Ever had one of those days where you just don't get it?

So I was thinking the other day about some of my really "head scratching" calls. You know, the ones where you just never really understand what happened and decide that you probably never will?

It was maybe a year ago--I know it was freezing outside but I don't really remember when it was--that my partner and I were dispatched to a MVC with a "minor headache". It was also O'dark thirty outside and we had been asleep for a few hours.

So ok, we check en route and Mike (my partner) drives us the short distance to the scene. When we got there, I think that I dang near soiled my britches!

This was no minor accident--This was a full blown tractor trailer--18 wheeler--semi truck, half flipped over, and teetering off the side of the road. Regardless of the status of the patient, we needed more help to safely access this patient.

I radioed dispatch and told them what we had, requested FD for rescue and extrication assistance, and asked to have Air Medical put on standby. We could see skid marks at least a half mile up the road. As I surveyed the scene, I also saw a sign that read "WARNING--GAS PIPELINE UNDERNEATH. CALL BEFORE DIGGING" Oh crap.

Well, step one was to get everyone out of the danger zone, including the cops who were crawling all over the cab of the truck. I inquired about the status of the patient and was told that she was semi responsive and "talking out of her head". Hmmmm. Thankfully the FD was only a few blocks away and they arrived on scene in record time. As soon as they had the semi initially shored up, Mike climbed inside and started an initial assessment of the patient. Once he relayed his findings to me, we launched the helicopter. We were also waiting on a large flat bed wrecker that had the capabilities to rig up safety wires to keep the semi from fully rolling over.

I started hanging lines and getting the patient compartment ready. I turned the heat on, attached electrodes to the cardiac monitor. I had already taken Mike the portable O2 and a non rebreather mask as well as a ccollar, so we had the basics covered until we could fully extricate the patient.

We wound up having to remove her from the truck through the side window. The doors were jammed and we decided that trying to have the FD use the jaws of life to pop the doors and gain access that way was just too risky. We were afraid that the wiggling and moving might cause the semi to become unsteady. I just wanted all my guys away from any potential danger as quickly as possibly.

So out she comes onto a LSB and we secured her quickly and got her in the back of the truck. We did a full trauma assessment and began treatment. Continued o2, monitor, warmed her up, IVs, etc. Her BGL was in the 40s. So she also got an amp of d50 which helped to perk her up some as well, although she was still lethargic and not responding appropriately.

We were driven to the LZ and in short order had the pt packaged for the helicopter and report was given the the flight crew and they flew her to the closest level one trauma center.

We went back to the scene and stayed with the FD and the wrecker crews for several hours while they attempted to remove the semi truck from the ditch that it was half in.

I guess the moral of the story is if you hear hoofprints, look for the zebra.