Crash Course

The crew members in Attack One's passenger compartment have just started to care for their patient.

The 78-year-old gentleman’s chest pain had begun about an hour before his 9-1-1 call, and when the crew arrived they evaluated him quickly in his home before placing him on the cot and heading to the hospital.

The paramedic was concerned that the patient was very pale in appearance, had a history of heart disease and had a number of prior heart procedures done at the region’s heart hospital. Those included receiving two coronary artery stents, which according to the patient had averted a major heart attack. His symptoms at that time were exactly the ones he is having now.

The heart hospital is about an 18-minute transport in the midafternoon hour, and the crew moved quickly to take the patient there, because a 12-lead EKG done in the house showed no acute myocardial infarction, and the paramedic felt she could do the rest of the treatment en route. The patient is feeling more comfortable after a nitroglycerin spray, and the paramedic is opening the narcotic box when…crash! A violent impact on the ambulance’s passenger side lifts its wheels off the ground and sends people and objects flying. The rig spins about 90 degrees to a screeching stop.

The first voice is actually that of the patient, still secure on the stretcher: “Are you guys OK? Are you guys OK?”

The paramedic is on the floor. The EMT is still belted in his seat, battered by a number of objects dislodged in the collision.

The driver of the ambulance is next to pose the question: “Is everyone OK? I don’t know what hit us!”

He reports the accident to the dispatcher, leaps out his door and crawls into the rear compartment through the back doors. The patient is still safely restrained on the stretcher, but the paramedic is down, blood coming from her head. On the bench, the EMT is bleeding from his right arm and looking at a left that is obviously fractured. The paramedic finally lifts her head and asks the patient if he is all right.

The driver uses his radio to report details to dispatch: that the unit was involved in an accident, two crew members and the driver of the car that hit them are injured, and they will need an extrication response to free the occupant of that car.

Moments later the EMS supervisor is on her radio, specifying that five ambulances should be dispatched, as well as an extrication assignment and the on-duty chief. She arrives on the scene minutes later to find the ambulance driver caring for the automobile driver, who is injured and unable to get out of her vehicle. The original cardiac patient is strapped on the stretcher in the ambulance, with the paramedic and EMT sitting together on the bench. Both are injured but want the supervisor to care for the original patient first.

“Please, connect him to a monitor and remove him from the vehicle,” the paramedic requests. “He is still having pain, and I haven’t been able to give him anything yet but some nitroglycerin spray. He needs to go to the heart hospital.” This direction comes despite a large bleeding gash in the paramedic’s forehead and a right arm and left lower leg that are obviously fractured.

The EMT is also in a great deal of pain, with a fractured left arm and other lacerations.

“We’ll get your patient cared for, and you also,” the supervisor says. “You lie down, stay quiet and let me get some equipment to immobilize your injuries.”

Additional crews arrive quickly. Responders stabilize both vehicles, shut down the ambulance’s oxygen tank and batteries, and remove the original patient to the first-arriving ambulance. The arriving fire equipment and personnel stabilize the small car that struck the ambulance and quickly remove the driver’s door to extricate its single occupant, the young woman who was driving. They assess her injuries and find them not immediately life-threatening.