Wednesday, July 10, 2013

Hijinks On The Mountain, Holiday Style

"Ambulance 1, stage at Summit and Back Mountain Road. Lost hikers."

Should this be a surprise? Perhaps. But it isn't. This comes after two previous calls, the first being an individual who filleted their forearm after multiple rounds of alcohol and the second being a minor motorcycle accident.

So we stage. In the meantime, an engine company assignment and the covering officer were dispatched to the area where the hikers were supposed to be near, at least according to the coordinates the cell phone of the hiker who called for help. When the other responding units arrived they prepared to go into the area where the hikers were thought to be located. We were subsequently sent to meet them because one of the hikers had a reported medical emergency.

We arrived on scene with the other units, including police, who were on scene as well. My partner was enlisted to go in with the crew (poor guy), and I stayed with the command post, monitoring the radio traffic.

It took the crew approximately 45 minutes to get to the hikers. They went in with a scoop stretcher and immobilization supplies in the event that the hiker needed to be carried out. In hindsight, it would have made more sense for the crew to have use of a Stokes basket, but it wasn't available; the basket was located on another piece of fire apparatus that was not dispatched to this call. From what I was told by the guys that went in to get the hikers, the terrain, plus the darkness, made it challenging to get both in and out. Granted, the crew utilized the lighting that was at their disposal, mostly in the form of handheld spots and flashlights, but it was still dark. It was a clear night with no moon, and it was quite warm; at midnight it was 85 degrees Farenheit. For early July in the northeastern United States, that is actually somewhat unusual. If the hikers had opted to not call, they would have had no problems with exposure.

When the crew made it back to the command post, they had the individual who had the medical issue. A 30 year-old female who had a panic attack, fell, and struck her head on a tree root. Reported to have had a positive loss of consciousness. Has a history of panic attacks and takes medication for them as needed. One of the other hikers thought it was one of this times because our patient was given a dose of her medication prior to the crew getting to them. By the time contact was made the patient was a little bit groggy.

So we loaded her aboard the ambulance. I assessed her and found her to be a little banged up. She had a mild headache and a laceration on her scalp where she contacted the tree. She had been fully immobilized on the scoop stretcher, and she was fighting with the cervical collar; in April she had surgery to extend her jaw line for correction of airway problems related to sleep apnea. And she apparently had a diagnosis of borderline personality disorder, which I found out about afterward. Not that it made any difference in the way I managed her on the way to the hospital; it didn't. She was conscious and alert, albeit a little sleepy. And all things considered, she was actually quite cooperative and easy to deal with. It could have been much worse.

On arrival at the hospital one of the attending docs who was working grilled me about why we treated her as we did - immobilization, etc. I explained to him in no uncertain terms that we had to deal with her based on what we were told, and there was really no way to do otherwise. He still thought it was dubious to have brought her in with precautions in place, but I really didn't have a choice. It was a no-win; if I had done the alternative and not kept her immobilized, I would have caught hell for not paying attention to "distracting injuries", especially the issues the patient was having with the collar. Normally I have no issue clearing the cervical spine in the field if I believe it is okay to do so. In fact, most of the time it is okay. However, this is one time I decided prudence was a better choice.

At the end of the day, we only did three calls in twelve hours. Under the circumstances, it took us all twelve hours to take care of everything around them. It was tiring.

1 comment:

Elizabeth @ The Garden Window said...

Goodness, that's a challenging shift under those circumstances.
Some of these docs should actually spend a day a week doing your work then they would have a greater appreciation of what you are faced with in the field and the decisions you have to make on your feet..