Chapter 4

The late Richard Pryor once said, "Death is a MoFugga, so far, don't nobody we know ever survived death."

Working in EMS, you will see death, plain and simple fact. But the deaths you will see will range from Granny easing off to see Jesus in her sleep, to the sudden violent death of a young person from a gunshot wound, and everything in between. One learns quickly to cope with it, or one quickly finds another line of work. While death is a natural part of life, seeing it on a regular basis is perhaps not. At any rate, death, traumatic injury, sickness and drama are a integral part of EMS.

Over a period of time, one can tend to become a bit jaded, developing a large callus on your soul to prevent going crazy. We each deal with death and the inherent sadness of our job in our own way. To outsiders, we sometimes seem uncaring or insensitive, but this is not true, we simply have to be the way we are to keep doing our job. But, it effects us all, in one way or another.

Without violating the sacred tenets of HIPPA, a law anyone in medicine knows, I'll share a few stories of some of the tragedies I've dealt with.

On a beautiful, hot Sunday morning early in the summer of 2006, we sat at the station relaxing and tossing about war stories, it had been a quiet day, without a single call so far. I was a fairly green EMT at the time, and wanted something, anything, to break the dullness of the day. I'd only a few minutes before commented to my partner, a seasoned paramedic, that we needed a call, something good were my words. He'd looked at me in disgust and said something to the effect of being careful what I wished for.

As if in answer to my statement, the calm of the morning was broken by the peal of the Rescue Tones.

"EMS, EMS RESPOND TO HIGHWAY 203 SOUTH AT MILE MARKER 21 REFERENCE TO A MVC 4 WHEELER VS CAR" My partner glared over at me, as we jumped to our feet and ran to the truck, "Guess you got what you wished for you Sonofbitch."

I hopped in the drivers seat and started the truck, he reached for the radio and called us in service, and requested First Responders to be dispatched.

"AFFIRMITIVE M4, FIRST RESPONDERS ARE ON SCENE REQUESTING EMS 10-18." (as fast as possible)

We rolled out onto the highway, siren and lights blazing, and headed south towards the accident. Our county covers a large area, and where we were headed was almost 23 miles away, and as luck would have it, we were in the slowest truck the service owned. As we turned onto the highway we were passed by several sheriffs deputies, my partner was on the radio trying to get a patient update, which proved difficult with all the traffic on the net.

"M4 RADIO, IS THERE ANYONE ON SCENE TO GIVE ME A PATIENT UPDATE?"

We rounded a large curve, and far in the distance, I could see the deputies disappear over the next hill, I cursed the truck for its sluggishness.

"RADIO M4, PER 243 ON SCENE YOU HAVE TWO CRITICAL PATIENTS AND THREE PATIENTS STABLE AT THIS TIME, STANDBY FOR FURTHER."

He swore, and radioed back to have Air Med launched, as well as another ambulance dispatched.

"RADIO M4, PER 243 PUT IT IN THE WIND, REQUESTING YOU PUT IT IN THE WIND."

He looked over at me, "Roll this thing Duke, don't slow down."

"You better get out and push then, cause I'm to the floor now" was my response. I squeezed the steering wheel as if that would give me more speed. We continued on towards the accident, and my partner gathered gloves for us, and began to issue instructions.

"When we get there, I'll triage the patients and tell you which one to take, I don't know what we got, so be ready for anything."

"I got a bird coming, we'll make the decision on which one to fly based on injuries, use the first responders! Let them fetch what you need, we'll deal with the worst ones and let the other truck take care of the rest."

We rolled over a small hill and before us was a sea of fire trucks, law enforcement cars, and bystanders, a fireman in a bright orange vest waved us to a open spot in the roadway. I called dispatch and gave our on-scene mileage, and pulled to a stop, even before we stopped, a grim faced volunteer was at the window giving us information.

"You got one here that is critical, she stopped breathing on us twice already, the one there is broke up bad but breathing ok, the ones over there are just scratched up."

My partner pointed in front of us at a group of people hovered around a prone body, "GO THAT ONE IS YOURS!"

I bailed out of the cab and ran towards the group, as I drew closer I could see a young girl thrashing around on the ground, several people were attempting to hold her still, two firefighters held a large blanket over them to shield them from the hot sun. Her right leg was lacerated and obviously fractured judging by the angle it lay at, her left arm was broken as well, and she had a large approximately 5 inch laceration on her left jaw that went from her chin to her ear. As I knelt by her, someone began telling me she had been unconscious, but now was "awake" and fighting them.

I directed two firefighters to go to the truck, instructing the to bring me a spine board, c-collar and bring me the IV kit and jump bag as well, then quickly began to assess her. Someone told me her name, and I spoke to her loudly, trying to get her to answer me. She only screamed and demanded we let her go, as she thrashed about.

"Hold her head still" "Get somebody on that leg, lets gently straighten it out"

My responders arrived with the spine board and collar, handing the collar to the person across the patient, I instructed them on placing it on her, I grabbed the stethoscope from the jump bag and listened to her lungs, clear thankfully.

"Duke, what do you need?"

I looked up to see Mikey, a former member of our company and a experienced EMT standing over me. Seeing him, the iron band around my chest loosened, and I asked him to get her leg and arm splinted. I started my rapid trauma assessment, checking her from head to toe, finding multiple lacerations and bruises all over her body, a quick check of her pupils showed she had unequal pupils, not a good sign, coupled with her combative nature, we were dealing with a head injury.