We get on scene to an accident after the rescue squad. I had to plow through some pretty heavy traffic to get there.
I see a car with front end damage, a spiderwebbed windshield and a knot of firefighters around someone on the shoulder of the road.
I take a moment to look over the car while my partner gets in to see the patient. There is no passenger seat. The driver's seat is there but the front passenger seat has been removed. The windshield has a spot on the passenger side where something round (most likely a head) has struck it from the inside and caused it to shatter and bulge outward. It seems to me that whoever hit that windshield came from the back seat. That's a far way to travel.
Lying on the side of the road, there's a crying kid of about 7 or 8 years of age who's bleeding profusely from his chin. The attending firefighters are as distraught as he is. He's a kid, he's bleeding and he doesn't speak a word of English. Something about hurt kids makes us all get silly. All of the crew from the rescue squad are pretty worked up. these guys are top notch and I've rarely seen them so upset. They won't let my partner get close. It's like a rugby scrum!
In short order, I get everyone to take a moment to catch their breath, slap a dressing on his cut chin, talk to the kid in Spanish and find out the following:
1. He was in the back seat.
2. He was NOT wearing a seatbelt
3. He doesn't remember much
4. The back of his neck hurts A LOT.
From the cut on his chin and his complaint of neck pain, cut chin and the shape of the windshield bulge, I surmise that this kid flew from the back seat and face-planted into the windshield causing his head to hyper-extend, or bend backwards as much as it will go, as his body kept moving forward with the force of momentum.
This is bad.
I look over to the scene commander, my Lieutenant. I point my finger in the air and spin it around a few times. I'm telling him we need a helicopter NOW. This kid is potentially really messed up and needs to get to a children's trauma center ASAP.
"Called for it when we got on scene. ETA is 3 minutes." He says as he winks at me. LT's got my back!
We get the kid packaged (cervical collar, backboard, immobilized) and moved into my ambulance where I have room to work and light to see. The bleeding on his chin, however dramatic, has stopped and appears to be superficial. Good. His pupils are normal and reactive and he's not leaking out of his ears, nose, mouth or eyes (other than the crying). Good. Skull appears intact, no problems on the front of the neck but the back of his neck is very sensitive to touch. So much that I don't have a chance to fully see if anything is out of place. He's too tender for me to probe that deep.
Lungs are clear and he's breathing without too much effort. No apparent injuries to his chest or abdomen. Pelvis stable. All his limbs are solid, intact and have pulses with appropriate sensory and motor response. His other vital signs are pretty normal considering he's in a lot of pain and scared.
Other than his neck this kid's fine! His neck, though is really troubling me.
By the time I finish my assessment, the helicopter has landed and the medic is at the door of the ambulance. He's a tall, stern cop/medic with a no-nonsense, don't-get-in-my-way look about him. His eyes are scanning and talking in the whole scene.
I run down the basics and tell him my assumption about the mechanism of injury. I also fill him in that the kid doesn't speak English. He doesn't look at me until I explain my thinking on how the kid's face hit the windshield and how that relates to his severe neck pain. His eyes dart to me, he nods once and says, "Let's do this."
less than 90 seconds later, the kid is in the helicopter that is roaring its way skyward. I hear the medic on the radio indicate they're taking the kid to the local children's hospital, Priority 1.
I take a moment to watch the flashing lights of the Bell Jet ranger in the clear night sky and then turn around to clean up my ambulance open up traffic and clear the scene.