were reportedly drunk and driving at high speed, erratic on the highway. Word also comes that the ladies in the van had been to an overnight church function at the coast and their children in a bus farther down the road. Explained all the luggage and sleeping bags in the back.

I looked the scene over once more as I had a second while rescue grabbed the tools for extrication. I saw the tire, rim, axle of the Vega across the road lying in the ditch. In the back of the Vega was a lot of household items, clear they were moving from the valley to the coast. The amazing came into focus. A defrosted corn dog had embedded itself in the back side window of the car, half in, half out still intact! The forces in that car must have been incredible. These observations were made within only a few seconds.

The rescue crew was gathering equipment, another paramedic unit arrived.Thank God for the calvary! I went to the trapped lady and stared an IV. I saw that her face had been badly damaged. Bones around both eyes had been broken, one eye sat deeper in the socket than the other. Her nose was broken, her upper jaw and lower jaw both broken. When she opened her mouth to scream there was a hole going up and one down her throat. She had broken the soft palate and I was looking into the bottom of her sinuses. This poor woman was going to be lucky if she lived.

My rescue team started a dash lift, the second paramedic asked how he could help. I asked him to prepare succinylcholine, a paralytic. Just as the dash was coming off the lady and we were finally going to be able to get her out of the van the helicopter landed. We administered the succinylcholine and pulled her out onto a backboard. As we moved her to the gurney and prepared to intubate her ( place a tube down her windpipe so she could breathe ) the medication took effect. Now she was paralyzed, unable to breathe on her own, unable to blink, unable to move at all. Eyes open and conscious of what is happening she lies there with wide open wild eyes.

A life flight nurse decides to intubate her. We bag her (breathe for her artificially) while the life flight nurse prepares to intubate. She successful and we move her to the awaiting helicopter. Once loaded they take flight headed to the hospital 60 miles away. A sense of relief washes over me and good wishes are extended to the lady. Now there is time to really look at the destruction that lay all around us. Clean up begins.

My ambulance is completely trashed. Nothing is where it belongs. Things are bloody, trash strewn about, equipment moved from the ambulance to somewhere on the scene. My time had been busy with directing people, ambulances, rescue, fire trucks, and yes, even the police. I was responsible for every little thing that was to happen on that scene. The weight can be almost unbearable, yet the task can be so easily accomplished. Letting myself stay calm, think, not get emotionally involved in what is happening and that people's lives depend on me was the key.

We went about our business and cleaned the scene, even washing the blood off the highway. Because I was so separated from the first part of the scene I had found out only later that there were four people in the first car. Injuries were fractures of limbs only. They had been lucky. It appeared that the Vega had lost control, hit the first car left front to left front, spun down the highway and hit the van head-on. It did not hit me until later.

The full impact of what I had seen, what I had done, the choices I made was not felt until later. After this I sorted through my mind my actions. Did I do the right things, could I have done something different, did I make the right call with the guy in the Vega, could I have made a bigger impact on outcome. Way too many questions. Then, the people. What was their outcome? I probably would never know. Little did I know that this was the beginning of a very bad week.

A couple of months had gone by and I had been summoned to court to testify on behalf of the lady in the van. I had found out that she had survived although would look different than she had before. Her companion had also survived. So in the end the only ones that had died were the two in the Vega. Was sad to think that two young men could end their lives in such a way. Driving crazy, drunk, thinking of only themselves, not realizing the other lives they put in danger and ultimately affected. Including the rescuers. I think back on this scene from time to time, such as today. When I do, I can still see everything, smell everything, hear everything that happened.

My life has gone on, I have become stronger over the years because of the life I spent as a paramedic. I have done some very amazing things and have been lucky enough to have made a significant difference in many people's lives. Maybe some day I will tell you the rest of that week. Someday when I can let it go.

Peace to all, love the people in your lives, you never know when your life will change, maybe forever.

Posted by renegade01 on 2009-11-06 16:05:44 | Rating: