True Life is Stranger than Fiction

True stories from the ER, and the streets of EMS.

Saturday, December 03, 2005

Love Potion No. 9mm

I ran this call a little over a year ago. I remember the exact date, but won't post it for obvious reasons.
It's a weeknight, after dark, although I can't remember exactly what time it was. I just remember we hadn't gone to bed yet. We get toned-out for a shooting. The address is just a few short blocks of residential streets from our station, so I decide to stage on the ramp. From this point, I cannot remember what came over the radio, only that PD was on the scene very quickly, and told us it was OK to come.
We proceed to the scene, the Engine Co. pulls in first and we follow. First thing I see from the unit is a small sedan on someone's front lawn. There is a person in the drivers' seat, cops are all over the place, and folks have made their way to the passenger side of the car.
I get out of the unit, and Dave (the Lt. on the Engine) is waving me over to the passenger side of the car. Other folks are tending to the driver, who I note is talking so I make my way to the other side to where a pt. is not talking.
I arrive on the passenger side of the car, which is literally on the front walk to the house, and the pt. is lying next to the car almost on the front steps. I look down and I know immediately she's dead. In fact, I believe my words were, "Oh s---, she's dead." I bent down to check for a carotid pulse. Nada.
Here's where it gets complicated, all in the span of a few seconds. I've got two victims shot, and there's only one Medic there (me). So, triage takes precedence, and I direct Ryan, a FF, to hook up the LifePak-12 and wait til there's a flat line, and run me a strip. I've essentially declared this young, unfortunate woman dead. I insist that nobody else make their way over, so as not to disturb the crime scene.
I then turn my attention to the man in the front seat. I lean over the passenger seat to see he is still talking, I figure out that he's also alert & oriented. Airway, LOC, check. I can't remember how his shirt came off, but upon exposing his chest, I notice two large, circular holes in his right anterior chest wall. Oh, boy. I was already incredibly hyped-up, now I was near freaking-out (in my head). I was outwardly terse and rushed, but hope I didn't portray the true panic I actually felt. I ordered a Med-Evac.
I did a quick rapid survey of his body to identify any other life-threatening injuries. There were none. Check. I asked him a few pertinent questions, and then proceeded to make my way to his side of the car for his extrication.
I stand up and turn back to Ryan, who says he's still not getting a flatline. At some point I had turned back to check the actual rhythm, and it was agonal. It was still agonal. I asked him just to print me a strip right then and be done with it.
At some point, Jon (my Rescue Chief at the time) had shown up. While I was concentrating on the still-living pt., he was verifying that the other one was indeed deceased. When I realized he was there, I was so relieved, I cannot begin to express how much.
We got my pt. out of the car, onto my stretcher, and into the back of my unit. During his brief extrication (I think my words were "Let's get him out NOW!"), word came over the radio that there was another shooting just a few blocks away. The next-closest medic unit was on the way there, with another Engine Co. headed their way, and one headed to the LZ.
I cannot remember who was in the back of my unit w/me other than Jon. He was at the head of the pt., placing Bio-occlusive dressings on the entry wounds for me. I knew they were entry wounds, because the pt. had been driving when he was shot, and there were holes in the windshield. Scene survey can tell you so much!
I got two IVs started quickly, and initiated a fluid bolus, because he was initially tachycardic and hypotensive. I'm thinking the worst despite his still-positive LOC.
We get several sets of vitals, and I dress the defensive wound on his hand (he put it up to shield himself from the bullet[s]). The bleeding was controlled from all three wounds. During all this, we were enroute to, then arrived at the LZ.
We find out that the other pt. is also getting a helicopter ride, but that mine is going first. Either that says something bad about my pt., good about the other guy, or vice-versa. We use the same LZ for both guys.
The flight crew arrives and we place my pt. on a backboard & c-collar for the trip. Upon placing him on the backboard, a bullet comes out of the exit wound on his back. Jon collects it for PD. There is no other exit wound. So, we have two projectiles, one still in him.
My guy tells us he loves us as he's wheeled away to the LZ. How sweet. I know he was just scared out of his mind, and grateful to still be alive.
Jon says to me, "Do you ever get tired of kicking ass and taking names?" I'll never forget that. I think we high-fived, but I can't remember.
I then showed him my shaking hands, and made a reference to a medic who came before me (S.M.) who's hands shook with adrenaline, too. It's amazing how they steady just before I insert IV catheters, then go right back to shaking after. Apparently, his did the same, or so I've been told/compared to.
Our guy's bird takes off, the other guy's lands. I watch as "Doc" and his crew load him up, and they have intubated and are bagging him. Not a good sign.
The second helo takes off, and I made my way back to the scene. I had to make some notations about the pt. whom I had declared dead.
I walk down there, my driver Chris by my side. We had to park several blocks down and hoof it, because there was a large area now declared a crime scene. Gang Task Force and other Plain-Clothed police were there, and we saw them in a driveway. I supposed this was where my pts. were shot. I'd already learned that they tried to escape their attacker by driving away.
I arrive on our scene and talk to "Ward", one of my favorite police officers. He was the one who pulled her out of the car. Apparently he knew she was dead, too, because he never bothered to initiate CPR.
I make my way to the other side of the car, being taking care not to disturb the crime scene (again). She now has a sheet draped over her. I think back to a lecture I attended given by a Medical Examiner where they said they don't like that. Sheets can transfer fibers and muddle forensic evidence. But, the onus of Chain of Custody fell on PD now, so I bit my tongue.
I lift the sheet to examine her bullet wound. It is located on her left side, in (I think) her 5th or 6th intercostal space (can't remember which, but it was a vital one). No exit wound. She either took it right in the heart, or the aorta, or spleen... who knows. Whatever happened, she bled out in seconds.
We make our way back to the unit and then the station where I write my reports and we clean the unit. I'm cleaning the stretcher and realize I've gone over the same spot somewhere like 3 or 4 times. I recognize the sign that I'm a little shook up by the call. I immediately place the unit OOS because I'm in no shape to come to anyone's aid but my own.
Almost immediately after the dispatcher announces that my unit is OOS, Jon calls me. He asks me what's up, and I tell him I'm freaking a bit. He says, come talk to me, I'm in the parking lot.
I make my way outside to his buggy, and Ed (the Rescue Captain) is there, too. We talk for about an hour. I feel much better, and am grateful for their understanding and reassurance. Informal as it was, I was debriefed.
While we're talking, we're actually observing the third crime scene, and the press swarming around it. That particular crime scene was literally across the street from my station.
The story behind all this is one of a real or imagined love triangle, which I do not know. The woman who died on the scene and the man she was with were shot by her ex-boyfriend. My male pt. was either her new love interest or perceived to be by her ex.
The driveway the police had cordoned-off was to her residence. Apparently the two were sitting in his car outside her house and approached by the shooter.
Once shot, they drove away, and ended up landing in some poor guy's front lawn. Their car took out his light pole, and had dented his brand new SUV (still had 30-day tags on it). I felt bad for the homeowner, having all this drama transpire right in front of his house.
After shooting my two victims/pts., the assailant proceeded to the third and final crime scene, the one across from our station. When he got there, he shot himself twice-once in the chest, and once in the head. He was pronounced dead at the hospital.
My pt. lived. He had a few broken ribs, and a PNX. I actually got to follow-up on him, because I work for the company that owns the hospital where he was flown. I also work with the MD that was the Attending that night, who later filled me in on the continuum of his care.
This one made TV news. I still have the clipping of the article that was in the paper.

6 Comments:

  • At 1:37 PM, Blogger MedicChris said…

    S. I have finally been able to check in. Good stories. I enjoyed hearing this one over dinner at symposium. Have fun with the blog, and I'll keep looking in too!!

     
  • At 8:22 PM, Blogger armywife said…

    Hi. I am glad I found your blog. I am about to start training as an EMT. It is nice to read your blog and get an idea of what it may be like for me later. It is especially nice to read it from a woman. Thanks again....

    Army Wife

     
  • At 10:27 AM, Blogger S. said…

    Army Wife,
    Thanks for stopping by! Military wives can probably start their own blogs, I bet.
    Good luck in EMT class.
    -S.

     
  • At 2:02 AM, Blogger JC said…

    What S. so humbly does not mention is that when I showed up she WAS kicking ass and taking names. As I recall I arrived about 4 minutes after S. & crew. When I got out of the buggy there were still officers with weapons drawn facing outward. The scene was secure, by the most minimal of standards. When I saw that "Ward" was "assessing" the guy in the car and telling his Lt. to blow it out his ear when the Lt. attempted to control Pt. access I knew things were going "well?" S. pointed to Pt.1 (dead) and told me to verify her call. Pt.1 was ~5'0" with a 9mm cave for an entry wound. The shooter put it right through the heart. There was zero chance for resuscitation on this Pt. S. made the right call in 15 seconds and moved on. Right thing to do. Right call to make. Just hard on the brain after things are over and done. By the time I got back to her S. was headed to the unit with Ward running cover. I actually did very little. S. ran the call like a seasoned pro. Cutting off the guy's "I love you's" long enough to get something important documented or a question answered and then calming and reassuring him. It was kind of funny when he heard the bird land and told S. that he wanted her to go along because he loved her. I laughed! I’ve run 4 of these double / multiple vic. shooting calls in my meager 15 years doing this. S. handled this one as well as any I've seen. Hell, I'd even let her work on me! J.

     
  • At 7:33 AM, Blogger S. said…

    Wow, J. Thanx for the Kudos. I honestly didn't remember some of those details. Really, how could I, with all that was going on.

    Thanks again for your support, both on and off scene!

     
  • At 10:13 AM, Anonymous Anonymous said…

    I enjoyed the story. Thanks for your service and good luck to you.

     

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