Eviceration

[jeepmedic]

Call sounds like a cluster.. and poorly handled. We all have been on them, and hopefully we can all chalk it up to experience, where it won't re-occur again. Yes, it is easy for all to play arm chair quarterback.. and personally, as the Paramedic I would review the call with "higher beings" so I would not be in this predicament again.

R/r 911

This is true. That is why this call was brought up here because the person who started this tread wanted input from all. So all could learn from it. The #1 problem with the call was the scene saftey The providers were staged on the porch of a house with a Pt. inside that had a gun with in arms reach, and was marching around like a mad man waving a knife at the Police Officers for about 45 min. to a hour with a hole is his abd. He was also playing with his organs. This was not a safe scene. The call will and is being reviewed.

 

[FFEMT1764]

The call will and is being reviewed.

I would hope so, but I think everyone involved should all sit down in a conference room and review it as a group, even if the med control doc didnt have a problem with it. I would also want the PD and FD in there so the issues that occurred can also be raised with them, make it a learning experience for all, not a mud throwing, blame passing meeting.

 

[trauma1534]

I would hope so, but I think everyone involved should all sit down in a conference room and review it as a group, even if the med control doc didnt have a problem with it. I would also want the PD and FD in there so the issues that occurred can also be raised with them, make it a learning experience for all, not a mud throwing, blame passing meeting.

It is so easy to judge when you were not on the call. This call was a cluster. It was also the worst call most of us had ever been on, including the medic who was there working by my side who put many years into UNC Tar Heel 1 as a flight medic. There were many things about this call to be learned from. That is why is was posted. If nothing else comes out of it, maybe it can be used as a scenario in training for future referance.

My hands were tied here. What I wanted to do and how it all turned out was a different story. Sometimes, we have to roll with the punches and make the best of what we have.

Our system in that area is not that of a tight organization. You have the FD tryng to out do the EMS, you have the PD trying to outdo the FD. You have EMS who is just hanging in the ballance trying to do the right things with everyone else trying to controle and dictate if you will. IT is an ongoing problem.

As far as everyone setting down talking about it, it won't ever happen. You have too many egos between the department that makes it impossable. Too many chiefs and not enough enemies.

Yes, this guy was bazar in a way you can't imagin. To give you more info, if you have seen the movie screem, that explains the scene and what it looked like. This guy was an obvious mental case. After he plunged the butcher knife into his abd, and cut upward, he pulled it out and reached down, played with his intestines, walked over to the kitchen table, sat there opened a beer and chugged it. He made the call to dispatch before he made his incision. He told us in the back of the truck that his plan fell through. THe sole purpose of him calling us all out there was to see how many people he could kill before he killed himself. He was trying to commit Hari-Kari. I think that is the correct spelling. I think it is a Japanees ritual suicide, suposidly to die with honor. That is what he was trying to pull off.

We had a stress debriefing about it. One of the EMT-B's who was in the truck that night has had such a hard time dealing with it that she did not run any calls for a few weeks, and now even, she still has flash backs.

I still have flash backs as well, however, I have found ways to deal with it.

I would like to point out something here. It does not make you a bad provider to have situations like this. To be able to recognize what went wrong makes you a good provider.

Pride stands in the way of alot of things that can be improved. I am humble enough to let this call be used as a lesson to other providers.

As far as our treatment for this guy? If I could go back and do it all again, there is nothing different I would have done as far as treatment. We were fighting a loosing battle. He had already lost mass quanities of blood. He had started decompensating. One thing about it, he did not die on my truck. He made it to the trauma center, and as far as I know, he survived.

Another thing, I know the guy who was dispatching for the helicoptor that night. If you knew him, you would understand the rest of the story as to why the flight situation happened the way it did. Jeep and Fedmedic know who I am talking about and they will know what I am talking about in saying this.

When your back is up against the wall, all you can to is follow your gut and do the best you can with what you have to work with.

We had to play doctor, we had to play psych advisor, we had to keep him mentally calm too. At one point, we found ourselves playing mind games with him because he was so psycotic. You just would have had to been there. On top of treating him and keeping him mentally calm, we had to deal with an EMT-B who was hysterical, a cop who was not willing to help, and a EMT-B who was subject to pass out from fear at any time, and a driver who was spastic. Flight who wanted to be difficult, and an onscene commander who didn't know what he was doing. An LZ that was set up wrong, cops who wouldn't take him down at the scene... I mean alot of things were at play here. Like I said, I think we did well considering the situations around the whole thing.

 

[FFEMT1764]

Trauma, its sad the the various department heads are to self centered and egotistical to sit down and discuss what can be done to ensure everyone works together for the good of the public, after all, that is why we (EMS,PD,FD) are all here. I am not doubting that you had your back in a corner on this call. It sounds like it was a true nightmare. I am just saying that I might have handled a few things differently. I respect the fact that you presented this scenario to us, and I am sure everyone has learned something from it. Maybe one day the people who fund all three agencies will make the agency leaders sit down and hash things out and make them work together, or maybe those higher up will dismiss the department heads as needed to fix the problem. I am also glad that you were able to deal with the PTSD from this call. I know alot of people who wouldnt have been able to deal with it, and they would be gun shy to ever see a truly injured person again. Thank you very much for what you do, and I hope that you and jeep and fed all continue to make the best of things in your area.