Spring Run Off

The river was deafening. Lander had received nearly three times the average rainfall last month and the Popo-Agie was brown-hued and angry. And there were people in it.

It was difficult for the Wilderness EMT students to wait. They shuffled gear around while the advance team surveyed the scene. Word came back: the scene was safe, the MOI (mechanism of injury) seemed to be a rafting accident in a high-velocity river, all the patients (6 people involved) had possible spine injuries. The care teams proceeded down to the scene with equipment bags to start their initial assessments of each patient.

Molly was soaking wet, obviously distressed, but seemed alert and oriented. She ran toward the rescue team, tripped and fell. Her care team initiated contact, gained consent and assessed her airway, breathing and circulation. They immobilized her spine and exposed the injury that was causing her pain. A small bit of white bone extruded out of a bloody wound. She had broken her tibia in her witnessed fall. It was a good reminder never to run on an accident scene.

The incident commander asked for a report. Chief complaints ranged from possible hypothermia, open pneumothorax, a mid-shaft femur fracture, a head injury and a patient that was only painfully responsive. Four people needed to be removed from the river.

The incident commander called for a carry team and the students responded as they had been trained. Despite the din of the river, cervical collars were fitted and the students began to lift people out of the water.

Katie, who was found on the riverbank was alert and speaking, but having trouble breathing. Her care team investigated and found a quarter-sized round wound on her right flank. The wound was bleeding and bubbling. The team covered the hole with a three-sided occlusive dressing. Her breathing became easier with the dressing and the oxygen that the students learned to administer on day 2 of the course.

Martin was furthest up stream. He was distressed, constantly asking about his friend Dallas. His face was bloody and he was starting to show bruises under his eyes. When asked, he said “I don’t know how long I’ve been in the water”. His disoriented state and facial injuries indicated a possible closed head injury. A full patient exam was conducted on the riverbank. His caregivers determined that his only apparent injuries were a possible broken nose and stress-induced nausea and vomiting. Martin was able to stand with support and walk to safety.

Dallas, his friend, had already been moved to the staging area. The head to toe exam performed on him revealed a patch of sticky blood on the back of his head. He may have had other injuries, but those are unknown because he never gained consciousness. He was immobilized to a backboard and transported to the hospital.

The patients: Martin, Dallas, Katie, Christy, Milenka, and Emil were all just play-acting. This was a scenario in the second week of the four-week Wilderness EMT course.

But it seemed so real.