Accident: OMFG

[Chimpie]

Video: Watch the guy on the left crossing the intersection. [Mod Note: Link Removed: see bottom of post for more]

STORY:

DAYTON | Doctors revived a man Sunday just hours after medics pronounced him dead on the scene of a car crash, police officials said.

Dayton Police Sgt. Charles Hurley said Scott Tegtmeyer was walking in the intersection of Third Street and Edwin C. Moses Boulevard at 12:40 p.m. when a Chrysler PT Cruiser ran a red light, struck a Subaru sports utility vehicle and sent it into the air.

The Subaru landed upside down on Tegtmeyer and dragged him several feet across the intersection, Hurley said. Tegtmeyer, bloodied and surrounded by shattered glass, was pronounced dead on the scene, but he suddenly started breathing while in transit with paramedics. By 3 p.m., doctors had fully resuscitated him.

On Sunday evening, he was in the Miami Valley Hospital Intensive Care Unit.

Neither of the female drivers of the vehicles involved were carrying passengers. The woman driving the Subaru was transported to Miami Valley Hospital. Information on the condition of the driver of the PT Cruiser was not available. Hurley said police talked to eight witnesses. He also said it is possible a camera mounted high above the intersection captured the crash.

Dayton police reconstructionists, trained at putting clues together after crashes, were on the scene with digital cameras and measuring devices. The flipped Subaru showed noticeable crash damage on the left body panel. Ten yards away, the customized P.T. Cruiser with a "AAA" sticker on the back of its tinted windows showed damage to its front end. "

*Link removed by mod because the movie was changed to one that was inappropriate for the site. This is not the fault of this member, but most like the person who initially posted the movie to the internet

[ResTech]

OMFG is the best way to describe that one! I downloaded that and was like WOW!. Thanks for sharing that.

[ffemt8978]

WOW! :o I had to watch it three times. That is one lucky dude to be alive.

[rescuecpt]

Those are the accidents that I sit in the bus with my fingers crossed and pray "please have all your arms and legs attached, please have all your arms and legs attachecd" as we roll up...

[ffemt8978]

Originally posted by rescuelt@Jun 28 2004, 05:42 PM
Those are the accidents that I sit in the bus with my fingers crossed and pray "please have all your arms and legs attached, please have all your arms and legs attachecd" as we roll up...
Yeah, me too, cause they don't make a 6 foot by 3 foot trauma dressing yet.

[SafetyPro]

Wow, what a video.

My question is, if he was pronounced dead, why was he being transported by medics? Around here, once we make a field determination of death (only an MD can pronounce), the patient can't be moved until the Medical Examiner/Coroner arrives. Do EMS providers transport bodies in other areas?

[ffemt8978]

Originally posted by SafetyPro@Jun 28 2004, 09:25 PM
Wow, what a video.

My question is, if he was pronounced dead, why was he being transported by medics? Around here, once we make a field determination of death (only an MD can pronounce), the patient can't be moved until the Medical Examiner/Coroner arrives. Do EMS providers transport bodies in other areas?
Where I'm from, the ambulance transported the victim to the Morgue after the M.E. was done with the body.

[ResTech]

In my area EMS never transports the body. After we call the pt. priority 4 or deceased, we call the coroner to come out to investigate in cases of traumatic, young, and other unnatural causes.

For old-age/natural causes, we call the family physician and give the details and normally they will agree to sign the death certificate. After that we help coordinate funeral arrangements and have to stay with the body until funeral home arrives.

[rescuecpt]

In New York State, anyone can pronounce death. For an EMT to pronounce, the patient has to have either: rigor mortis, dependent lividity, obvious death, or decapitation. Otherwise, you work them. I was always told "they're not dead until they're cold and dead" (unless it was a cold water drowning, of course).

[sunshine1026]

Holy $#!^...what an incredible video!

Can you imagine what must have been going through his mind as he tried to duck out of the way? Good grief!

[SafetyPro]

We can "determine" death based on the following criteria:
Decapitation
Incineration
Massive crush injury
Decomposition
Evisceration of heart, brain or lung
Pulseless/apneic with extrication time >15 minutes and unable to perform resuscitation while trapped
Pulseless/apneic during a mass casualty with inadequate resources
Drowning with submersion >1 hour
Rigor mortis
Post-mortem lividity

For rigor and lividity, we have to also do the following assessment:
Check/open airway
Look/listen/feel
Auscultate lungs for 30 seconds
Auscultate apical pulse for 60 seconds
Palpate carotid (adults/children) or brachial (infants) for 60 seconds
Check pupil response
Check for response to painful stimuli

Once we determine death, we have PD secure the scene until the ME arrives and we leave (assuming there's not something else going on like a TC or fire).

Only an MD can "pronounce" (which can be done by radio contact with field EMS personnel) and sign the death certificate. The difference between "determine" and "pronounce" is a legal technicality.

If the patient is under a doctor's care and the death is related to that condition, the ME doesn't have to come. The body can be released directly to a funeral home, who will handle the transport.

[ffemt8978]

Our criteria for "obviously dead", which will allow us to pronounce is as follows:

Decapitation
Evisceration of heart or brain
Incineration
Rigor Mortis
Decomposition

Also, we do not use the AED/Defibrillator on patients who are in traumatic cardiac arrest (but we still do CPR :blink: )

[SafetyPro]

Originally posted by ffemt8978@Jun 29 2004, 07:48 PM
Also, we do not use the AED/Defibrillator on patients who are in traumatic cardiac arrest (but we still do CPR :blink: )
Same here. Reason is that traumatic arrest is caused by other factors (volume loss, neurological injury, etc.) rather than an arrhythmia, so defibrillation has little benefit.

[ffemt8978]

Originally posted by SafetyPro+Jun 29 2004, 08:31 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (SafetyPro @ Jun 29 2004, 08:31 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-ffemt8978@Jun 29 2004, 07:48 PM
Also, we do not use the AED/Defibrillator on patients who are in traumatic cardiac arrest (but we still do CPR :blink: )
Same here. Reason is that traumatic arrest is caused by other factors (volume loss, neurological injury, etc.) rather than an arrhythmia, so defibrillation has little benefit. [/b][/quote]
Yeah, same reason here. However, some EMT's take this to mean that trauma dead is dead and that they don't have to do CPR on a trauma victim. I found out that they were actually told this in their EMT class! :angry:

To correct this problem, I asked this scenario: What do you do if your MVA patient is in cardiac arrest? When they tell me that trauma dead is dead, I respond that there is minimal damage to the vehicle. My point being in this scenario is that the patient had a heart attack which caused a minor accident. I then direct them to the applicable portions of the protocols, so that they may educate themselves.

[ffemt8978]

Originally posted by Chimpie@Jun 28 2004, 02:21 PM
Video: Watch the guy on the left crossing the intersection. [Mod Note: Link Removed: see bottom of post for more]

*Link removed by mod because the movie was changed to one that was inappropriate for the site. This is not the fault of this member, but most like the person who initially posted the movie to the internet
I actually saved the video to my hard drive, but need a location to post it if you want. Otherwise, members can PM or e-mail me with a request and I'll send you the video.

[rescuecpt]

Originally posted by ffemt8978@Jun 29 2004, 11:38 PM
To correct this problem, I asked this scenario: What do you do if your MVA patient is in cardiac arrest? When they tell me that trauma dead is dead, I respond that there is minimal damage to the vehicle. My point being in this scenario is that the patient had a heart attack which caused a minor accident. I then direct them to the applicable portions of the protocols, so that they may educate themselves.
JEMS had a great article sometime in the past 9 months about "Seeing the whole picture" on an MVA.

Of course, the other MVA issue is low blood sugar that looks like intoxication.

[SafetyPro]

Originally posted by ffemt8978@Jun 29 2004, 09:38 PM
Yeah, same reason here. However, some EMT's take this to mean that trauma dead is dead and that they don't have to do CPR on a trauma victim. I found out that they were actually told this in their EMT class! :angry:
Never told us that, thankfully.

I did my ride-along during my training with an LA County FD paramedic squad. Third call of the day was a single motorcycle TC. Got on scene to find a yellow tarp covering our patient (PD had already decided he was DOA). He'd hit a center divider barrier on a 4 lane road and been thrown about 50 feet into the oncoming lanes. The medics went up and uncovered him...right leg was nearly amputated just below the knee. They hooked the monitor up to him, so we started working him (first time doing CPR for real for me). The docs ended up calling him about 5 minutes after we got to the ER...turns out his pelvis was totally crushed as well and he probably had major internal bleeding. Still, we did what we could.

[ffemt8978]

Originally posted by SafetyPro@Jun 30 2004, 04:37 PM
I did my ride-along during my training with an LA County FD paramedic squad. Third call of the day was a single motorcycle TC. Got on scene to find a yellow tarp covering our patient (PD had already decided he was DOA). He'd hit a center divider barrier on a 4 lane road and been thrown about 50 feet into the oncoming lanes. The medics went up and uncovered him...right leg was nearly amputated just below the knee. They hooked the monitor up to him, so we started working him (first time doing CPR for real for me). The docs ended up calling him about 5 minutes after we got to the ER...turns out his pelvis was totally crushed as well and he probably had major internal bleeding. Still, we did what we could.
I like to hook up a three-lead and see what the heart is doing. Unfortunately, a lot of our newer medics seem to be afraid of the three-lead and only think it is appropriate on a cardiac/chest pain call.

I feel that if I'm going to call medical control to pronounce, the least I can do is tell them the patient has no vital signs and is flatline.

[rescuecpt]

I found the JEMS article - it's the case of the month from February 2004, entitled: "MVA & AMS - Never assume the obvious, your patient's life is at stake" by Paul A. Matera, MD, EMT-P.

[TTLWHKR]

Yeah, me too, cause they don't make a 6 foot by 3 foot trauma dressing yet.

Sure they do... Get some military surplus, those things are sooooo freakin huge you'd bleed to death before it was completely soaked!

[MMiz]

The video can be downloaded at the very bottom of this page:
http://www.snopes.com/photos/accident/carcrash01.asp#add
I'd link directly to it, but I think it's best to just link to the page.