Monday, May 11, 2009

Today brings yesterday to mind

Today, in the confinds of my immediate response area, three persons died in different automobile collisions, including a 6 year old little girl.
Now death is not something that I dwell over, or something that I concern myself with. I see death routinely in my choosen career. But still, every time it involves a child, my mind has to stop for a bit. So let me share with you an ambulance call that involved a child.

Its 1845 Christmas Eve 12 years ago. That's right Christmas Eve. And yes, I do remember it. Sometimes, ghosts follow us the rest of our lives. I worked the night shift of a local hospital based ambulance service and our shift change was at 7. We normally went in alittle early to see what has happened that day, what kind of bullshit is going on, and to generally smoke cigs and hang out.

The 911 phone rings for a motor vehicle collison out in the county. Something in the dispatchers voice told us it was going to a bad collision so part of the day shift responded with the night shifts. Before it was over, all of our available units and staff were to b needed on scene.

We start responding and our dispatch contacts us via radio. A deputy on scene was doing CPR and people laying everywhere. unit 2 and 3 were immediately dispatched also. We continued our response, our minds focusing on our job. The normal chatting and conversations that we have ceased. Silence was in our ambulance during that response.

As we approach the scene, I see the broken glass and metal of 2 vehicles as the emergency lights bounced around the scene and bodies laying around. We slowly drive through the scene until we see the deputy bent over a small body, doing CPR. Fuck, this is going to be a real traumatic code. Now, understand that 12 years ago, the medical knowledge of the zero surviability of blunt trauma cardiac arrest was not a common practice of prehospital providers, not like today.

We jump out and immediately take over...unresponsive, apneic, pulseless, asystole on the cardiac monitor. One of my partners immediately started CPR as I prepared and properly inserted an ET tube into the small airway. Then quickly log rolled to a long spine board with C collar placed and secured. Loaded into the unit and gone to the hospital. I started an IO (IV in the bone marrow) enroute and gave the proper vasopressor medications. Dammit, we got a pulse back. Ceased CPR, checked a BP, it was too low, initiated a domapine infusion.

Upon arrival to the hospital, I turned the patient over to the waiting pediatrician who has already called for air medical to regional trauma center in Memphis and helped prepare for the arrival of 5 other critical patients from the 4 other ambulances that went to the scene.

A 17 year old prisoner from Parman Prison on holiday leave got drunk with his friends and struck the family.

I don't remember what the little girl looks like, but I can still hear the mother crying and saying "she hasn't even opened her christmas presents yet", and the family begging for a reason why this happened. We couldn't give her any. I remember my brain being about 5 steps ahead of my hands.


Pediatrics cause us to act differently. We can handle adults dying everyday, getting injured everyday, acting stupid everyday. A child involved; however, causes our hearts to be involved. I have permanent hearing loss from diving after a drowned child in a local spillway. I can remember hearing the mother crying so loudly, begging for us, anyone to help. Clothing removed and dove right in. As I was diving at about 10 feet down, my left eardrum riped open from the pressure. Dammit. I had issues with my eardrum in my childhood and was not suppose to go more than 5 feet in water...but I did anyway...and I would today.

We could go only 12 feet down. The child was 16 feet down, trapped by a limb in the water.

I remember my then live-in girlfriend, now ex-wife getting upset at me for diving for that child. She was trying to remind me of all the things that could have harmed me. I explained that I couldn't help it. The mother's crys for help were too much for me to stand there and do nothing. I can still hear those cries.

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