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It's OK to lose...but it sucks

failure

 

I had the opportunity to talk about a horrendous call with some co-workers. The situation was described by a deputy chief as "one of the most complex and difficult extrications I have ever seen in my 35-year career"

The operators were experienced. Very experienced. They have the technology and equipment to get people out of the most unthinkable situations....and they lost. The patient, while alive when finally removed after close to 90 minutes, coded in the ED, had a thoracotomy performed and it was still not enough. 

Sometimes no matter, what we lose.

I went to talk to the crew about the call the next day (not knowing the outcome) and knowing the crew, figured we would have a great conversation about the technical aspects of not only the extrication, but how things went EMS and operationally wise. I arrived, found my way to the coffee pot and saw one of the medics writing a chart. He had a very quiet demeanor about him, which is unusual for this group. Normally full of bravado and pride, he looked broken. We started talking about the call when he told me he heard the patient died in the ED. He was kind of in shock talking about and I could tell he was just beside himself. We didn’t talk about tools, cribbing, manpower...we talked about the patient and how he had bonded with her. Of course, the second guessing started....what if we got her out faster, what if we could have started a second or 3rd line in her, what if she would not have been so completely inaccessible we could have been able to asses her better....you know how that goes. 

Given the circumstances, there was nothing more that could have been done. HEMS was unavailable, the mobile surgical team was mustered but was still too far out. they had the play the hand they were dealt. She was stuck...stuck bad. She was alert and oriented...but now we know she was bleeding internally. and just like any other crush/entanglement, they were prepared for her to crash when she was removed and felt they were on top of it..but again...sometimes the injuries are just too much. He said when she started talking about how she was going to die, he knew it was bad, because we all know, when they tell you that, they are usually right..but everyone pressed on and took care of business.

I guess what struck me most about this call, was not the injuries or the extrication...it was how the crew was when I went to visit. It was hard to see them like that...normally a jovial boisterous group, they didn’t like losing. There was no jackassery that morning, no ball busting, no laughing and carrying on.. it was quiet and somber. Pissed off they lost, pissed that no matter how much they trained, practiced, simulated, studied, it just wasn’t enough...and sometimes it's not going to be. 

It made me proud to be associated with such a dedicated group, who at this very moment, I'm sure, is waiting for redemption, because it will come...it always does. They will get that big win and all will be right in the world again.

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