The neighbor said as she looked out her window across the complex she saw a doll falling from a window. She looked again and the doll was moving on the ground and she heard crying. She ran out and found a child on the ground below the second story window. The child’s dad called 911.
The call is toned out at the station; a toddler has fallen from a second story window.
Here comes the anxiety again. Of course it’s on the other side of town on a busy afternoon with plenty of traffic.
What’s going through your head as you roll down the road to another child in trouble? Knowing just days before another crew responded to a child that was killed in an accident involving a bicycle.
Is it our turn for the bad call?
Anyone in this business for very long has to take their turn, “please not today”.
Some people wonder when they hear an emergency responder say, “that was a good call”. You will never hear that in reference to a child that is really sick or injured. They are never “good” calls. Sure we all like to use our skills to help people but we don’t hope for tragedy to befall anyone. The “good” calls are the ones you can mitigate and make a difference in the out come, that’s a good call.
We arrive on scene to find the father leaning over the child who is lying on the grass crying, below the window she fell from. First glance and overall scene assessment brings a measure of relief. Crying and purposeful movement, on the grass not concrete, no obvious injuries, all brings a quiet sigh of relief.
Extreme mechanism for injury, so all the normal precautions are to be taken.
The screen broken and on the ground, I’ve seen this many times before. The child climbs on the bed, dresser or chair to look out the window leaning on the screen not realizing there is no protection. Out of the window the doll falls, sometimes from the ground floor but most of the calls we get are from the second floor or higher.
The child is secured to an immobilizer and transported to the emergency room. A follow up later that day revealed the child was virtually unharmed with a swollen lip and sprained wrist.
That’s a good call.
Saturday, July 10, 2010
30 Feet to Impact..
We’re dispatched up the canyon for a male that fell and is off the highway. We respond with technical rescue equipment and an ambulance not knowing how far off the road the patient will be or what kind of terrain we will have to cross with him. Even with lights and siren it takes us twenty minutes to arrive at the location on the highway where we need to be to access the patient.
A man stands on the side of the road waiting for us and ready to guide us in to the patient. I grab a bag of equipment and my paramedic partner grabs another bag and we follow the man up the steep side of a hill that is covered with thick trees. About forty yards up the hill, we find a collage age male lying at the bottom of a cliff. I look up at the cliff and recognize this climbing wall. I climbed this wall about eight years ago with some friends. It was not an easy climb. There are anchors placed in the wall of the cliff to increase the safety of the difficult climb.
As a climber ascends the wall they place a carabineer in the anchor and run their climbing rope through the carabineer so if they loose their grip and fall they will only fall a few feet. They get banged up against the rock wall but they should not fall to the hard ground below. When you are in the out doors safety should always be at the forethought, there are diverse ways to get injured. Climbing, repelling, hiking, spelunking (caving), rafting they all involve risk. In this case it turns out to be inexperience and lack of attention to detail.
The patient is alert and speaking in full sentences. This is a good sign after a fall of about thirty feet onto hard ground with rocks and not wearing a helmet. Yes, that’s right another lucky one. He landed about two feet from a huge bolder that would have surly cracked his head open like a watermelon. His complaint is his right foot and rightly so. It’s attached only by the skin around the ankle. Another tib/fib fracture but this one almost severed his foot off.
I leave my partner and quickly get back down the hillside where the rest of the crew including a few chief officers, are just arriving. One of the officers asks me what we will need to get the patient down to the waiting ambulance. I tell him we will need to set up a lowering system for the stokes-basket and that our patient is not critical but has a serious fractured ankle. I grab the stokes-basket and give the other crew members some direction as to what needs to be done and head back up the hill. We use the stokes-basket to remove patients from off road areas. Shaped like a basket that an adult can lay down in and be immobilized while the rescue workers move them out of the back county, sometimes miles, to an ambulance.
One of the chiefs brings rope and equipment up the hill and starts setting up anchors for the lowering system while another chief helps my paramedic partner splint the ankle. One of the firefighters hold manual stabilization of the head and neck. I ready a bag of IV solution for one of the firefighters who is starting an IV. We administer pain medication through the IV. As the patient receives relief from the pain we roll him onto a backboard and secure him for the stokes-basket. He is placed carefully into the basket and lowered down the hill side. The basket is tied into the lowering system. Six of us hold up the basket and the chief gently lowers us all down to the waiting ambulance. The patient is removed from the stokes-basket, placed on the cot and readied for transport. The ride down the canyon was uneventful with repeat vital signs and reassessments.
He tells us that he side loaded an unlocked carabineer and that was the cause of the fall. I don’t say anything to him but I noticed when I removed his pelvic harness on the hill it was not secured properly. It didn’t fail this time but he will have plenty of time to learn the right way to lace it before he climbs again.
A man stands on the side of the road waiting for us and ready to guide us in to the patient. I grab a bag of equipment and my paramedic partner grabs another bag and we follow the man up the steep side of a hill that is covered with thick trees. About forty yards up the hill, we find a collage age male lying at the bottom of a cliff. I look up at the cliff and recognize this climbing wall. I climbed this wall about eight years ago with some friends. It was not an easy climb. There are anchors placed in the wall of the cliff to increase the safety of the difficult climb.
As a climber ascends the wall they place a carabineer in the anchor and run their climbing rope through the carabineer so if they loose their grip and fall they will only fall a few feet. They get banged up against the rock wall but they should not fall to the hard ground below. When you are in the out doors safety should always be at the forethought, there are diverse ways to get injured. Climbing, repelling, hiking, spelunking (caving), rafting they all involve risk. In this case it turns out to be inexperience and lack of attention to detail.
The patient is alert and speaking in full sentences. This is a good sign after a fall of about thirty feet onto hard ground with rocks and not wearing a helmet. Yes, that’s right another lucky one. He landed about two feet from a huge bolder that would have surly cracked his head open like a watermelon. His complaint is his right foot and rightly so. It’s attached only by the skin around the ankle. Another tib/fib fracture but this one almost severed his foot off.
I leave my partner and quickly get back down the hillside where the rest of the crew including a few chief officers, are just arriving. One of the officers asks me what we will need to get the patient down to the waiting ambulance. I tell him we will need to set up a lowering system for the stokes-basket and that our patient is not critical but has a serious fractured ankle. I grab the stokes-basket and give the other crew members some direction as to what needs to be done and head back up the hill. We use the stokes-basket to remove patients from off road areas. Shaped like a basket that an adult can lay down in and be immobilized while the rescue workers move them out of the back county, sometimes miles, to an ambulance.
One of the chiefs brings rope and equipment up the hill and starts setting up anchors for the lowering system while another chief helps my paramedic partner splint the ankle. One of the firefighters hold manual stabilization of the head and neck. I ready a bag of IV solution for one of the firefighters who is starting an IV. We administer pain medication through the IV. As the patient receives relief from the pain we roll him onto a backboard and secure him for the stokes-basket. He is placed carefully into the basket and lowered down the hill side. The basket is tied into the lowering system. Six of us hold up the basket and the chief gently lowers us all down to the waiting ambulance. The patient is removed from the stokes-basket, placed on the cot and readied for transport. The ride down the canyon was uneventful with repeat vital signs and reassessments.
He tells us that he side loaded an unlocked carabineer and that was the cause of the fall. I don’t say anything to him but I noticed when I removed his pelvic harness on the hill it was not secured properly. It didn’t fail this time but he will have plenty of time to learn the right way to lace it before he climbs again.
What! No Helmet ?
There is always additional adrenalin pumping through the blood stream when responding to a child hit by a vehicle. The tone sounded and dispatcher stated a child on a bicycle had been hit by a car in an area of town that is on far edge of our response district. I knew it would take extra time to arrive on scene. We respond to that area of town for fire alarms almost every shift rotation. Now a child is hurt and traffic is heavy. We can't get sloppy with our response and cause an additional accident, more injuries or worse. That will delay help for the child that's laying on the road now waiting for us. I know the child is frightened and if the parents are on scene time is dragging very slowly, it will seem like forever if the child is in serious condition.
We arrive to find a crying child laying on the edge of the street. I'm already relived...crying means mostly good things when it comes to children and trauma. After a quick glance over the patient my anxiety was mostly gone. I could see a probable fractured leg and a scared child reacting normally.
The lead medic was talking to the child explaining what was being done and what would be done for him. I spoke to the mother and found out the child was not wearing a helmet, had no past medical history or allergies, was not taking any medications and the name of their family doctor. Information that is useful to the lead medic for good patient care.
I grabbed the the vacuum splints while my firefighter held manual stabilization of the child's' leg. The lead medic was holding manual stabilization of the c-spine while his partner readied the ped immobilizer (a mini back board for children). I gently removed the child's shoe and sock on the affected leg. I then checked for capillary refill and a pulse before we wrapped the leg with the vacuum splint. Since the vacuum splint was introduced in pre-hospital care in 1993 it has proven to be a very effective tool for splinting and conforming to the body in a way that avoids impeding circulation or manipulating the bones unnecessarily. The child was then secured to the ped immobilizer and loaded onto the cot for transport.
On the way to the hospital an IV was established and the child was calmed down. A lower tib/fib fracture and that was the extent of injuries. Hopefully a lesson learned by both the child and the mother. It happens fast so ware a helmet and remember cars can hurt, mam and kill.
It's always easier to sleep when you don't have to think about how a mother and/or father will deal with the loss of their child or how the driver of the vehicle that just killed a child is going to move on with their life. Both sides of the story are not the story book ending you see on TV or typically read in a book.
We arrive to find a crying child laying on the edge of the street. I'm already relived...crying means mostly good things when it comes to children and trauma. After a quick glance over the patient my anxiety was mostly gone. I could see a probable fractured leg and a scared child reacting normally.
The lead medic was talking to the child explaining what was being done and what would be done for him. I spoke to the mother and found out the child was not wearing a helmet, had no past medical history or allergies, was not taking any medications and the name of their family doctor. Information that is useful to the lead medic for good patient care.
I grabbed the the vacuum splints while my firefighter held manual stabilization of the child's' leg. The lead medic was holding manual stabilization of the c-spine while his partner readied the ped immobilizer (a mini back board for children). I gently removed the child's shoe and sock on the affected leg. I then checked for capillary refill and a pulse before we wrapped the leg with the vacuum splint. Since the vacuum splint was introduced in pre-hospital care in 1993 it has proven to be a very effective tool for splinting and conforming to the body in a way that avoids impeding circulation or manipulating the bones unnecessarily. The child was then secured to the ped immobilizer and loaded onto the cot for transport.
On the way to the hospital an IV was established and the child was calmed down. A lower tib/fib fracture and that was the extent of injuries. Hopefully a lesson learned by both the child and the mother. It happens fast so ware a helmet and remember cars can hurt, mam and kill.
It's always easier to sleep when you don't have to think about how a mother and/or father will deal with the loss of their child or how the driver of the vehicle that just killed a child is going to move on with their life. Both sides of the story are not the story book ending you see on TV or typically read in a book.
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