8 Case Study: Aaron Knoll Motor vehicle accident

Patient: Aaron Knoll

Patient: Aaron Knoll
Date of Birth: 09/14/19xx

PERSONA

Aaron Knoll is a 24 year old student in his final year of studying Environmental Science. He lives with his mother (his father died 10 years ago). He has no siblings.

Aaron works part-time as a waiter at a local restaurant. He enjoys bowling, hiking, and snowboarding. He recently met his girlfriend, Melissa, at a party and they have been enjoying spending time together.

Aaron has no allergies, no medical conditions, and no surgical history. He does not smoke and he drinks alcohol occasionally.

Day: 0
Time: 22h30
Place: FireHall #6

“Attention, attention,” blares the announcement. “Motor vehicle crash, Hemlock and Willow, two casualties reported. Respond, code 3.”

Six fire personnel jump up from their table and rush to the small ladder truck.

Jack, the driver, hits the big red button to open the large garage door before hopping into the truck.

“Dispatch, this is Truck 6, responding code 3 to Hemlock and Willow,” Jack responds. “ETA three minutes.”

“Roger, Truck 6. ETA three minutes.”

The ladder truck moves quickly out of the station with lights and sirens on. Maneuvering the truck through the neighbourhood, they arrive in three minutes at the scene.

Quickly surveying the scene from the truck, Jack says, “Captain, this looks pretty bad. Car looks significantly damaged. Looks to be gas leaking.”

“Agreed. Ok, Smith and Sidhu, you have traffic,” directs the captain. “Manage the scene and direct cars and bystanders to the other side of the street. Johns and Roche, you guys grab the foam and check out that gas leak. Jack, you’re with me. Let’s take a look inside the car to see what we have.”

The captain and Jack make their way to the car and see two people, a young male in the driver’s seat bleeding profusely from the head, and a female passenger with no apparent wounds.

“Ok, check the pulse on the passenger.”

“Captain, she has a pulse,” Jack reports. “It’s weak but present.”

“Dispatch, this is Truck 6 at Hemlock and Willow. What is the ETA on the ambulance?”

“ETA on ALS crew is five minutes.”

“Roger that, Dispatch. The sooner the better.”

“Ok, Jack, there is no way we can extract them without removing the doors and maybe the roof. Roche, how’s that gas leak?”

“Cap, the leak is pretty small. Laid some foam down. Should be ok.”

“Great. Go grab the saw and a couple of long bars, and tell Johns to bring the oxygen and some blankets.”

The crew works quickly to apply oxygen to the two victims in the car. Johns carefully drapes a blanket around them.

“Ok, I want you, Roche, to cut those two forward pillars and then we’re going to pull the roof back.”

Roche quickly cuts through the two pillars holding the windshield and the roof. Using the bars, the captain and Johns lever the roof back like a tuna can, exposing both the driver and the passenger.

The captain checks the pulse on the driver. “Ok, still doing all right. Let’s lever the doors open on both sides. I hear the ambulance. They should be here in less than a minute.”

The crew, grunting with effort, manage to open both doors and Roche cuts the hinges off, dropping the doors to the ground.

The white and blue ambulance, its lights still flashing, pulls up. Two paramedics hop out, each with a tackle box in hand and make their way over to what is left of the car.

“Hey, Captain, not often seeing you out on a call.”

“I like to keep practicing. Can’t sit at a desk all the time. We were short a man tonight, so here I am. We have two victims, a male driver and a female passenger. Airbags deployed and seat belts were on. Both have weak pulses and rapid respiratory rates. We’ve given them oxygen and started dismantling the car for you to extract them. We haven’t moved them. The female passenger’s legs look like they are stuffed under the dash and we may need the jaws to move the dash off her.”

“Ok. Thanks, Cap.”

The two paramedics move to the driver’s side. Checking ABCs, they find the driver is breathing but his pulse is thready. “James, you take the passenger. I’ll get Cap to help me here and have him assign someone to you. Looks like IVs to start, then let’s immobilize and extract onto backboards.”

“Sounds good,” James says.

Both paramedics get to work, establishing large bore IVs in the ACF of each victim. After each has secured a cervical collar, they both stand up and take a look around at the car, trying to see how to move the occupants out of the automobile.

“Dispatch, this is Truck 6. Can you send another ambulance? We have two victims here. Both unconscious and will need transport to Memorial.”

“Roger, Truck 6. Is this a code 3?”

“Dispatch, negative on code 3. Code 2 for transport only.”

“Roger, Truck 6.”

“Ok, Captain. James and I will slide the backboard behind the driver here and secure it, and then if you and the guys can help us move him out of the car?

“No problem.”

Working as a team, the fire crew and the two paramedics quickly get the backboard behind the driver and, keeping the driver’s back straight, slowly move him out of the car and onto the pavement.

“James, you stay with the driver here. Looks like he might need some more fluid. He’s looking a bit shocky.”

Repeating the same process for the female passenger, the fire crew and the paramedics are able to extract her after pushing the seat as far back as possible from the dashboard.

Checking her vital signs again, the paramedic finds them to be stable but she is unresponsive.

“Captain, if you can have a couple of your guys hold her IV bag and keep an eye on pulse and respirations, I’ll help James with the driver. When that other crew arrives, they can take her directly to Memorial.”

“Will do. Sidhu and Roche, check pulse and resps on the passenger and keep that IV going. Smith, check the gas leak and see if we need to do anything more. Let’s throw down some absorbent to soak it up.”

Both Sidhu and Roche move to the passenger and begin their checks. The second ambulance arrives. Two paramedics pull a stretcher out and move towards the scene.

James waves them over to the female passenger. “She appears more stable than the driver. Check her vitals and, if things are good, transport to Memorial.”

“You got it, James.”

“James,” says the second paramedic and pointing to the driver. “How is he doing?”

“Resp rate is 28, pulse 130, BP  90/70. He’s had one liter so far and I have another liter hanging. He looks a bit shocky. Other than his scalp lacerations, everything seems ok. His belly is a bit firm and he moans when touched there. Still not waking up. Here’s his wallet and phone.”

The lead paramedic looks at the wallet. “Name is Aaron Knoll, age 23. Appears he is a student at the college down the road. Maybe the passenger is his girlfriend?”

“Not sure, but let’s get him in the ambulance and to Emergency. He looks stable, doesn’t need intubation right now, and all vital signs are reasonable given the situation.”

“Hey, Cap, can we have a hand to lift and place the driver on the stretcher?”

“You bet. Hey, Sidu, Smith, and Roche, give a hand here for a lift.”

The fire crew and the paramedics work together to move Aaron to the stretcher and then into the back of the ambulance.

“Thanks, Cap. That was really helpful. Tell your team they did really well and made a difference tonight.”

“Thanks, James. I’ll pass that on to my crew. I appreciate it. We still have some clean up here to complete, and the RCMP will want to do their investigation. Might be a longer night than I expected.” James smiles and shakes hands with the captain and hops into the back of the ambulance. His partner moves to the driver seat.

A hard thump on the back of the door and the ambulance moves out with lights on, no siren.