The whole night was a blur.

Not much in the evening hours. We cleaned the ambulance and made assignments.

Got a call for an unresponsive male on a bus in the next jurisdiction over. Coincidentally, about 2 blocks from my house. By the the time we got there (I didn't need the map book to find it) dispatch stood us down. The local ambulance had finally arrived. One of the firefighters on the scene comes up to my side of the ambulance.

"What's up?" I ask.

"Last passenger off the bus tells the driver there's some dude in the back asleep. Driver goes back there and the dude is KTFO!" He laughs.

"KTFO?" J asks me as we drive away.

"Knocked The F**k Out."

We laugh for 1/2 mile.

No sooner do we get back then we're called to an accident on the highway with bad directions. By the time we get on scene, we're stood down again. Apparently one of the drivers kept driving after the impact for a while. The other driver is walking away from his overturned vehicle followed by 2 firefighters, an EMT and a cop. We roll on.

Return to the station. Get out of the ambulance. Fill my water bottle and the bell rings again. Auto accident, Engine from another station on scene.

I get out of the ambulance to find a person on the grass of the shoulder surrounded by Firefighters. They've got C-spine immobilization on him manually and are cutting off his clothes. They make room for me as I slide right in. Their turnout gear smells of old fires and fresh sweat. They're all looking at me. I'm EMS. Nothing's on fire and they seem a little lost.

"Light, I need light." I say.

Blank stares.

"C'mon, you all have flashlights hanging from your jackets. I can't see in the dark!"

Oh, yeah! Suddenly the patient is fully illuminated.

He's 15, thinks George Washington is the president, that it's 4 days earlier than it is and today, "starts with a 'T', Tuesday?" (It's Friday night). One of the firefighters is already doing a full body patient assessment. He's checking abdominal area for tenderness and ribs for flail chest. Good. I check pupils for equal response and it's there. Pain in neck, shoulder where the seatbelt was, knee where he hit the door and his head. It's 1:30 in the morning and he was riding in a car on the highway with his father about 30 miles away from where he lives.

"Were you wearing your seatbelt?"

"Yes."

"Were you in the front or back?"

"Front."

"Were you the driver or passenger?"

"Passenger"

"Did you hit your head?"

"No."

"Did you lose consciousness?"

"No."

"Why does your head hurt?"

"I bumped it on the window and then I closed my eyes."

"Do you know were you are."

"I'm [a location 60 miles south of where we are]."

No crepitation or deformity anywhere in the areas of complaint. Just some pain and the altered mental status. J asks me if we should go to the local ER and I say no. I call for us to go to the local trauma center and nobody bats an eye. Apparently, I'm in charge!

We execute a perfect log roll to get him on the board. I choose to use the spider straps because we have a ways to walk and, since I figured out how to use them, they're great for securing someone to a backboard. I've almost never seen them used by BLS units in my area. I have to spend a bit of time educating a few of the assisting Firefighters on how to set them up but we get the patient packaged very well.

"Is the father coming?" I ask. The policeman standing next to the father gives me "the look." OK. dad's going to jail. I find out from J later that standing downwind from dad would get anyone drunk.

All the way to Trauma, he's complaining about his shirt and his shoes. I feel bad for him. It was a nice sports jersey and we cut it right off of him. His shoes? Well, we left them for his father to take but I realized the kid's going to have to get them from evidence or property if he wants them back.

At Trauma, we're greeted by the sight of the driver of the earlier accident, fully immobilized to a backboard, being read his rights by an angry looking police officer in the ER. HA! We slide right into trauma and the team takes over. I pass as much information as I can and help to transfer him to a bed. The doc and the nurses seem surprised at a volunteer EMT giving them tons of info, chief complaint, the fact that he got out of the car himself, his altered mental status, his initial vitals and his condition during transport. I'm pleased to see social services is there and he gets the patient's address and guardian name from me.

Back at the station, I manage to get a shower and actually into bed when the bell rings again. 14 y/o male with severe leg pain. Can't move. The call goes out as a leg injury.

On scene, the mother tells us he has a history of sickle cell anemia and asthma. J and I gingerly, and compassionately move this kid to the ambulance. He's hurting. He's so skinny that at first, I think his leg is broken. The bones showing through his skin make his legs look deformed. He's a good looking kid and he has a sense of humor through the obvious pain. Other kids his age are "running ball" or goofing off. He's feeling more pain at 14 than most people feel in their entire life. I don't cry but it takes work.

Mom rides with us and in the ambulance, I tell him that I'm not going to do anything to hurt him but if he hurts, to tell me. I do my best to make him comfortable. I give him a full exam to make sure I haven't missed anything and to keep my mind on my work.

We get to a quiet ER and, surprisingly, have to wait. Apparently, dispatch did not call us in to the ER and they had no bed ready. Mom's frustrated and the triage nurse, after hearing what we have, takes off. My cynical side is grumbling when I look down the ER, over the heads of various nurses and techs that are sitting around, to find the triage nurse cleaning a room and changing the linens herself. Awesome!

She signals us down and we transfer the kid to the bed. I apologize to mom that they had to wait and then I go out to talk to the triage nurse. Nobody's around but us and I sincerely apologize that she wasn't notified and thank her for her effort. She's staring at me, open-mouthed, as I tell her the patient's SAMPLE history, last vitals and chief complaint. Before she goes to his room she grabs my arm, looks me in the eye and says, "Thanks." I swear, I must be the most atypical EMT-B in the state!

Back at the station, it's 4:35. I hit the bunk and sleep.

I dream of twins, thunderstorms and little girls saying, "Look, Daddy, Look!"

--maddog