The last two and a half weeks have been both the best weeks and the worst weeks of my life professionally and personally.
It all started on what was supposed to be a 36 hour shift over New Years Eve and New Years day. Great time to work EMS right? Good calls, fun times.
Well it didn’t quite work like that. First few calls of the shift were all routine. A drunk or two, a minor MVC or two, a drunk doing CPR on a fully alive drunk person (“Sir, if the patient is saying ‘OW!’ every time you compress his chest, he DOESNT need CPR!”), and then it started to get interesting.
We worked a nasty tractor trailer rollover about 15 miles from town. We get on scene and see a pretty much demolished tanker truck laying on it’s side. The roof of the cab had been peeled back by the wreck and the patient was laying about 10 yards from the truck. He was laying on the ground moaning but not really responsive to us at all.
We quickly get him collared, boarded, stipped, and strapped and then haul into the bus. Just a quick look at him showed what looked like a grossly deformed femur, shattered left arm, distended neck veins, and no breath sounds on the right. Left pupil was sitting pretty at about 4mm and slow to respond while the right was about 2mm and non-responsive.
Our second bus pulled up on scene as me and my medic were getting him situated in the back. We pull the medic from the second truck to come with us while her basic drove. A PD officer drove our second truck back into town. It was decided by my medic that we would call the local fixed wing transfer service to get them ready and just meet them at the airport to get the guy to the Lvl 1 200 miles away from us, since the rotor would take at least a half hour to get to us, and the airport was in town.
We took off towards town and started our thing. Pads and electrodes on, 1 14g in the good AC, an EZ IO in the good leg. Started giving him a fluid bolus cause his pressure was in the dumps. My medic darted his chest and got a little air out, but not much, which led us to believe maybe a hemo. I cleared his airway with suction and tossed in an NPA, then tried positioning and tossed in an OPA.
I noticed his breathing was getting more and more ragged and irregular, so I double checked with the medics and grabbed a scope and ET tubes. Snap on a Mac 3 and grab a 7.5 w/ stylet. Go in and take a look and I can’t see crap. I suction him out some more and still can’t see anything. Ask for cricoid pressure and finally see that white winking of the cords. I sink the tube, pull the stylet.
Grab the slipstream, hook it up and start bagging. Listen to lung sounds? Yep they’re there. ETCo2 looks good too. I look over the patient, who is looking more like a train wreck every minute. His femur that’s deformed looks like it’s quickly collecting tons of fluid, which between that and the chest would very easily explain his low BP. We get about to the airport when I notice that I can’t feel a pulse in his neck anymore. I look quickly to the monitor and notice flatline (like the monitor making all sorts of noise doesn’t clue us in). My medic starts CPR just as the back doors to our bus open up and the flight team hops in.
Since we’re not sending him by flight we beat feat to the ED and get him in there as soon as we can. They work him for another twenty minutes but never get any organized rhythym, let alone pulses, back.
We take our time cleaning up from that call and get paged out to an 911 hangup call that PD went to and then called us out on. The PD officer sounded frantic which made us wonder what was really going on. We get on scene and find something that goes down as the worst call in my career so far.
“PD, Medic 4, we’re pulling up now, does the officer have an update for us?” I casually ask into the mic, wanting to make sure the scene is still safe for us to enter and see what we might need.
“Medic 4, PD 214, get in here quick, young child unresponsive, trauma related!” This PD officer used to be one of our EMTs back when we were a volunteer agency, or so I’m told, so we know we can usually trust his judgement. Hearing him that upset rattles us a little bit though.
We bail from the unit, grabbing our pedi-board, collar, first in bag and toss it all on the cot. As we get inside we get the story from the officer.
“The husband and wife were apparently having an argument, and the kiddo dropped and broke something. So because the father was upset and the kid broke something he beat the kid until the kid was quiet. Wife called 911 then hung up after she thought better of it,” The officer tells us. We take a look at the kid and my vision goes red.
He is completely unresponsive to us as we get in there. He has bruises already forming on his face and neck, along with old bruises that we reveal when we start cutting into his clothes. He has several lacerations to his face, along with several to his forearms that look like they are defensive injuries. His face appears to have several fractures, but we can’t tell just how bad.
My medic and I work quickly and silently as we get the little boy packaged up onto our board and call our local fixed-wing service to get the boy transferred up to the childrens Lvl 1 250 miles+ away from us. I drive the bus so the medic can be in the back with the kiddo but we wind up staying in the ED to help prep the kid for the flight out. During transport my medic had intubated the kiddo because he had stopped spontaneous respirations, and reported that the kids’ pupil was blown.
The kid was transferred to the flight crew without any more problems and flown to Big City Hospital Lvl 1. I’m still waiting to hear more, I would love to hear that the kiddo would be ok, but I don’t know if he is. He is still on my mind and I can’t get him out of there. It’s just… I don’t know…
Seeing that just shook me to the core. I don’t like kids, but I want them eventually. My ex-fiance and me were supposed to have one, but working in the field made her miscarry, at least that’s what the docs said. There’s another little girl that I would help take care of in a heartbeat if the mother decided she wants to come out here with me. I love them both more than anything and I haven’t even met the little one yet.
What makes this even more like a roller coaster is the fact that the call that I term as the best call of my career. I had my first delivery in the field as a lead EMS provider. It was the most amazing experience I’ve ever had. I helped deliver a healthy little girl into this world without any problems for her or mom. I.. I can’t even begin to put into words how this felt. It felt like it made up for all the bad calls I’ve had since I moved here, all the bad stuff I’ve seen since I became an EMT 3 years ago (BTW, I realized that earlier this month marked my third year anniversary as a certified EMT). It has given me the energy and drive I need to push me forward, to continue on and keep going. To keep on riding hte bus day after day.
Then again, life is like a roller coaster to begin with, and EMS just exemplifies this.