Twister, Tales of Rural Ems
The mere sight of mangled human flesh, limbs twisted into unnatural positions, blood and gore abounding is just wrong, no matter how it occurs. The effect it has upon the person observing it depends however, on the number of times you've been exposed to it, your own level of resistance to the macabre, and the situation you're in at the moment. As I ran towards a young boy with his arm entangled in a PTO shaft of a large machine, I steeled myself for the worst, these are never good, and often if not always, horrific. The sheer power of your average farm tractor is enough to rip a body to pieces, and this one was larger than most. It sat silent a few feet from my patient, who was ominously silent as well. I knelt at his side and relief washed over me as he looked me in the eyes, and saw the primal fear and agony in his glaze. Another man, a volunteer fireman, one of many in the area, began to give me vital information as he desperately cut through the jacket which was tangled around the shaft, crushing the boy's arm against the shaft. The arm, broken and twisted looped over the shaft, his wrecked shoulder protruding forward showing its obvious shattered state. Large abrasions and lacerations covered the child's back, a large knot on the side of his head wept blood, and his breath came in ragged gasps, his feet, free of the rest of the tangle, dug furrows in the sandy soil. "Get me out of this fucking thing" he cried, "Oh God it feels like my arm is still on the ground."
What do you say when confronted with something like this? They never teach you that in EMT school. It is something that you have to come up with on the spot, adapting to the situation as it unfolds, hoping that when it comes, it will be the right thing to say. To say that you feel helpless and inadequate is without question.
"I'm here, and we'll take care of you."
What else could I say at that moment, suddenly, here I was, the person who was expected to have the answers, the expertise and knowledge to fix this disaster his life had become. Never mind that I was also scared and shocked, never mind that I wanted to recoil and run, this was my job, and do it I must. With a grunt, the firefighter slashed through the last of the jacket and his arm flopped free, without thinking I caught it, and straightened it out as best possible, hoping to get the blood flow back to his cold hand. This was something I knew, I felt for a pulse as I assessed his mental state. What other injuries did he have? Spinal injuries? Skull fracture? In my mind I ran down the possibilities, so many that it staggered the imagination, checking off each one.
Let me back up a bit, the day had started off quietly for us, we'd been sitting at the station, enjoying a quiet morning of a beautiful day, cool and sunny. I had just finished a cup of coffee and was thinking of nothing more that what might be for lunch, or perhaps sneaking a nap if our director went somewhere. My partner stood talking with the office personnel about other people we knew. Neither of us remotely thinking that in a moment's time we would be rushing to the rescue of someone we never even knew existed. Vaguely I heard someone talking on the fire frequency of our station radio, and just from habit, I paused to listen. A volunteer fireman, on his portable radio was fading in and out in scratchy static, giving an address.
"Tony, what's that about?" I asked.
Without warning, the station rocked with the blare of the Rescue tones, stopping all conversation immediately.
"EMS, RESPOND TO 434 POLK FARM ROAD IN REFERENCE TO A 15 YEAR OLD TRAPPED IN FARM EQUIPMENT."
We looked at each other with that "deer in the headlights" look, then, as if one person, ran to our truck scattering debris behind us.
I jumped behind the wheel as my partner grabbed the radio microphone.
"What's the mileage D?"
I told him, then dropped the ambulance into gear, flipped on our lights and rolled out the bay.
"M2 RADIO, WE ARE ENROUTE STARTING MILEAGE 321"
The dispatcher relayed the information she had to us, a 15 year old boy was caught in the shaft of a cotton sprayer, he was alert and breathing, but she had no other information, except to say the female caller was hysterical.
We radioed back for her to put Air Med on stand-by and dispatch First Responders, those brave, insane, wonderful and sometimes pain in the ass volunteer Firemen, who are ready at a moments notice, to drop everything and come running.
For those of you who don't know, First Responders and volunteer Firemen, usually the same person, are your neighbors, everybody from the skinny, greasy kid with the too long hair who changes your tire at the service station, or the middle aged farmer in overalls with chewing tobacco stains on his shirt, to the owner of the busiest restaurant in town. Most of them you never pay attention to at all, except to wonder why that "Billy Bob" looking fool has lights and a siren on his old 4X4 pickup.
For the most part, they are ordinary people, going about their lives just like everybody else, but they are an entirely different species altogether. These are the men, and women, who are blessed, or in my thinking, cursed with for lack of a better word, Hero Syndrome. But let me digress, I ain't talking about the "LOOK AT ME!" type hero, in fact, even though they are many times over hero's lets call it something else.
Rescue Syndrome, that would be more accurate, a compelling force that makes them run towards disaster and trouble, when any one with any amount of good sense would break and run the other way. They will stand in the middle of the highway directing traffic around the smashed up remains of a car on a rainy night, braving rubbernecking idiots, or run into a burning house with a hose.
And when we call them, they run to our aid, ready to get bloody, strain their backs lifting, or anything else we ask, to protect and render aid. And they are paid nothing, except maybe, time permitting, a quick "Thanks Guys."
Down the highway we flew, dodging and weaving our way past cars in the way, looking for the road, digging out gloves, debating with each other as to the probable severity of the call, and possible outcomes for the patient.
As we approached the cross road, we slowed and turned down a rutted dirt road, looking for a "field on the right" that we were assured we couldn't miss. Look for a gray Dodge flatbed truck, they'll guide you in. As we bounced down the road we spotted a truck flying across the field, leaving the ground completely several times as it sped towards the road. We turned into the field, and began to bounce towards the back side of the field, spotting a large tractor sitting near the wood line, several people were milling around the tractor, a woman desperately waved at us and pointed towards the back of the tractor.
We notified dispatch we were on-scene, then jumped out of the truck and rushed over towards the tractor.
As I stabilized the shattered remains of his arm, my partner and the First Responders brought over the necessary equipment, and we quickly placed the boy on a spine board, put on a cervical collar, and moved him to the ambulance.
Once on board, we began to treat him and assess the extent of his injuries, without speaking to each other except quick terse comments, we stabilized his arm, started IV lines, applied oxygen, and checked him over for further injuries. His arm was cold to the touch, obviously fractured in several places, I could feel the stub of the upper bone as he struggled and fought us, where his jacket had been twisted up in the shaft the arm was compressed deeply and still looked as if it was bound by a tight rope. This injury was doubtless impeding the blood flow to the lower arm. I had straightened, or as we say, reduced the fracture in a vain attempt to get the blood flowing again, but could see no indication that it was successful.
My partner applied a ladder splint as I held the arm, then reached for the drug box as I called medical control for orders for pain medication. Receiving orders, he began to prepare the medications, while I made arrangements with dispatch for the landing zone for a air evacuation of our patient, assigned a firefighter to drive us there, and then assisted Tony with our patient.
Our driver started off across the field, trying vainly to avoid bouncing us around, in the back, we held the boy as still as possible, and cringed with each bounce and bump, knowing the pain it was causing him. After what seemed an eternity, we gained the road, and began to roll towards the Landing zone, which again, was being set up by our First Responders.
Our patient was becoming extremely agitated, screaming and trying to get out of the straps which held him to the spine board. We both tried to calm him, but he wasn't having any of it, so in an effort to distract him, I began to tell him about the Air Med nurses that would meet us at the landing zone, and how beautiful they were, hoping all the while that the ones I meant would be the ones who responded.
"Man, wait till you see Charli, man oh man, she is hot..." I began to expand on her virtues, and Tony began to chime in too. We regaled this boy with tales of her beauty all the way to the landing zone, keeping his mind off the fact that he was injured. Thankfully the morphine began take hold and he quieted down.
As we pulled into the volunteer fire station where we were to meet the helicopter, I could see a sea of concerned faces, old and young glancing at our truck while they stood guard on the landing zone, stopping traffic, holding back the gawking spectators. They didn't know this kid from Adam, but he was a soul in need, and that was enough.
We parked as the helicopter fluttered to the ground, and like blue clad angels, Charli and Joanie ran towards our truck with their stretcher. We opened the door and they climbed in, listening intently as we gave our report even as their eyes sought our patient to assess him.
In the midst of all our conversation there suddenly came a loud voice from our patient, demanding, "WHICH ONE OF YOU IS CHARLI?"
Everyone stopped speaking for a moment, Charli leaned over into his field of vision and smiled, "I'm Charli sweetie".
He looked over at me with a serious awed expression on his face and exclaimed, "You were right, she is Beautiful" after which he closed his eyes and fell asleep.
"I'll explain later Charli" was my only comment.