Reception

re·cep·tion

1. the act of receiving or the state of being received

2. a manner of being received; a cool reception

3. a function or occasion when persons are formally received; wedding reception

I hear the dispatcher call our unit number, preparing us to receive a Code-3 call. “Medic 40, copy Code-3. Respond Code-3 to 123 Main Street for a 242, assault – possible stabbing. Your scene is not secure, please stage out.”

The sun went down maybe an hour ago so the strobes on the rig are creating high contrast shadows on the surrounding traffic and graffiti covered fences as we speed through the hood to the call location.

Sitting in the dim light of the back of the rig I’m considering treatment and transport decisions for trauma victims. The call came in as a “possible stabbing.” I’ve run a few pretty severe stabbing calls but not in this large urban county. Having just moved here from the predominantly rural county where I trained this is a slightly different call than I’m used to. Treatment is basically the same but I now have designated trauma centers for patients who meet the criteria.

Sitting up in the passenger seat is Hank, my FTO (Field Training Officer). It’s his job to evaluate my performance on the call and ensure that I’m sufficiently acclimated to work independently in this county. Hank is a twenty-year medic and much of that time has been spent in the military with multiple deployments to the Middle East. He’s seen more trauma calls in a year of service than most medics see in a career so this is pretty run-of-the-mill for him.

As for me, the actual trauma doesn’t freak me out either. I look at it as a series of tasks that need to be prioritized and completed by the time I arrive at the ED. What does freak me out is being evaluated – having every move scrutinized. Sometimes I’m my worst enemy in that respect – I seem to make mistakes when being evaluated that I normally never make on my own.

It’s our second shift together and I’m still in my grace period. Hank is available for questions and will offer suggestions. In the next shift or two he will transition to full evaluation mode but we’re not quite there yet.

Five blocks from the call we see a fire engine with four fire fighters parked in a red zone. We flick off our lights and siren as we pull in behind them. This is our staging area – the place where we’ll wait until the police secure the scene so we can approach safely.

A minute later the BRT (big red truck) comes to life with lights and siren. We fall in behind them to cover the five blocks to the call location.

As we turn the last corner we find that the street is a parking lot of police cars with red and blue lights flashing. Officers with assault weapons strapped to their backs are rolling out yellow police line tape. We can’t get any closer so we pull over and start walking up to see what we have.

Hank sees an officer he knows and asks what’s going on. Continuing to walk towards a reception hall he answers. “I don’t know, our radio just said multiple stabbing vics.”

As the fire and ambulance crew turn the corner of the parking lot it’s obvious this is a total cluster fuck. Thirty to forty young men and women are standing in the parking lot wearing party dresses and variations of rancher style tuxedo attire. Women are screaming in a different language, men are moving with rapid motions trying to find something to fix, and kids in party outfits are crying. Secure scene my ass, this is chaos!

As we approach, a slim man in his twenties staggers towards us, blood on his hand. He sees the blood and wipes it on the salmon colored ruffles of his tuxedo shirt, managing to miss the bolo tie. Hank walks up, seeing the blood stain centered on the man’s back and lifts up his shirt. Dropping the shirt Hank says, “This guy is yours, package him up and I’ll see what else is going on.” As Hank walks off with the fire captain into the crowd I see the Paramedic Supervisor show up. He must have been following the incident on the police radio. This is probably the biggest call in the county right now – otherwise he wouldn’t be here.

Having been given an order by my FTO I tunnel vision into my patient and ignore the rest of the commotion. I take two fire fighters and Hank’s EMT partner to help me evaluate and treat the young man. I lift his shirt to see a two centimeter stab wound in the mid lumbar area, and not more than an inch away from the spinal column – close enough to the spine to warrant strapping the guy to a spinal immobilization board. He walked to us so I know he has use of the lower extremities – I’m not really suspecting any neurological complications distal to the wound but I can’t say which direction the knife penetrated so precaution is the best course of action.

We get him immobilized to the back board with a trauma dressing over the wound. The direct pressure of the board stops the bleeding. Once moved to the ambulance I look out the back and see three more ambulances pulling up behind us. More patients on back boards are being loaded into them as I start two IVs on my patient. Just as I’m finishing up Hank jumps in and tells his partner to drive. Code-3, trauma activation to the trauma receiving hospital that is closest to our location.

Throughout my assessment and treatment my patient has been agitated, yelling in another language to his girlfriend who is sitting in the front passenger seat wearing a matching salmon colored party dress. I can do a decent medical assessment in his language but I can’t follow the rapid fire dialogue between them except for the profane adjectives which leads me to believe he’s pissed off at someone; probably the person who stabbed him.

On the way to the trauma center I can see another ambulance, strobe lights blazing, fall in behind us headed to the same hospital. As we both pull into the ambulance bay I prep my patient for the ED. We take him in the side door to the waiting trauma team. I do a quick hand-off to the resident and head back outside to start on paperwork.

Hank comes over for a critique of the call. Basically I did everything I was supposed to do and accomplished all the necessary tasks in the time that I had with the patient. Finally he tells me what all the craziness was about; a different faction of the family crashed the festivities and things escalated to a series of knife fights. The supervisor who arrived just after us assumed command of the medical responsibilities of triage, transport, and calling additional resources. Ultimately seven people were transported with penetrating wounds and lacerations, four of which were critical enough to qualify as trauma activations.

As I’m finishing paperwork, using a laptop and software that are unfamiliar to me, I wonder what I just got myself into. I had some crazy calls in the rural county that I interned and first licensed in yet nothing like this. I mean seriously; a multiple stabbing MCI (mass casualty incident) with 20 cops on scene with assault weapons?? Acclimating to this urban county is going to be a challenge and in a few weeks I could be responding to a similar call as the only paramedic on scene with no supervisor.

This could get interesting

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~ by KC on August 2, 2010.

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