04/13/09 96 W, 1 I - + 14 - 12 This Afternoon's MVA / Davis Drive

Motor-vehicle accident with injuries in Apex at 1343 Davis Drive. Loaded dump truck overturned on passenger car. Three patients, one pinned in auto, under the truck. Alarm time 4:06 p.m. Patient extricated 6:00 p.m. Extensive cribbing, shoring, cutting, prying, and lifting, the latter including two enormous wreckers. Transported to nearby WakeMed air ambulance. Units on scene, if recorded correctly, included Apex Engine 1, Rescue 3, Engine 3, Rescue 1, Brush 6 and trench trailer, Battalion 1, Car 1; Cary Engine 5, Ladder 5, Truck 7, Rescue 4, Battalion 2; EMS 51, EMS 55, EMS 54, District 5, and MD 1. Photos by Legeros forthcoming. Read the WRAL story.

Mike, just so you know the WRAL link goes to Google Maps. Thanks for all you do.

DHFD - 04/13/09 - 22:15

Sounded like an excellent response, given the fact that the dump truck was resting on top of the car. How long do most extrications take? The WRAL story mentions that an emergency worker was able to reach the patient while the dump truck was still on top of the car, what type of medical treatment, other than oxygen, would they have been able to give. Again excellent response and prayers for the injured.
Adam - 04/13/09 - 22:19

Well, I know me personally, as a (soon-to-be I hope) paramedic, I would try to do a couple of things:

**C-collar – can be done easily, and you can tell the person not to move if they are alert – most patients will not move in these situations, due to pain.
**Oxygen – always in trauma situations
**IV access – Large-bore, and two, if you can…
**ECG monitor – if you can… but a trended vital signs will do better than the monitor will. Also, a BP cuff, watch, stethoscope, and pulse ox will take less room, along with pen and paper.
**Pain management – this is a dicey subject, depending on who you talk to. If you can assess well, find nothing, and have good vital signs, then a small amount of pain management can be considered, especially in a situation like this, where anxiety could be a big factor for the patient.
**Advanced airway management – If it is needed, then you can do it in these situations, especially with the Medical Director on scene, as he can authorize Rapid Sequence Induction if it is needed. More than one person would be better, but plenty of medics have done RSI with only themselves to do things. Would I want to do it? NO. Could I do it, if I had to? Yes.

The real truth of this is, you can do a lot with a little bit of space, but it takes teamwork and communication from everyone there, especially the person in charge of extrication. It does me no good in the car to try and start an IV, if the extrication team will be punching into the window that I’m closest to.
CJS (Email) - 04/13/09 - 23:23

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