RTC? RTA?……….. Crash!

No matter what you want to call it, the coming together of two objects often ends in injury, or worse. I had not long started when I was called to my first fatal RTC (Road Traffic Collision). I think they were still known as RTAs at that point (Accident) but later someone decided “accident” implied that no-one was at fault. I was still working in the big city, it was winter, the roads were icy and there were celebrations going on.

One driver, of a rather large car, had decided one for the road was not enough. Suitably oiled himself, he had taken a large corner too fast and slipped over to the opposite carriageway halfway round, straight into the path of an oncoming 4×4. Not a scrappy German, WAG taxi style 4×4, a real, solid built one. The result of the head on collision was spectacular!

On our arrival, two other crews were working in the rear of the large car in the middle of the road, while the fire brigade were busy dismantling what remained of it. The other vehicle was on the grass verge, looking like it belonged to a passer by who had simply stopped to help. It had a slightly cracked grille, scratched paint…..if you looked closely, and a broken light (not an exaggeration!). The driver was being checked over by a Dr who had come from a house nearby by seemed ok, other than a bit shaken.

There were three people in the large car. All were rather large, none were wearing seat belts. The crews on scene were working hard with the fire crews (aka, with utmost respect, “drip stands”) to extract the two passengers from the rear. Both were in critical condition.

There I was, barely qualified, already a number of RTAs under my belt, but never at night, never in the biting cold, never with so much noise from so many fire engines. I stopped before getting out of the Ambulance and turned to my partner, a veteran of many incidents. My heart was pounding, the noise was mind numbing. “Breathe, then assess the situation” they said in a calming voice. That advice stuck with me throughout my career.

By the time I left my ambulance I knew what my part was and what I had to do. The driver was my patient. Because work was going on in the rear of the car, I had to wait until the passengers were out before I could attempt to deal with the driver. I knew I had to keep his head straight, something important in every impact situation to try to keep the Spinal column straight and prevent any damage to the Spinal chord. I also had to keep them calm while their car was being cut apart around them. I grabbed a fireman and asked them to remove the front windscreen. Once done I was able to talk to them, making sure they were looking straight at me all the time, and not moving their head. Even the length of the bonnet away from them, the alcohol fumes were strong. I asked my partner to put an oxygen mask on the driver, then it was just them and me…..in the middle of a world of organised noise.

I stood in front of that car for, what seemed like an eternity, talking to the driver and finding out all about them. They had been to a party and had decided the roads would be quiet enough to drive home ok. My hands and face were numb with the cold by the time the first passenger was extracted from the rear of the car. I could tell from the looks on the peoples’ faces that it wasn’t going well. They disappeared off to A&E. Then the second passenger was extracted, my partner was helping and they shook their head as the lifeless body was wheeled to the other ambulance. The crew were giving CPR, but I could tell it was hopeless.

As soon as the fire chief gave me a thumbs up I was in the remains of the car, holding the driver’s head from behind their seat. I had already established that the whole front of the car was pushed back, the dashboard and steering wheel pressing against the drivers legs and chest. They had complained about pain in their right hand so I looked from behind them, now I was able to attend to them properly. “it will be ok, well get you sorted” I said, as reassuringly as I could muster. The hand was hanging by nerves and skin at 90 degrees to their arm. The broken ends of the bones were visible at the end of their arm, and sticking up from their hand. Mercifully there was no arterial bleeding!

The fire chief and myself quickly worked out a strategy and explained it to the patient, then they got to work removing the front of the car. The cutters made light work of the metal. Then the whole chassis broke in half, down the length of the car. My left leg was jarred down suddenly and the engine dropped on to the road at the front of the car. The oil sump cracked and oil ran everywhere.

We patched our patient up, extracted them with the help of a spinal board, then into the Ambulance. The journey to A&E was quick and we handed our patient over. As we walked away the patient said something, muffled by the oxygen mask. The nurse lifted it and the patient looked me in the eye and mumbled, still slightly drunkenly, “Thank you. Happy New year, when it comes”. My heart sank! Neither of the two passengers had survived as far as A&E. The driver would never drive again, possibly not even walk. Not a very happy new year.

The moral is simple, obvious, but there will always be those who think they know better. There will always be ambulance crews who will try their best to save them.

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