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May. 13th, 2007 04:38 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
drewkittyIn a World Without Oil
(Disclaimer: This is a World Without Oil post. This DID NOT HAPPEN. However, if you choose to carry gasoline in your car's passenger compartment and get in a car wreck, you could get to field test this for me. You or your next of kin can write and tell me how it turned out.)
To keep the guards honest (and well trained, and deliver good service), we have to have people go out and check on them now and again. Days, nights and weekends. It is an operating cost of our business. I'm running around with a decidedly nontraditional vehicle: a white Honda Civic hybrid. Still carries five, which is sometimes useful during a startup.
So I'm driving northbound on Highway 101 JNO Montague at about 1 in the afternoon on a Sunday when I see the accident. The driver of a small white SUV suddenly hits the brakes and a black pickup truck loaded with construction supplies slams into the back of the SUV. About forty MPH collision speed. I actually see the airbag deployment as the driver of the pickup truck takes the bag in the face.
I snick the hazard lights on as I come to a stop blocking the affected lane, dismount from the vehicle, go back to the trunk and put on my traffic safety vest. I'm already on the phone via Bluetooth to the CHP.
For a wonder, no busy signal. "911 what are you reporting?" "Injury traffic accident, two vehicles involved, white SUV rear-ended by black pickup truck. Blocking #4 lane. EMT on scene." I pick up my emergency medical pack and actually LOOK at the wreck.
The small white SUV is on fire!
I quickly add, "Roll fire and medics! SUV is on fire and fully involved!" as I get out the fire extinguisher.
Rest later . . . power outage here and I have to save on batteries.
Resuming story . . . as a trained emergency medical technician, I know that cars do not just go up in flames. It usually takes several minutes for the engine to fully catch, and by the time the car heats up enough, the fuel tank parts separate and dump some flaming gasoline on the ground. No explosion, just a fire. And it takes time.
But this SUV is already fully involved about ten seconds after the wreck. Just like a Hollywood movie car fire. I know how they get those. Five gallon plastic bags of gasoline.
I sling the emergency medical pack, grab the rescue bag in my left hand and run towards the SUV, rather overloaded. But I'm going to need all this gear and I wish I had lots more.
Just about then, the driver's side door to the flaming SUV opens and the driver gets out and starts running and flailing. He is on fire.
I drop the extinguisher and screech at him "STOP! DROP! ROLL!" while I fumble out the fabric blanket from the rescue bag. He turns and starts running, flaming, down the freeway shoulder. I chase him still screaming "STOP!" "STOP!" "DROP! DROP!"
I bunch up the blanket in both hands and do something stupid. I tackle him. Flames and smoke as we both slam into the dirty asphalt and I frantically beat at him with the blanket, screaming "DROP! ROLL! ROLL! ROLL DAMN IT ROLL!" and pushing him sideways until he catches on and starts to help me. He ends up on his side with me beating out the last bits of flame. We both stink of gasoline and fumes and my hands ache and itch. I don't even notice the bruises on my hands and arms.
I unsling the emergency medical bag, rip it open and flick out the EMT shears. I efficiently start cutting off all of the victim's clothing including his shoes. I have one bottle of eye wash, not the best to use, but all I have. I pour it on his smouldering hair and face.
Behind me I hear screaming and shouting. The pickup driver is trapped in his vehicle. Other people have stopped to help and they are trying to bank on the vehicle.
Grabbing up the medical pack and rescue bag, I run back. A quick rush of brains to the head -- I put on the leather gloves. The palms of my hands hurt as I slide them on. Someone has grabbed the extinguisher and is discharging it onto the hood of the pickup truck. Damn it! What a waste!
I fumble out a roll of duct tape and the window punch. I push someone out of the way of the pickup truck window, wincing at the heat as I slap a quick taped "X" across the side window. Someone asks "What are you doing?!?" and I snarl "BACK OFF!" Then I slap the window punch into the corner of the side window, which obligingly shatters. I peel it out of the frame, held together only by the X of duct tape I have just applied. Then I unlock the door and start to reach across the moaning, bleeding driver of the pickup truck. He is the only one in the truck.
The heat on my face has turned prickly and my left eye is hurting. No time to find the quick-release buckle. I close my left eye and ignore the pain as I cut through the seat belt with the EMT shears. IF I LEAVE HIM IN HERE, HE WILL BURN TO DEATH FOR SURE Rapid extrication. Hold the head and spine in line the best I can as I free-drag him clear of the hot wreck. My forearm brushes the frame of the truck and immediately starts itching.
Somehow I am about thirty feet from the truck with the pickup driver's head cradled between my hands. A crowd of people is around me.
I flip open the emergency medical pack. "YOU! CALL 911! YOU! GO CHECK ON HIM! DOES ANYONE KNOW FIRST AID?"
Someone does. I hand her a set of nitrile first aid gloves. "Put these on. I need you to hold his head and neck exactly still for me. That's right, hold the back of his head. HOLD HIM STILL!" as he starts to thrash. I take off the leather gloves and put on a set of nitrile myself.
"Sir! My name is Andrew, I am an emergency medical technician, I am here to help you. What's your name?"
He's moaning inarticulately. "Sir! What's your name? Do you know where you are?"
I reach down and rub his sternum, hard. Painful stimuli. He moans louder.
"We're here to help you, sir. It's very important that you don't move your head. Try not to move."
Rapid assessment. Head to toe. Scalp bleed. Facial lacerations, minor, no airway compromise. Neck distended and at an angle. Chest bilateral rise and fall of the chest. I run my hands up and down quickly. No life-threatening bleeding. Respirations maybe 12 and shallow, strong radial pulse. Possible broken neck. Altered mental status. Stabilization and immediate transport.
"Don't move, sir. We're here to help you." I turn to her and say in command voice, quietly but with absolute arrogance "Stay With Him." Then I grab up the pack and run back to victim #1.
People are also standing around him and not knowing what to do. He smells like charred meat. Because he is. I peel off the first set of gloves, put on a second set of gloves and see blood on my hands in the interim. Damn.
He's lying on his back and gurgling. I lean forward and roll him towards me on his side. Someone says "Don't touch him!"
I look at the patient and say "I'm Andrew, I'm an emergency medical technician. What is your name?" While waiting for the someone to identify themselves and level of training, I do my rapid assessment. They don't ID themselves so I ignore them completely.
Airway. Gurgling. I open the patient's mouth and a mix of blood and vomit and serum come out in surges. I flip out the emergency medical kit. I don't carry oxygen and my only suction is a turkey baster. Better than nothing. I start suctioning out the patient's mouth while continuing my rapid.
Face: red and hot. Hair, burnt and smells nasty. Charred flakes and serum on my forearms and his clothes and the ground. Respirations, heavily labored, maybe six a minute. Damn I wish I had oxygen. I pause suctioning and rig the bag valve mask. I'm gonna need it.
The rest is a blur. I am way over my head. A single EMT with a major burn victim.
Rule of 9s. Head 9, Left Arm 9, Right Arm 9, Chest 18, Back 18, Left Leg 18, Right Leg 18, Genitals 1. Both legs, back of head, both arms, most of back, some of front. Call it seventy percent burns. Breaths shudder to a stop. Respirations zero. Begin resuscitation. Thousand-one thousand-two thousand-three thousand-four BAG. Thousand-one thousand-two thousand-three thousand-four BAG.
A CHP officer is holding someone back. He asks me, "What do you need?"
"Two paramedic ambulances for two critical trauma patients. BAG. Patient 1, respiratory arrest, 65% burns BAG including airway. Patient two, painful stimuli, C-spine compromised BAG, altered mental status. Back over there." BAG. The CHP officer pales, clicks down on his radio mike and runs back to his cruiser.
I check the victim's pulse. It's strong. Privately I feel that this is not an unmixed blessing. BAG. I fumble out the single 4x4 burn dressing. BAG. Put it where it will do the most good, on the front of his burned neck. BAG. It is like putting a bandaid on a slaughterhouse.
A bag is dumped next to me. C cylinder oxygen from the CHP cruiser. Thank Goddess! BAG. I flick it open, open the regulator. BAG. Hook up the BVM 02 line to the regulator. BAG. Set flow rate to 15 LPM. BAG.
I am still bagging and assessing vitals, having taken one BP and having no response to efforts to assess mental status, when the medics run up.
"Burn victim, 65% partial thickness burns, gasoline splash, respiratory arrest, BVM for 5 minutes, BP 80 palp, massive fluid loss, O2 at 15 lpm."
"We got it. Keep bagging. Doug, set up the burn kit. John, suction. Amy, 2 lactated ringer's wide open. Load and go, expedite AMR on a one. What is Valley Med? Red? Stanford? Also red? Tough, tell VMC they got one on the way. Roll him on the sheet. You, bystander on the bag, call it."
There are lots of hands. Firefighters. "On three. One, two, THREE." and we roll. "Again, to lift, one, two THREE." Someone takes the bag.
"We got it from here," says one of the firefighters. "Son, follow me. What's your name?"
"Andrew, I'm an EMT."
"Do you know where you are?"
"I'm AxO times four, side of Highway 101 post vehicle accident, I saw it happen, it's a Sunday."
"OK. Take off your gloves and hold your hands out." He looks me over from head to toe. "Can you open your left eye?"
I wasn't aware I had it closed. He shines a penlight on it. "Did you hit your head? Can you see out of your eye? Is it clear?"
"No, yes, and yes."
Then I start hurting all over. My right forearm from where I burned it on the edge of the superheated pickup truck in contact with the burning SUV. The left side of my face, which feels sunburned. My left eye which weeps until the firefighter puts a patch on it with ointment. "Should be OK." Someone is taking a BP on me. The bandages with gel on my itchy hands feel really, really good.
Two ambulances have left. A third one is still present. They start to get me to sit on a gurney.
"No, sorry guys, I have Kaiser. I'll self-transport, thanks. Where's the refusal?" I promise faithfully to go directly to the Kaiser ER, do not pass go, do not collect $200.
They mutter a little but not much. I sign the refusal and start to gather up my gear. A CHP officer interviews me. What did I see? Did I see brake lights flash? The freeway is shut down for two lanes and I see all sorts of police and fire uniforms. I start to fumble for my ID in my wallet, can't with my gloved hands, and the CHP officer stretches a point and takes my business card as a valid ID.
Then some jerk with a business suit accompanied by another with a camera asks what happened. I point at the number painted on the side of the vehicle.
"Call my office." Then I throw the gear in the back of the car and merge slowly back into traffic.
New destination, Kaiser urgent care, for treatment of minor hand and face burns. At least until I walk into the urgent care and ask for an appointment. They whisk me out of urgent care without even asking my patient number (!) and sit me in an exam room.
They peel off the bandages and I get a glimpse of myself in the mirror.
I am covered with blood and lymph. My eyes are crazed and my eyebrows singed. The left side of my face is visibly redder than the right. I look down at my hands. Just one little spot of hot red blisters on my right forearm, but it hurts like a blowtorch.
Full thickness burns don't. Hurt, that is. The nerves are burned away. They just kill, if the surface area is big enough and infection cannot be fought. So does one breath of superheated gas, which destroys the lungs.
The news is on. Five o'clock news. So much time?
"Another gas price casualty? Fatal traffic accident on US 101 North at Montague. Two people lost their lives when a pickup truck rear-ended an SUV. According to CHP, the SUV was carrying four five gallon plastic cans of gasoline in the back, apparently in a effort to save money on buying gasoline in bulk. The driver of the SUV regained consciousness briefly, then died at Valley Medical Center in San Jose of lung damage. The pickup truck driver, also transported to VMC, died of a broken neck and spinal injuries. CHP reminds all drivers once again not to carry gasoline in the passenger compartment of cars or SUVs. In our next segment, the dangers of riding mass transit."
I start to bury my head in my hands. Then have to think better of it.
Stupid people under economic pressure do stupid things. In this case, carrying twenty gallons of gasoline in the same compartment on the freeway. Much safer to carry the same weight of explosive. Much.
(Disclaimer: This is a World Without Oil post. This DID NOT HAPPEN. However, if you choose to carry gasoline in your car's passenger compartment and get in a car wreck, you could get to field test this for me. You or your next of kin can write and tell me how it turned out.)
To keep the guards honest (and well trained, and deliver good service), we have to have people go out and check on them now and again. Days, nights and weekends. It is an operating cost of our business. I'm running around with a decidedly nontraditional vehicle: a white Honda Civic hybrid. Still carries five, which is sometimes useful during a startup.
So I'm driving northbound on Highway 101 JNO Montague at about 1 in the afternoon on a Sunday when I see the accident. The driver of a small white SUV suddenly hits the brakes and a black pickup truck loaded with construction supplies slams into the back of the SUV. About forty MPH collision speed. I actually see the airbag deployment as the driver of the pickup truck takes the bag in the face.
I snick the hazard lights on as I come to a stop blocking the affected lane, dismount from the vehicle, go back to the trunk and put on my traffic safety vest. I'm already on the phone via Bluetooth to the CHP.
For a wonder, no busy signal. "911 what are you reporting?" "Injury traffic accident, two vehicles involved, white SUV rear-ended by black pickup truck. Blocking #4 lane. EMT on scene." I pick up my emergency medical pack and actually LOOK at the wreck.
The small white SUV is on fire!
I quickly add, "Roll fire and medics! SUV is on fire and fully involved!" as I get out the fire extinguisher.
Rest later . . . power outage here and I have to save on batteries.
Resuming story . . . as a trained emergency medical technician, I know that cars do not just go up in flames. It usually takes several minutes for the engine to fully catch, and by the time the car heats up enough, the fuel tank parts separate and dump some flaming gasoline on the ground. No explosion, just a fire. And it takes time.
But this SUV is already fully involved about ten seconds after the wreck. Just like a Hollywood movie car fire. I know how they get those. Five gallon plastic bags of gasoline.
I sling the emergency medical pack, grab the rescue bag in my left hand and run towards the SUV, rather overloaded. But I'm going to need all this gear and I wish I had lots more.
Just about then, the driver's side door to the flaming SUV opens and the driver gets out and starts running and flailing. He is on fire.
I drop the extinguisher and screech at him "STOP! DROP! ROLL!" while I fumble out the fabric blanket from the rescue bag. He turns and starts running, flaming, down the freeway shoulder. I chase him still screaming "STOP!" "STOP!" "DROP! DROP!"
I bunch up the blanket in both hands and do something stupid. I tackle him. Flames and smoke as we both slam into the dirty asphalt and I frantically beat at him with the blanket, screaming "DROP! ROLL! ROLL! ROLL DAMN IT ROLL!" and pushing him sideways until he catches on and starts to help me. He ends up on his side with me beating out the last bits of flame. We both stink of gasoline and fumes and my hands ache and itch. I don't even notice the bruises on my hands and arms.
I unsling the emergency medical bag, rip it open and flick out the EMT shears. I efficiently start cutting off all of the victim's clothing including his shoes. I have one bottle of eye wash, not the best to use, but all I have. I pour it on his smouldering hair and face.
Behind me I hear screaming and shouting. The pickup driver is trapped in his vehicle. Other people have stopped to help and they are trying to bank on the vehicle.
Grabbing up the medical pack and rescue bag, I run back. A quick rush of brains to the head -- I put on the leather gloves. The palms of my hands hurt as I slide them on. Someone has grabbed the extinguisher and is discharging it onto the hood of the pickup truck. Damn it! What a waste!
I fumble out a roll of duct tape and the window punch. I push someone out of the way of the pickup truck window, wincing at the heat as I slap a quick taped "X" across the side window. Someone asks "What are you doing?!?" and I snarl "BACK OFF!" Then I slap the window punch into the corner of the side window, which obligingly shatters. I peel it out of the frame, held together only by the X of duct tape I have just applied. Then I unlock the door and start to reach across the moaning, bleeding driver of the pickup truck. He is the only one in the truck.
The heat on my face has turned prickly and my left eye is hurting. No time to find the quick-release buckle. I close my left eye and ignore the pain as I cut through the seat belt with the EMT shears. IF I LEAVE HIM IN HERE, HE WILL BURN TO DEATH FOR SURE Rapid extrication. Hold the head and spine in line the best I can as I free-drag him clear of the hot wreck. My forearm brushes the frame of the truck and immediately starts itching.
Somehow I am about thirty feet from the truck with the pickup driver's head cradled between my hands. A crowd of people is around me.
I flip open the emergency medical pack. "YOU! CALL 911! YOU! GO CHECK ON HIM! DOES ANYONE KNOW FIRST AID?"
Someone does. I hand her a set of nitrile first aid gloves. "Put these on. I need you to hold his head and neck exactly still for me. That's right, hold the back of his head. HOLD HIM STILL!" as he starts to thrash. I take off the leather gloves and put on a set of nitrile myself.
"Sir! My name is Andrew, I am an emergency medical technician, I am here to help you. What's your name?"
He's moaning inarticulately. "Sir! What's your name? Do you know where you are?"
I reach down and rub his sternum, hard. Painful stimuli. He moans louder.
"We're here to help you, sir. It's very important that you don't move your head. Try not to move."
Rapid assessment. Head to toe. Scalp bleed. Facial lacerations, minor, no airway compromise. Neck distended and at an angle. Chest bilateral rise and fall of the chest. I run my hands up and down quickly. No life-threatening bleeding. Respirations maybe 12 and shallow, strong radial pulse. Possible broken neck. Altered mental status. Stabilization and immediate transport.
"Don't move, sir. We're here to help you." I turn to her and say in command voice, quietly but with absolute arrogance "Stay With Him." Then I grab up the pack and run back to victim #1.
People are also standing around him and not knowing what to do. He smells like charred meat. Because he is. I peel off the first set of gloves, put on a second set of gloves and see blood on my hands in the interim. Damn.
He's lying on his back and gurgling. I lean forward and roll him towards me on his side. Someone says "Don't touch him!"
I look at the patient and say "I'm Andrew, I'm an emergency medical technician. What is your name?" While waiting for the someone to identify themselves and level of training, I do my rapid assessment. They don't ID themselves so I ignore them completely.
Airway. Gurgling. I open the patient's mouth and a mix of blood and vomit and serum come out in surges. I flip out the emergency medical kit. I don't carry oxygen and my only suction is a turkey baster. Better than nothing. I start suctioning out the patient's mouth while continuing my rapid.
Face: red and hot. Hair, burnt and smells nasty. Charred flakes and serum on my forearms and his clothes and the ground. Respirations, heavily labored, maybe six a minute. Damn I wish I had oxygen. I pause suctioning and rig the bag valve mask. I'm gonna need it.
The rest is a blur. I am way over my head. A single EMT with a major burn victim.
Rule of 9s. Head 9, Left Arm 9, Right Arm 9, Chest 18, Back 18, Left Leg 18, Right Leg 18, Genitals 1. Both legs, back of head, both arms, most of back, some of front. Call it seventy percent burns. Breaths shudder to a stop. Respirations zero. Begin resuscitation. Thousand-one thousand-two thousand-three thousand-four BAG. Thousand-one thousand-two thousand-three thousand-four BAG.
A CHP officer is holding someone back. He asks me, "What do you need?"
"Two paramedic ambulances for two critical trauma patients. BAG. Patient 1, respiratory arrest, 65% burns BAG including airway. Patient two, painful stimuli, C-spine compromised BAG, altered mental status. Back over there." BAG. The CHP officer pales, clicks down on his radio mike and runs back to his cruiser.
I check the victim's pulse. It's strong. Privately I feel that this is not an unmixed blessing. BAG. I fumble out the single 4x4 burn dressing. BAG. Put it where it will do the most good, on the front of his burned neck. BAG. It is like putting a bandaid on a slaughterhouse.
A bag is dumped next to me. C cylinder oxygen from the CHP cruiser. Thank Goddess! BAG. I flick it open, open the regulator. BAG. Hook up the BVM 02 line to the regulator. BAG. Set flow rate to 15 LPM. BAG.
I am still bagging and assessing vitals, having taken one BP and having no response to efforts to assess mental status, when the medics run up.
"Burn victim, 65% partial thickness burns, gasoline splash, respiratory arrest, BVM for 5 minutes, BP 80 palp, massive fluid loss, O2 at 15 lpm."
"We got it. Keep bagging. Doug, set up the burn kit. John, suction. Amy, 2 lactated ringer's wide open. Load and go, expedite AMR on a one. What is Valley Med? Red? Stanford? Also red? Tough, tell VMC they got one on the way. Roll him on the sheet. You, bystander on the bag, call it."
There are lots of hands. Firefighters. "On three. One, two, THREE." and we roll. "Again, to lift, one, two THREE." Someone takes the bag.
"We got it from here," says one of the firefighters. "Son, follow me. What's your name?"
"Andrew, I'm an EMT."
"Do you know where you are?"
"I'm AxO times four, side of Highway 101 post vehicle accident, I saw it happen, it's a Sunday."
"OK. Take off your gloves and hold your hands out." He looks me over from head to toe. "Can you open your left eye?"
I wasn't aware I had it closed. He shines a penlight on it. "Did you hit your head? Can you see out of your eye? Is it clear?"
"No, yes, and yes."
Then I start hurting all over. My right forearm from where I burned it on the edge of the superheated pickup truck in contact with the burning SUV. The left side of my face, which feels sunburned. My left eye which weeps until the firefighter puts a patch on it with ointment. "Should be OK." Someone is taking a BP on me. The bandages with gel on my itchy hands feel really, really good.
Two ambulances have left. A third one is still present. They start to get me to sit on a gurney.
"No, sorry guys, I have Kaiser. I'll self-transport, thanks. Where's the refusal?" I promise faithfully to go directly to the Kaiser ER, do not pass go, do not collect $200.
They mutter a little but not much. I sign the refusal and start to gather up my gear. A CHP officer interviews me. What did I see? Did I see brake lights flash? The freeway is shut down for two lanes and I see all sorts of police and fire uniforms. I start to fumble for my ID in my wallet, can't with my gloved hands, and the CHP officer stretches a point and takes my business card as a valid ID.
Then some jerk with a business suit accompanied by another with a camera asks what happened. I point at the number painted on the side of the vehicle.
"Call my office." Then I throw the gear in the back of the car and merge slowly back into traffic.
New destination, Kaiser urgent care, for treatment of minor hand and face burns. At least until I walk into the urgent care and ask for an appointment. They whisk me out of urgent care without even asking my patient number (!) and sit me in an exam room.
They peel off the bandages and I get a glimpse of myself in the mirror.
I am covered with blood and lymph. My eyes are crazed and my eyebrows singed. The left side of my face is visibly redder than the right. I look down at my hands. Just one little spot of hot red blisters on my right forearm, but it hurts like a blowtorch.
Full thickness burns don't. Hurt, that is. The nerves are burned away. They just kill, if the surface area is big enough and infection cannot be fought. So does one breath of superheated gas, which destroys the lungs.
The news is on. Five o'clock news. So much time?
"Another gas price casualty? Fatal traffic accident on US 101 North at Montague. Two people lost their lives when a pickup truck rear-ended an SUV. According to CHP, the SUV was carrying four five gallon plastic cans of gasoline in the back, apparently in a effort to save money on buying gasoline in bulk. The driver of the SUV regained consciousness briefly, then died at Valley Medical Center in San Jose of lung damage. The pickup truck driver, also transported to VMC, died of a broken neck and spinal injuries. CHP reminds all drivers once again not to carry gasoline in the passenger compartment of cars or SUVs. In our next segment, the dangers of riding mass transit."
I start to bury my head in my hands. Then have to think better of it.
Stupid people under economic pressure do stupid things. In this case, carrying twenty gallons of gasoline in the same compartment on the freeway. Much safer to carry the same weight of explosive. Much.
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no subject
Date: 2007-05-17 06:37 pm (UTC)You're right; we can't save 'em all. But we gotta keep trying . . . .