Collateral Patient Care

When you are working a medical incident, does your team take care of all the patients or just those with visible wounds, obvious symptoms, and the loudest complaints? Do you take a moment to look around? What about that loving spouse peering over your shoulder? What about that the less than obvious survivor hanging back just beyond the edge of the action? Over the years our volunteer EMTs have become proficient at comforting loved ones. We have individuals who know just when to counsel the elderly woman who just watched us unsuccessfully perform CPR on her husband of sixty years. Even though this is not a popular duty, it is one that is undertaken with compassion and professionalism.

Earlier this year, after reading Ray Giunta's God @ Ground Zero which chronicles the activities of "Chaplain Ray" working at Ground Zero following the 911 terrorist attacks, my eyes were opened to other victims. Chaplain Ray worked with numerous firefighters and police officers who experienced survivor's guilt as they witnessed hundreds of their comrades dying in service to their fellow man.

"Why am I alive?" was the question that haunted many of these heroes. Tragically, these walking wounded were not counted among the victims of those barbarous attacks. Like the physical victims of the terrorist attacks, these emotional casualties were not limited to rescuers; many every day citizens felt the same remorse. These were office workers who survived. Some were rescued, some got out on their own, some were just out of the office for the day, and some were just casual bystanders witnessing horrific events. I was moved by the immense emotional pain these people bore and how the author and others were able to bring peace and serenity to many shattered souls.

I began to ask myself how this might apply in our small rural volunteer fire district. We have a pretty good support system for our members including a regional Critical Incident Stress Debriefing, but there is little support for those suffering from collateral damage.

Ready or not, the answer was less than 24 hours away. I was home early from work the next day when my pager sounded. The call was an amputation at the boat launch on our local lake. Since the patient was about a mile from my house I preceded directly to the scene. While en route I asked our dispatcher to launch the medevac helicopter since we were more than 20 miles from the trauma center and it was rush hour. I was distressed to discover that the air ambulance was grounded as a result of an impending storm which was due to arrive at our location within the hour. Let's take stock: I am arriving on scene as the sole EMT, the most rapid means of transportation has been taken away, a major thunderstorm was looming over the horizon and I had a patient with a missing limb. I thought I would be the one needing comforting.

As I arrived, a very anxious deputy directed me toward a ski boat. His demeanor was my first clue that the situation was dire; usually these deputies are cool as a cucumber. Climbing into the boat I discovered a twenty-five year old woman sitting in a pool of blood with her arm severed at the elbow. Needless to say, she and everyone around her were very traumatized. This vibrant young woman had taken on the appearance of a small, wet, and bedraggled child. Although I have been witness to numerous traumas, this was my first amputation.

I worked quickly to stem the bleeding and reassure the patient. As I would later realize the role of comforter was just as crucial as the medical care I rendered. She was a young mother whose life had changed forever. Would she ever be able to cradle her children? Would her marriage survive? As we later discovered her husband was apparently at fault for this terrible accident.