Friday, December 21, 2007

I'm certain there is a perfectly reasonable explanation for all of this:

Local story. Links first, then a summary.

Victim, assumed dead at accident scene, was alive
UPDATE: Woman left for dead dies
Controversy over woman left for dead
Doc held out hope for woman

Short version of the story:

At 4am last Sunday, a drunk woman crossed over onto the wrong side of Loop 410 on the South side & hit another car head-on.

Erica Smith, passenger in the hit car, had traumatic injuries. Apparently, part of her brain was exposed, or at least her skull was partially caved in.

Paramedics responding to the scene treated the other three people--at least two of whom, according to eyewitness reports, were ambulatory, and all of whom had non-lifethreatening injuries--but not Ms Smith. She was covered with a tarp.

The Medical Examiner, called out to the scene two hours later to examine her body and pronounce her dead, realized there was a small kink in this plan: she was still alive.

At Brooke Army Medical Center--a high-level trauma center, sometimes called "the Walter Reed of the West"--doctors told her family she had 50/50 odds of survival. She died Monday afternoon at about 2pm.

The shit, as they say, hit the fan.

There are two big issues with the story. First off, police officers on the scene apparently told the paramedics at least twice that the woman was still breathing. The response? "No she's not; she'll be dead in a few minutes." The temperature at the time of the accident was 29 degrees, which apparently is enough to retard vital signs. According to various reports--WOAI radio has been standing on this story--standard procedure wasn't followed to determine whether she had a pulse. And, of course, there's the little issue of her breathing and, apparently, moaning. Of course, I understand that breathing doesn't exactly require brain function, but it was later determined to be present.

The second issue is this: fire chief Charles Hood brilliantly stood in front of reporters, declared that the paramedics hadn't done anything wrong, and said "There's nothing to apologize for. We weren't driving the vehicle that hit the car." While indisputably true, this is hella insensitive. And, of course, there remains the fact that no one knows yet whether the paramedics acted appropriately or not.

Me, I don't know. I don't have the training to know whether she really could have been saved. I don't know who covered her with a tarp, or whether they did it as an "out of sight, out of mind" sort of thing or an attempt to somewhat protect her from the elements (umm, blankets?). My first impulse is to say, as I did in the title of this post, that I'm certain there's a perfectly reasonable explanation for all of this. I do know that the calls to Joe Pags's shows on the subject, mainly from ER nurses with a couple of trauma docs thrown in for good measure, have said there was a major screw-up at best and neglect at worst. I do think that there needs to be a very thorough review of procedures, because something quite obviously went wrong. But I don't know what could or should have been done differently, at least as far as triage goes. Apparently in this state when a person presents with traumatic head injury and no detectable pulse (there's a laundry list of stuff & you have to have two of 'em, according to the paper), as was the case with Erica Smith, the person can be presumed dead & you treat the others instead. Again, though, I'm butting up against a big ass lack of knowledge.

1 comment:

Mark said...

As a former EMT and volunteer firefighter, this really disturbs me.... When we rolled up to an accident and started triage, if they had a pulse and were still breathing on thier own, it didn't matter how badly they were injured they got first call on our services. The non-life threatening injuries take second tier. Those medics and EMT's need to have thier proceedures reviewed.