It’s raining. The Saab comes around the corner and sees a car pull out ahead of it. The driver turns to the right. Immediately the car begins to hydroplane. Ahead is a telephone pole.
We are dispatched to a MVA at a familiar location – a known bad corner. It is ten minutes before crew change. I leave with a new EMT and a young MRT, awaiting his EMT written results. The EMT’s father, who is coming in for the next shift, says he will wait for the night medic. We should be all set.
When we come around the corner, I think, Oh shit. This person is going to be f----ed up. This could be a fatal. The Saab is wrapped around the telephone pole, driver’s side impact.
The pole is up an incline, The car’s rear wheels point straight up the incline, the front points to the left and almost back around. Approaching the car, I can see an airbag has deployed. A bystander stands in the open driver window, holding her hand against the driver’s head. I hear the driver screaming. “He’s bleeding real bad. His head is open," the bystander says. I tell my crew to bring a collar, the 02 tank and a nonrebreather. The patient is pale and clammy. He says his head hurts. He asks to get out of the car.
I tell him my name. “We’re going to do our best.
This is a serious pin job. The driver is not getting out of this car without the fire department. The door is wedged into his thigh. The steering column has been crumpled by the door. The car is tight against the pole. The passenger door is also warped.
I ask if he can move his legs.
He says he’s stuck.
I apply a trauma pad to the back of his head and wrap a cervical collar around his neck, telling him to hold still. I put on a nonrebreather. I reassure him that we will do the best we can, but I feel helpless to get him out. Suddenly the car is shaking. I look and see two police officers pounding against the door, with a crop bar and a hammer, trying to pry it open.
“Even if we get the door off," I say, "He’s not coming out without the fire department. He's completely wedged in." I still can’t believe he’s even talking to me. The door is two thirds of the way into the driver’s seat.
“We have to do something.”
The car shakes. I look up at the wires on the pole. They look pretty secure. I listen for a fire engine. The siren I hear is our other ambulance. The night medic has arrived. I go over the situation with him. He asks if we can get him out through the roof. "He’s wedged in the seat," I say.
Somehow they pop the door, and force it open. The night medic goes in the back seat, I go in the front. I tell the crew to bring the stretcher around and a board. We’ll give it a try.
In my head I am flashing back to a call I did many many years ago, a young woman wedged in a car, and we couldn’t get her out, her leg crushed under the front door. We did futile CPR with her half in the car, half out. I wonder if this patient will die still in the car.
Amazingly, although he is screaming in pain, we are able to pull him out. I get my right hand in under his legs and my left on the back of his pants. Fortunately, he is not a big man. it seems as if I am holding him in the palms of my hands. We ease the board under him and then we are out, and out of there. Onto the stretcher, into the back of the ambulance, and off lights and sirens. I have the other medic in the back with me while the EMT's father – one of the best and smoothest drivers I have ever worked with, driving lights and sirens. How great it is to work with another medic. I get the patient’s clothes off and do a full assessment while the other medic gets a BP and a line in the right arm. Lung sounds are clear and equal, good chest rise, ab soft. The patient’s heart rate is in the 150’s. Bp 130/60. The left hip/pelvis is badly deformed, but the patient is still alert, although he doesn’t remember everything about the accident, just skidding. I call the hospital right away and request the trauma room. I tell them we are ten minutes out. I hear back just a lot of static mixed in with voices. “Did you hear me, I need the trauma room!”
“You’re scratchy. Is the patient stable?”
“No, the patient is not stable.”
“Okay, we’ll see you in the trauma room.”
His hip is killing him. We can’t get him to straighten his leg. It is almost as if his left leg has been displaced into his body. I have to hold it in just the right way to keep the pain under control. We switch holding the leg as each of us do what needs to be done. I get a line in the left arm and then get his name, date of birth and medical history. The other medic does the pressure again and repeats the assessment.
I wish I could give him morphine, but he is not stable and this is multi-system trauma. Who knows what else has been injured?
They are ready for us in the trauma room. I give the report and then clear out. As I am leaving the room, the patient calls me by name, as he is being turned over to check his backside, and thanks me. I tell him, he is in good hands.
After writing my report, I go look at the X-rays.
The doctor has seen nothing like it. The left pelvis is almost where the right pelvis is. It looks almost like one person sitting on top of another.
He is headed up to surgery as we leave. The next day I will learn, the patient is in intensive care – much of the pelvis is dust.
I think that is probably the only way we could have gotten that patient out. The pinned left side wasn’t there. It was over on the right
One of the crew comes in the next morning with pictures of the car taken at the garage where it was towed to. Unbelievable that anyone could have survived that.
I wonder how the patient would have done if we couldn’t get him out. If we had to wait for the car to be moved and the metal bent to free him. When I see the cops who were hammering at the door, I tell them what a job they did, how they may have saved his life.
“There was nothing else to do,” one says, “The guy was screaming. We had to do something.”
***
Driving home in my own old Saab the night of the accident, I feel the car skimming over the road. I look ahead at the turns, the telephone poles. I ease back on the speed. I look around at the car that holds me. Solidly built, room to move around in. Hold the blacktop. Take me on up the road. Get me home safe.
