I know the answer...but...

[c-spine]

My best friend was killed in a car accident 2 years ago tomorrow. He was riding in the back seat of his grandparents' car with his little brother; and grandparents were in the front. A pickup truck hit them going approximately 83 mph (according to the experts). The back seat was pushed up an absurd amount, and the car was pushed over 300 feet from impact.

There was a semi-truck in front of the car and luckiliy a first responder (or EMT, I'm not quite sure) was riding and hopped out to help. (The semi was turning onto a side road).

Thomas snapped his neck - but everyone was convinced he was breathing and had a pulse (agonal respirations?). They also said that when they did get the car cut apart and got Thomas out, that they used neither backboard or KEDs. Or any sort of precautions, for that matter.

I know the answer to this; but I still need the reassurance from other medical personnel. I haven't asked anyone in the medical field about it. I don't normally talk about it. Do you think there was a chance that he was still alive? Not that either answer will make a great deal of difference - he's still dead because of a careless driver. But I'm still curious to get input from other FRs, EMTs, Medics, etc.

 

[rescuecpt]

I don't know what to tell you. It's hard to hypothesize without having been on scene to see it for myself. If the diagnosis was that his neck was broken, then he may have been alive for a little while, but maybe not. Especially with younger patients responders sometimes feel a pulse or breaths that really aren't there, because they so badly want them to be. As far as the KED or collar, etc., if the scene was safe enough to take the time to cut him out, then they should have taken the time to immobilize him - but if his neck was broken already immobilization probably wouldn't accomplish much.

My cousin died in a similar way, he was in a car that was in a fender bender but was so tall (like 6'8") that he broke his neck when his head hit the rollbar. Everyone else walked away.

I'm very sorry for the loss of your friend.

 

[c-spine]

Thanks... you too.

His mom still refuses to wear a seat belt (though she wasn't in the car at the time). She just recently got into an accident and wasn't wearing a seat belt. The front end of her car was demolished, and she had bruises on her knees from sliding down and hitting the dash under the steering wheel; and burns from the air bags. Her theory is "seat belts don't save lives" because her son died (while wearing a seat belt).

It's sad. People need to take time to realize that they're driving a couple thousand pounds of metal. Though safety has improved greatly; they're not indestructable. And nor are people. -sigh-

 

[MMiz]

I too am sorry for your loss. I don't think any of us could say whether or not he was still alive, or could have even recovered from the incident. There are far too many variables that we don't know, and even with that information I'm not sure anyone could give you any information beyond a wild guess. I can tell you that I've taken patients out of cars without backboards or KED devices. Sometimes there isn't the time or room to properly immobilize the patient. We do our best with the situation we're given.

I think it's safe to say that the people involved did whatever they could to save his life.

 

[gradygirl]

I am so sorry to hear about this. Like everyone else has said, I'm not sure there is much to glean from the account as none of us were there.

As for his mother not wearing her seatbelt, that's very irresponsible. My high school friend's older brother was involved in a crash and was thrown through the windshield; he died on scene in his friend's arms. He was an unrestrained passenger who would still be here if he had been wearing his seatbelt. I'm not sure what else can be said to his mother, as she seems utterly convinced, but I hope that she will realize the importance of restraint.

 

[c-spine]

Thanks, all. Someone (I think the truck driver who was on scene) might have mentioned that Thomas was still breathing (agonal respirations, but she didn't say that); and his mother took it to mean that he was still alive. She blamed the medical crew, and before I took the Basic class, I did too for a while. My first thought was 'why didn't they put him on one of those boards?' But I took the class and learned about CSF and head trauma, etc... in the sentencing, Thomas' father was telling of how losing Thomas has affected him, and he said the worst part was Tyler (Thomas' brother) having to watch his brother die - he mentioned that Thomas was bleeding from his ears... which is a sign of massive head trauma.

I'm going to use that scenario, if you don't mind, Tcert, to see if I can't open her eyes. And her son, Tyler, after his mom got into her accident, was really afraid that she was going to die; and she was all convincing him that she's ok and 'not going anywhere.' You'd think that her son's concern would be enough... but no... -sigh-

I lost one best friend to a car accident, I don't need to lose one who has been like a mother to me.

 

[MMiz]

Here's my seatbelt story...

A family was driving down the local interstate one summer night. A man that had too much to drink sped down the interstate too. I believe he had hit multiple items that were lodged in his car, and multiple people phoned 911.

Around 10:00 PM or so I hear a call go out for an MVC with multiple patients pinned in car. ALS units respond while I continue on my way to the granny stackers where I had a call waiting. I then hear PD ask for additional units over their radio, so I radio that information to dispatch and respond RLS to the scene.

When I got there the car we had to crawl through the back window to pull our patients out. Because of the limited space, and fear that the car would go up in flames, we only had time for a c-collar.

Everyone that was wearing a seatbelt, the drunk included, was fine. The one women happened to take off her seatbelt because it had gotten too tight. Before she could put it back on she was struck by the drunk driver. She died on scene.

There is no excuse for not wearing a seatbelt. Having worked in EMS, I can tell you that they absolutely save lives. I've seen accidents that looked horrible, but a restrained person walked away from it. I can't say the same for those who decide not to wear seatbelts.

 

[c-spine]

Her excuse is that because her son died in the accident, that seatbelts don't save lives, so why bother.

 

[Ridryder911]

Anyone can make any analogy for anything if need be. Although, I am no psychologist, but I highly suggest that she needs to seek counseling. There appears to be a lot of displaced anger, blame, and even more so of problems of inappropriate grieving than one may be recognizing. I also wonder of potential tendency of suicidal ideologies and risk taking as well.

It takes a lot of trauma to kill someone, especially blunt trauma. That is why research is showing blunt traumatic arrest should NOT be attempted to be resuscitated and worked upon.

Although, it does not help, but it is very doubtful that her child suffered. With a description of such injuries, head, with c-spine would be one of the fastest and possibly painless deaths. If I had my choice especially in trauma this is the fastest and most humane death.

Yes, the 1'st responder might had seen agonal breaths, but again so many assume "guppy breathing" and true respiratory drive is the same, while it is not. It is a shame that the first responder was careless in describing the scenario as such. If I had been on the call personally, I would had not treated at all and left the body for M.E.

Although, if they were going to treat the child, yes spinal immobilization to a point should had been used, but if the child was so seriously KED immobilization is NOT appropriate treatment at that time... rapid removal from car using manual, or LSB should be used for aggressive treatment. Again, most EMS would not have progressed this far other than pronouncement of death.

This family needs psychological counseling and fast. Possibly discussing this scenario with a hospital Chaplain, counselors, etc. to obtain a a good therapist for this family. These tragic events can and do destroy lives, families, and can cause them to have potential risks to themselves and others at the same time. This was a tragic event and the wounds it caused was more deeper than the wounds to the child.....

I wish you the best of luck..

R/r 911

 

[DT4EMS]

LEt me ask a question.........

"Who" said they saw him breathing? Friends or family members? I know of first responders and EMT's who have been worked up and siad "He has a pulse", I have checked and didn't feel one. Then hook up the monitor and see Asystole. It is usually unlikely for a person to go from having a pulse to Asystole in an instant. It may be due to the stress of the situation people may have been a little confused over what they saw. These are just thoughts and questions I had. I was not there, so I am only speculating.

The other thing is "if" he was in cardiac arrest, that clasifies as a rapid extrication situation. In other words, if the medic felt there was something that could be done, they will try to manually hold C-Spine and pull the person out, not taking the time to KED or short spine board.

Even now the new teaching of CPR teaches people to try the jaw-thrust to open the airway, but if that didn't work to use the head tilt-chin lift.

ANother point is cardiac arrest secondary to blunt trauma has less than a 1% survival rate. I am very,very sorry for the loss of your friend.

 

[c-spine]

-nod-

I've gotten over blaming the rescue teams... it's not their fault. I didn't understand how EMS worked at the time, and so was naive as to what went on. It makes more sense now that I've gone through the class.

I think the family and the first person on scene said he was breathing, but like I said, it may have only been agonal respirations. I did the same thing once... mistook agonal respirations for actual respirations.

So... I dunno.

 

[DT4EMS]

The more you are in the biz, the more you wil see how we (in EMS) are usually on the receiving end of doubt. Sometimes we deserve it, but most often times we do not.

I worked a cardiac arrest not all that long ago, where we had a 4 min response time. On arrival I could see the guy looked bad (not a code yet).

We scooped and headed for the truck. We had a 40 min transport time to te hospital code 3.

He had "the big one" within minutes of us getting him in the truck.

Even with the logs from dispatch, the family still swore it took us 20 minutes to arrive.

See stress does things to our perception. It also affects the way we remember things.

In DT4EMS Classes, after the participant is attacked by the person in the "FIST" suit we have them write their name on a piece of paper. Most of the time it is difficult for them to read their own writing.

You can also ask them what happened and they really don't recall until we show them the video tape.

Stress is stress. The body has proctective mechanisms that even though they protect us physically, they may hinder us mentally.

Just remember how you feel being on the family side of this situation. It will help you deal with the EMS side later.

This is another reason why I say on fatal scenes, the family needs to be treated as yor patient as well. It saves trouble later, plus it is the "right" thing to do.

 

[c-spine]

I've always been a "people-person." I swear that I'm not... but I guess I'm good with people. I used to work for a CBRF and I've had people on the phone that I had to put on hold (ok... put the phone in my pocket...no "hold" button) and take care of a resident...such as putting one back to bed cause he's got dementia. I came back on the phone and the caller said that I was really good with the residents.

I've always put myself in the family's shoes, whether I should or not. I was on my way to work and ended up at a scene with a 23 year old male (fatal scene) in a truck where he was not wearing a seat belt. My first thought after "omg..omg..omg" was ... does he have kids? A wife? Brothers, sisters; who are his parents? What I'm most surprised by is the fact that I stayed calm through the entire incident. I was the first person on scene with any medical training. I was only about half way through my basic class. 2 other guys were there and I told them what I wanted them to do, and they did it without thinking. I think it was just because I was calm about it. I was fine until I walked away, got into my car and looked back at the scene with the fire crew, the rescue crew, the ambulance crew and a bunch of cops that I lost it.

I dunno... I think that i'm a stress magnet.

 

[gradygirl]

I dunno... I think that i'm a stress magnet.

Ditto. I will tell you what a very wise person once told me: compassion is your greatest virtue, but too much compassion is your downfall. Everything must be in moderation, for if you give too much of yourself to others, then you won't have enough of you for yourself.

 

[c-spine]

My dad has told me something similar. He's told me that I need to take care of me before anyone else. My friend's stepdad died unexpectedly 5 months after my best friend and I had my dad take me over to their house (they asked me over). I wouldn't eat. Adrenaline, worry, and a mix of a million other emotions prevented it. It was a long week, I'll tell you that...but I managed it. I need to work on taking care of me; but it's hard - I've always given myself to people. -shrug-

 

[Ridryder911]

If you don't take care of your self first, you will not be any good to provide thorough care to others. One needs to learn empathy from sympathy, you can feel generically for those victims, but to dwell have an over emotional response, one will never make it in this business. You have to be able to clear emotions and thoughts immediately after they occur for the next run, your next patient deserves all your attention. This is the part of the deal that either one can make it or not.....

R/r 911

 

[c-spine]

Yeah... It's something I need to work on. I'm still not on a service yet, and have been trying to get on one. I can't actually do any patient care with the first responder group until I have my state license, which could be a while; and I dunno. I need to work on not being so sympathetic/empathetic/what-have-you.