I had worked at this new station for maybe a week when it happened. I had started my shift off as I normally did – dropping my stuff off in a room for the day, chewing the fat with the off-duty crew. I said my goodbyes and headed to start truck checks. I was standing just on the edge of the “floor” of the cab, checking on patient forms. My partner, Steve, was busy checking the engine with the hood up. Satisfied we were well-stocked, I stepped out of the cab, aiming for the first step. I missed the step and fell backwards, landing with a loud thud on the concrete floor, landing straight on my back. Dazed, I remember Steve poking his head over the hood.

“Are you okay?” He rushed to my side as I lay there. “Megan, are you okay? Can you hear me?” I could only moan. I felt his hands on either side of my head, holding my neck still and keeping my c-spine stable. “Megan, I want you to hold still. I’ve got you,” he reassured. I was pretty much out of it at this time; I lay there moaning, not responding to my surroundings or the questions and prodding that was coming. “Mike! Mike! I need your help now!” Steve shouted through the connecting doorway. He wished he could get to his radio, which was in the truck on the other side of the door.

Mike appeared at the doorway and stopped, shocked. He rushed down the stairs. “Oh my goodness! What happened?” He stopped beside her. “Megan! Megan, can you hear me?” He was only met with groans. He rushed to the back of the ambulance and yanked out a c-collar, backboard, and straps. Setting these down beside her, he grabbed the Thomas pack from the truck. “What happened, Steve?” he asked, as he started digging in the pack for a blood pressure cuff and stethoscope. He donned a pair of gloves and started taking vital signs. “She was checking the cab and fell. I don’t know if she hit her head or not. I was checking the oil when I heard a loud thud and saw her lying on the floor. You’d better notify dispatch, Mike.” Steve was justifiably worried.

Mike nodded, and radioed the situation to Dispatch, putting the unit out of service. He then turned his attention back to Megan. Behind the scenes, the dispatcher notified the county fire department, requesting their assistance at the station. “Blood pressure is 92/56, pulse 136 and thready. Respirations are…” Mike started. “Resps are 22 and shallow. Her eyes are glassy, and she’s not responding verbally. I’m not noticing anything coming from her ears or mouth,” Steve responded, giving what little info he could, considering he was still holding her neck stable.

Mike nodded, and reached to carefully feel the back of her head and neck. “I’m not feeling anything abnormal here.” He reached for the c-collar and carefully applied it to her neck. He then started a quick head-to-toe assessment. He didn’t find anything immediately injured with her lying face-up.

They heard the sound of a large truck pulling up outside the building, plus the hiss of air brakes, followed by a double horn honk. Mike quickly hit the button to open the bay door and returned to his patient. Four firefighters followed him into the building. Chad, the captain of the crew, motioned to Megan.

“What’ve you got? What happened?” He motioned to the backboard, and a couple of the men went to get the straps and board ready, while the fourth man (Will) set about shutting the hood of the ambulance and getting it ready to go.

“She fell out of the cab and landed on her back. She’s not really responding to us. We need to get her backboarded and to the ER.”

Chad nodded. “Bret, Mitch, give us a hand with that backboard.” They pulled the board up close to Megan’s side, and carefully logrolled her onto her side. Mike carefully felt her spine and back, pulled the board up to her back, and they rolled her back onto the board. Mitch and Bret started securing the straps to the board. Will had pulled the stretcher out of the back of the ambulance at this point. The backboard was carefully lifted and set on the stretcher, and it was wheeled around to the back of the truck and secured inside. Mike hopped into the ambulance, and Chad passed him the Thomas pack.

“Do you need someone to ride along with you?” he asked.

Mike thought for a second, but shook his head. “No, I think I’ve got this covered. Thanks for the help.”

“No problem. Good luck!” Chad shut the doors and thumped on the back twice. Steve had by this time started the engine so that the truck would be ready to go. He entered the side door of the ambulance. Mike had already turned on the compartment lights and was dragging down a couple of sheets.

“I need to get these clothes off her, start an IV, and get her on the monitor. Could you put some oxygen on for her?” Steve nodded, and pulled down a nasal cannula, which he hooked up to run at 3 liters O2. He then took patches and placed her on the cardiac monitor. He pulled out the supplies for the IV and set those up.

During this, Mike was busy cutting clothes off Megan. It was necessary to expose her, as injuries can often hide themselves under clothing. He was careful to be as discreet as possible, keeping her covered as much as possible, but making quick work of it as well. Mike hadn’t found anything obvious so far with his exam, but was extremely aware that he needed to get her to the hospital.

“Steve, let’s go. I can start the IV en route.” Steve nodded and headed out of the side door and up to the cab. He radioed dispatch that they were headed to the hospital, and pulled out of the drive. He turned on the lights and the siren and started driving towards the city, 12 miles away.

Mike started first one large-bore IV, then a second one. Megan still wasn’t responding well to him, but she was no longer moaning. Rather, she was crying. He kept talking to her, trying to get her to respond to him, reassuring her she’d be okay. He finished cutting her clothes off, keeping her covered with sheets. Her now-naked body lay under the sheets, strapped to the backboard with her clothing in pieces underneath her. Mike discreetly checked the lead placements for the EKG, and listened to her heart and lungs. She sounded slightly congested due to the cold she had, but nothing that sounded like she was having breathing difficulties. He checked her vital signs again. Her blood pressure was still low, around 86/palp. He increased the drip rate of the IVs, and continued to monitor her condition.