This is the first in a series on emergency calls that have stuck in my head after all this time. After a couple decades in the field it’s an odd mix of calls and patients I have floating around. Kind of like a screen saver cycling through your favorite photos but in a semi-morbid way. It made me wonder which calls get re-run in other folks heads? Is there a lesson to be shared with the next generation of emergency responders? If I can elicit some interesting comments from this post I’ll keep the series going.
One person died in this three-car crash. (KATU News photo)
My first EMT call -First some background to set the scene. I had been a member of a volunteer fire department for several years. We did first response medical out of a rusty station wagon with minimal equipment and one wrist watch for taking an accurate pulse between three of us. Keep in mind this was back in the 1970s’ and no I do not recall seeing any dinosaurs. In 1976 the department was able to send us to attend a Basic EMT class. At the end of class our instructor asked me if I would like to come work for his ambulance service. I’m not sure if I impressed him during class or I was just the first person he asked who said actually said yes. He needed someone to fill in while an employee was on their 2 week vacation. It was just the beginning of summer on the Oregon coast. My shift started Friday morning and by the time the afternoon weekend traffic was building I was on my way to my first call as an EMT. A head on motor vehicle crash on a nasty corner of the highway coming from Portland about 10 miles from our station. There were only two patients alive after the crash. One who was ejected through the windshield and one quiet patient trapped in the car. This was back in the day when our ambulance service carried hand extrication tools because fire departments were still mostly wanting to do fires not medical. If you’ve never cut and bulled your way into a car chassis with a K BAR T you’re missing a good workout. Imagine trying to open a 50 gallon drum with a little 25 cent military surplus can opener and you’ll get the idea. My partner assigned me to the conscious ejected patient once we had extricated the trapped patient. My patient was in the roadway and had multiple laceration injuries but the chief complaint was the dislocation of the head of their femur. Pretty simple to package up and manage if you don’t count the loud screaming.
What I learned on that call – A loud, swearing, screaming or crying patient is better than a quiet patient. I was impressed with how painful a dislocation like this was. It was a twenty minute run to the closest hospital equipped to handle trauma patients. I learned that pain meds help but brute force was the key to reducing the dislocation in this case. Once that femur popped back in place the pain meds kicked in and they were snoring and happy as can be. The quiet patient did not fare so well. They never really complained and did not survive long. Over the ensuing years I had had my share of quiet patients. My advice for the new medical person would be suspicious of a patient wanting to rest when the situation is telling you they should be climbing the walls.
I’d like to hear about your first patient and what lesson you can pass down to the new generation.
Jan,
This should make for an interesting thread! I honestly don’t remember my first patient. One of the ‘firsts’ that sticks with me the most, though, was my first unattended death. An elderly man who had been diagnosed with throat cancer. He didn’t wake in the morning. His wife, intending to take him to the hospital herself, dressed him but soon realized she was not able to get him to the car. Certainly upon our arrival, there was nothing to be done. I remember being very angry, mostly with the wife, thinking that had she called 911 sooner, he might have a chance. After some time, I came to realize that with a number of factors, including the cancer, the outcome likely wouldn’t have been any different. I also learned that people handle crisis differently. The wife, who likely had taken care of her husband for many years with little assistance, was simply doing what she had always done. These were some important lessons for me as a young EMT.
TR
My first two calls as a brand new volunteer EMS provider were pivotal. I most certainly could have quit before I really got started.
My first call was a heart attack call for a retired, elderly gentlman. I lived in a small town rural farming community where the Sheriff’s Dept. would back us up on our calls. In the end the patient survived and is actually still alive today, 10 years later, and the young, 30 something,football build, Sheriff’s Deputy who assisted me that day passed away just 4 days after that call, while on duty, of his own heart attack. Lesson:Don’t stereotype your patients.
Just a couple days after my first call was my second call which paged out as a vehicle fire where a van hit a bridge with the driver trapped inside. My heart sank hearing this knowing that I was about 10 miles away from the accident at the time and would probably not make it in time and felt utterly helpless. Once the fire was out we discovered there had been two occupants and probably no way of knowing who they were to notify family until a missing person’s report came in. The charred vehicle and bodies were well beyond recognition. Feeling a mix of helplessness and uselessness as well as a flood of other emotions, I searched the tall grass filled ditches methodically on the off chance that there could be a third victim out there who had been thrown free upon impact. I found no further victims but came upon a license plate on the opposite side of the intersection that turned out to belong to the charred van and had snapped free when they hit the bridge. Lesson: Sometimes we are meant to help serve the family more than the patient but we are never helpless or useless. It’s not always about the patient.
After having been literally “baptized by fire” into EMS I contemplated what I had gotten myself into at that point. I considered quitting multiple times over the next 10 years but then the call to deliver a baby would come in or some other rewarding call and I kept serving. Yes, there is the collection of calls in my mind that are the most memorable. I learned from each and every one of them. I just retired this month due to moving to a different town and the saying is most certainly true…It is the toughest job you will ever love.
Thank you for sharing Sharee. I agree that people find out if EMS is for them very quickly, it just clicked with me. You mentioned a strategy that I adopted and actually incorporated in the hospital-based service I ran…strive to make a positive outcome. It was not always the patient. Sometimes it was for family, survivors or even the other fire, EMS and law enforcement on scene.