AAR: 2 Vehicle MVA w/ Entrapment... How did I handle it?

[Twitchy]

So today was interesting... On the way to school encountered a 2 vehicle MVA, Dully Truck Vs SUV / multiple entrapment... Was a nearly head on collision at around 45+ MPH, no brakes applied before impact. Below is basically what I found when I arrived, after I conducted a mental triage of victims. Chose to extricate one victim to get him out of the hazardous situation, and he was not complaining of injury... From their, I handled the patient still pinned in the car... Then I attended the others (Already generally okay since they were discussing what happened, AKA walking wounded (Level Green Triage) )

Oh, and a nurse arrived and did absolutely nothing but call 911 as another bystander and I extricated the victim...

PT 1 was a 20-22 YO Male, had minor injury to the bridge of his nose, was driving the truck...

PT 2 was a 16-17 YO Male, was driver of the SUV, no injuries except some abrasions to the face from the airbag deployment...

PT 3 was a 16-17 YO Male, was front right passenger in the SUV, complained of pain in his left leg. was pinned in the car by the dash and his door was jammed quite bad... Also complained of a "Fuzzy, numbness feeling" around his body, primarily on the right side... He was also conscious and coherent, able to explain the pain he was having in a calm manor... Not sure of his VS as was unable to get them.. Had I, I would have handled that situation differently as it later turns out he had a very close call with a puncture wound within an inch or so of his femoral artery.

PT 4 was a 16-17 YO Male, trapped in the back due to the back doors being jammed from the accident. Me and another guy that stopped got a passenger door open to get him out of the vehicle. Claimed he was fine w/ no visible injury (He was moving around quite a bit trying to kick the back door open)...

After we got the one PT out of the vehicle, I attended to the severely injured PT until the paramedics arrived...

Did I mention that the cops were useless, more interested in getting ID's than helping the patients initially? One was so oblivious to his surroundings that he stood in a puddle of gasoline / motor oil that was leaking near a smoldering car... sigh...

Basically, arrived on scene, triaged the patients according to needs, and handled the situation from there... Critique?

(No injuries that were visible that i was able to treat as a BLS responder, FWIW)

- - - Updated - - -

FWIW, I was simply driving to school and encountered this... Handled it quickly, We had everything ready for medics to take over when they arrived about 7 minutes after I did...

[4suchatimeasthis]

As nothing more than your average uneducated, uncertified and untrained civilian, I would have loudly hollered "hey NURSE/OFFICER, can I get a little help here!" while extracting people. Then again, if there are puddles of fluids around smoldering vehicles, maybe people were being cautious?

Other than that, it sounds like you did all you could, to me.

Offhand, I wonder if it would do any good to keep a pry bar or crow bar of some sort in the trunk, for just this type of thing. Hhmmm....

[bacpacker]

Twitchy, sounds to me like you did good considering the situation! Main thing you were able to give some aid to the ones that needed it and had things set by the time the paras got there.
Glad things worked out for all them.

[apssbc]

You did just fine by the sounds of it. Handled it the same way I can imagine I would have, and I do this on a regular basis. Triage is most important on scenes like this and it sounds like you did well. Part of EMS is choosing who lives and who dies sometimes. The other day had a massive head on PI major damage with rollovers and entrapment to both vehicles. A "doctor" on scene told me one patient was "Fading fast." Being the first unit on scene I checked this patient and sent my partner to the other. Decided my patient was going to be a DOS and wasnt worth the effort in delaying extrication of the other patient to try and probably not succeed in saving her. So it was off to the other patient.

A few things to learn about car accidents here. PD generally does info gathering on major scenes. Most have no medical training, many have no medical kits in their cars. Very few are adept enough to actually help instead of hinder. I always watch out for them getting into dangerous spots cause lets face it they are our brothers and sister too. They just do a different job.

Nurses...god bless them most tend to be utterly useless on scenes of emergencies. Think about it they are used to dealing with patients who are semi stabilized when they get them. Plus they do not have to make many choices in full on emergency situation. Sure they have codes in a hospital, but nothing compares to a multiple patient car accident, or house fire when they pull five patients out. They just dont do that.

We have 2 or so years of training and operate by ourselves doing most anything a er doctor does in the field with no one telling us what to do. They need doctors orders to do just about anything. Really the only life saving things a doctor can do that we cant is chest tubes, central lines, and special diagnostic equipment. ER docs usually wait for the surgeons to show up and make the calls anyways. Its just a difference in the jobs. Moral of the story dont expect much help from in hospital medical providers.

Otherwise solid work.

[Twitchy]

As nothing more than your average uneducated, uncertified and untrained civilian, I would have loudly hollered "hey NURSE/OFFICER, can I get a little help here!" while extracting people. Then again, if there are puddles of fluids around smoldering vehicles, maybe people were being cautious?

Other than that, it sounds like you did all you could, to me.

Offhand, I wonder if it would do any good to keep a pry bar or crow bar of some sort in the trunk, for just this type of thing. Hhmmm....

Its possible, but we were pretty far away from the liquids...

A crowbar would have been pointless in this situation... true jaws of life moment...

On another hand, If we had been able to get him out, it may have complicated his condition, it was a situation to let the medics decide in and I made the decision to just get his info for the medics... I didn't have the equipment or training to safely extricate him...


Twitchy, sounds to me like you did good considering the situation! Main thing you were able to give some aid to the ones that needed it and had things set by the time the paras got there.
Glad things worked out for all them.

Thanks!


You did just fine by the sounds of it. Handled it the same way I can imagine I would have, and I do this on a regular basis. Triage is most important on scenes like this and it sounds like you did well. Part of EMS is choosing who lives and who dies sometimes. The other day had a massive head on PI major damage with rollovers and entrapment to both vehicles. A "doctor" on scene told me one patient was "Fading fast." Being the first unit on scene I checked this patient and sent my partner to the other. Decided my patient was going to be a DOS and wasnt worth the effort in delaying extrication of the other patient to try and probably not succeed in saving her. So it was off to the other patient.

A few things to learn about car accidents here. PD generally does info gathering on major scenes. Most have no medical training, many have no medical kits in their cars. Very few are adept enough to actually help instead of hinder. I always watch out for them getting into dangerous spots cause lets face it they are our brothers and sister too. They just do a different job.

Nurses...god bless them most tend to be utterly useless on scenes of emergencies. Think about it they are used to dealing with patients who are semi stabilized when they get them. Plus they do not have to make many choices in full on emergency situation. Sure they have codes in a hospital, but nothing compares to a multiple patient car accident, or house fire when they pull five patients out. They just dont do that.

We have 2 or so years of training and operate by ourselves doing most anything a er doctor does in the field with no one telling us what to do. They need doctors orders to do just about anything. Really the only life saving things a doctor can do that we cant is chest tubes, central lines, and special diagnostic equipment. ER docs usually wait for the surgeons to show up and make the calls anyways. Its just a difference in the jobs. Moral of the story dont expect much help from in hospital medical providers.

Otherwise solid work.

I guess i do see where you come from with the nurses... lol...

I did mention to the cop that he was basically an unlit human roman candle at the moment, just in more professional terms... "Hey, officer, excuse me, but your standing in a puddle of possibly flammable chemicals near a smoldering vehicle, might want to watch out!"

It was an interesting situation considering I had to decide how to proceed with who to treat, who I could effectively treat / extricate, etc. By the time rescue arrived they only needed to work on the still entrapped patient... I am always one to try to get as much info to dispatch to give to the rescue so they know what they are rolling up on... IT helps them treat the patients much more effectively...

What is your professional opinion on PT 3?

[apssbc]

Pt3 was conscious and coherent which means he has a pulse and is somewhat stable. The fuzzy feeling could be from a head injury, spinal injury, or even temporary nerve damage. Could even be his reaction to the adrenaline of the situation. Depending on the leg wound and what all was there you probably made the right call. Nothing you could have done without jaws so you did all you could with the resources provided.

[Twitchy]

Pt3 was conscious and coherent which means he has a pulse and is somewhat stable. The fuzzy feeling could be from a head injury, spinal injury, or even temporary nerve damage. Could even be his reaction to the adrenaline of the situation. Depending on the leg wound and what all was there you probably made the right call. Nothing you could have done without jaws so you did all you could with the resources provided.

That is pretty much what I figured... Just wanted your opinion... Like you said, not much I could do other than pass on to the medics what I found out...

[Twitchy]

I should probably mention that this is my first severe injury / trauma incident / complicated emergency that I had to deal with...