Single MVA

21032011Alpha
Squad 1
RA-1
BLS-1
BLS-2
ES-1

*Hearing the call I leave the meeting room at Headquarters take the elevator code blue to the first floor. Briskly walking to the garage entry room, I take my scene jacket with the vest on it out, and grab my hat as well, before going outside to a reserved ERT only parking spot on the side of the building, turning on my lights, R/W and pulling out the front gate*
"ES-1 COPA, Enroute code 2 to scene, advise of information, will assume EMS command when on scene."

________________________-

*On scene I pull up before anyone else, and flick on my hi visibility lights to try and catch traffic's attention*
"ES1 COPA I'm on scene, establishing EMS command checking victims"
*Hearing the sirens in the distance approaching, I decide to check out the break victim first*
'Hi, I'm Jason Riles, I'm a medical supervisor with the ERT, You've gotten in a car accident, right? What's wrong?'
'My arm'
'Lemme take a look'
*After a quick exam, I can almost certainly call a break*
"BLS team, be advised, we've got a possible arm break, lotta swelling, advising ETC to prepare for vic"
'Alright, let's get your name, the ambulance will be here shortly'
'John Landward, I live right there, 48, alone. No meds.'
'Wow, you've done this before?'
'I live here, it's part of my life, I've been shot, stabbed, and wrose. This is bad, but not the worst... Hey you got any drugs?'
'No, I can give you a tylonal, nothing more'
He rejects the offer

"RA-1 is out, 52 Phoxlind."

*I turn off the siren, and pull the truck ahead of the accident. I press a button to turn on the rear scene lights, I press the Anti-Theft button, clip the keys to a belt loop and step out.*

*I go around to one cabinet, get the jumpbag out and pull the strap over my shoulder, I go to another cabinet, get a backboard, and put it down against the ambulance. I walk over to two people on the sidewalk.*

'You guys have a seat for now, I have to check on the victim in the car. Just sit back ont eh sidewalk since the road is still open for now'

*I walk over to the entrapped victim*

I come roaring up onscene with the sirens. I stop quick behind the car accident, throw the car in park, and shut my siren off. I then hop out and run over to the car. I then also turn on my portable and radio in to COPA.

"SUP2, I am onscene, one medic unit is onscene. Still standing by for fire. Vehicle is off the roadway into a pole."

"Basic 1 is on scene"

*I turn off the siren and pull off of the road*

"Basic 1 to Basic-2 and ES-1: We will take the patient who lost conciousness"

*I say as I step out of the truck and head to the patient holding her head*

"Understood, Riles updated he's got the arm break while you're waiting for BLS-2. If you need medic assistance and RA is busy, he's about as trained as they get without a D-R in front of their name."
"SUP-2, can you keep an eye on traffic?"

I walk to my car and grab the flares out of the back and go light some and put them in the road. I then start directing traffic will EMS is starting to deal with the patients.

"HEY! If you guys need me, just yell for me!"

"Affirm, I'll direct traffic."

"Basic 1 Copies"

*As I approach the patient I identify myself*

'Hello Ma'am i'm Dave and i'm and EMT with ERT'

'Whats your name?'

'My name is Sarah Clancy'

'Ok, Ms. Clancy can you tell me what happened?'

'I just remembered my head hitting something and then I blacked out'

'Ok ma'am were you wearing your seat belt?

'No, I wasn't'

'Ok, what were going to do is put a Cervical collar on you for a precaution for any possible neck injuries'

'Alright'

*I then place the C-collar on the patient and get the cot out of the back of the rig and secure the patient to it*

'How are you doing, still doing ok?'

'Yes i'm fine. Just a little scared'

'Well don't worry your in good hands with ERT'

*We then put the patient in the back of the truck and I get a set of vitals*

'BP: 110/70 P:85 Resp: 22'

*I arrive on-scene, pulling the truck over to the side of the road. I grab my jump kit and send Chet to get a backboard, going for the break victim.*

"Dispatch, we're on-scene."

'Are you having any trouble breathing?'

'No'

'Ok, i'm gonna start the PCR and then we should be on our way in just a few'

'Sounds good'

'What is your DOB?

'5/1/90'

'Do you have any Medical conditions?'

'No'

'Are you on any current medications: Prescribed or over the counter?'

'I'm on birth control'

'Ok, what brand?'

'Enovid'

'Ok, do you have any allergies?'

'Yes peanuts'

'Ok, well just sit tight and we will be leaving in just a bit'

*I then step outside and walk over to where Riles is*

'Hey Riles, lady who blacked out wasn't wearing a seat belt. So she may have either hit the airbag, or another object in the car.'

'She seems pretty stable at the moment, vitals are a tad unusual, but i'm watching them.'

'Do you need us for anything else before we take off toward the hospital?'

*I glove up as I get out of the truck. I walk over to the entraped patient.*
'Doug grab the collar bag and a long spine board.'
"RA-1 to ES-1, once you transfer care to BLS 2 can we use you to assist in the extrication of this patient."
*I reach the patient and see that he is the restrained driver. I notice marks on his neck that look like he was hit there by the seat belt.*
'Sir, my name is Cory, Im a paramedic with ERT FD, how are you feeling?.'
*He only groans.*
'Ok sir, Im going to get in behind you and grab your neck, whatever you do, don't move your head or neck, ok?'
"Hutchison to McGuire, once you have that collar come and take C-spine from me."

"RA-1 that would be Basic-2"

*I say as see Reilly walking up*

(Riles is handing off the broken arm to BLS-2)
*While Im waiting for Doug, I feel what I can of the head and neck. I feel what I think is a fracture of the mandible. I reach for a pluse and feel a rapid, weak pluse.*
"RA-1 to Squad 1 we have a possible shock patient with a possible broken mandible. Once you get on scene we need the door off the drivers side and the roof off of this vehicle."

(I think were on the same page, I just saw where you put Basic 1 and wanted to make sure I didn't typo somewhere)

*I look at the car, and hear Hutchison call out a possible broken mandible and then look at Riles*

'Well, that defiently has to hurt.'

*The team from BLS-2 walk over, and I transfer care to them of my patient.*
"ES1 COPA, we've got teams working on every victim now, do we have anyone ready for receiving at the ETC or ER?"
'RA-1, still need my help over there?'

"ES1 come on over if you would and grab your drug kit. I need a line in this guy. Only access to front of patient compartment is passenger's side. We have a console in the way of getting him out that way."
*I see doug get back over and I trade off C-Spine with him. I hear the patient make one more groan and then...nothing.*
"RA-1 to ES-1 wh have a respritory arrest."
*I walk with purpose over to the RA and grab the airway kit, the Trauma bag, and the EKG. When I get back to the patient, I hand the BVM to Doug while I get the intubation equipment ready.*
'Doug, lets go ahead and lay his seat completely back, so that we can easily controll the Airway and C-spine.'
*Once the patient is laid back, I insert the laryngoscope, pull the tounge out of the way by using the up and left technique. I visualize the vocal cords and pass the tube. I check for proper tube placement by listening for breath sounds over all fields of the chest and the epigastrim. I hear bilateral lung sounds. I secure the tube and Doug continues baging.*

*I pull the squad to the side of the road near the accident.*
"Squad 1 onscene."
*I break the Q, turn off some of the lights, and get out. Then I put on my jacket and helmet. Then I head to the side of the squad and get out the jaws of life, a backboard, and some other things to prepare for extrication.*
'Alright Raven, what's the plan?'

As Davis stops the Squad, I hop out and put my helmet on.
I help davis and get a C-Collar out of the squad.

'Ready when you guys are'

I'm directing traffic and then I hear that CE1 is in a foot pursuit. Then seconds later I see 2 state police cars go roaring by code 3.

"Damn accident!"

I just think to myself of a way of being able to respond but have no idea how I can get out of this. Then a PPD car pulls up onscene.

"SUP2 to COPA, a PPD unit is onscene saying he will take over traffic control and the accident. May I clear to assist CE1?"

"RA-1 to S-1 I have a patient in respritory arrest here. I need immediate extrication. The roof is bowed in and Drivers side door jammed. We need them removed. We have the pt. in c-spine controll and are breathing for the patient at this time. BREAK to ES-1, Sir I have an airway placed and am looking for an IV now so you are not need over here at this time, unless you would like to assist me."
*I find the AC and sink a 14 ga. I se flash and I set the .9 NS up at a TKO. I hook the patient up to the monitor and see sinus tach at a rate of 140. I feel for a pulse and find a coresponding pluse.*
'Doug stop ventilations for a moment.'
*Doug stops and I look at the chest, I see a few gasping breaths.*
'Ok Doug, keep ventilating, I'll push some versed and and etomidate so that he doesn't get up the strength to start pulling at the tube.'
*I grabe the prefills of both the versed and etomidate and push them.*
"RA-1 to ES-1 we have some gasping respriations, and are assisting ventilations. Patient still has no gag reflex. Once the squad gets him out we'll be transporting."

"Go Sup2" (From now on, when you take a call, don't ask to leave it please and thank you)

*After walking back to the truck I look at the patient*

'Are you still doing ok?'

'Yeah, just have this headache'

'Ok, once we get to the hospital they will give you something for it'

*I say as I tell Richardson were ready to go*

"Basic 1 is entroute hospital nonemergent"

*As we are driving down the road, I change the channel on the radio to the hospital channel*

"Basic 1 to EDC"

"Go ahead One"

"Good evening, this is Lafferty and Richardson on Basic 1. We are enroute non-emergent, with a 20 y/o female c/c of a headache. Upon examination did note a small contusion on the forehead. Patient was the passenger in car involved in an MVA, patient was not wearing seatbelt. Upon arrival patient was out of the car walking around, placed patient in C-collar and transported. Vitals are: BP: 110/70 P:85 Resp: 20/regular. Patient stated she is on Birth Control pills. We have about a 5 minute ETA, do you have any further questions or orders?"

"Negative One see you when you arrive, EDC Out"

"Affirm, Basic One out"

*After another five minutes we back into EDC and walk in to deliver our patient.*

*After finishing our paper work, I advise dispatch*

"Basic 1 is back available, enroute quaters"

*I kneel beside the patient*
"Hello, lad, I'm Angus, an EMT with the ERT. Can I get your name, address, and any complaints?"

"John Landward. 48 . The supervisor said my arm was broken. And I've got some cuts on my palms and forearms from when I tried to keep from hitting my head on the sidewalk. I got thrown off my bike."

"You got hit by the car and thrown?"

"Kinda. The car hit my bike, and my arm got caught between the pole and my body and it broke."

*I quickly bandage his wounds and splint his arm.*

"Chet, hold him in C-spine while I get a C-collar."

"Okay."

*Chet places the patient in C-spine while I go to the truck. I get a C-collar and the stretcher, taking it back to the patient.*

"Okay, I'm going to put this C-collar on you, then we'll put you on the backboard and on then on the stretcher. Got it?"

"Got it."

*I apply the C-collar.*

"Okay, now I need you to lie down on this backboard, please."

*The patient complys and lies down on the board. I strap him down, ensuring that he is fully immobilized.*

"Okay, Chet, let's get him on the stretcher. You get his head, I'll get the feet."

*I move to the patient's feet as Chet moves to his head.*

"One....two.....three...lift."

*Chet and I lift the patient onto the stretcher.*

"Okay, let's get him back to the unit and transport."

*Chet and I wheel the stretcehr to the unit and load him up, me climbing into the back while Chet gets in the driver's seat.*

I activate my radio.

"BLS-2 Dispatch, be advised we are en route to the ER non-emergent."

"Let's go, Chet."

*We leave.*

*I keep doing the ventilation's*

'Cory, I can't reach my radio, so get somebody to grab the stretcher and the backboard, should be laying again the side of our truck'

*'Anytime now would be perfect, Squad 1' I think to myself*

"Understood BLS-2, do not return to scene, clear and return to quarters"

'McGuire, when you get him out, let me know, I'll help you get him ready for transport, then go with you to the hospital as an escort'
"ES1 COPA, I'll be leading RA-1 to ETC when theyt're ready to go"

((Sorry guys, just been way to busy to think about this. Fell asleep last night durring it.))

"Davis windscreen cutter, Jansen let's grab the jaws." I say and put on my gloves and open the locker doors.

'Got it Lt!' I say as I start up the generator and get the jaws.

'Ready when you are Davis'

'Alright, thanks Riles. Fore now just get the stretcher and backboard, I already have a backboard out, it will be laying against the side of the truck'

*I see Davis and Jansen moving in to cut the car*

*I walk over to the RA and get the stretcher out, place the backboard on it, and roll it over, dropping it to the low level, while leaving it off to the side of the wreck. It looks like the boys are getting some work done on the car now, hopefully our driver will survive, he looks pretty beaten*
'Lemme know when he's out guys, I've got my jumpbag here, see if we can't stop the bleeding and clean him up a bit first, before loading him inside. First priority though if he isn't bleeding heavily is immobilization'

'Alright copy. I got the windshield.'
*I get out a windshield cutter and begin to cut around the windshield. Then I pull down the visor on my helmet to protect me from any glass.*

'Let's cut it open' I say as I pull down my visor.

I start the jaws and start opening the door with it, after a few times the door opens and I put down the jaws. Then I take a look at the vic.

'McGuire! You think you gen get him out trough the door or do you want we to take the roof of?'

*I look around the car and look outside thinking of the best way to get him out*

'Well, we are going to need to get him onto the backboard. I think we could probably get him through he door just have a few guys outside and a few inside the car to get him on it. What do you think Cory?'

'I was thinking that since we have the seat lying down already, lets just roll him towards you get the board under him, roll him on to the board and lift him right out on to the cot. Sound good to you. And that would me removing the rear door on this side, the roof and the "B" post.'
*I look towards Riles, as if anticipating him to chime in.*

'Sounds good to me.'

*I turn to Riles*

'Anything to add?'

'Jansen go ahead and remove the rear door, the roof and the B post for us.'
*I look around and notice that no one threw a fire blanket over the patient to protect him from the cutting.*
'Wait, Jansen let me get the patient some cover before you start cutting again.'
*I head over to the RA and grab the fire blanket. I get back to the patient and lay the blanket over him and Doug to protect them.*
'Ok Jansen, go ahead and cut.'

'Got it Cory'

I start removing the rear door, the roof and the B post, just like cory said.
After a few moments it's done. They should be able to get him out now, I think to myself, while putting down the extrcation equipment.

'Okay, lets get him out!'

'OK Jansen go over to the other side, in the front seat and be read to roll. Davis, get on the trunk and grab c-spine from Doug.'
*I wait for them to get into position.*
'Ok, now when we count off we roll the patient towards Doug and Jansen stop when he is at a 90 degree angle. Then, I'll slide the board under him, we go over towards Doug and Jansen another 45 degrees. Then I'll slide the board the rest of the way under and we roll him back on the board. Got it?'
*I see nods of acknowledgement, then Davis counts off and we move the patient, I get the board under him. We move him again and I get the board all the way under him. Then we move him bak on to the board. I grab the head blocks, as Doug and Jansen strap him down. Then I put the head blocks on and grab the head from Davis.*
'Davis come over here and grab this side of the board and we'll all move him on to the cot.'
*Davis gets next to me.*
'I count off 1..2..3..lift. 1..2..3..down.'
*Now that the patient is on the cot Davis and I lift the cot and get it locked in. As we strap the patient down and Doug gets out and heads for the driver's seat.'
*Davis and I load up the patient.*
"RA1 to COPA, extrication complete, enroute code 3 to ERT:ETC with 1 as a trauma alert."
*I get in the back of the truck and shut the doors behind me.*

As the RA leaves to the ETC I start packing the equipment. After I've done that I check if everything is still complete and walk over to Lt. Raven and Davis.

'I hope he's gonna make it. Lt. should we wait for a tow truck or can we clear?

'I think traffic will stay or something. Just pack up, and wait to see what Raven says.'

*While Jansen puts away the jaws, I grab a broom and head over to the car. I start sweeping all the chunks of metal and glass into one big pile on the street.*

"All units please return to station, you're clear"

'You here that Davis? Let's go!
"Squad 1 to COPA, copy.

I shut the compartments and hop in the squad, waiting for Davis to drive away

"Squad 1 clear, returning to station."

*I hop in the squad, put my jacket on the seat, helmet on the dash, and close the door. Then I put it in drive, turn off the lights, and pull away from the scene and back to the station.*