21 February 2006

A Tale of Two Scenes

Do you like making a "Grand Entrance"?

I have to admit, I sorta do.
And they don't get much "grander" than landing a helicopter on an Interstate Highway that has been shut down waiting for your arrival!

Last night we were dispatched to the scene of a single vehicle accident. On a clear night, on level terrain and barring obstructions, you can see the flashing lights of emergency vehicles from more than 20 miles out. We called 5 minutes from landing and the State Patrol shut down the highway in preparation for our landing. By the time we arrived, traffic was backed up for about a mile.

A young lady had departed the roadway at a high rate of speed and struck a tree with her driver's side door. The crew walked our stretcher to the ground ambulance where the first responders were working on her.

In ten minutes, my Paramedic returned to the helicopter with an empty stretcher......
that's not good!

To me he shouted, "She's arrested. We're taking her to the hospital by ground."
There was a local hospital within 8 minute's drive of the accident scene. CPR can be done more efficiently in the back of a ground ambulance than in the back of the helicopter.
Good decision.

I flew solo to the local hospital and shut down.
Five minutes later my crew arrived with the first responders.
After 15 minutes of CPR and heart stimulating drugs, the patient showed no improvement.
They pronounced her dead just before 1 A.M..

Tonight, just after my preflight, the phone rang again.
Another scene flight, this time 12 minutes away, on a two-lane country road. A 24 year old male left the roadway and crashed into a creek, partially submerging his car. ( It's 35 degrees F. outside......that water is near freezing! )

I earned my pay on the landing.......
the terrain rose steeply on both sides of the highway, and then was covered with 60' trees.
The only "safe" way to land was to come to a very high hover situated exactly over the highway centerline and hover down to land, sweeping the searchlight to it's extremes watching for wires.

With my crew on the way to the ambulance, the scene commander came over and shook my hand.........
"Beautiful job!" he shouted over the din of the machine.
Nice to hear. (Another Grand Entrance! )

The crew approached with the stretcher 12 minutes later, this time WITH the patient.
I helped load him, did a quick walk around to make sure all doors were secure, and did a vertical takeoff to 100 feet before transitioning to forward flight.

The patient was in the water to just above his waist, unconcious, and of course was hypothermic. He had an open head injury exposing his brain. He also had a priapism......(an erection).....an indication of high spine trauma. In the 14 minute flight to the hospital his heartrate slowed to 40 beats per minute and my crew gave him adrenaline to stimulate his heart.

I landed and went to the rear of the aircraft to help unload the patient and found the crew busy administering more drugs and pumping on an "ambu" bag to give him oxygen. I released the lock on the stretcher in preparation to unload it. The crew had cut off the patient's black, wet, cold sweat clothes and they were in the way of the stretcher's wheels. I moved them out of the way, and found that was a mistake.......my hands immediately felt sticky........the clothing was covered with his blood.

His prognosis is not good either. His injuries will probably overcome him before the sun shines once again.

I've had a bad string of scene flights lately. This is the fourth in a row where the patient either died before I could transport, or will likely die in a short time.

Sure, it comes with the territory.
But I'd much rather have the feeling I helped to make a good/better outcome more likely!


Neil said...

"He also had a priapism......(an erection).....an indication of high spine trauma"
Fascinating. I had never heard of this connection. Amazing what we know about the human body, and what it can tell us.

Im sure its a difficult thing to deal with, but folks doing the work you do greatly increase the opportunities to save someones life. I hope I never need to be scopped up by the medevac chopper, but knowing its there with folks like yourself at the controls is comforting.

I have a random question: Many years ago I heard that anyone who is flown in the chopper where I live gets billed for the ride. Usually a big pile of money too. Is it true for your service also? Is that a standard?

The local emergency helicopter here in Delaware is State Police Trooper 10.

Greybeard said...

Yes Neil, the bill for flying in the helicopter is pretty steep.
Most folks that need us don't care much about the cost though. Insurance picks up the tab if they think use of the helicopter was necessary. Your auto policy probably provides some medical coverage.
But we fly folks all the time that cannot afford the ride.....our company picks up what funds are available from the government, and eats the rest. No one is turned down due to lack of ability to pay.


10 years or so back, I was taken to the hospital by ground ambulance. It was nothing serious. But after the whole ordeal was over, my insurance company sent me a bill ($474) for the ambulance ride because I didn't go to one of their hospitals.

If I wanted to contest the bill, I had to answer some questions. One of them was, "Why didn't you go to a Kaiser hospital."?

I answered, "Because I wasn't driving the ambulance."

They paid the bill.

Neil said...

Ahh. i had wondered. Thanks for the response...