Thursday, May 19, 2011

Curbside Carnage

There I sat, like a minister of death praying for war listening to the radio, I waited there hoping and wishing for a case. Our air condition had been broken for 2 days now and I sat in our sweltering hot station wallowing in my own juices due to the fact it was over 100 degrees F outside. A dead mosquito and some grains of sand stuck to my skin and all the energy had been sucked out of me. I just needed a case so I could get out of the station.

That case finally came at 430am as I lay there in the dark, hot, sweaty and miserable. I jumped at the oppertunity to get out of the hot station and hit the road. I could hear dispatch calling ambulance after ambulance from several stations across the city all to the very case we where just sent on. Update en route to the scene confirmed there was at least 10 people injured including some that where listed as critical. My partner floored it and we flew down the highway. I started playing things out in my head and trying to prepare myself mentally for possible injuries and scene management issues with a large accident.

Flashing lights, twisted metal, bodies, and a large crowd began to form in the horizon as we approached.  We entered the event horizon of this catastrophe and our unit was directed right into the middle of it. The ussual unruly mob of bystanders and on lookers stood in our way. The fire department who where busy cutting entrapped people out of cars had to help create a gap in the crowed as we slowly drove into the middle of this mess, there was no going back now. Time seemed to slow down and there was an erry silence inside the ambulance despite being surrounded by all this mayhem. I looked outside from our almost sound proof window to see people bleeding laying on the ground all over, people crying and screaming walking around with dirt, sut and blood on there faces.We navigated our way right to the middle and stopped. It was almost like a movie watching it from the inside of our unit. The silence I was experiencing from inside was soon broken the moment I cracked the door. It was like the front door opening to an amphibious landing ship full of soldiers at the beaches of Normandy on D day.

I tuned out all the noise as best I could. I had become accustom to all the chaos around me by now after a year as a self proclaimed flesh mechanic in Riyadh.  I grabbed the trauma bag and off I went. I could see other EMT's and Medics arriving and pouring in behind me to help. The first man I came to was bleeding badly from the head and the bone from his leg was sticking out.  He had been pulled out of the car into the dirt and had broken glass and sand all over him. He was pale, cool,. clammy in shock and had no palpable radial pulse but was breathing. Another U.S. paramedic arrived as I was assessing the first man. I told him to continue triaging the others while I managed this guy.
 I ensured his airyway was clear and we placed a large bulky dressing over his  bleed. I got some of the EMT's to help me place a neck collar on him,  and package him up on a backboard with some oxygen. Another EMT worked on his broken leg. We started a large IV whilst this was going on and checked for any other injuries. The guy looked like crap and I was not sure if he was going to make it. but there where so many others and there was not much more I could do for him. Time was of the essence.  I left him with the EMT's and another Paramedic once he was ready for transport and went to check on the others. A man came up to me with a broken arm begging for help but I had to tell him to wait with other "walking wounded" until we gathered all the people who where unable to walk and critical. I wanted to make sure we did not miss anyone in this mess.

Like a dysfunctional easter egg hunt I went searching through the vehicles, debris, pieces of flesh, groups of rescue workers and crowd for the injured. We had more than enough resources at the scene now including some doctors and I just wanted to ensure all the critical patients on the scene had been found, stabilized, and transported before we left. I loaded up the last  patient that was unable to walk my partner had found. He was showing early signs of shock and had been hit by a car as a pedestrian. I jumped in the ambulance with him and our journey to the hospital began. He got a full work up and was treated for shock. His condition improved en route and he was successfully delivered to a hospital further away from the accident to scene to help distribute the large volume of patients across multiple facility's. Its important to do this during large accidents so one hospital does not become over whelmed and under staffed. I think our guy will be fine.

I found out later what happened. Apparently only 1 or 2 vehicles had a car accident and the people where transported by ambulance with no problems. However there was such a large crowd of bystanders and onlookers that had stopped to check things out or ran over to help that oncoming traffic hit a group of the bystanders and also caused a car pile up. 

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