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“Oh man! Hey Emily, come look at this!”

I was at the foot of the stretcher, pulling our trauma patient towards the roof top doors leading to the elevator.

We had been sent to transfer a trauma patient who had the unfortunate luck to be in her convertible enjoying the day when a truck hit her.

She was at the sending hospital for just enough time to be assessed, have trauma (Advanced Trauma Life Support) films taken and blood hung. For those of you unfamiliar with ATLS, it is standard to have a lateral c-spine, chest and pelvis x-ray done as quickly as possible in search of the injuries that can kill you quickly. According to the ATLS course manual (p. 7) “X-rays should be used judiciously and should not delay patient resuscitation.”

In this case, we were able to roll into the room, glance at the films and immediately understand that this patient needed a trauma surgeon, and quickly.

Some how, in some way, she was maintaining her oxygen levels even with a hemothorax, multiple rib fractures, and a possible flail chest. Her blood pressure, initially, was in the scary low category and even the novice, looking at her, would see that she had a closed head injury. Her disconjugate gaze was disconcerting, even to me.

As I thanked the EMS gods that we got her to the trauma center quickly, and made the right decision to “load and go” instead of “staying to play,” I ran over her vitals and coupled them with what we had done for her. High flow O2, pain medication after her blood pressure stabilized, packed red blood cells, IV fluid, c-spine immobilization, reassurance.

I couldn’t think of anything else.

I heard Steve’s voice, and hesitated, realizing what an amazing night it was and how much I loved to be on the roof of the hospital. Strange the things that float through my mind during a transport.

My head turned and I saw my flight physician’s hand holding a dressing over the top of the patient’s head.

I know my face reacted, but I stifled my voice. The last thing I wanted to do was let the patient hear.

Her skull was almost pearlescent. I caught a glimpse of its milky white before he replaced the dressing which had come loose. The area was bigger than my hand.

Meeting the medics,
originally uploaded by crzegrl15.

What a gorgeous day for flying!! We are waiting for the ambulance to
meet us at the local airport close to the sending hospital. Sometimes
they will send the patient in order to cut down on transport time when
the sending hospital doesn’t have a helipad.

I walked into flight communications realizing the room was quiet. The physical presence of the crew was missing, and over Terri’s shoulder, the mission’s flight path was mapped across the computer screen.

I blurted out the obvious, “So they are out then?”

She humored me. “Yup, should be landing back here any minute.”

I dropped my bags, half hearing the conversation she was having with Travis. For a good part of a 24 hour shift we have two people in our communications center, one to dispatch and manage flights, the other to handle ambulance communications for the entire county. Our communicators are the voice and brain of what we do. A good flight communicator releases the flight crew to do what we do best—care for the patient. They pick up the baton of a conductor and manage 30+ phone calls of coordination, sometimes battling other times begging and still other times demanding until they get what the patient needs. They need to know how to do what, when.

Some of the communicators may not realize it, but they can set the tone of a flight. Many have been doing it for so damn long they make it look as simple as breathing. In reality, the newbies have enormous expectations to live up to.

I walked over to the desk and leaned over to get a look as the aircraft approaches high. Without thinking, I interrupt the conversation flow between the two communicators.

“God, watching that thing land never gets old, even on a bad day it just makes me happy. How can I ever complain about my job?”

Terri turns, mid-sentence. Her strong, professional exterior breeched for a moment.

“It always reminds me that I get to go home and kiss my kids. Who ever we just transported doesn’t get to do that.”

The three of us silently watched the aircraft settle softly and gracefully. Back safe from another patient transport.

“Down safe, 1857,” Terri states over the radio, once again all business.

The crew was home, all was well. She resumed her conversation with Travis, almost at the very word she stopped on, consistent with the talents of those in EMS.

So many lives interrupted, in so many ways.

Flight Nurse Blogging,
originally uploaded by crzegrl15.

Why didn’t I become an accountant? No cool helmet.