Of Flipped Cars and Brain Bleeds

If EMS has taught me anything it's that appearances can often be deceiving.

On this particular Monday morning, I happened to be covering for a friend who decided it was a good day to skip town and go camping. Around 9am we got a call for a motor-vehicle accident (MVA) with one patient.

Alright, fair enough.

We take the local highway to get to the scene, and along the way, we meet up with three police cars, two rescue trucks and a fire truck. Hmm... interesting - this much attention for an ordinary car accident?

Our entourage of seven emergency vehicles is barreling down the highway much faster than it should be (typical guys, we like to show off our engines). And the sound of all our sirens must be deafening, as pedestrians on the sidewalk visibly cringe in pain when we pass. Finally, after twenty minutes of concocting all sorts of interesting theories about this call, we see the scene and gasp.

When you approach an overturned car sitting in the middle of the road a few things start going through your mind, not the least of which is how you can safely stage the ambulance on a major roadway. The real problem will be getting this patient out of the car (extricated) because he will obviously be stuck (entrapped) in an awkward position. His spine has also likely taken quite the jolt so it is imperative to keep him straight and move him gently lest our movements sever the chord and paralyze him. So my partner and I unload all of the rescue equipment and rush over to the car ready to provide life support and extricate this victim.

We anxiously approach the car and look inside, afraid of what we might find - and hey, there's nobody in there. A heavy-set man comes up behind us and is furious, "I'm not paying for a trip to the hospital. Go home! Let me sort this out with the police."

Needless to say, I was absolutely shocked: "Sir - you just crawled out of an overturned car on a major highway. You could be bleeding in any number of places, your brain could have been bruised, bones could have broken and, frankly, you could drop dead at any second!"

This was one stubborn dude. He cursed and yelled and swore until he was red in the face. Not only did he wreck his car, but now he'd have to pay for medical treatment.

Poor guy.

After nearly 20 minutes of begging him to come to the hospital, he finally relented and we put him in a collar, backboarded him and took off driving faster than when we had arrived. There were no symptoms or signs on scene. The patient felt completely fine, complaining of no pain at all. When we started transporting, however, things got a little shady.

A minor headache turned into nausea, which became difficulty breathing, which finally escalated to loss of consciousness (LOC) just as we entered the emergency department.

As it turns out, this gentleman, who at first refused to be transported, had a major subdural bleed (bleeding in the brain) and had fractured several vertebrae.

To be sure, when I said he could have died on the spot, 'twas not hyperbole.