By Michael Ellis
It was 1996.
My wife and I, and our two kids, were traveling to visit her parents in Texas for Christmas from Phoenix. I was a medic in a level one trauma center in Phoenix, and a flight medic.
On Interstate 40 about 60 miles east of Flagstaff, Ariz., we came upon a traffic back up — Which was odd considering it was past midnight. I could see flashing lights in the distance. It took us about 20 minutes to get to the scene, where I noticed an 18-wheeler on its side, half in the median and half in the passing lane.
As I made my way past I noticed a single highway patrol car with a single trooper directing traffic. My wife asked if I was going to stop. I was hesitant as the temperature was in the teens, and not seeing any other medical personnel on scene I really didn’t want to be stuck there for hours. She reasoned that someone could really be hurt, so I swung into the left lane, took my emergency light from the console and popped it onto the roof as I climbed out of the nice warm blazer.
Zipping up my jacket against the bitter cold, my blue light casting reflections in the rapid falling snow, I jogged back to the trooper and asked if I could help. I identified myself as a medic based out of Phoenix. When he replied “Thank God” I knew I should have stayed in the car. The trooper told me the weather was too bad to get a helicopter out, but an ambulance was on the way from Winslow, 40 miles away.
We jogged over to the over turned truck; upon arrival I then noticed the windshield was covered in blood. I climbed up the side and peered into the cab. The driver was a bloody heap lying in a ball by the driver side door. I told the trooper to go to my vehicle and have my wife get my trauma bag from the trunk. As he ran to my blazer, I lowered myself into the wrecked cab.
The driver was unresponsive. I checked for a pulse and got a weak see thread one radially. The patient had snoring respiration and was bleeding from multiple cuts on the head and face. His left arm was obviously fractured.
I turned and mule kicked the windshield out. As the trooper ran back with my trauma bag, I had him help me extricate the driver as carefully as we could. I wasn’t overly concerned with c-spine as his airway was my immediate concern. We laid him on the road and I opened up my kit, quickly donning a pair of gloves, then using my flashlight I checked his airway. There was a lot of blood in his mouth along with a few broken teeth. I cleared his airway with my hand-held suction unit, inserted a nasal trumpet, then placed a cervical hard collar on him. The trooper went to his car and returned with a small oxygen cylinder and a non-rebreather.
After getting him on O2 I asked how long before the ambulance would get there, as we needed to get the patient off the road. He radioed dispatch and the reply was 10 minutes out. By this time other people had stopped and provided us with blankets. I heard the siren faintly and looked up the highway, seeing red and blue strobes headed our way. I did a quick secondary and made mental notes of what I found to pass on to the ALS crew when the ambulance arrived.
The ambulance pulled up and the driver jumped out and circled around, opening the back to get the gurney and backboard. The passenger opened the side doors and grabbed their grey box and O2 bag. The four of us secured the patient to the backboard and placed him on the gurney, racing across the icy road to the ambulance. Once inside, I inquired who I needed to give a report to.
The driver looked to be about 19 if he was a day. And the passenger looked to be about 90. The deer in the headlights look was my first clue something was wrong; glancing at the patches on their jacket sleeves cinched it.
The younger guy was an ECA (emergency care attendant, basically a first-aid trained driver) and the old guy was a basic EMT. It was then that it dawned on me I was stuck with this guy. I asked if an ALS unit was en route. The response of course was no. They were the only ones on.
Cursing under my breath, getting mad at my wife for making me stop, I asked the trooper to go tell my wife to follow the ambulance because I couldn’t leave this patient now that I had started care. He acknowledged, thanked me for stopping, then shut the doors. I told the kid to drive like a bat out of hell to the closest hospital: Winslow, 40 miles away. He climbed into the driver’s seat and away we went, sirens blaring.
My wife was hot on our tail in our four-wheel drive Blazer, blue light still flashing on the roof. Looking around the bus I noticed it was a fully stocked ALS unit. Come to find out, the medic went home sick.
I quickly cut off the patient’s shirt, attached him to the monitor, opened their grey box and put a 14 gauge in the patient’s antecubital vein with ringers running. I had the EMT splint his broken arm as I tried to control the bleeding coming from the multiple lacerations on his face and head. Grabbing the stethoscope, I listened for breath sounds and became alarmed when I didn’t hear any on the left side. Palpating his chest, I noticed multiple broken ribs on the left side. Glancing at the monitor he was becoming tachycardic and hypo-tensive. He was circling the drain fast.
Impelled for incubation, got him tuned and had the EMT bagging him. I found a 14 gauge 2 3/4 inch catheter and quickly needled his chest releasing a crap load of blood. I grabbed the headset for the EMScom radio and called into the hospital in Winslow.
By God’s grace the doctor that got on the line was one that I knew from Phoenix; he was moonlighting in Winslow over Christmas. I gave him the run down, told him how far out we were and asked if he had any orders. None that he could think of, outside of giving the patient some drugs to put him under. Concerned about his ICP I told the doc I would give him some versed, but that was it. Once he was decompressed his vitals improved slightly, but enough for my satisfaction.
It took us almost an hour to get to the hospital due to the weather. Upon arrival the doc and I shook hands, I gave the trauma team (such as it was) my report, then went and sat at the nurses station to write out my report. My wife came in for a cup of coffee and I stepped out to watch our blazer as the kids were asleep inside. They had not moved or stirred the entire time.
The trucker wound up with a fractured left arm in three places, all of the ribs on the left side were broken causing a tension pneumo, his spleen was lacerated but encapsulated, a non-surgical pelvic fracture, and a small subdural that didn’t require surgery. He spent a couple hours in surgery, then went to the ICU where he would spend Christmas. The trooper came in as I was leaving the ER and thanked me for stopping, taking my name and address.
We stayed in a hotel in Winslow that night as I was exhausted. When we got up the next day to continue our trip, the snow was beautiful. We stopped by the hospital so I could check on the patient. I met his wife who had arrived from Albuquerque that morning. The nurses evidently talked me up pretty well as the wife hugged me tightly and thanked me for saving her husband’s life.
As I thought about it as we were driving, I couldn’t be mad at my wife anymore for making me stop because he most certainly would have died. The Arizona highway patrol awarded me and the patrolman that were there that night both life saver awards. Weeks later and I got the opportunity to meet John. He definitely looked a lot better standing next to his wife than he did when I first met him.