Two Rollovers on US93 One Fatal One Not

December 22^nd 2016 was a cold day with fog and rain in the Dolan Springs area. As usual I was listening to scanner traffic on DPS, MCSO and fire dispatch channels.

A little after 9:00AM DPS put out two rollover accidents about four miles apart on Highway 93 North of Rosie’s.

Several DPS units a Mohave County sheriff’s deputy and the Lake Mohave Ranchos ambulance were dispatched to the first accident, an SUV at mile post 22. DPS dispatch advised responding units that the driver at mile post 22 was hanging out the window of an SUV.

The MCSO deputy was the closest unit and was first on scene at both accidents. The deputy checked the second accident first as it was closest to Dolan Springs at mile post 24. Checking for injuries the deputy advised dispatch that the driver had self extricated and was walking around the vehicle.

The deputy then proceeded to the first accident at mile post 22 about four miles away. Upon arriving at the accident, he advised dispatch that the driver was pinned in the vehicle in critical condition and he needed EMS.

It was a foggy day and they had a hard time finding a medical helicopter willing to fly. When the helicopter did arrive they couldn’t land. Law enforcement at mile post 22 kept saying the driver was pinned in the vehicle and in critical condition and kept asking for EMS.

At some point the LMRFD chief asked the ambulance to call him by cell phone. What he didn’t want to say over the radio, we’ll never know.

When the LMRFD ambulance arrived at the accident at mile post 24, the one where the driver was walking around, fire dispatch said no, and wanted them to respond to the other accident.

The ambulance R415 said this “negative alarm Per-chief 401 we were advised to stop at the accident at mp24 we’ll be out investigating”.  Basically telling dispatch no, and hanging up on them. Law enforcement continued to ask for EMS that never arrived.

I literally listened to patient at mile post 22 die over the radio as reports from law enforcement got worse and worse until around 10:00 AM DPS advised troopers it was now a fatality accident.

Nobody has the right to triage a patient from 40 miles away and decide who lives and who dies. EMS should always use first hand reports from those on the scene and respond to most critical patient first, especially when it’s known that the other patient is walking around.

We all know about the Golden Hour and in this case it was wasted on a stable patient rather than the critical patient who needed paramedics.

To me the fact that the driver was breathing on his own and lived for almost an hour tells me he didn’t have a spinal injury that caused paralysis and would cause his breathing to stop. The fact that he lived for around an hour laying on the cold wet ground, tells me internal bleeding wasn’t bad enough to cause him to bleed out rapidly.

None of this information can tell us if the driver would have survived the accident. What it does tell us is that LMRFD paramedics should have responded to the most critical patient and done everything possible to give him a chance to survive.

NOTE: The accident at MP 22 ended up being at MP 20.5

UPDATE
This is the call that Charlotte was referring to at the November 20th board meeting when she asked if complaints should be directed to the chief. I saw no point in reporting a bad action by the fire chief to the fire chief...

If it was your family member pinned in a vehicle in critical condition what do you think was the right thing to do? 

There's what may meet the requirements of the LMRFD's CON Certificate of Need and then there's what's the right thing to do.

CON says ambulance must respond to 50% of calls in 20 minutes, 70% of calls in 30 minutes, 85% of calls in 45 minutes, and 98% of calls in 60 minutes.

The patient at MP 22 was an 18 year old kid who had just graduated high school and was in Vegas looking into a job and visiting his sister.

It was raining on December 22nd, it was cold and only 40 degrees. Someone can die from hypothermia in 1-2 hours at 40 degrees. He could have been suffering from hypothermia. My paramedic training was that any patient with hypothermia is not dead until they are warm and dead. 

The EMS Board looked into this and said LMRFD did respond to both calls. Thats is True 

The LMRFD ambulance was dispatched at 09:11 hrs and arrived at the accident where the driver was walking around at 09:37 hrs. Other EMS did not arrive for 20 minutes after they had transported the stable patient.

In the report the medical director said it was reasonable to respond to the first patients they encounter. MY PROBLEM is that the LMRFD ambulance was dispatched to the critical patient at MP 22 not the MP 24 accident. Yet at the chiefs direction the ambulance stopped at a stable patient 4 miles short and picked up a stable patient.

Engine 431 from Meadview was dispatched for extrication at 09:11 hrs but didn't arrive at the critical patient until 10:35 hrs He was already dead.