I left the boat at 0510 drove to the Clinton car ferry that transported 150 plus cars over to Mukilteo. At this time in the morning most of the traffic was Boeing employees going to work, after parking the cruck I walked up the stairs to the upper deck where I plopped into a booth with a magazine and pretended to read but was really off in lala land dreaming of warm water, tropical beaches, my sailboat gently bobbing at anchor and a scantily clad female with an all over cinnamon tan rubbing suntan lotion on my back. Reality check, the Capt announced that the 20 minute trip was over and haul your ass to your car so as not to delay traffic, well, maybe he didn't quite use those words but you got the point. I have ridden the ferry for a lot of years and only once fell asleep coming home, finally the only vehicle without a driver they sent someone to check the decks I was drooling on my shirt laying in a booth.
I drove off the ferry and 30 minutes later I pulled up at Starbucks, what can I say I'm a hopeless addict. Five minutes later I was parked in the employee parking and dragging my muffin, latte and my overnight bag into the station. I dropped my bag at my locker. The off going shift was still sleeping maybe they had had a quiet night. 15 minutes later I was shaved, showered and in uniform ready for another day of fun. 0650, Shift change was at 0700, people were starting to straggle into the day room (sort of a large living with a commercial size kitchen attached.) A dozen Lazy boy recliners were lined up in front of a 52' TV and sometimes we even got to sit in them. This morning was not going to be one of them. Five minutes before the off going shift was leaving Firecoms dispatched a call for an MVA (motor vehicle accident) with entrapment, meaning whoever called it in thought the Jaws of Life would be needed to cut someone out of a car. My shift being the nice guys we are took the call so they could all go home. We cover a large area of Snohomish County and wind up in areas where it takes a long time to get a patient to a trauma center. So we use helicopters for really bad cases and fly all of our serious trauma to Harborview Trauma center in Seattle. We have three hospitals in our area; however, none of them are a level one trauma center, which means they don't have trauma surgeons and other specialists just waiting for a patient to arrive so they can pounce on them. The Golden hour in trauma care just simply means patients who receive treatment within the first hour of their injuries do better than patients who's care is delayed, hence the use of helicopters for rapid transport.
One of my jobs as a senior medic is to mentor the new medics on my shift so for six months they have me standing behind them watching every move they make, sometimes nudging them along a little faster and sometimes teaching them to walk a little slower.
My current rookie was Tony Russel a 5' 4'� 27 y/o half Italian half Mexican who was testing my teaching skills. Rusty was driving the Medic unit I was sitting in the officer's seat with Tony in the back. 'Hey Rob, why don't we put Air/evacs in the air this sounds like a bad wreck'�, 'sure Tony, good call'�. I called the dispatcher and requested a helo meet us at the scene we would update them when we arrived in one minute. Now, for this wreck we had one Battalion Chief in a Suburban, one fire truck complete with rescue tools on it, one Paramedic unit advanced life support* and one basic life support ambulance(BLS)** upon arrival the incident command system was being set up by the Battalion Chief who over sees the big picture and directs the flow of things plus orders more equipment and man power if needed. What this really means is, they stand there with a radio and look good, however, at this wreck the BC's curiosity caused him to get a little dirty. It seems two young couples had gone out late last night partying and drank a wee bit too much. Coming home this morning still drunk the driver decided to see if he could make the corner at 120 mph, well, he did, however, the first telephone pole slowed the car down and the second pole 200 yards down the road actually stopped it. When we went to the car it was obvious the driver was pinned around the pole, the front seat passenger wasn't moving and had that look in his eyes that he was no longer on this planet, I reached in checked his pulse and saw the damage to the side of his head, he was DRT (dead right there) and was now in the way of getting the two other people out of the small, what appeared to be, a two door of some unrecognizable make. Tony was surveying the other side of the wreck trying to figure out how he was going to get the driver out who was literally hugging the pole with the car wrapped around him and screaming about his balls! As I turned I damn near stepped on the BC who had come over from his post to poke around and see what was happening. 'Hey Larry, grab his arms and pull while I get his legs, then lets put him behind the back of the car while we get the two out of the back'�. As Larry pulled a mixture of brains and blood oozed onto his fresh white shirt, try to stifle a chuckle and get on with the job at hand. I said 'bummer Larry, when we're done would you get a blanket and cover him before all the looky loo's get here'�. Larry informed me Firecoms called and said our helo would be here in 10 minutes, then threw me a blanket and said he was going off to set up a landing zone. Tony was working with the engine crew to free the driver who was still screaming loudly about his balls hurting. I directed the crew from the BLS ambulance over to the passenger side then went over to help Tony. Rusty had two IV bags of normal saline waiting, Tony was now telling the guy he was going to put a big needle in his arm, and to hold still, he just kept screaming about his balls which was now becoming very annoying and difficult to hear yourself think. 'Tony, what do you think about giving this guy something and quick'�. 'That's what I was working on'�. Tony had a syringe in his hand and slipped it into the IV port and injected 2 mg of Versed the guy got quiet. Rory the captain off the engine made the last cut now the whole side of the car was gone. Both of the drivers legs were broke in multiple places and probably his pelvis. One arm was defiantly broke and probably multiple ribs. For his troubles he got a c-collar applied on his neck to keep his neck straight just in case he had broken that as well. A long board was placed under him, he was slid out on to it, placed on the gurney then strapped down so he couldn't move. Tony followed up the Versed with 120mg of anectine a short acting paralytic drug. Basically the Versed was a happy drug he would not remember how we pulled him out of the car with his legs looking like Gumby sticking out at odd angles. The anectine would paralyze all his muscles except his heart, he would not be able to breathe on his own, so a tube was placed into his lungs and then hooked to a small portable ventilator. Five minutes later Air/evacs landed their Agusta A109/Mark II helicopter, two nurses climbed out of the helicopter and came over to us. Nancy the tall one smiled and said hi Rob, Tony gave them the scoop then offered to give the patient a longer acting paralytic for the flight, they said thanks and started removing our heart monitor and attaching their own followed by their ventilator and vital signs monitor that tracked blood pressure and how much oxygen he had in his blood. Tony finished pushing the Norcuron which would keep the patient paralyzed until Seattle. With this finished we helped load the patient into the helo. We stepped back to watch the nurses load their gear bags back in the helo and climb in to prepare for lift off. 60 secs later the helo was airborne with a 12 minute flight to Harborview at 160 knots. Tony turned to Rusty with a big grin 'did you see the tall one when she bent down, I think I'm in love. Whoever orders the jumpsuit for the nurses likes to see them fit every curve with nothing left to the imagination'�. 'Come on you two'�, some things never change. I had actually seen what was under Nancy's flight suit and it was exquisite, but they didn't need to know about that. Besides we've got a pissed off BC to calm down, I explained the small mishap and Larry's shirt much to their amusement, Tony asked 'how did you manage to have him get the messy end'�. 'Well, that's why you're still in the mentor program'�. The other crew had taken the two patients from the back of the car to the local hospital. It was time to go back and finish the breakfast that we had never even gotten started on.

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