Saturday, June 13, 2009

A Splash of Blonde

The view from the cab of the truck as we arrived was surreal. We pulled up and found an imported car that had slid sideways into a tree. As it was a few hours after midnight, only a few bystanders were there. The scene was eerily lit in a pale yellow-orange hue from a street light conveniently located by the twisted car.

A young man was seated in the open driver’s seat door, with his head in his hands, his feet on the ground. He looks up as the truck rolls to a stop – it is obvious he isn’t completely there. I don’t yet know where he is, but he isn’t all there. A couple of the bystanders are tending to the young man.

“Dispatch, truck 221 is on scene. We have one car into a tree. T221 will be investigating.”

As I get off the truck, I note that the car had hit the tree pretty hard. The tree is imbedded a couple of feet into the passenger’s side door. It is obvious that speed was an issue here. There are numerous trees within a hundred feet of this scene, most, if not all, have battle scars from other accidents. I have been here a few times before on fatal accidents and I don’t even work in this district.

As I near the young man, I ask him how he is doing. He mumbles something about being shook up. One of the bystanders says that the young man had been seated in the driver’s seat and had been semi-conscious. I make up my mind that this guy is going, even if he doesn’t really want to. I ask him if he has any pain, he tells me no. The other bystander says something like this guy is lucky to be alive. Inside, I agree.

By now, the firefighter has climbed down off of the tiller-box, retrieved the equipment and has arrived at the car. The engineer (driver) has placed his cones and flares and is approaching us as well.

I look into the car and note that there is extreme intrusion into the passenger compartment, the debris that is all of the stuff that people always carry in their car is strewn about in a random manner. There is a splash of blond hair visible from what was once the area between the front seats of the car. Hoping it is a wig, I pull my flashlight out of my turn-out pants pocket to get a better look.

The blond hair belongs to a female, who I later learn is 17 or 18 years old. She is wearing dark clothing and is wedged between the door and the center console. She and the seat are stuffed into a very small space. She is motionless and does not appear to be breathing. Shit.

“Truck 221, engine 221, we just cleared our call, can we assist you?” Talk about good timing.

“E221 that’s affirmative. We have two patients and an extrication problem.” I also ask dispatch for an additional ambulance.

As the only way to access the female at this point is through the driver’s side door, we move the young man to the curb and ask one of the bystanders to stay with him. I get into the car and determine that the female has no pulse and is not breathing. I don’t see any injuries of the type which would enable us as EMTs to determine death. There is no way she is coming out of the car without the use of power tools to remove some of the wreckage from around her.

I tell my crew to set up for an extrication operation while I start to put an extrication plan together. They are going to pull the “jaws” (I know, I am supposed to call ‘em spreaders, but I am old school), the hydraulic rams, some cribbing and as we don’t have an engine company on scene yet, a fire extinguisher.

Severe side impact crashes, especially ones like this, can be very challenging. They are probably my least favorite. Trees and high speed lead to a tremendous amount of energy focused in a small area. Often, as in this case, access is impaired by the tree. The impact energy folds the floor, often trapping the patient’s feet within the folds of the misshapen floor. The use of tools is difficult as there are few if any purchase points to push or pull from. The patient occupies the space where you need to work. These can really suck.

Engine 221 and the first ambulance arrive as my crew is getting the equipment together. I assign the ambulance to the young man and have the engine assist us with the female. The medic approaches me. I tell him what we have and ask him to re-assess our patient. He disappears into the car along with the monitor. He reappears moments later. He shakes his head, letting me know that he can, and has, determined death.

The sense of urgency disappears as now it will be several hours before we remove this young woman from this mangled car.

“Dispatch truck 221”

“Go ahead truck 221”

“Dispatch truck 221, this is a confirmed code Charlie, advise S.O. Also be advised engine 221 will be released in about 5 minutes.”

The young man leaves the scene in the ambulance. He is conscious and has become more oriented. I think about his future, about how he is in for a very rough time. I also think about how a family is going to get a knock on the door in the middle of the night, one that nobody ever wants to get.

I think about how no one mentioned the young lady when we arrived. I guess the driver could have been altered enough where he couldn’t mention her. Maybe the bystanders didn’t know she was there. The pale light did not light up the interior very well and she was wearing dark clothing. I sure didn’t expect to see a splash of blond hair when I looked into the vehicle. That’s why we look I guess.

As this is a fatal accident, a Major Accident Investigation Team (MAIT) will be called out and conduct the investigation. The coroner will be called near the end of the procedure and will take their own set of pictures and document a few things as well. The patient is not coming out of the car without our help, but it is going to be several hours before we are needed. We advise the S.O. sergeant that we will clear the scene and to call us back out when it is time to extricate the body.

We go back to the station. The guys go back to bed while I start on the report. As I know a lot of people will be reading it, I spend a little more time on it. I make sure the incident is well documented and that I don’t come across as the uneducated hick that I am.

Sure enough, two hours later the phone rings, they are ready to remove the body. As much as I hate to see people killed in car crashes, I enjoy the technical aspect of cutting bodies out of cars. It is a great training tool, a chance to try different techniques without sacrificing patient care. There is no urgency and it is as realistic as any training can be. I treat the victims with dignity and view it like organ donation. Something good out of something bad.

This call came back to me last night as I sat in a church sanctuary, watching my son and his friends receiving their high school diplomas. This is the same venue where I met my wife, 29 years ago. I know that my recollection of this incident is kind of a dampener on a joyous occasion. But every year, about this time, the local rag has a headline about some kids balling up a car and not living to tell about it.

This weekend will be filled with parties and other social events for my son and his friends. My son probably thinks I am a worry-wart for telling him to be safe and be careful when he goes out. I can’t help it, even though I know the influence of his friends is growing, while mine is waning.

Good job little buddy, I am proud of you.

Thanks for reading,


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