The other day I got an email from a friend of mine who is a paramedic in a rural part of the country. She spent most of her Christmas being observed by the on duty crew at her station after she was injured on a call. She’d responded with the local fire service to a call where extrication was needed. During that process, a firefighter whacked her in the head with a metal bar. Before anyone says anything, yes she should have been wearing her helmet. On the other hand, people using heavy implements should be careful where they are swinging them. She ended up with a concussion, but declined to go to the hospital. So, the crew kept her at the station so they could monitor her. Typical of EMS workers, isn’t it?
As an aside, she is definitely NOT one of the females I was talking about in the post about equality. In fact, she’s more typical of the women I’ve worked with in EMS. Tough as nails, does the job, and asks no special favors.
Auto extrication is one of the things we’ve come to expect of the fire service, but it wasn’t always that way. There was a time when EMS services, fire based or not, were expected to do light extrication at MVAs.
Extrication is not exactly rocket surgery. Or at least it wasn’t back before someone decided that cars needed to be made safer. Which they actually did need. When I took my original EMT course (1973) and then second one (1977) auto extrication was part of the curriculum.
One places where I work now includes it in the EMT course, but I think it’s optional. Others don’t even include it.
At one time I had a home made metal cutting tool made from a leaf spring and piece of pipe. I carried that in the ambulance with me for several years and we used it once or twice. That was back in the days when the FD only came to MVAs if there were reports of fire, entrapment, or leaking fluids.
Back then it was all entrapment, but now we differentiate between entrapment and the patient being “pinned”. I’ve done my share of both and been in cars while the FD was cutting around me to get the person out. There was a lot of friction at one time where the FD didn’t want us in the car. Eventually we worked that all out and we now work as a team. The OIC even listens to us when we tell them what we want them to do.
More than once I’ve been in the car disentangling the patients legs or feet while the rescue company is working on the roof or doors.
Popping doors is the most common thing that the FD does, and it can be done with fairly simple hand tools in most cases. We were supposed to wear our helmets when we’re in cars being cut apart, but I used my judgement about that. Judgement in EMS, another vanishing thing.
Which brings me to a story.
Back about 4-5 years ago we were dispatched to an MVA/roll over. This was at the intersection of two streets where traffic didn’t usually go very fast. It was 0530, so traffic was light. Which made me skeptical about the roll over part.
We rolled up on scene and sure enough there was a large SUV on its right side. It wasn’t one of those spectacular Hollywood roll overs, though. What had happened was that the SUV was hit on the left side and slid just enough to hit the curb, which caused it to tip on to it’s side. Minimal damage was actually done to the vehicle. The driver wasn’t hurt, but she wasn’t wearing a seat belt so she’d slid down into the passenger side floor well and couldn’t get herself out. She was awake, talking to us, following commands, and moving all of her extremities. She had no real complaints.
Sorta Big City Fire Department rolled up at the same time we did and on the firefighters climbed up on to the left side of the SUV and stuck his head in the window. He told the nice lady that they were going to get them out. Then he reached in, turned the ignition switch off, pulled the keys, and tossed them to the ground. He called for blankets because the fire department was going to cut the windshield to get her out. The rescue company arrived and started to remove their extrication equipment and get ready to go to work.
I watched this with mild amusement. Then I walked to the big tail gate of the SUV and tried the latch. Locked. I was going to ask the fire fighter to find the unlock button, but he was hanging upside down through the window talking to the woman. He couldn’t hear me, or was ignoring me. Either way, he was not going to be any help. So, I walked around the SUV looking down at the street. I spotted the keys and as luck would have it, there was a remote control key fob. One of the buttons had the symbol of an open tail gate. I pressed it and was rewarded with a THUNK! as the lock opened. I pulled the tail gate open and crawled into the SUV.
When I got to the front I introduced myself to the patient and gave her a once over. I also looked up at the upside down fire fighter and said hi. He could not for the life of him figure out how I got in. I asked to have some of my people pass in a back board and C Collar. An EMT climbed in with the stuff and between the two of us we got her on the board and then passed her off to the other EMTS at the back of the SUV. Then she went into the BLS ambulance and off to the hospital.
The guys on the rescue company were very unhappy that they weren’t going to get to cut up a brand new $50,000.00 SUV.
My partner and I got back in the ambulance and drove away.
As I said, most times this job isn’t exactly rocket surgery.