In response to Randy Danielsen's story of emergency response on an airplane, an NP relates her history of responding to roadside emergencies, even when the only help she can offer is comfort.
I live on the northern Lower Peninsula of Michigan, known for its rural beauty—and its very long distances to health care. It’s a dicey situation under the best of circumstances, and treacherous in the dead of winter. We have several superb regional referral hospitals, but some locations are an hour away. You are likely to be the only other person on the scene for some time, let alone have another health care provider show up.
The first accident I attended happened 37 years ago, before I was even a nurse. A car got T-boned at the intersection of the store where I was working. I called the hospital and flew out the door. Imagine my surprise when I saw my brother in the car that had gotten hit! He was furious and was trying to get out of the car, even though he had numerous lacerations. I could tell he was not acting right. I told him I’d tell Mom if he got out of the car, and he stayed put. He did have a concussion, so I’m glad I was able to keep him from getting out of the car.
I attended to people in a number of fender benders (no serious injuries), but the next big accident happened on my day off work. I could see a tractor-trailer jackknifed across the road after hitting a small car that was pushed into its path by the car behind it. The truck center-punched a utility pole, and the car that had been hit twice was in someone’s front yard. In it were three small children with their dad. No other health care providers were on the scene, but as it turned out, the passengers were the family of a coworker at the hospital. I tracked her down, and everyone was OK.
The next two incidents were a double-header—on the Fourth of July, no less. My husband and I were heading out to the parade a block from home when we heard “Help me, help me!” I found an elderly lady in the arms of a younger woman. She wasn’t breathing. In one part of my brain, I was thinking, “There goes the parade!” while another part started cranking up the ABCs of resuscitation. Fortunately, just repositioning the woman’s airway got her breathing, and I thought, “I’ve dodged that one.”
But that moment of relief did not last long. Later that day at a picnic, the son of a friend came up to me with a funny look on his face—something I’m used to and understand as a PNP. But he kept looking at me, and I realized he wasn’t breathing! Something made me say, “Johnny, open up your mouth. Are you choking?” As he opened his mouth, I could see and smell a huge wad of grape bubble gum. After multiple whacks on his back, his dad tipped him upside side down. I asked Johnny to open his mouth. “Don’t bite me,” I said, “and I’ll get the gum out.” He didn’t, and I did.
The next experience is one that actually caused me some PTSD for a long time. My husband and I came upon the scene of a one-car rollover accident. The truck was in one lane, and two men were lying in the road on the other lane. They had obviously been thrown from the vehicle, and as I got closer, I could tell why they probably weren’t wearing their seat belts. Alcoholic fumes wafted from both men, one of them breathing and the other not. This man, I assessed first. No pulse. Blood was everywhere, and my gloves and stethoscope were 60 miles away, back home. “Uh-oh,” I thought, “CSF coming out his ears and nose is not a good sign.” A flashlight was handed to me, and I could see his pupils were blown.
Since nothing could be done for him, I turned my attention to the other man. He too had CSF and blood everywhere, and his pupils were constricted and reacted only marginally. His respirations became more rapid, then went into Cheyne-Stoakes. Just as I was checking his pupils again, they blew. He was gasping and choking, and I only wanted him to live long enough for the EMTs to get there. He did—but then he died. We tried CPR and suctioning, but when his chest wall began to collapse to his backbone with each compression, we decided to stop. Needless to say, that was one of the most traumatic experiences of my career. No equipment, and only my five senses to help me.
There’s a lot more to the story, but I will add one final detail. The two men were brothers, out celebrating a birthday. I talked with both of their widows and apologized that there was nothing we could do—but they expressed their gratitude that someone had tried to help and was there with them when they died. I can remember like it was yesterday ... it was one of those “time stands still” episodes in my life.