The Final Chapter:

We're plowing our way through heavy traffic to get to the accident site. Plowing is about right. We have to get right up behind each car with blaring horn, siren and flashing lights before anyone notices us and then gets out of the way. People can be so stupid sometimes.

As we pass one car in particular, the driver pulls the cellphone from her head to holler an obscenity at us and give us the finger with the other hand that's holding a cigarette. No hands for driving and she's in heavy traffic. Yep, I'll see her again. In the back of my ambulance, I'm sure.

*Sigh!*

This particular road is a highway with only 2 lanes in each direction and a huge, impassible median. On the scene, there's a line of crunched cars, a closed lane around them and a line of people sitting on the grassy shoulder holding various parts of the bodies while wincing. I count four. I request another unit, make that two.

I get one. Oh well!

I hop out as we stop and go up to each person on the shoulder. I find out which car they were in and briefly ask them their complaints. All the while I'm assessing mental states, airway and range of movement. The police are already there interviewing everyone and their states of mind and physical conditions are not getting me too worried. Good, I have time to look at cars.

As I mentioned in the previous entry this is "...U-haul truck into Saturn Sedan, into Chrysler Sedan into Acura hatchback..." and none of the cars' passenger areas are displaying any deformity with the exception of the Chrysler. The drivers seat in that one has been knocked off it's track. That's the car with the patient who's complaining of back pain.

By the time I get back to the patients, the other unit has arrived and are with Mr. ChryslerBackPain. I give them a quick report on the state of his car. The driver of the Acura has wandered in to the scene complaining of neck pain and looking stiff. One of the EMTs from the other unit manually immobilizes her C-spine by holding her head & neck in a neutral position.

He and I, with some help from another firefighter, perform a textbook-perfect standing takedown and get her into my ambulance. A standing takedown is where we put a backboard behind a person who's standing and immobilize her to the board in such a way as to protect her spine while we tilt the board back and get the whole assembly on a cot. In school, the test for a good standing takedown is to pickup the boarded patient (another student) by the side and there should be only a minimal amount of shifting on the board. Of course, we did not try this with our patient but as we lowered the board to the horizontal position, I was pleased to see that she did not shift at all.

The driver of the Uhaul truck claims to be uninjured and (this sucks for him) is married to the driver of the Saturn Sedan. Hoo boy!

With Ms. Acura on the cot talking to the police, I do a quick assessment of Ms. Saturn. She's complaining of shoulder pain. She says she put her hand out when her husband rear-ended her car and her shoulder got jammed when her car hit the Chrysler. She denies neck and back pain and her range of motion is good with no pain reported. I decide not to collar her and she goes into the rear-facing captain's chair in the ambulance.

This position allows me to treat and assess both patients in turn as I sit on the side bench and I can still reach all my tools and materials in the ambulance. Being over 2 meters tall (6ft4in) I usually can reach anything in the ambulance from anywhere I sit.

So, Ms. Acura-on-the-backboard is complaining of a headache, 7 on a scale of 1-10, but an appreciable lessening in neck and back pain once we have her immobilized. I get her on 15Lpm of O2 via Non-rebreather Mask (NRB) and turn to Ms. Saturn. She's guarding her shoulder pretty well and complains of pain of a 7 on a scale of 1-10.

Junior pops his head in the side door at this point.

"How you doin'?"

"I'm good but let me get a good assessment and stabilize this shoulder before we roll."

"That's cool, Let me know when you're ready."

I assess the shoulder and find tenderness at the top and side of the shoulder but the clavicle (collarbone) is unremarkable and painless as is the scapula (shoulder blade) ribs and humerus (upper arm bone). I put her arm in a sling, stabilize it with a body-wrapped cravat and apply a cold pack on the painful part of her shoulder.

We roll.

Ms. Acura, as a result of the O2, is now rating her head pain as a 2 on a scale of 1-10 and Ms. Saturn's shoulder pain dropped to a 3 as soon as I slung and stabilized the shoulder. Yay! Both had unremarkable vital signs on scene that remained stable during transport.

We go to a hospital I haven't been to before as an EMT since traffic would make transport to the geographically nearest hospital a 2 hour endeavor. At the new place, everyone is organized, pleasant and professional. Nice! No waiting and the admitting nurse was very interested in my notes on the vehicles' deformities and the patients states during transport. That made me feel much better that I took the time to note it. Often times, on a busy night, our local hospitals don't even seem to care or listen to my prehospital notes. I suppose that's common enough.

When we get back to the station, we discover one of our members has come in with a real "hotrod." He's taken a bright yellow 80cc scooter and done it up with flame decals, a logo from Orange County Chopper. This thing's also equipped with a remote alarm and remote start.

We all take turns starting it up and zipping around the station trying to look like a badass while riding a tiny yellow scooter.

Hoo hoo!

I've got ANOTHER duty night tonight. I'm sure there's more on the way.

--maddog