Fire engine mvc with car

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EMT192229

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YOU ARE DISPATCHED FROM YOUR STATION AT 3:30 IN THE MORNING FOR A WORKING FIRE.

ENGINE 2 (CREW OF 2) AND 4 (CREW OF 5) ALONG WITH RESCUE 1 (CREW OF 3)SIGN ON AS RESPONDING.

WHILE EN ROUTE ENGINE 4 PULLS INTO THE INTERSECTION OF MAIN AND TAYLOR. A CAR DRIVING SOUTH BOUND STRIKES THE FRONT PASSENGER SIDE OF THE CAB OF ENGINE 4.UPON IMPACT THE 3 FIREFIGHTERS IN THE REAR ARE THROWN TO THE FLOOR,THE OFFICER WAS JARED INTO THE DOGHOUSE AND THE DRIVE JARED TO THE DRIVER SIDE DOOR.

DRIVER- HEAD LACERATION/MINOR BLEEDING 120 / 82, 84 , 18 (21 y/O)

OFFICER- RIGHT SIDE ABDOMEN PAIN WITH CHEST DISCOMFORT 174 / 100, 110 , 32 (54 y/o)

FIREFIGHTER 1- RIGHT ANKLE PAIN 122 / 82, 74 , 18 (21 y/o)

FIREFIGHTER 2- UNRESPONSIVE WITH CHEST LACERATION 112 / 64, 72 , 14 ( 18 y/o)

FIREFIGHTER 3 - HEAD AND NECK PAIN , DIZZY AND WEAK 140 / 88, 80 , 22 (32 y/O)

WEATHER- SNOWING WITH ICY CONDITIONS, POOR VISIBILITY, 9 INCHES ON THE GROUND

THE RESOURCE AVAILABLE ARE-
ENGINE 2
RESCUE 1
(3) BLS UNITS
(1) ALS CHASE TRUCK WITH (2)PARAMEDICS
PEOPLE RESPONDING P.O.V

....................................................................................
CAR
DRIVER ONLY
48 y/o UNRESPONSIVE / ENTRAPED
 
Okay, I'd start with a big "Oh Crap!" and then move on to triage and tx.

We would definitely need extra help from the ALS unit and the other engine. Check the car pt for pulse. May be DRT and not needing extrication. I'd be concentrating on the unresponsive chest lac and looking for a possible pneumo. FF3 and the officer also need some rapid attention and transport. Depending on how many can transport in each rig, possibly call for mutal aid from nearby district. Assign pts to people as they arrive on scene. Careful to watch the adrenalin levels of responders treating some of their own. There needs to be a strong command on the scene to keep things in check. This is one of those scenes that can quite quickly turn into a cluster :censored:
 
Geez, No one wearing seatbelts?
 
Driver of the car is Bradycardic with rate of 24 and Hypothermic

Firefighter 2 - has a Hemopneuthorax

officer- after 2 minutes had crushing chest pain radiating up into the neck

Engine driver had seat belt on ,All others were gearing up with SCBA's

...............................................................................................
This happen in our town a couple of years ago.
 
First of all, department protocols need to be rewritten to mandate seatbelts at all times.

I would notify dispatch of the problem. Hopefully, other stations will take care of the fire, because if I were the incident commander on the MVC, none of the units would be leaving it. I'd also request some backup ASAP. Have crews begin establishing a safe area around the accident in all directions. With low visibility and ice, this scene could easily pick up another MVC or two.

Get the Rescue crew busy extricating the Car Driver, and the other Engine crew busy triaging and then treating patients. The Officer, FF2, and the Car Driver are the priority patients. They're going to the hospital ASAP. I don't have a trauma center in my area, but if one was available I would route those patients to it if protocols reccommended/allowed it. Due to the weather, I'm assuming that a MedEvac unit is simply not an option.

I'm not sure whether the Officer is having an MI, having non-cardiac (traumatic) pains, or has internal injuries, but I'm not taking chances either way. I'd also keep a sharp eye on FF3 to make sure that his condition doesn't deteriorate.

I'd put FF2 and the Officer on the first ambulance with a paramedic (I'm assuming that your BLS units are like ours and carry ALS equipment but are staffed with only EMTs). When the Car Driver gets extricated, he's going with the other paramedic (and FF3 if he's still looking iffy). FF2 can go BLS; FF3 might if he remains stable.
 
First BLS ambulance can manage: FF Driver, FF1 (watched over by Engine 2 crew, until arrival)

ALS chase truck can treat FF 3 upon arrival (monitored by Engine 2, until arrival). O2 Sat? EKG? BGL?


Rescue 1 crew can treat Officer & FF2.

Officer 1: Assess and determine if pain is suspected cardiac in nature. If so, O2, ASA, NTG, Morphine. His RR is high, but his his tidal volume adequate? LS? Skin signs? Pulse regular? Hx/Algy/Meds? Pupils? EKG? O2 Sat

FF2: Adequately breathing? O2. LS? Skin signs? Pulse strength/quality? Pupils? Is bleeding controlled? If you say, he has a hemothorax, judge severity. JVD? Tracheal deviation? Perfusion status? Level of consciousness? EKG? O2 Sat?

One of the medics from the chase truck can jump into Rescue and transport both, so they don't need to wait for the BLS ambulance to arrive.
 
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