Friday, February 5, 2010

Eight years and I still remember!

It was eight years ago, Labor day weekend, people everywhere, enjoying that last weekend before the school year. A typical day at the firehouse as well, the only difference between a holiday or normal day is that we are allowed to watch TV at noon, instead of five in the evening. Otherwise our day is filled with routine work consisting of house chores, rig checks and responding to calls. Hoping that instead of walking into chaos, we could rest throughout the afternoon. As most people I do not remember much of that day, however, one event that I will never forget, still haunts my mind today.

Responding to the tollway that Labor day, I was on the ambulance, getting reports of ejections, knowing I was coming into a bad situation. My mind began thinking of all the possibilities, always thinking worse case scenario, hoping that I am wrong, knowing that your gut is usually right. As expected the closer we got, the traffic slowed, then stopped, we could see it was stopped in both directions, riding the shoulder we slowly got closer to the accident. As usual we had already launched a helicopter, knowing that we can always return them if not needed. But today I had a feeling that they were needed.

As we came upon the scene we couldn't even get across to the other lanes of the expressway, grass median in the middle, cars everywhere, traffic stood still on both sides. We could see people surrounding someone on the ground in the roadway, same with the median. A car split apart, silver in color, resting halfway in the road and on the shoulder. The trunk of the car and rear axle were located in the median. Debris everywhere, it was hard to tell how many vehicles were involved. Your mind has mere seconds to input all of the information, with training, schooling and experience, your body naturally sets in motion doing what you have been trained to do. It is only afterwards that your mind is allowed to think, wondering if you did everything possible to save a life, still knowing that it was unsavable.

My partner and I split up, triaging how many patients, the severity of their injuries, it was then that we realized the magnitude of this accident. My partner went to the child in the median, not realizing it was a child until she moved through the sea of people to gain access the victim. I saw the driver for a brief second, still sitting in the car, crying, unknown if she was injured, assuming she was, like I was in slow motion, I was distracted by the people doing CPR on another child in the roadway.

Our Captain had arrived with us as well and he had put the wheels in motion for more ambulances, knowing that we were committed to our most severe patients. Mine being the most severe of them all. Alone, by myself, I grabbed my monitor, jump bag(everything I need to immediately render care,including drugs and airways). Doing the same thing as my partner, parting the sea of people, gaining access to my patient.

While they were doing CPR the woman shouted at me that she was a nurse, which I truly appreciate. I rapidly began placing the monitor on the child, wanting to see what her heart was doing. The nurse on the other hand was thrown into something that she is not accustom too, being in the field, which is a drastic difference from the controlled environment of whatever hospital she worked for, alot less equipment and people to ask for assistance. I knew she was rattled, I couldn't get her to stop CPR just to see the monitor. She had now become a hinder and not a help, which often happens in this type of situation.

I am pretty sure I yelled at her to stop, finally I could see and the monitor, it showed a rhythm, now feeling for a pulse. People shouting to do something, the nurse still wanting to do CPR, it was chaotic, stressful, sweat was rolling off my brow. To this date it amazes me the things that I remember so clearly and things I hardly remember. I began working on this little black girl with pig tails. Her brown eyes looking at me, fully dilated, staring, now realizing she was probably dead. Checking to see if she was breathing, which she was not, grabbing for my equipment, trying to give her the best care that I could.

It was not long after that when the neighboring department showed up for assistance. They too cover the expressway to the west, they were returning from the hospital and came upon our accident. One of the EMT's who worked part time with us as well, came running up to lend a hand, asking what I needed, soon followed by two other crew members giving us a total of four. Meanwhile the Captain informed me the helicopter was coming for my patient. My job was now to keep her alive until they arrived.

Everything was moving at such a fast pace, however, at the moment, it seems as if life is standing still. The other crew brought necessary equipment so that we could package this girl and get her off of the roadway into our environment, away from onlookers, allowing us to do our jobs. I was handed the C-collar, holding her head, the EMT and I placed the collar around her neck. As we did this, I looked over to see the monitor, watching her heart change from a heart rate, to a pulse less rhythm. Quickly we placed her on a board, connecting the straps and rushing into the ambulance.

Hollering at the Captain, letting him know that we arrested, redirecting the helicopter, which was now for our patients sibling. Grabbing my bags, I hopped aboard our neighboring departments ambulance, telling the other EMT to just drive. The other paramedic who I also worked with before, just sat there, stunned, frozen, unable to help. Her EMT partner yelled at her as well, still frozen, I was left to do it all. The EMT was doing everything he could, while I used my paramedic skills, meanwhile she sat there, staring, unable to help.

I remember looking at her, asking for her assistance while I tried to secure an airway.Essentially I was trying to stick a tube down this seven year old's throat, while bouncing down the roadway. I felt inadequate that day, not having my normal crew and surroundings, making the best of what I had. I felt like I had worked for hours on this young girl, feeling as if I was running a marathon with no end in sight. Looking at her brown eyes, I knew she was gone, I continued working.

As we arrived at the hospital, we were surrounded by staff, all feeling the same way, wanting to help. In a matter of what seemed seconds, the doctor came in, stopped everyone, checked the monitor, felt for pulses. Asking how long we had been working, an estimate of time was given. He gave some orders and the staff resumed their roles. We all stepped back watching them work as well, hoping for a miracle, realizing what was to become the outcome.

Our crew then removed ourselves from the room, I was physically and mentally drained, wondering if I did everything I could. Wondering if putting that collar around her neck, was the stamp that sealed her fate. Everyone was quiet, not a word was said. Slowly we began to replace and clean our equipment, preparing for the next call. Silently we all climbed back into the ambulance so that we could return back to the station. As we arrived at my department, I graciously thanked the other crew. Sending them back to their department, humbled by that days events.

Later that evening they returned for CISD otherwise know as Critical Incident Stress Debriefing. This debriefing is supposed to allow the emergency workers the opportunity to discuss the event, allowing them to opportunity to know that this is normal to feel the way we do. Some handle it better than others, some talk about it freely, others keep it hid inside. I remember talking about how I could still smell her blood, see her eyes, but I never admitted to what I have always wondered.

Still eight years later, I still ask myself, if I did everything right that day.