Twenty-eight-year-old paramedic Meghan McCoy surveyed the car wreck as they approached the scene in the ambulance. Mangled cars partially blocked the busy highway, and it didn’t appear everyone had gotten out of their vehicles. “Dispatch, it looks like we’ve got 3 vehicles involved in this MVA, partially obstructing Hwy 63. We’re gonna need wreckers, PD, Fire, and a second ambulance to the scene. We are arriving on scene now.”

“EMS 18, copy. Fire and PD are en route to your location. I’ll contact the towing company, and dispatch a second EMS unit.”

Meghan didn’t wait for tones sounding for the second ambulance, climbing out of her truck and issuing orders to her EMT. “Tony, grab a backboard and the trauma pack. I’m going to head for the middle car. Start checking on some of the ambulatories, okay?”

Tony waved his acknowledgment, and she started for the car. The car itself was the furthest into the roadway, and some of the cars passing the scene were trying to maintain highway speed instead of slowing down. Meghan shook her head at this and adjusted her neon yellow traffic vest as she went.

The last thing she remembered was her partner’s yell, a screech of tires, a flash of red, and pain before everything went black.

**********

In the ER at County Medical Center, Dr. Mitchell Tanner Branston was just settling into a chair with a cup of coffee when they heard the EMS radio crackle to life. “EMS 21 to County Med, EMS 21 to County Med, over.”

A nearby nurse went to the radio. “This is County Med, EMS 21. Go ahead.”

“We have a Code-I, Paramedic down. I repeat, Code-I, Paramedic down. Alert the Trauma team. More info will be coming shortly.”

“We copy, EMS 21. Trauma team will be on standby. Awaiting patient info.” She turned to the floor clerk, who was already dialing the hospital-wide intercom. Soon the page was heard over the loudspeakers: Trauma Team Alert. Trauma Team Alert. Report to Trauma Bay 1. Trauma Team Alert. Report to Trauma Bay 1.

Things suddenly got very busy as the team assembled. Everyone was donning gloves, goggles, and protective gowns. A mobile x-ray unit was brought in, as well as the ultrasound machine. Dr. Branston, as Chief Attending for the shift, waited close to the radio to hear the report when it came in.

The radio crackled to life again. “EMS 21 to County Med, EMS 21 to County Med, incoming patient report, Code-I.”

“We read you loud and clear, 21. Go ahead with patient report.” The nurse had pen poised over paper to write down the information.

“I have a 28-year-old female, hit at highway speed by a vehicle. Patient was thrown up on the hood and then to the pavement. Patient is unconscious but breathing. Pulse 120 and thready, BP 88/62, respirations 18. We have 2 large-bore IVs with Normal Saline. Possible tib-fib fracture on the left. Monitor showing slight sinus tach. O2 via nonrebreather at 12 LPM. Pupils equal but a little sluggish. Patient is on backboard with restraints, leg splinted. ETA is 5-7 minutes.” You could hear the slight wail of the siren in the background as the report was given.

“Copy, EMS 21. ETA 5-7. Report to Trauma Room 1 on arrival.”

The nurse and ambulance signed off, and Dr. Branston took the report from her, heading towards the trauma room to give everyone a head’s up.

“Okay, they’re bringing us a paramedic hit by a car at highway speeds, about 5-7 minutes out. Female, unconscious, possible tib-fib fracture, possible head injury. I want a full set of x-rays, cardiac monitor, catheter, abdominal ultrasound. Draw labs: CBC, Chem panel, UA, drug screen, ETOH. Get me arterial blood gasses. Call CT and order head and c-spine.” Dr. Branston finished rattling off his preliminary orders and noted the nods and flurry of activity as people gathered supplies and prepped for the patient.

Dr. Branston made his way to the ambulance bay just as EMS 21 pulled in. Techs threw open the ambulance doors, revealing the paramedic and a couple of firefighters changing the oxygen from the ambulance’s supply to a tank on the cot, settling the Lifepak 15 on the back of the cot, and grabbing for the Toughbook charting system. The cot brake was released, the cot rolled out, and they started for the Trauma Room.

Dr. Branston was carefully listening to the report when he glanced down at the patient lying on the cot. His heart about stopped, and he froze for a moment. Oh, no! It’s Meghan! The paramedic and nurses rushing the cot to the Trauma Room glanced at him, and he quickly brought his attention back to the present as they wheeled her into the bay.

A flurry of activity ensued as the team converged on the patient, transferring her to the gurney, cutting off her clothes, doing x-rays, lab work, you name it. The paramedic finished giving his report, got a signature handing over patient care to the ER staff, and left.

Dr. Branston had no time to worry at the moment – making sure Meghan was stable and determining the extent of her injuries was his focus. “Let’s get her off this backboard.” Several hands removed the straps securing her to the board and then stood ready to carefully logroll her to her side and off the board. “On my count: one, two, three…”