EMR In Action, ctd.

Team member Will McCammon had a recent medical experience:

I was on my way to a Sunday afternoon shift at the County Fair when I came upon a single-car accident on Highway 4. The car had flipped over and the lone occupant was lying on the side of the road surrounded by a small group of people.  As I didn’t see any first responders on scene, I pulled over to see if I could help. 

A big thank you goes to the EMR training staff for constantly stressing the basics because as I got to the subject, I had my gloves on, was asking if 9-1-1 had been called (it had) and was looking for mechanisms of injury (MOI). While the car was an obvious MOI, I wasn’t sure if the subject had been thrown from the car, had gotten out on his own, or was helped out by bystanders.  

The subject was groaning (ABCs – check) but wasn’t responsive to verbal commands (A&O = 0) and only responded to painful stimuli. Bystanders indicated that he only spoke Spanish and they had pulled him from the car. My first thought was C-spine issues and that he should have been left where he was.

As I was thinking this, an off-duty EMT arrived and asked if he could hold C-spine, which I had him do. A second off-duty EMT (who spoke Spanish) was right behind him and attempted to communicate with the subject (get him to stay conscious and stop moving).  During the few moments before the ambulance and fire personnel arrived on scene, we took vitals (high pulse and rapid respirations) and ascertained that he was injured both on his right side and pelvic area.  

As soon as fire and ambulance responders arrived, everything kicked into high gear. They grabbed C-spine and quickly moved into assessing the patient. Within one or two minutes, they were setting up the patient packaging gear and I found myself applying the skills we train on so often. The only variation with our training was the use of Velcro with the cheese blocks and not tape (I am a convert!) and the need to maintain one leg at a 90-degree angle on the board due to injuries.

Although I wasn‘t tracking our time, I believe the total packaging time was around five minutes. This says something about constant training! The subject was loaded into the ambulance and I was able to head off to the County Fair for the rest of my day.

Reflecting on my first medical experience taught me several valuable lessons:

·       Always be as prepared as possible by having BSI and basic equipment such as a CPR mask readily available – I was heading to the County Fair, so I was geared up.  I can’t count on that in a future event unless I plan for it.

·       A big thanks to the EMR training team and their training process – BSI, scene safety, calling for help, ABCs, etc. rapidly came to mind. What wasn’t so easy was when the process didn’t follow our standard scenarios (patient speaks English and is awake, etc.). I need to mentally rehearse and practice thinking outside the easy patient assessment routines and prep for when the process breaks down. This includes ascertaining available help and skills with bystanders. (I was fortunate an EMT was on-hand to hold C-spine.)

·       Practice, practice, practice – My day job does not provide me with any training in the medical arena, so it’s up to me to develop the skills to feel comfortable and prepared if and when the need arises.