Dr. Andy

Reflections on medicine and biology among other things

Saturday, November 12, 2005

A real doctor

Today I got to play a real doctor.

I was doing some laundry when by wife pointed out a bunch of smoke outside our window. I ran out and saw that someone had driven their car straight into a light pole. Smoke seemed to be pouring out of the engine and some landscapers who were working at our neighbors were trying to get the driver out.

My initial reaction was just to watch, but once I realized the driver was still in the car, which could burst into flames any minute, I ran over to help. One of the landscapers had managed to cut the seat belt and he and I pulled the driver out. Luckily, he had been wearing a seat belt and his airbag had deployed.

It turned out the engine wasn't smoking at all. Rather the drivers foot was stuck on the gas and the right rear tire was spinning against the curb, generating all the soke. Once the tire had fully worn down, someone realized this and turned off the ignition. Once we realized there was no imminent danger of fire or explosion we stopped moving the driver and laid him down with his feet still in the car.

It took me a second to remember what to do (I hadn't been in a similar situation since I was a senior resident nearly 5 years ago). ABC: airway, breathing, circulation. He had a bit of mucous at his mouth, but was breathing well and had strong carotid and radial pulses. Now there was nothing to do but wait until help came.

One thing I've read about emergencies is that people tend to stand around thinking everyone else will do something. If you order someone to do something they will but if you just ask for someone to do it, everyone will think someone else will do it. So I pointed at my wife and said "Call 911 now!" Too late, she and several others already had. So I told her to get a blanket, but our neighbor had already gone to get one.

The driver was not responding, but at least he was breathing. Incredibly, a tow truck driver made it first, followed by a fire truck and then an ambulance. The landscapers taunted the tow truck driver as a "vulture." The firemen asked if he had a pulse, which he still did. When the EMTs got there they put him on a board and in a collar.

He was moving his legs and fighting a bit when the strapped him down, which I took as a good sign. I had been worried when we moved him that he might have had a spinal injury although the fact he was wearing a seat belt and had an airbag were in his favor. Of course, worried the car would catch on fire, I would move him again.

Later, I talked to the women who had been behind him. She said she saw him jerk around BEFORE the crash, suggesting he had a seizure. He had hit a car in front of him before smashing into the light pole

Whew. I was glad to get through that without everything going well. It is hard to be sure, but I assume the driver will do well. The crash was bad, but not horrendous and he had no obvious orthopedic injuries.

I am not a natural at these situations. My inclination is to stand and watch, and as a resident I was never comfortable in code situations. I had trouble taking charge. But today I did okay. It took me a few seconds, but I got in there, took action and followed the algorithms. Realistically, it didn't make much of a difference as if noone had done anything the guy would have been okay, but I was glad I did my best


At 7:13 PM, Anonymous Bruce Small said...

I remember that lesson in first aid decades ago: Someone has to take charge. It can be the least qualified person, as long as they give clear orders. As you said, "Call 911 now" works perfectly.

At 9:59 PM, Blogger ollie said...

good job Andy; you ARE useful after all!


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