3 A.M., Sixteen Degrees, Wind Chill -4F.

The phone rings anytime after midnight- you can be pretty sure it's not a personal call.
"Weather check for Limetown, please."
"We can do that."
"Then your scene flight is a go. It's an MVA with extrication still in progress. We'll have more information to relay when you're airborne."

I was napping. I don jacket, stocking cap, and gloves and step outside toward the helicopter. My breath is taken away...
The temperature has dropped and the wind has picked up... 16 degrees F. with 12 knots of wind from the Northwest.

I start both engines, take off, and quickly turn on the bleed-air heater.
"Your coordinates are ********************.
Your patient is a 23 year old male victim of a two-car head-on collision. They are still extricating him. You are the second aircraft to respond to this scene. (Our competitor) has an aircraft on the ground at the scene now. Your point of contact is Unit 7201 on Fire-Mutual Aid."
I punch in the coordinates and announce "Our ETA is 12 minutes."
"Roger that".

I change the frequency on my secondary radio to Fire-Mutual Aid and contact Unit 7201. He gives us LZ information and an update on our now extricated patient. Our patient is the unrestrained driver of one of the cars and somehow found himself trapped halfway outside the car when the machinery came to a stop and the dust settled.
In addition to having two broken legs, he's bruised and contused all over.

With 50 miles visibility, we see the flashing lights at the scene, 20 miles distant . The air-to-air frequency crackles...
"****** 4 this is ######### 8, over." It's our competitor.
I can see his anti-collision light as he lifts from the scene. He fills in details about the LZ and tells us his destination. I appreciate his professionalism.

We circle and recon the accident scene. There are wires to the East and South of our landing area and the wind is strongly out of the Northwest, so I'll have to cross over the wires to land. We're landing in a newly harvested soybean field, but we've had enough rain lately that dust and debris shouldn't be much of a problem. The ground guys have 4 red strobes marking the LZ for us. West of the scene we see 4 flashlights, well dispersed, searching for something. South of the scene we see 3 more searchers, also well dispersed.

"Base, *******4 is landing scene".
"Roger ******4."

After turning on my fixed landing lights and adjusting my two moveable searchlights I say to my crew:
"As usual gang, this will be steep and slow. Shout if you see anything."

Safely on the ground my crew unloads the stretcher and heads to the ambulance. I log my landing time and exact coordinates, then dismount to keep innocents from walking into the tail rotor. The scene commander approaches and shakes my hand. I ask about the searchers....
"One of the victims thinks one of the passengers walked off, dazed and confused."
To myself I wonder if we'll be coming back here later for a hypothermia patient.

From a knoll behind our BK117 I can see the scene-
Two small cars collided head-on, and both cars have extensive left-front damage. The roof of one car has been cut at the "A" pillars and folded back over the trunk and the driver's door is bent open...
Our victim's car?

Ten minutes pass and my crew approaches with the assistance of two ground personnel... a guy at each corner of the stretcher trying to smooth the way across the rutted soybean field. I stand guard to insure no one strays too far toward the rear of the aircraft. Patient loaded, I direct our helpers away from the aircraft, then close the clamshell doors as my crew boards the aircraft. I do a final walk around to insure all doors are secure and nothing is hanging outside the aircraft, board, plug in, buckle up, and bring the engines to operating RPM. Searchlights/landing lights back on, I sweep the moveable searchlight left to right in several sweeps as we takeoff and climb out. I turn the heater on full-blast to help warm our patient. The flight to and landing at the Trauma Center are routine.

Now, please consider-
How do you dress when driving on these Winter days?
I'm not sure what time this accident happened, but the scene was in a very rural area, so from the time of the accident let's assume it took EMS personnel 20 minutes to arrive. After their arrival it took another 20 minutes to free our patient who was trapped by the mangled driver's door.
In shirtsleeves, he was exposed to 16 degree temperatures and 12 knot winds for at least 40 minutes. Had he and other people involved in this accident not been near homes that heard and quickly reported the collision, those times would have been much longer.

The force of any collision could break (all?) windows and will certainly send loose articles in the car flying. So if you are trapped you'd better be wearing warm clothing...
If you're immobilized you won't be able to search for and put them on, post-collision.
When driving, do you dress to prepare to be exposed to such conditions?
You (we) should!