It was a quiet morning at the station with no call so far. The weather was typical for July, warm with a few showers. The tones broke the silence of a slow morning. “Medic 1, Engine 1, Rescue 1 report of a car striking a utility pole. Power is out in the area. Caller reports one male appears to be trapped in the vehicle.” Time out 0937.
The response time was short because the crash was only a few miles from the station. On our arrival we found a small car had slid into the pole. There was heavy damage to the car.
The driver appeared to be a young teenage boy and he was trapped in the vehicle. He appeared to have multiple injuries.
Scene assessment revealed no power lines down. There was major damage to the pole and the transformer was hanging by what appeared to be one bolt. Any movement of the car caused the transformer to shift back and forth. A decision had to be made to stay back until the utility company arrived or take the chance to enter the car and start treating the patient. The young man needed help so we made the decision to enter the car.
Upon entering the car I was amazed at what I found. The young man’s femur was broken. https://www.moveforwardpt.com The impact of the crash forced the lower half of the broken bone through the skin and over the bottom portion of the steering wheel. This was not going to be an easy or rapid extrication.
The young man exhibited the early signs of shock so two IVs were established to replenish some of the lost fluid. He had several deep lacerations to both arms and head. All bleeding was controlled. As I palpated his chest I could feel several fractured ribs. He was not in good shape but he remained conscious.
The utility company had been notified and were responding. When the state trooper arrived he was informed of the situation with transformer. He then called another trooper to provide an escort for the utility company truck.
Once the patient had been somewhat stabilized, we had to figure out what to do with the leg injury. The protruding bone had a lot of debris on it so we flushed it the best we could. But the bone still had too much debris on it. Letting the bone slip back in the leg would cause him infection problems down the road.
We wrapped the bone with moist dressing. In addition we secured the injured leg to the bottom portion of the steering wheel. It was tight to prevent the bone from slipping back in the leg.
Next, we cut the lower half of the steering wheel and left it attached to the leg. Then we secured the leg in its current position. Now he could be moved without of the bone slipping back in.
As the extrication continued, the dash of the car had to be pushed forward and away from the patient. The drivers door was particularly wrapped around the utility pole so we decided to remove the roof of the car and extricated him straight up out of his seat. This proved to be quick and provided less movement of the patient’s leg. It worked and the patient was transported to the hospital with no further issues.
After surgery and rehab for his leg the young man made a complete recovery.
“Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.” Isaiah 41:10.