This call is from my first semester. As such, I was an attendant and protocols were different. The details may be inaccurate and I didn’t take all the vitals. However, I will go over certain points from my current EMT point of view.
It was relatively early in the night for a call. Everyone is awake and studying, playing games, or joking with their crew and friends. We hear tones drop for a Delta determinant unconscious patient at Robison field and calmly rush to our boots. Athletic injuries are common at RPI, but the trainers could handle most issues themselves. We’re called only for when the situation is serious enough to require hospitalization. We responded priority 1 and wide awake. Because of the determinant Troy Fire also responded, and we arrived on scene barely before them.
Although it was already dark the field was illuminated by its own lights and we quickly saw two trainers holding the patient while another attempted to draw our attention. As we, the four person crew and Troy Fire’s three medics, approached one of the trainers gave us the history on our unresponsive patient. He had a head-on collision with another student during football practice. He has conscious afterward but had lost consciousness while sitting and was now held by the two trainers who were stabilizing his cervical spine. The stretcher and jump bag came straight out with us. Tom, our crew chief, began to cut through the patients gear and clothing in order to examine him and ready for transport. He was aided by the Troy Fire medics and the patient was collared. The trainers passed the patient into our care while they assisted in our information gathering. Meanwhile, I went to the ambulance to fetch the longboard and head blocks. Due to his mechanism of injury and potential spinal injury he was to be transported on a backboard.
The whole field was abuzz with activity. The trainers had given us the go-ahead to back the ambulance up onto the field and Tom and the medics had stripped the patient, acquired vitals, and began further stabilization. His vitals were acceptable, but he was still almost completely unresponsive to any stimuli. Two of the medics from Troy Fire were to ride along with us in the RPI Ambulance. They had the patient hooked up to their Lifepak and were to monitor him throughout the event and ensure their high level of care while we transported him. I returned with backboard and head blocks and we quickly secured the patient and moved him onto the stretcher. With his head completely immobilized he was ready for transport. We loaded the patient into our van and Tom, two medics, and I hoped in. Our other attendant went in their ambulance to return to us later.
While the medics took care of constantly tracking the patient’s vitals, Tom attempted to illicit a response from the patient. Samaritan was close ready for us. In the van and during transport the patient was in and out of consciousness, albeit never alert or oriented. At first he was completely unresponsive to aural and tactile stimuli. His pupils were equal and reactive to light, which was a relief for us, but otherwise he was unresponsive. After some increasing rough attempts at a pain-response, we receive some grunting. He responded to our voices then, but he was still disoriented and barely there. We focused on attempting to keep him as alert as possible during the relatively short transport.
We arrived at Samaritan hospital and swiftly rolled the patient into the receiving bay. We met the presiding nurse who administered the most aggressive sternal rub that I have ever seen. She got a decent pain-response from him, and the patient seemed to be mildly alert. Tom and the medics passed down our information while I fetched new sheets for the stretcher. The patient’s condition hadn’t deteriorated during the call and he was finally at definitive care. We had done our job.
A few aspects of working with other parties impressed me during and while looking back at this call. It might be expected from professionals, but it was still was great to see the trainers at RPI trained and up to date on proper emergency response for their part in the event. Football isn’t very big at RPI (Division 3), so I appreciate their proficiency during these kinds of medical events. Concussions and head injuries in general have become a bigger issue in sports so this may have been in response to the increasing standards for care and rehabilitation of those who receive or may have received concussions. The ease and coordination that we had immediately when we began treating with Troy Fire was also good. Not all of our crew was EMTs, so even though we were not trained in everything that was going on, leadership was clear, instruction was brief and to the point, and no one was in the way.
I didn’t mention some of the treatments for the patient because it would seemout of place. This was a rapid board and transport. He was on oxygen, I think 12 liters by mask but I don’t remember precisely. Oxygen is administered in order to maintain high oxygen saturation and proper brain functions despite the expected lower respirations that come with unconsciousness. If his respirations were to become too low, we would have artificially respirated him. With the medic reassessing and watching trends constantly through the Lifepak there was little room for interpretation of treatment. The priority in this case was to transport. It was a suspected concussion but that did not affect our care. Because of the mechanism of injury there could be a potential spinal injury, thus stabilization was used in order to prevent further injuries.