Fall Call

I love these posts from author and EMS expert Dianna Benson where she weaves medical detail into a fictional piece.

Welcome back, Dianna!

I shake my head to full awake from my cat-nap, and gear up for the trauma call less than a minute drive away. Once my partner and I roll on scene, I note the three cop cars arriving.

Additional information regarding the call flashes across our ambulance laptop screen.

“What’s the deal?” my partner yells out the driver window at a cop rushing toward the building.

“Another worker pushed the guy.”

“Ah,” I say with a nod. “Attempted homicide.”

“Or homicide, but if the guy’s not already dead, he’s gonna need us.” My partner jumps out of our ambulance.

We grab a C-collar (cervical collar) and a backboard, and toss it onto our stretcher already loaded with EMS equipment and supplies.

“Remember caution?” I remind my partner.

“Yeah, yeah. Guy was pushed not shot or stabbed. Let’s go.”

I really didn’t want to hang back either. Our patient’s life may be over if we wait.

Inside the building, we push through a crowd of gawkers. I notice three cops drawing their guns at a man choke-holding some young woman, her wide eyes glossed-over.

“Let her go,” the cop at the left yells out. “Now.”

I’m hoping the guy follows the demand or we’ll have more than one patient. As I rest my hand on my radio in case I need to request additional EMS crews, I scan the area for an injured man on the ground. I spot our patient on the other side lying supine and lifeless in a pool of blood on the cement, his attacker in the middle and blocking us from our patient. I glance up and see the catwalk and assume our patient was pushed off of the suspended walkway about twenty feet above.

The guy fell twenty feet? I think to myself.  If he’s alive over there, he’s in critical condition.

“Clear out,” the cop to the right shouts. “Everyone. Out of this room. Now.”

The crowd scampers away. My partner and I hold our position behind the cops. The perpetrator doesn’t have a weapon, so there’s no danger to us.

After a few drawn-out minutes of the cops warning the perp to let the woman go, and our patient remaining lifeless and out of my reach on the ground in the near distance, I somehow dig up my most gentle tone and interject, “Sir, I don’t think you want to hurt her. Do you?”

The perp jerks his head in my direction. Ten seconds tick by with him just staring at me as if pleading me to help him out of this. “Ah…no. No, not really.”

“I didn’t think so. How about letting her go and we’ll talk?” Stop blocking me from my patient. If he’s not already dead, he needs me now. Needed me minutes ago.

 “Talk? Yeah, yeah,” he nods, “I just need to talk.” Chest panting, arms shaking, the perpetrator shoves the woman aside and drops on the ground. All three cops pounce on him and drag his arms behind his back.

I roll the front of the stretcher around the chaos on the ground; my partner pushes from the back. As I pass the perp, I ignore his insistent yells to talk with me since my focus is on my patient.

“Sir?” I say to the lifeless man as we approach him.

No answer. No movement of any kind.

I slide my fingers to his neck and find a thready carotid pulse. His chest is rising and falling in steady rhythm bi-laterally.

My partner holds his head in an in-line spinal stabilization position as I strap the C-collar around his neck. I slip a towel underneath his head for hemorrhage control and feel for trauma. I find an open skull wound, crepitus bone, and flesh.

Two firefighters appear at our side and assist me with log rolling the unconscious patient onto a spine board and strapping his body down. I secure the man’s c-collared head to the backboard with head blocks, straps and tape, allowing my partner to finally release the manual c-spine stabilization.

“What do you need from me?” some guy asks. “I’m his supervisor.”

“How old is he?”

The manger answers that pertinent question as well as all my others, as I connect my patient to our cardiac monitor. Less than a minute later, I’ve assessed all vital signs and the heart rhythm, as my partner performs a rapid trauma examination. Our patient remains unconscious. I’m thinking internal bleeding is the main cause and he’s headed to hypovolemic shock, and if that’s the case, surgical interventions are vital. No more time to waste on scene.

“Femur fracture,” my partner says.

“Among other things,” I say. “Let’s go.”

All of us lift the backboarded man onto the stretcher, and roll it out to my ambulance.

As one of the firefighters drive, my partner and I attend to our trauma patient in the back with the assistance of another firefighter. Our patient remains unconscious. In order to protect his airway, I slide a lubricated oropharyngeal airway down his throat. With a curved laryngoscope, I lift the epiglottis and gain a visual of the glottic opening and white vocal cords. I drop the orotrachael tube between the cords, down the trachea. I connect a bag valve mask over the tube opening. To keep him oxygenated, I squeeze the football-size bulb every five seconds.

“Take over bagging,” I say to the firefighter, and he grabs the bag valve mask from my hands.

I spike an IV bag as my partner slides in an eighteen-gauge IV needle into our patients left arm. Since the patient is unconscious, there’s no point to administer pain meds.

I grab the radio mic. “Wake Med ED, this is EMS 16.”

“Go ahead EMS 16.”

“We are en route with a thirty-three year old male. Trauma patient. Twenty-foot plus fall onto concrete. Unconscious. Intubated. Open head trauma posterior. Fractured femur. Normal sinus cardiac rhythm. BP 95/52 and falling. 182 heart rate. ETA 5 minutes.

Even if this man’s body survives, his brain will probably never be the same. I swallow the sadness clogging my throat, hoping he doesn’t have any children, and I re-focus on finishing my job on this trauma call.