Well, I suppose I was due. I hadn't been on a nasty wreck in a long time. It just doesn't happen in my district very often. So, of course, this happened when I was working a mandatory overtime. And even at that the rig I was on was covering in at a different station so I was out of place twice.
The call came in for an auto accident at an intersection quite a ways down a two lane road that led into a neighboring jurisdiction. It was reported that someone was trapped in a vehicle. It took a little while driving until we found the wreck.
As I pulled up to the scene we could see a chp officer yanking on the damaged drivers side door of one of the vehicles trying to get it to open. It appeared that one driver had drifted over the line while coming around a bend on this two lane road and had run head on into the other car.
With CHP and bystander vehicles stopped in this small space we couldn't really get a good view of the other car or the true extent of the damage. We got out and my firefighter started to grab the extrication tools so we could free the one trapped victim we did know about and of course stop the CHP officer from continuing to rock and shake the vehicle with the injured driver in it regardless of his good intention.
As I came around the back of the engine I was met by a man who was holding a bloodied and dazed two year old girl in his arms. An ambulance medic was holding manual C-spine and a firefighter from the neighboring jurisdiction was walking beside them. Despite the fact that the girl did not look in good shape I was encouraged by the fact that apparently an ambulance and another fire engine were already on scene. Although if I had really thought about it I would have wondered why the girl wasn't being taken to the ambulance and instead was being carried to us at the back of my engine. But I was a little more focused on what we were going to do for this kid.
I was told that she was in a car seat in the rear of the vehicle but that was all we knew. She had a bloody nose and mouth, unequal and non reactive pupils, was staring blankly ahead, and was unresponsive to anything we did. We set up to suction her mouth and found her jaw clenched down tight as well. None of these are good signs. The kid obviously had a pretty major head injury.
To add to the confusion, the man was just a bystander and not involved in the accident at all. So....why was he holding someone else's kid? And where was the parent or driver?
Turns out that the ambulance medic holding c-spine was just coming off duty in his own car and still in uniform when he encountered the accident and stopped to help. The other firefighter on scene had the same story so we actually didn't have any other help on scene. Just then however, Truck 15 arrived and went to work on the extrication which was pretty
simple actually. Our first ambulance arrived right after that.
We knew this kid was critical and one of us would be riding into the hospital with the ambulance. My firefighter was also a medic and not a driver so he agreed to go with the ambulance. Fortunately for us the off duty ambulance medic said he would go ahead and ride in with her which left us free to help with other patients on scene. He left his keys with us and when all was said and done we drove his car back to the station with us so he could pick it up there.
Once the girl was loaded and secured on the ambulance and they had taken off I turned my attention to the rest of the scene as our second ambulance arrived. The truck crew had the drivers door off already and the patient assessed - multiple fractures at least but alert, oriented, and pretty calm considering. They were waiting for the ambulance before they took her out of the vehicle so their engineer and firefighter had moved on to the third patient.
This was the driver of the first car and presumably the mother of the kid. She was laying on the ground and the crew, with assistance from yet another off duty hcp (a nurse), were cutting her clothes off and getting ready to secure her to a backboard. I helped them get her in full c-spine precautions and loaded up for the third ambulance when it arrived. I also got an IV established with the nurse handing me tape and other supplies as I worked.
It's awfully nice to have professional help you can actually count on helping out on scene. This call could really have gone sideways if the patients were flipping out and there was no help around and if our other resources hadn't arrived as quickly as they did.
As it was, the husband and father of our two patients arrived on scene and he was understandably pretty worked up. I ended up with the job of filling him in on what was happening with his wife and daughter and keeping him calm. He was collected enough to understand and devise a plan for where to go and how to get there safely. Tough spot considering his wife was going to one hospital and his daughter to another. Where do you go first? We got him sorted out and calm, all patients off to hospitals with their ambulances, bystanders and helpers thanked, the cars moved, the road reopened, and were able to return to quarters.
Still...there was the girl. It's part of the job of course and, all in all, the rest of the call went very well and smoothly but it does suck when you just know a patient is going to have a bad outcome. When the medic came back to pick up his car he said they had to divert to a closer hospital because they couldn't secure her airway due to her jaw being clenched shut. A doctor got on the ambulance and got the girl was intubated using sedation to loosen her jaw and allow for tube placement. They were then able to continue on to a children's trauma hospital.
It's rare that we get any follow up on our patients nowadays with tighter HIPPA laws and all, but a month or so later I worked with that firefighter again and he said he ran into the ambulance crew and they had just learned that the girl left the hospital with no deficits and neurologically intact. She had some seizures in the hospital and may continue to have them periodically throughout her life but she has no permanent or debilitating brain damage.
This really blew me away as I hadn't expected to hear anything like that or even to get any news of this patients outcome. I was quite surprised but definitely relieved. It's nice to get good news now and again.
