Motorcycle down on the Freeway

Interesting. I'm guessing the CareFlight airship would be coming from Havasu.
Yeah it's around 50 miles or so and you are correct they come from Havasu
 
Ok so what went down is just like I wrote out, we were merging onto the freeway for the call (Actually we were merging in from a N-S freeway to the E-W freeway where the call actually was) reported at the next cross street when I spotted the guy down under the pickup truck almost parallel to me. I opted for the hard left turn and hopped the shallow curb in the gore point, and still had to actually make a short three point turn to fit in behind one of the stopped cars (traffic was heavy enough that was the only way I felt I could position the ambulance to block the scene without driving around in a giant circle fighting hordes of people wanting to get home on the 105 ha). I was literally at a 90* angle on the freeway....but I had two whole lanes blocked off where we could work safely :)

The cop on scene must have been a detective or something, he was in plainclothes (his badge was on a neck chain) driving an unmarked Charger with two little LED's flashing away in the back window.....parked so the entire scene was BEHIND him (thus exposed to traffic -_- ) Otherwise no other responders on scene. We were initially dispatched with LACoFD but a) the station the units were coming from was West of our westbound incident, they'd have had to get on the eastbound, pass us and most likely pass the freeway interchange to the next exit a couple miles before that to get to our actual location, which was b) in LA City Fire's jurisdiction. We called in the updated location to dispatch (and then had to convince them that yes, we were pretty sure this was the correct not a duplicate incident, how many motorcyclists down under a pickup truck are there on that stretch of freeway at that time? Once away from the rig I couldn't hear the County radio so I honestly don't know if they investigated their stretch of the freeway just in case of a duplicate or once told of the corrected location simply said "That's City's area, send the call to them")

So anyways, that's kind of what made this specific scene somewhat memorable to me, just me and my partner on the BLS ambulance alone with a patient and one LEO helper for an extended period while fire figured out what was going on behind the scenes.....both me and my partner were like "This is something straight out of EMT school skills day!" lol

So back to the scene....bystanders/witnesses told us the motorcyclist was riding along in traffic, splitting lanes, when someone from the carpool lane cut him off, supposedly cutting right to make the next exit and the MC swerved and laid the bike down and slid up under the other pickup truck where we found him, the pickup truck swearing he didn't actually run him over.

The patient was supine, mostly under the truck with his hips pushed up against the front tire. I literally got down on my belly and crawled under the truck to hold manual C-spine and begin assessing the patient. He was Conscious, Alert, Oriented to person only (knew his name and birthday but not where he was or what he was doing), the cop told us the patient asked those questions "at least 6 times before you got here" so we judged the patient Altered with repetitive questioning, +Knocked Out, unable to recall event. That being said he was talking to me in full, clear sentences, so he had a nice patent airway and was otherwise breathing just fine. Using our rigs flood lights and a hand held flashlight we determined that there was no immediately obvious major bleeding or long bone fractures or any other trauma jumping out at us at this point in time, Pt's only complaint was R Clavicle pain. He had good CMSx4.

We did slide his helmet off and place a C-collar. Now this is the biggest point of divergence between what most of you said you'd do and what I actually ended up doing, where most of you went ahead and said you'd want to get the patient on the backboard with just you and your partner...while my partner was willing, I was personally a little hesitant. Partially because I wasn't quite sure the two of us could safely roll him onto a board without torquing his neck or back. I was already laid out under the truck myself with a relatively limited range of motion, I just personally felt a lot more comfortable waiting for a couple extra hands due to the awkward positioning involved. Meanwhile, my partner got some vitals and did what he could do to assess for additional trauma while only having access to half the patient.

So City (finally, felt like they took forever!) showed up. Now many of you like to roll your eyes at LA Co for their habit of sending and Engine and a Squad and an Ambulance to calls. Well LA City is not one to be shown up by County....the call must still have come in on their end as a pinned rider because they brought a full Task Force. Not just an Engine and Rescue ambulance, but a Light Force as well for good measure (They turn a tillered ladder truck company into a Quint company by simply adding a full pumper engine and dispatching both vehicles as a single unit) so We got the engine, truck, it's second engine, paramedic ambulance, and a BC for good measure (when I got a chance to steal a look it was a sea of red behind my rig lol) From there they went right down the straight forward trauma pathway you guys said, stripped off the guys clothes for a full head to toe, and drove to the Level II just down the road a ways, presumably getting those large bore IVs enroute (I didn't get much chance to watch them as we started to police up our own gear, make sure we didn't leave anything on the roadway, and while their medics didn't load and go per say, they didn't stick around all day either).

So all in all, pretty straight forward, glad it got as much discussion as it did! :)
 
Now this is the biggest point of divergence between what most of you said you'd do and what I actually ended up doing, where most of you went ahead and said you'd want to get the patient on the backboard with just you and your partner...while my partner was willing, I was personally a little hesitant. Partially because I wasn't quite sure the two of us could safely roll him onto a board without torquing his neck or back.

Me personally Jim I share your same view. With the awkward way with his body position (half of him underneath a truck) I would prefer another set of hands to help move his torso.
 
That is pretty much the type of TC that popped into my head. Motorcycle splitting lanes so he isn't going too fast at all. Car pulls out and he lays the bike down and slides a little bit without getting ran over.

If his speeds were under 20mph then for my system we would contact the trauma base hospital due to the LOC and they would tell us where to go. Honestly we may be transporting to a non-trauma hospital. Once again for my protocols I would not be placing this patient on a backboard but he may get a C-Collar.

Only other thing I would do is establish an 18G and contact our trauma base for pain meds orders. Finish paperwork, talk to other crews, clear, rinse, and repeat.
 
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