Crash Course.

Things had been fairly slow over the last 2 nights until about 2:30 on Saturday morning, when our radio chirped up dispatching us to a motor vehicle accident.

"Patient's head is pinned beneath the vehicle."

Trust me, whatever you're thinking right now is exactly what I was thinking when I heard it. I was expecting another fender bender until then. We arrived on the type of scene that I had been waiting for. As students, the type of scene we dream about. It was a rural road, almost in the middle of nowhere. No street lights, so the the only illumination when we arrived were the fire truck spotlights aimed at the car and the flashing lights from every other vehicle. I could hardly hear anything over the engines and the spot lights were blinding.

The first thing I noticed is that there was no car on the road. Everyone seemed to be peering over the guardrail down a steep embankment at the edge of the forest. As I walked over I couldn't help but watch the lights flash by against the trees. All I could see was white, red, white, red, etc. moving from right to left, with my shadow jumping from side to side.

I looked over the side to see the bottom of a car facing back up at the road. The top had been almost totally flattened and the car was resting against a tree on an angle with the passenger windows flat on the ground. The passenger's head was sort of outside the car pinned under the beam between the front and read windows (the "B" post), drifting in and out of consciousness. Alive, though.

A closer ambulance had taken over there, and we let the firefighters do their thing. They began cutting, so we tracked down the driver. Amazingly, he had just a small cut on his head. He had left the vehicle himself and found help. He knew he was in big trouble, and kept asking about his friend. Those are hard questions to answer. When you know he is trapped beneath a car, struggling to breathe. Just tell him "I don't know, someone else is working on it". Not the most reassuring words, but what else can you say without scaring him even more, or lying and saying he's doing just fine? One thing about this job is that you have to choose your words very carefully.

**********************

Shortly after we cleared from that call, another accident.

Downtown, a lady had come down the hill and t-boned a car full of teens. The side of their car was punched in a good 6 inches, but it was the the lady in her SUV that was of concern. She was quite scared an anxious, crying an complaining of pain in her neck. My preceptor held her head steady while I looked her over. She'd occasionally tell me she couldn't feel her hands, arms, or whatever, and then change her mind. She was just scared but we took all precautions.

The plan was to lift her up to get the edge of the spine board underneath and then spin her onto her back. I was at the driver's side door, with a firefighter in the passenger seat. We had one of the belts from out board to slide under her thighs and buttocks to lift her up. Now, this lady was not exactly tiny. Quite the opposite. As I wrapped the belt around my wrist to get a good grip, I heard one of the firemen behind me say to his partner, "I don't think he's strong enough". I turned around and looked him in the eye (he realized I'd heard him) as we counted to three and lifted her straight off her seat as they slid the board under her. He didn't say a word to me afterward.

I had a difficult time accepting how much control I have at a scene. With an injured patient, police and firefighters will look to me for instructions. My preceptor jokingly told me that the firefighters will do anything the attending medic says: "Scratch your back, rub your shoulders, massage your scalp...", okay I get the idea. It's a crash lesson in assertiveness that's hard to learn when you're not sure if you're even doing things right. A medic I was with the other day sent me in first to a chest pain call and as he entered, sat in the largest chair he could find in the lady's living room, legs crossed, arms on the arm rests, looking like a king on his throne and just watched me. I'm glad he did. It's the best way to learn. I don't even ask questions on a call anymore because I know exactly what they'll say: "What do you think?". I know they won't let me kill anyone. I just do what I've learned.

I enjoy being the one others look to on these calls, when I know what to do. I'll have to avoid power trips and try not to abuse it. I can't see me doing that anyway. Just to cover myself though, to you firefighters out there, if we're ever working a call together and I tell you to massage my shoulders, I'm (probably) joking.

-AM

because we separate like ripples on a blank shore