I was 22. It was Christmas, 1999.
My high beams reflected off of her back.
Turned away from me, her hoodie up, one hand raised to her face.
Two passersby stood next to each other, facing her and facing me, the blood drained from their blank faces. Something was very wrong.
The hooded girl turned around, light revealing her face slowly, evenly, left to right.
Blood ran down the right side, dripped into both eyes and the ear where she held the stranger’s cell phone:
“Mom, Mom I was in an accident! I’m bleeding! I can’t see!” She was yelling into the phone.
Her forehead was split with a gash 6 inches long running diagonally from just above her right eye back into her hairline past the center of her head. I could see her skull.
I was driving home from family Christmas in Springfield, IL. It was about 2:00am on I-55. I passed two cars on the shoulder with three people standing outside, a car with its flashers on, another running idle. A third was out in the field between the off ramp and the overpass, headlights dim and windshield spiderwebbed; the door was open.
I was still a trained First Responder from the Western Montana Mountain Rescue Team and it looked like they needed help. I was in derivatives finance now, not on a rescue team. It was not my job to help.
I U-Turned twice and rolled up behind the hooded girl. I turned my emergency flashers on.
The girl was so drunk she was using the white lane marker on the right edge as her guide. When the line curved off onto the exit ramp, she followed the line until she realized it was an exit. She jerked the wheel back to the left and the car launched off the exit ramp, crossing about 100 yards of field before hitting the bridge embankment head-on.
Her head hit the windshield.
Rule #1: When you come across an accident the first thing you do is make sure the scene is safe, under control and determine how many people are in the accident. If it is not safe, under control or you’re not sure, leave it to professionals. If you must park your car, park it out of the way with the flashers on.
“Have you called 911?” I asked
“No, she wanted to call her mom so I gave her my phone” the woman said
She was on the phone with her mother.
Never give your cell phone to a victim to make a phone call. They cannot think straight. Call 911.
I took the phone “I’m a first responder and I’m going to help your daughter. Your daughter has blood in her eyes from a cut; she’s not blind. I have to hang up now so we can call 911”
I hung up.
“Call 911” I said to the woman
I told the man to go get something for the girl to sit against. She was going into shock.
I always carry at least 1 pair of rubber gloves with me and a first aid kit in my car. I grabbed a roll of paper towels, a big blanket and the kit.
I put on the gloves.
Rule #2 – Always carry rubber gloves with you. You can protect yourself from blood, but they also make great water balloons, inflatable turkeys or can be used to flush the toilet you don’t want to touch.
I sat her down and leaned her against a cardboard box from the man’s car. I covered her in a blanket and pulled her lacerated skin back together with my hands, then pressed a big square block of gauze to her head, keeping the skin together with pressure. The gauze bled through quickly, so I packed paper towel on top of that until it bled through again, and repeated, stacking bandage on bandage. The best way to treat non-arterial bleeding is by applying direct pressure.
Head injuries bleed a lot.
Once the bleeding was covered up I treated her for shock and assessed further, keeping my hand pressed against her head.
The woman was behind the girl bracing her head and neck.
I could smell the alcohol in her blood seeping from her head.
In a car accident, body parts fly everywhere. Injuries aren’t always obvious. If victims are not treated at a hospital within an hour, their likelihood of survival goes down, especially when the head is involved.
Rule #3 – Never move a victim unless you have to (like a car is going to explode). More injuries can be caused by moving victims than by keeping them in place.
With head injuries a lot of other things can happen. Things can break, hemorrhage, pop, slice, and dent. Frequently it takes hours, sometimes days, for the injury to present itself. People have died from simple head trauma thinking they were okay.
Sometimes it takes awhile for damage to show up. When it does, it’s too late.
The girl sat under the blanket. The ambulance was on its way.
The emergency road guy showed up but he didn’t get out of the truck. We asked him for gauze from his kit. The sheriff showed up, but he wouldn’t get out of his car. “It’s not my job.” they said.
Rule #4 – Don’t expect anyone except the ambulance to do anything medical at the scene of an accident. “It’s not my job” is a ubiquitous phrase and people are afraid of being sued for wrongful harm. It is a risk.
I was asking questions and taking measurements. The man was writing down the answers to the questions and the woman was doing everything else.
The three most important questions are used to determine alertness:
A. What is your name?
B. Do you know where you are?
C. Do you know what day it is?
I used more questions to monitor alertness and distract her from panic. I ran through more checks like heart rate, breathing rate and pupillary response. Everything seemed good but she wanted to sleep – an alarming sign of shock and other larger problems.
Rule #5 – once the area is secure/stable, assess the victims based on the ABCs: Airway, Breathing, Circulation (and then C-Spine)
Airway – is the airway clear or obstructed?
Breathing – is the victim breathing?
Circulation – is there a heartbeat? is the person bleeding? From where?
C-Spine – stabilize the cervical vertebrae (the vertebrae of the neck); the c-spine is most vulnerable to accident injury.
The ambulance arrived. The first medic approached.
I told him “I’m a first responder. This is a single intoxicated 26 year old female who was in a single car accident and is the only victim involved. She has a 6″ laceration on her forehead and is nearly in shock. Here is the information we have (handed the note)”
He looked at my hands covered in blood, and the clotting pile of gauze and towels on her head. He thought my hands were bare.
“I’m wearing gloves. Do you have antiviral wash?”
I went in the ambulance, rinsed the gloves in solution that kills everything and peeled them off. Somehow my thriftshop-found cashmere sweater and white pants (yes, I broke that rule) were blood free.
She was loaded in, doors closed and driven away. She was taken to Loyola University Medical Center, the hospital where my mother was a nurse.
The blanket and box were covered in blood and the man and woman were still silent, in shock.
We carried on small talk as they explained how they saw the accident and the girl walking across the frosty field to the road, flagging down help.
They had never seen an accident or an injury like that before.
I’ve seen too many. The unharmed drunk man ejected from his pickup in Montana after rolling it 3 times into a field. The Mexican family of four t-boned in a West Side Chicago intersection cut by glass from the shattered windows. A family of two in Chicago driven off the road into the cement median on I94 North near Touhy Avenue. The speeding motorcyclist who hit the pickup truck in Portland, Oregon packing a 9MM in his waistbelt and a ball of cocaine; most of his upper body and a leg were broken, probably his skull too; the helmet was dented. The cyclists I saw after they were hit by cars in LA, more than a few on Wilshire alone. And more.*
At night sometimes when I close my eyes I see these things flash by: Split skin, dead bodies, injured kids crying, broken glass, my own arms bent at impossible angles, my family hurt and in pain.
Then I wake up. It’s a new day. Someone else will be hurt today. Maybe physically, maybe emotionally. Someone needs you to save them. Will you do it?
*More than 31 percent of traffic fatalities involve alcohol. The numbers are higher if you include other drugs. In most of the cases I’ve seen, drugs or alcohol were involved.