Friday, December 9, 2011

Long Time Coming

Father forgive me, for I have sinned, it's been 2 months and a day since my last post....

Yeah, long time. I guess you all thought I was gone, and I guess I was. I was a-wandering out there looking for my soul, direction, and some other stuff. I buried myself in my music lessons trying to get away from the stuff we see. The PTSD had built up and I knew it was eating me up. I had nothing to write that was good or worthwhile. It was a dark place.
 No, I am not "back" and "healed". I am still working on that. Music therapy is helping (anybody wanna donate ticket money?) but I had my first really positive experience in a long time this week and I thought I might share it. It occurred to me that when we suffer a loss, a patient that does not survive, I mourn my shortcomings for anywhere between a day and a week, depending on the circumstances. But if we 'suffer' a win, I generally don't celebrate it for more than a day. That's not right.
 Several days ago we had a 'nasty'. 2 car MVA head-on, 110 MPH closing speed. As luck would have it, I wasa the 2nd EMS person in the car of the serious patient (the other driver RMA'd if you can believe). I took the head of a patient with a serious head injury, depressed skull fracture, snoring respirations, multiple lacerations, and very combative. Extrication was around 10 minutes (great crew), but we had difficulty getting her out because she was flailing. The flight medic was on scene in less than 10 minutes from dispatch of the original call because the were returning form a previous call. The first Trooper on scene was also a Paramedic and an RN. He got the main torso and assessment, while I took the head and did observations and support. Lots of blood in the car but no serious bleeds were evident when I got there.
 Once set up in the rig, we had 4 medics and 2 EMT's working the patient. It was like poetry even though none of us had much, if any time, working together before. We all held the same thought "This patient probably won't survive the flight to the trauma center".
 With all the critical calls I've done, this was my first 'squirter'. When the pressure in her head injury finally overcame the ability of the skin to hold it back, she blew a stream across the rig and shot a medic in the belly. I surprised myself because it didn't really mean much, I just moved my index finger over the hole and closed it off. We dressed it up when time allowed a few minutes later. It appeared she had a deviated trac and one medic placed his fingers to hold the trac in line while the other slid the tube in. Good hit on the first try. Good breath sounds, bilateral. The monitor showed good vitals considering and we all took 3 seconds to celebrate, as we kept working.
 This was also my first hot load. Normally the flight protocols call for shutting the bird down during the load operation, but in tis case the flight medic called the pilot while enroute and told him to 'wind it up and be ready to go" (this saves 2-4 minutes). So we loaded hot and had to maneuver the patient right past the tail rotor. Not a comfortable situation for me, having the handle end of the stretcher, but what the hell.
Off they went, and I collapsed on the tailboard of my rig, while the other guys started clean up. I was shot and began to sink into that depression that comes with the realization that even with all the effort and care, she probably won't make it.
 18 hours later there was a blurb on the local paper's web site about the accident and that she was in the trauma center in 'serious' condition". I was walking on air, she survived the night. "WOO HOO!" I thought. Then as the hours and days passed, pieces of information began to trickle back, either through medical channels, or the small town network, that she was conscious, knew her name, could wiggle her toes, etc. This gal is gonna make it, I thought. FINALLY, I get to work a bad one that doesn't turn out bad! This is, I kid you not, a first for me.
 Now I know, it's not about me, and the calls and jobs I am dealt, it is about the patient. However, I have gotten the feeling that if you are a patient in critical condition, you really don't want me showing up. It's my personal perception of a back cloud. I have never had a CPR save. I have been on some calls where I didn't expect the patient to survive and they made a full recovery, but this is the first time I have had a critical trauma patient survive. It's a very good feeling.
 About 0300 this morning we had an automatic alarm call that turned out to be false, but while on scene I ran into a friend of the family of this gal who gave me a update about the surgeries that had taken place in the past 12 hours. She said that the mother of this gal wanted to find out who had taken care of the girl's head during the incident, because the Doctors told her that this was probably what saved her life.
 I don't know what the physiology of the trauma is for this gal, but I have to tell you that as far as C-spine precautions go, this was probably the worst job I have ever done at stabilization. She was flailing and thrashing all over. I actually had my left arm across her upper chest, and had wrapped her hair in the fingers of my right hand the try and control the head. I felt like I was trying to restrain a prisoner. I was not happy with my methods. It was nothing that they ever taught me in class, and I don't recommend it. The mental picture of doing this had me awake that entire night, I felt like a failure at treating this patient in a controlled and proper way. Hindsight tells me that I got lucky. Next time I have to do better.
 At any rate, it's nice to have a winner. From what I can see now, it appears this gal will recover with most functions in tact.  I don;'t think she'll be the same as she was before the accident, but she will be alive and functional, and that's a lot more than any of us who were there could expect. I'll take that as a "win".
 With all the ugly and negative stuff I have posted here, I thought it was only fair to take an evening out and share this piece of positive news. Probably there is nobody out there reading this anymore, but on the chance that one or two of you have stuck around, I put this up for you.


  1. Awesome story!
    I'm glad it turned out so well for her- and for you.
    I know, and you know, it's not about you, but I'm going to be glad for you anyway.

    Strange world, isn't it? You just never know.

  2. We're still here...You keep healing and sharing.

  3. Glad to hear that you had a save that turned out so well. It is rare when its such a bad accident.

    We are still here listening, so please keep sharing :)