By Michael N. Ciampo
History always has a sense of repeating itself and, unfortunately, those to whom we respond to help, serve, and protect often come up on the short end of the stick. The night before Thanksgiving, I always have an eerie feeling in my gut when working the night tour because of the kids home from college who are out partying, socializing, and having mini-reunions. Luckily, many times the tour is quiet and nothing unusual occurs, but then there are those memorable events that will forever be etched into your mind on an occasion that should be for family and giving thanks.
It was about 0430 hours, a notorious time for tragic accidents because of the bars closing at 0400 hours. We responded to a motor vehicle accident with people pinned on a stretch of highway notorious for bad accidents. During the response, the dispatcher gave us additional information of people pinned in a car that hit a tree. While responding, the chauffeur and the officer were discussing the highway’s curves and blind spots so that the rig didn’t come around a bend and add to the accident scene. Remember, responding to the scene on the highway doesn’t give you the right to have the “pedal to the metal”; anticipate that the accident could have occurred at a bad spot in the roadway. In addition, fire apparatus don’t stop as quickly as regular vehicles because of size and weight, so be prepared when you can’t see the roadway in front of you!
As we approached the scene, we were a few hundred feet back from the accident and attempting to use the shoulder as our roadway, like so many others who have a disregard for the lights and siren and don’t want to become stuck behind an accident scene. As we got closer to the scene, we could see three cars sitting precariously between lanes, and the other responding units coming from the other direction were stuck in “rubbernecking” delays. In some cities, it is normal response protocol to have units respond from both directions in case one side of a highway is shut down or unapproachable. In addition, it allows units to cover ground before and after the “reported” location in case the caller is off with the exact landmark, direction, or location of the accident.
As we got to the location, three cars sitting across the highway made it look like it was a “fender bender.” Off the shoulder and up an embankment, a car hit a tree, and its four occupants were either pinned or ejected. Immediately, the chauffeur parked the apparatus so that it closed down the highway and used it as a physical abutment to protect the rescue workers while they assessed the three vehicles strewn across the highway. Although shutting down the highway can cut off additional responding units’ arrival, you must make the scene safe for the initial rescue workers. Use the apparatus and its warning lights, traffic cones, and road flares to protect members. Once you size up the scene and make it safe for personnel, you can decide whether to reopen any lanes of the highway to allow other units to respond. If the accident scene on the roadway looks minor, keep in mind injured victims could be in the vehicles or on the opposite side of the vehicles on the roadway.
We turned on the floodlights, enabling us to quickly size up the scene and have better visibility as we approached all the vehicles. One member chocked the rear wheels to make sure the vehicle would not roll down the embankment back toward the rescuers. As we got closer, we could see that this would be a difficult extrication of the occupant on the front passenger side. Extricating the two rear occupants looked easy once we removed the rear doors and roof. A quick size-up revealed that once we had them on a board and immobilized, we could get them out of the vehicle effortlessly.
Unfortunately for the driver, things were touch and go; he was ejected from the vehicle on impact. Plus his leg was severed from just below the knee and was lying a good distance from the vehicle. Fortunately, he was no longer pinned, but he needed to be our first priority to save his life. Luckily, a medic unit arrived simultaneously and enabled us to immediately implement advanced first-aid procedures. Quickly, a medic applied a tourniquet to his leg as a firefighter pressed in on his pressure point on the thigh. As we began to put a cervical collar on him and place him on a backboard, others were working on starting an IV. Then we picked up the backboard and began to walk down the embankment to the stretcher. As we began rolling the stretcher away from the scene, one member blurted out, “Someone grab the leg.”
Quickly, one of the senior members grabbed two large trauma dressings and tore the packing open and laid the dressings over the limb (you also can use a sheet, a large burn dressing, or a blanket). He picked the limb up and carried it to the ambulance for transport with the patient. This accomplished a few things: First, it protected the limb from the elements and kept it in a sterile environment for delivery to the hospital. Second, it covered up the leg so other rescuers and bystanders could not see it and react in an adverse way. Third, covering the limb can take your mind off what you’re carrying and make you look more professional as you care for the injured.
Using some common sense, showing some compassion, and acting professionally makes others give thanks that we’re responding to their emergencies.
MICHAEL N. CIAMPO is a 25-year veteran of the fire service and a lieutenant in the Fire Department of New York. Previously, he served with the District of Columbia Fire Department. He has a bachelor’s degree in fire science from John Jay College of Criminal Justice in New York City. He is the lead instructor for the FDIC “Truck Company: Essentials” H.O.T. program. He wrote the Ladder chapter and co-authored the Ventilation chapter for Fire Engineering’s Handbook for Firefighter I and II (Fire Engineering, 2009) and is featured in “Training Minutes” truck company videos on www.FireEngineering.com.
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