28 August 2004
"The Story of Mike and Scott - Part II"
(Before reading this..you must read entry "The Story of Mike and Scott" off of http://journals.aol.com/sekirley/LifeSaver (Stories from my Ambulance) to be able to keep up with what is going on)
There they were. Two small children lying on a stretch of highway with their eyes closed in a fetal position as if they had grabbed a carpet square and went to sleep after watching "the Wiggles" for the fourth time before lunch. Motionless...and barely breathing. Looking at the distance from where I stood to where the pick-up truck stopped at, I am guessing that a double ejection took place.
This was it...this was the real deal. No mock disaster, no "do-over" if we forget something, and most of all, no time to error.
"Hey Scott...what's the damage?" I yelled across the road barely audible with the shifting of the winds and rain filtering my sound.
"This one is DOA, what do you have?" Scott replied cuffing his mouth as to create a megaphone effect.
"I have two critical here plus the driver of the truck. I need you to call for an MCI and tell them to get on their high horses...this storm is gonna give us a run for our money."
An MCI is a Mass Casulty Incident. Basically there is more patients than resources so you need to call in the calvary. Seeing we had one dead, we had a crime scene too although in 20 minutes, the storm was gonna take care of that for us.
Hearing through the shoulder mike on my radio, I can hear Scott call in for extra help.
"Kahuku 1 to dispatch..declaring mass casulty incident at our location. Request...."
The radio went silent.
Ever get that feeling in the pit of your stomach where it warms you from the inside out and you can just feel the tension in your body triple. The nausea and the lack of focus overwhelms you into a state of subconsciousness where you feel like you are standing besides yourself...still helpless?
Color me that color.
Looking over my shoulder, I saw Scott banging on the radio as if were an old TV that needed some "adjustment with a fist" to get the picture back. Then he shot a glare over to me that only meant one thing....
It's John Wayne time...we are on our own.
"Storm knocked the repeaters out. They MAY come back if we get a break in the clouds. Back up is coming..should be here in about 3 minutes depending on road conditions." Scott explained to me.
180 Seconds. For anyone that has ever called the ambulance or currently works in the medical field, you know that three minutes will feel like three weeks. You keep looking around to see when help is coming and when the horizion is clear, you start to panic. You get nervous and frustrated all at the same time. Your sense of time actuality becomes distorted and you feel impending doom....until help arrives....three actual minutes later.
The weather was getting worse, the rain was falling harder, the winds shifted to about 40 MPH (63.48 KM/Hr for all you Canadian readers, eh). We needed to formulate a game plan....we had 10 seconds to do so.
Scott and I decided that it would be best to take care of the children first as their injuries were more life threatening. The driver of the truck was watched over by the first police officer to show on scene. There were three of them and two of us...I hate it when I am down in the odds.
I sent Scott to get the squad and bring it as close as he could to our patients seeing that the less we had to travel for equipment, the better.
As Scott, manuevered the squad effortlessly to our patients, The fire department rolled in to lend a hand...and two turnout coats. Too late, we were soaked. We put on the coats nevertheless to identify us as rescuers in what turned out to be a chaotic scene with many tourist and other motorist rubbernecking to see what had actually occured. Did they stop to help??
Starting our assessments, I took the two year old boy. Scott took the three year old. Dad, who was still in the truck, was being extricated by Fire. The back up unit had arrived and with the chaos and the lack of radio traffic capabilities, never heard them coming. Scott stopped them in mid trek and instructed them to assess the other patient in the car.
Placing our rented jump bag in the middle of the road, Scott and I took turns reaching in and grabbing equipment to prepare to stabilize our patients.
Holding cervical spine control, a firefighter had applied a collar so as not to move the spine. He took over holding the head..I assessed the patient......Oh No!!!!
My patient suffered from a skull fracture, a broken femur, and had blood coming from the mouth. His pupils were unequal and his pulse was getting faint.
I needed that helicopter...I wasn't going to get it.
"Scott, what do you have?" I yelled over the diesel engines and the fury of Mother Nature.
"Bi-lateral tib/fib fracture, flail segment, inward rotation of the right leg. And you?" Scott replied.
"Massive head injury, femur fracture, probably a collasped lung too. We don't go soon, we are gonna be in a world of hurt out here." I said
He agreed...it was time to make like a tree and leave.
Loading the patients into the squad, Scott recruited two firemen from the scene to "drive and dive". One drives the truck to the hospital, the other dives in the back to assist us. Scott also touched base really quick with the other crew who was packaging thier patient up.
Hearing the high idle of the truck shift down, I felt the squad begin to move. It was a race against time now. Scott and I estimated we had about 30 minutes before the patients became unrecoverable....drive time was 45 Minutes...you see the problem???
"Hey man, drive it like you stole it." I yelled up front to the lone firefighter who was driving us to the hospital.
Looking aimlessly on the shelves for equipment, Scott asked what I needed.
"An IO needle would be nice." I caged out in my frustration.
"Here" Scott handed me the needle with that "do you need a hug?" voice.
I took it in disgust..I was staring right at it.
Opening the needle, I measured it and began insertion.
Man, this was NOTHING like what I learned in class.
Nevertheless, I got the fluid to flow without infiltration. Preparing to marvel in my success, I looked to find the other firefigther assisting Scott with stabilizing the chest of the young patient they had.
Sigh...a silent victory.
Feeling the wind push the squad from side to side, I knew that the worse was just about here. I prayed harder than I ever did before.
"Hail Mary, full of grace...." I kept repeating in my head... God, I hoped it worked.
Taking off the coat that now weighted more than I did because of the rain, I re-assessed the vitals of my patient..everything was good...then I heard what was just the icing on my cake.
"Damn it, he's coding" Scott said with a disguntled voice.
I turned around to see a very confused fireman and Scott, hooking up peds adapters on the paddles to shock the patient which had gone into a ventricular fibrilation rhythm.
"Hey, watch this kid!!" Pointing to the patient, I instructed the firefigther.
Switching places with him. I grabbed the intubation equipment and threaded a 4.0 ET tube to place in the patient. Scott placedthe paddles.
"Clear!!!" he yelled looking around making sure no one or nothing was touching.
"Charging 50 joules" He said.
Works for me!!!
I quickly intubated the child while Scott gave the patient some Amiodarone to make sure he didn't do that again.
I wiped the sweat from my face..I almost had to change my pants.
The call went on and we stabilized the patients as best we could. They got no better, but they certainly didn't get any worse.
The fireman driving us was a NASCAR driver in a previous life because the 45 minute ride took 27 minutes...in the storm.
I guess the brakes were overrated.
Transferring care, Scott and I looked like a couple of drowned rats leaving puddles of water wherever we went. A nurse grabbed us and handed us a couple pairs of scrubs to borrow until we got back to the station. I started the reports, Scott went for coffee.
I sure hope he put some Jameson in it.
The next morning, I awoke still feeling saturated from all the water I took in. Opening the blinds and partaking in the beautiful Hawaii morning, a knock on the door, distracted me from my enjoyment of the Pacific island view.
Scott showed up early to take me to breakfast while tossing me the local newspaper.
"Paramedics clutch three from Estelle: One dead, Three injured in storm caused crash."
Ahh..15 minutes of fame....if that fireman is driving our publicity bus, we will only get 12 and 1/2.
Theday was spent touring the convention center and testing product that were new innovations to the EMS field. We sat for a couple lectures, then played hookey escaping early.
What did you expect?? I am Hawaii...and I am gonna live it up while I can.
Scott and I have another rotation in two hours.
I am a glutten for punishment.
Rounding third and heading home,