Dispatch: “Ambulance XYZ, you’re going to the South Gate for the fall in the stairwell”
Ambulance XYZ: “Received & responding.”
Cursing under my breath I switch to tactical driving to fight through the game-time traffic.
Cursing even more under my breath I hike up a gigantic flight of stairs that didn’t seem nearly that bad from the bottom. “Where the hell is the elevator here?!” A small crowd is huddled around a young man laying at the bottom of the stairs. His clothes have been stripped off rapidly and I can hear it already, the raspy, ragged breathing. A quick peek reveals that he’s lying in a pool of blood ("OH SHIT!" is the only thing that comes to mind) but the airway is patent with no secretions or vomit. Another quick listen with the stethoscope confirms what I can see already, he’s struggling to breathe, with deep, irregular, wheezing respirations. I shout his name and pinch his shoulder; nothing, completely unresponsive, his body resembles a fish out of water as he shudders with each gasping breath ("will that one be his last?" rushes through my mind; I block out the demon and focus on the tasks ahead). C-spine precautions are already in place, a collar is applied & he is log-rolled onto a backboard to reveal an even more gruesome picture. His face in unrecognizable (FUBAR in EMS terms), with multiple fractures, a black eye, and a gigantic blood clot coming out of his nose. Unbelievably, he starts to moan. GCS just got upgraded from a 3 (that of a rock) to a 4. His airway is cleared and the oxygen mask re-applied to his face. In seconds I evaluate his now obvious injuries: a rigid, bruised belly, a grossly deformed wrist, and bloodied, deformed fingers of the opposite hand. Looking around for witnesses and trying to keep my cool I ask for the story: the cop relates that the young man fell 30 feet onto concrete and landed on his head, possibly striking the steel railing with his arm. He doesn’t look much taller than 5’8”. A fall more than 5 times his height? Forget major trauma criteria, the fact that he is still breathing seems to defy all laws of physics, gravity and physiology; how can anyone survive this kind of impact? In just a few more minutes he is loaded up into a waiting ambulance, and in another few minutes he’s in the capable hands of the trauma team at the hospital. He starts to groan and moves his arms and legs upon transfer; not a good sign – his brain is panicking from the building pressure inside. My heart sinks, CTD ("circling the drain")?. He’s intubated and we have to leave. He’s just 3 years younger than me, a life that has barely started and already seems cut short. Outside in the parking lot we pack up the trucks and the crude jokes start flying as we suppress our fears, devastation, anger, shock, insecurities, worries and personal problems that suddenly seem so insignificant compared to the phone call his family is about to receive. We seem like a truly sick group of individuals with bad coping mechanisms, but within minutes we all get back in our ambulances, and like a cavalry returning to battle, we leave the ambulance bay en-route to the next job, the next emergency, the next personal crisis, the next “worst day” of somebody else’s life. That night we are all left with the gruesome images of the day and an odd sense of wanting to protect our own families by not saying a word about what we witnessed.
----------------------------------------Follow Up:
12/10/2010 0611hrs: I found out via a blog the patient's family has created that 2 days ago he was released from the hospital and walked into his own home! Back to his normal self, walking, talking, hearing, seeing and joking around. Absolutely unbelievable, an absolute miracle!
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