Skating to Patients

     It had snowed all afternoon, but nothing much happened -- just a few illness calls. Big, wet flakes that melted on the road surfaces but turned the grass a nice shade of white. At about 1600 hours the sky cleared, the sun came out, and the temperature began to drop as the cold front came in. The Attack One crew is watching a beautiful sunset from the station as the Saturday evening meal is prepared.

     As darkness falls, though, the station scanner starts to chirp. Crash, fall, crash, fall, more crashes. The local helicopter service is requested for the first crash dispatched, in the service area just east of Attack One's district. What is going on? Dinner is being pulled out when the tones for Attack One come through the radio: "Attack One, respond on a multiple-vehicle collision with a trap." The site is a bridge about two blocks from the station.

     As Attack One approaches, a police officer waves it to a stop. "Don't even try to drive on the bridge," he says. "It's solid ice, and you won't be able to stop. Leave the vehicle here, and walk along the railing to hold on."

     The police officer's car is a short distance away, where he slid into the railing himself. There isn't a car on the bridge that's sitting straight in a lane. Three are crashed on the middle of the bridge. One minor trap, although the vehicles are heavily damaged. The young woman has multiple leg fractures, but is able to talk with the crew. Four other people are injured, but seat belts and passive restraint systems have prevented serious injuries. The most verbal patient is a young man screaming in pain from a badly dislocated elbow. He wasn't in one of the cars that wrecked, but was walking from his vehicle to help when he fell and injured his arm.

     The difficult issue: Basically, no one can stand safely on the bridge without holding on to something. The Attack One crew essentially "skates" their way to the vehicles and victims. They slide their equipment on the ice to avoid having to carry it. The ice has formed from the melting of the afternoon snow and an instant freeze when the sun set. It's "black ice," the slick, almost-invisible coating that's always so dangerous. The bridge is covered with it, although the surface streets between the station and bridge are almost completely clear. The drivers involved in the accident, like the first-arriving police officer, had no idea what was happening on the road until they were sliding out of control.

     The rescue unit arrives but can't make it safely onto the bridge. Extrication equipment has to be pushed to the vehicles. And the police officer has more bad news: There will be no salt trucks for at least an hour. The road crews had no idea problems were coming, and had not prepared people or vehicles. Then dispatch relays another downer: There are so many accidents and falls, only two transport ambulances in the entire mutual aid region can be found to respond. And the accident reports keep coming in.

     The scene is manageable. The victims are relatively stable, and no fire risks are present. Extrication will be complete in about five minutes. One of the Attack One crew members has triaged the other patients and arranged appropriate packaging while the transport units are en route. Another has had everyone on the bridge either sit down or hold on to something to avoid more injuries.

     But the radio is crackling: "Bridge Command, can you please speak with CareFlight?" This is the helicopter service that was dispatched to the previous accident the crew was listening to at the station.

     "CareFlight to Command, can you please update me on your patients?"

     Command gives a brief description of the scene and patients.