Dispatch Complaint: Traffic Collision
DCAP BTLS. ABCs. Load & go. SAMPLE. OPQRST. I closed my eyes, repeating these acronyms in my head over and over, to the rhythm of the siren. DCAP BTLS. C-spine. This is a trauma - even if I forget everything else, this is the one I need to remember. I glanced down at my pager for the hundredth time, ingraining the limited information dispatch paged in my mind:
[Run #5645/1 - Emergency Code - 3/Barranca Ave/Traffic Collision - Train v. car]
Train v. car. For my second call ever? I had absolutely no idea what to expect when I arrived on scene - would the car be in pieces? Did the train stop just in time to result in a simple side sweep of the car? Would the victim be still in the driver’s seat? Would this be a case of a rapid extrication? I hope not… To be completely honest, I don’t really remember what to do in that situation. The point of an ambulance is to arrive at an accident as fast as possible, but in that moment I wished for us to slow down - I needed more time to review. I desperately wished for just five more minutes to glance at my trauma curriculum (man that certification exam was hard). But true to the nature of emergency medicine, we arrived on scene in just three short minutes.
“Put this reflective gear and this helmet on, and let’s get going!” My partner was staring at me intently.
I glanced up with a meek smile - “I’m nervous…”
“You got this. Just keep your head in the game.”
It’s amazing how much blood the human body contains - about 1.5 gallons. The sight of blood is often what makes people feel queasy. I’d argue that the smell of blood is what really catches you off guard. Blood is the first thing I saw (aside from the small silver car crushed under the weight of the train). Cars are durable - but certainly no match for a 200,000 pound vehicle traveling at 60 mph. I rushed to the victims side, and immediately began a head-to-toe assessment, just as I had learned. I was on autopilot. Deformities no, contusions yes, abrasions yes, burns no, tenderness yes, lacerations yes, swelling yes. Man, this poor guy. The medics started compressions as I assembled the BVM. One squeeze every 5 seconds, DO NOT OVER INFLATE. That damn train driver. Shortly after, we loaded him up in the ambulance and sped away. His weak pulse carried us to the emergency room, where we transferred care to the trauma surgeon. Just like that, my first John Doe was gone, and I wouldn’t see him again.
As I sat in the ambulance filling out the ePCR (electronic patient care report), my mind was racing. Is he going to be okay? Was he on his way to work? Did we do everything we could? Was I fast enough? What was that train driver thinking?! Didn’t he know that this guy likely had a family?
Shortly after the event occurred, news began to roll out and the dash cam footage from a bystander’s car was revealed. From this footage, I discovered that the car had driven straight past the railings into the oncoming train. My partner concluded that this had likely been a suicide attempt, considering the nature of how the car drove with no intent of slowing down for the oncoming train. My heart sank with guilt - just a few minutes earlier, I had jumped on the opportunity to blame the train driver for carelessly driving with no due regard. Of course I had not voiced my opinion out loud, but I was driven with sorrow for the man who had lost his life shortly after arriving at the ER. I was fully proven wrong when it was clear that the train had complete right of way. Who am I to judge a situation in which there is no one to blame?
I have a lot to learn in this job.
