Emergency situation last night

I was 2nd or 3rd on the scene of this last night.
Car accident

I was flagged down by other passerbys asking me if I had knife or scissors. One of the victims was upside down trapped in his car by his seatbelt.

Some interesting things, I was the only one with a knife and flashlight (my Photon freedom on the keychain), I also had a Resqme and 2 lifehammers in the car (I also make my wife carry a resqme and have a lifehammer on both the driver and passenger sides). Didn't need to use the Resqme, another passer by showed up ,said he was an off duty fireman, pronounced the two passengers in the other car beyond help by going through the back seat.

Before we could extricate the victim a police officer came on the scene, and actually asked if anyone had a knife...so I gave him mine and he cut the victim out...a bit odd an LEO wouldn't have some kind of rescue knife.

We started to take the victim out before the LEO came on the scene but the 911 dispatcher told us to leave him where he was for EMS. Any idea what we should have done? Since the LEO cut the seatbelt and removed the victim, I am assuming that was the correct procedure.

I really can't recall from my first aid training what we should have done.

Actually it was more chaos than I would expect, when the firemen came on the scene they asked for help carrying equipment , then the on-duty ones told us to vacate, the off duty asked us to stay and help. I went by the on duty fireman and left the scene.

I wasn't sure who was taking charge of the situation, the LEO, the fireman or the EMS who came by a few minutes later.

Anyone know what the protocol is? The off-duty fireman showed up first, then the LEO, the fireman, then EMS. Who was supposed to take charge?

A sad story indeed, but I'm glad you were there to help. Thanks for stepping up!!

I'll let those with more knowledge further elaborate, but certainly the victim should only be moved if he is in immediate danger (like the vehicle on fire).

There was a similar incident here a few years back. Traffic accident, young kid trapped in the backseat by the seatbelt. No one had a knife or any other useful tool for cutting a seatbelt. That's when I bought a dedicated Spyderco Rescue folder for the truck console. I need to add a ResQme to each of the seatbelts for personal use.

Not every scene is a model of efficiency. I stopped to help a bicyclist who had been struck by a car. EMS came up with a backboard, and I was squatting to help with the body roll, and the EMS guy just asked the victim to wiggle onto the board. That was a novel technique that we hadn't covered in any of my classes, but I am sure it save the EMS guy a lot of work..

Congratulations on stopping to help! Most people would not want to be involved.

What a sad occurrence, especially on Christmas Eve. God bless their loved ones. Great that you could assist.

Ditto the directive not to move an injured person unless they are in imminent danger, such as from fire.

My sister, then age 16, drove off the road and into a tree. Friends were behind her in another car. They were about to pull her out of the car when a trucker stopped and told them not to move her.

That trucker was the first person to save my sister's life that night. The volunteer EMT who responded was her next savior. Three neck vertebrae were shattered on impact (C-5, 6 and 7).

Pieces of bone were poised to slice her spinal cord. She also suffered severe head injury. Her surgeons said that had she been moved she'd likely have been rendered quadriplegic, or dead.

Don't move a trauma victim.


P.S. -- she was only going 30 mph. Tell kids to buckle up!

Most places have the first one on scene be "in control" until the situation dictates otherwise. In this case, the FD would be in charge due to the extrication. EMS would essentially tell FD what they need to do for the patient before/after extrication and FD would usually work around those recommendations. The captain or battalion chief is in charge, usually with a paramedic coordinating EMS while the Capt/BC does the fire/extrication side. There's all sorts of flow charts.

Cops usually go back to traffic/scene control as soon as FD or EMS show up.

I'd leave you hanging like a chandelier until EMS said to cut you down, or there was an immediate risk to your life.

MDiana's got it right....of course we're flexible enough to bend jobs around for the exact situation at hand. As for the EMS crew that asked the person to wriggle onto the board.....bad crew. I can't stand that..... Ticks me off. Anyway....

Aside from anyone's 'training' and experience....it is kind of like the saying.....If it seems too good to be true....it probably is. If your common sense is telling you not to move someone....DON"T. A lot of this job is common sense....

There are those situations though that leave you thinking...like the 30 MPH MVA with the shattered vertebrae. I travsferred a person who was involved in an MVA and there was absolutely NO VISIBLE DAMAGE OF ANY KIND TO THE CAR! Nothing. Not even a scratch on the paint. NOTHING. But her neck hurt and she was brought to the hospital....It took a CT scan to see the broken neck! Floored everyone. Doctor's included.

Goes to show that you NEVER know.

Being inverted and suspended too long can be fatal all by itself. Moving an injured person can be fatal, too. Its a judgment call. But doing nothing is safer for you. Cops often don't know the right thing to do in a medical emergency, either.

State statutes often specify who is in charge. Usually, it is either the senior fire officer or LEO on-scene. Typically, it's not much of an issue, since fire, law and EMS have separate duties to perform. But conflicts happen occasionally.

BTW, thanks for stepping up.

That lazy, incompetent jackhole should be fired. He's a danger and embarrassment to the profession.

Hookpunch, good work stopping and rendering assistance. You were right to look for guidance in treatment from the others arriving on scene. Don't let any outcome for the victims get you down, learn from it and move on.

As for the rest of this, I'll talk out of my alternate orifice:
- the arriving off duty fire fighter did the right thing by evaluating *all* accident victims (the two in the other car), not just the victim who was inverted that you were directed to. That alone would count for some points with me in determining who was in charge of the accident scene. Its always a risk that folks who are early on scene will tunnel vision on one victim and ignore some others.
- cutting out the inverted victim: that's a judgment call imho, maybe a paramedic could clarify the protocol for an off duty doing this. I couldn't make that judgment unless there was a proximate risk to the victim (fire), or I detected they had stopped breathing (ABC). If the off duty firefighter made the call before any other help arrived I would assume it was because he assessed the victim was in danger due to the inverted position - I might directly ask, should we wait for EMS and more equipment, they are minutes out. He might stick to his initial assessment, or go with the assessment of the 911 operator to stay put and stabilize the victim. If he decides to cut the victim out, you do your best to assist with stablization during and after cut out.
- LEO made his own decision to cut the victim out: assist with stablization during and after the cut out.

The rest is noise, you were okay to be confused by it. Some responders might want you to continue assistance if you are immediately involved and they don't want you to move off task (my first accident victim I held her head in place for 20 minutes until they could get a collar around her), also with additional responders they may have re-assessed the other two victims and been short of hands for a while, which subsequently showed up, putting you more in the way than being any help. Don't sweat it - you stopped, you kept your assistance to your training, almost any responder should thank you for that.

Ditto. My other pet peeve are the accident victims walking around in C-collars. F*ing ridiculous.

Who's in control at various scenes has caused no end of trouble. There is what NIMS says (which is supposed to be federal law - hahaha - I'm funny sometimes), there is what is real. Want to have fun? Watch FDNY and NYPD try to decide that, when it's a possible crime scene, along with a technical rescue, where the FDNY Rescue units and ESU are both on scene. It's come to blows in the past

I should probably have mentioned that, like so many of my war stories, this one came from the millennium just past. Recent encounters with EMS (the plumber next door who fell from the roof, the lady at work with a petit mal seizure) have been impressively professional.

Your experience with nobody having a knife reminds me of the time I hired some "carpenters" to do some work at my home. I had to loan them a tape, framing square and a circular saw! They didn't last long.

Kinda exciting in a bad way isn't it.

Good job on stopping to render aid.

The drivers in the family got Benchmade Houdini Pro rescue tools in their stockings this year. I would have gone with the keychain version, but I like the idea of the added leverage/controllability available in the larger version.

The thing to do is review your actions (not second guess yourself), and learn from the experience. You should have been along for the ride two Thanksgivings ago. I forget the thread name, but I mentioned it here once.
I relearned a great deal from that experience that I had forgotten over the years, and DS really got an eye opener on vehicle accidents.

You should see how much Kerlix and how many 4x4's can be vac-sealed and stuffed into an M3 medic bag....

Keep in mind, that short of the badge they are wearing, the radio they communicate with, and the vehicle they are driving, MANY (if not most) LEO's and Fire/EMS folks provide their own gear from their own resources. This is especially true in small departments or volunteer units.

Sometimes one also forgets something on the nightstand at home.

Thanks, it was Ontario Provincial Police, a very large department, I guess I thought that a rescue hammer and seatbelt cutter would be standard equipment given they patrol the provincial highways and have a traffic focus more than the municipal departments like Toronto or Durham where I live.

My brother is an LEO on the Toronto force, I'll ask him what standard equipment they get.

Still though, who knows with bureaucrats though, maybe they don't think of providing that type of equipment.

Can't say as I know much about Ontario, just what I have heard. Almost did though ...

I have seen a bit of Quebec, and met a few LEO's (on good terms). Did not see outward evidence of a knife, but then I wasn't searching their pockets. I do know that during my time in civilian LE, I provided EVERYTHING but the radio, car and badge.