Allergic Reaction

Posted by on Mar 27, 2015 in Uncategorized | 0 comments

“EMS 6, allergic reaction, at 123 Main Street.” At 7:40 Christmas night, my partner and I flip on the lights and sirens and race our ambulance toward 123 Main Street. En route, my partner reads off details of our dispatched call on our dashboard laptop. “Twenty-year-old female. Respiratory arrest.” I grab the radio. “This is EMS 6, requesting assistance on our anaphylaxis call. Copy?” “Copy EMS 6. FD 14 is en route.” Once we roll up on scene, several people wave us into the two-story home, their faces contorted in panic. As we hear sirens from an approaching fire truck, we rush our loaded stretcher inside the front door and toward the young lifeless body lying on the tiled kitchen floor, cyanosis around her lips. I notice our patient’s chest is motionless, and I don’t feel or hear any air moving out of her mouth or nose. “What is her name?” I ask no one in particular in the crowd of about a dozen surrounding us. “Ally,” several voices answer. “Ally?” I rub my knuckles over her sternum. “Unresponsive,” I inform my partner, who’s yanking out a BVM (bag-valve mask), other airway equipment, and the med box. I feel for a carotid pulse on her flushed neck. “Rapid and weak,” I say to my partner. We share a look of understanding—our patient is headed for cardiac arrest. Our interventions must be quick and efficient. “What happened here?” I again ask the room full of people as I press the mask over my patient’s mouth and nose with my left hand in the E/C formation. With my right, I squeeze the football-sized bag every five seconds to oxygenate the young woman’s system. Her chest rises and falls with every squeeze, indicating her airway isn’t blocked by swelling or any foreign object. “She was eating and started coughing, and said her chest is all tight,” a hysterical woman answered, suddenly kneeling next to me. “She was itchy all over, had trouble breathing, hives on her back.” I face the middle-aged woman, tears flowing out of her eyes and down her cheeks. “Are you her mother?” “Yes. She was severely allergic to peanuts when she was little but out grew it or whatever.” As I continue bagging, my partner pushes epinephrine IM (intermuscular) then inserts an IV into our patient’s left arm for med access and fluid replacement. A fire crew of four men darts into the house. Without an exchange of words, I hand one of the firefighters the BVM, and two of them take over bagging. One presses a tight seal over the mouth and nose, the other squeezes the bag. “Hand me our monitor,” I ask the firefighter closest to our cardiac monitor. He and the fourth guy assist me in hooking up a twelve led ECG to our patient’s four limbs and chest. I study the monitor for our patient’s vital signs, looking for indications of imminent anaphylactic shock and cardiac arrest. “BP 80/52. Pulse 134. SPO2 86%. Normal sinus heart rhythm.” “Uh-huh,” my partner says, letting me know he heard my report of the grave vital signs. I hand him diphenhydramine and methylprednisolone to administer into the IV line. “Does Ally have any medical conditions or take any medications for anything?” I ask the mother. “No. Nothing.”...

read more

In Honor of EMS Personnel

Posted by on Jul 16, 2014 in Blog, Medical/EMS | 0 comments

In Final Trimester the main character, Paramedic Jodi Duncan, is not based on a real person. She’s simply fictional, but she’s also a mix of real-life character traits I’ve found in the numerous EMS partners I’ve worked with throughout the years. I’ve never worked in EMS full time; it’s always been a part time career for me (too intense for full time work). My respect and gratitude for full time paramedics, EMTs, firefighters and all law enforcement is so high I dedicate this book to honor their devotion to helping others in need. They risk their life, health and limbs on a regular basis and for low wages. Being an author of fiction, I can say I wish entertainers (writers, actors, musicians, athletes, etc.) could somehow pass along the praise and income we receive to those who truly deserve it—our men and women who fight on behalf of the public when help is desperately needed. Like a braid, three entities work emergency scenes together: EMS, the fire department, and various law enforcement agencies. I hope Final Trimester depicts EMS in a way that encourages readers to deeply value the emergency medical system and the intensity and depth of the job. In movies and books, cardiac arrest scenes are often shown as someone places their fingers on the unconscious person’s neck for a second or two and then says something to the effect of the person is dead. Reality is: When someone finds an unresponsive person, they call 911, and if they have some medical training, they also initiate chest compressions and rescue breathing. Once EMS arrives on scene, unless we find the body fits the criteria to withhold resuscitation, we work a cardiac arrest for up to forty-five minutes with defibrillation, several rounds of eight different medications via IV and IO (intraosseous), cold fluids, etc. There is nothing a hospital can do that EMS can’t, so we work cardiac arrests on scene until there’s clearly no hope of resuscitation. The opening scene in Final Trimester shows the real-life manner EMS works a cardiac arrest. One cardiac arrest I worked, I had the strong sensation (for lack of a better term) of the patient’s soul eyeing me and speaking: “Please stop. Tell everyone to please let me go.” Often times I wonder if we shouldn’t attempt resuscitation; it feels like we’re playing God—who are we humans to reverse death? With some patients, regardless of age, even if we can resuscitate, maybe we shouldn’t because their quality of life will be next to nothing due to various reasons (coma, severely brain damaged, paralysis to the worst degree, etc.). Every day around the globe, EMS personnel work under extreme circumstances, making decisions and giving it their all for a stranger’s life. On scene, sometimes bullets are flying, bystanders attack us, the patient becomes combative, and the environment itself is dangerous. So for full time EMS crews, I dedicate Final Trimester in honor of them and all the hours of devotion and care they graciously give to the...

read more

Trauma Call/Domestic Violence: Dianna T. Benson, EMT

Posted by on Jul 15, 2014 in Blog, Medical/EMS | 0 comments

“EMS 6, Stabbing, TAC Channel 12”   Responding to a domestic disturbance call, my partner and I park our ambulance in front of an upscale home over a million dollars. Not atypical – EMS is too often called out to the rich on domestic violence.   “Did you know the power company turns off this zip code for lack of pay more than any other in the state?” I ask my new partner.   “Yep. Idiots living beyond their means. No wonder they’re so stressed out and hurt each other.”   At the front door, we join a fire crew, as three cops enter the house, all three with weapons drawn.   “Scene isn’t safe?” I ask.   “Not sure,” the last cop answers then trails his two buddies.   The fire crew of four hangs back with me and my partner.   “Was the door unlocked?”   “Yup,” one of the firefighters answers me.   After five long and boring minutes of standing around on the lawn in the dark of night, I radio in to dispatch. “EMS 6. Standing by outside residence. Any updates from PD on scene?”   “Yes. Scene is secure. PD is with victim.”   “Copy that.” I roll the front of our loaded stretcher into the house.   In the family room, I find one officer bent over a body, the other two talking with an agitated man.   I kneel at the woman’s other side. She’s supine on the carpet, her lapped hands pressed to her lower abdomen and covered in blood.   “Ma’am?” I touch her shoulder in comfort.   My patient blinks at me then flutters her eyes closed.   “Can you tell me your name?”   “Judy,” she whispered in a pained voice.   I brush my hand over hers. “Judy, are you hurt anywhere other than here?”   “Don’t know,” she mumbles.   “Judy?” I stare into her eyes, mascara smudged underneath them. “Can you move your arms down at your sides?”   She does.   My partner hands me trauma scissors, a stack of 5X9 sterile gauze pads, and an occlusive dressing. As I rip open the gauze packages, my partner hooks up the patient to our cardiac monitor and focuses on assessing and monitoring vital signs.   “How can I help?” one of the firefighters asks me.   “Perform a rapid trauma assessment.”   “You got it.” He starts at the head.   With the trauma scissors, I cut Judy’s shirt, exposing the wound. Noting no debris other than blood, I cover the gushing horizontal wound—thin but long—with one sterile gauze pad after another, and apply direct pressure with my palms. “Did a knife do this, Judy?”   “He did.”   “With a knife?”   “Steak knife.”   “I see nothing else,” the firefighter informs me at the patient’s feet.   I nod. “Thanks.”   I glance at the monitor screen for Judy’s vital signs. Her heart rhythm is normal, but her blood pressure is too low, pulse too high, indicating she’s headed to shock due to blood loss. My guess is she’s bleeding internally, the knife blade sliced an organ or two, maybe the abdominal aorta. Regardless of what’s injury, she needs a surgical team.   I look at my partner. “We gotta go. Now.”...

read more

A Son’s Tale of Traumatic Brain Injury

Posted by on May 20, 2014 in Blog, Medical/EMS | 0 comments

The term concussion is well known. The medical field refers to a concussion as a TBI – Traumatic Brain Injury. Contact sports are one of the top causes of a TBI, another are MVCs – Motor Vehicle Collisions.   My teenaged son has endured four concussions. The first two as a goalie for the Junior Hurricanes and the third in a MVC. The first one took him out of school for a month and hockey for three months. The second, a year later, was more mild, which is unusual. Typically, a patient suffers a more severe TBI the second time. In the MVC, a classmate was driving them to school when another car struck them. This third TBI ended my son’s hockey career, preventing him from attending the Junior Hockey draft in Canada Spring of 2013.   The problem wasn’t simply that this was his third concussion, although that in itself is a strong reason to end a contact sport career. With this third TBI, a neurologist evaluated him versus just the concussion clinic MDs who’d treated him with the first two. Not only was it his third TBI, but his symptoms were extremely severe, which didn’t make sense to me – the details of the MVC didn’t suggest such injuries for my son: 1) None of the others involved in the crash suffered any injuries 2) No air bags deployed 3) Vehicle damage was minor. As an EMT for nearly a decade, I wondered about underlining health conditions in my son. I also considered he had not fully recovered from the first two concussions and was in denial about his symptoms in order to play hockey.   Sure enough, the neurologist diagnosed my son with hyper-mobile joints (something I already knew but wasn’t aware of the danger with contact sports.) The MD also diagnosed him with mild CP (cerebral palsy), a diagnosis that made sense to me since my son was born in respiratory arrest and was non-verbal and had spasticity until over age two. Both diagnosis are a recipe for injury, especially in contact sports. The MD gently told my son he was done playing goalie forever – it was devastating and crushed him. Understanding his hockey career was over, he admitted he’d ignored symptoms because he had a shot to play Junior Hockey, college hockey, and possibly professional hockey. A life-long athletic competitor myself, I completely understood the denial that led him to ignore his body.   Hyper-mobile joints, while creating an incredibly athletic body, are highly susceptible to any musculoskeletal injury in that individual. For my son, after two TBIs in a contact sport, his hyper-mobile neck was easily and severely whip-lashed in the MVC, jostling his brain fiercely, causing all his concussion symptoms to return and more heightened than ever.   Ten months after the car accident, the fourth TBI occurred December 2013 just days after the neurologist cleared my son to return to his life minus contact sports. The neurologist gave my son the green light to snowboard. That December day on the mountain, my son didn’t even hit his head and he sustained no head trauma – simply snowboarding jostled his brain enough to cause another TBI.   Even though he’s extremely athletic, my son’s body shouldn’t do what it can to...

read more

Fall Call

Posted by on Jun 26, 2013 in Blog, Medical/EMS | 0 comments

I love these posts from author and EMS expert Dianna Benson where she weaves medical detail into a fictional piece. Welcome back, Dianna! I shake my head to full awake from my cat-nap, and gear up for the trauma call less than a minute drive away. Once my partner and I roll on scene, I note the three cop cars arriving. Additional information regarding the call flashes across our ambulance laptop screen. Proceed with caution. Law enforcement dispatched. “What’s the deal?” my partner yells out the driver window at a cop rushing toward the building. “Another worker pushed the guy.” “Ah,” I say with a nod. “Attempted homicide.” “Or homicide, but if the guy’s not already dead, he’s gonna need us.” My partner jumps out of our ambulance. We grab a C-collar (cervical collar) and a backboard, and toss it onto our stretcher already loaded with EMS equipment and supplies. “Remember caution?” I remind my partner. “Yeah, yeah. Guy was pushed not shot or stabbed. Let’s go.” I really didn’t want to hang back either. Our patient’s life may be over if we wait. Inside the building, we push through a crowd of gawkers. I notice three cops drawing their guns at a man choke-holding some young woman, her wide eyes glossed-over. “Let her go,” the cop at the left yells out. “Now.” I’m hoping the guy follows the demand or we’ll have more than one patient. As I rest my hand on my radio in case I need to request additional EMS crews, I scan the area for an injured man on the ground. I spot our patient on the other side lying supine and lifeless in a pool of blood on the cement, his attacker in the middle and blocking us from our patient. I glance up and see the catwalk and assume our patient was pushed off of the suspended walkway about twenty feet above. The guy fell twenty feet? I think to myself.  If he’s alive over there, he’s in critical condition. “Clear out,” the cop to the right shouts. “Everyone. Out of this room. Now.” The crowd scampers away. My partner and I hold our position behind the cops. The perpetrator doesn’t have a weapon, so there’s no danger to us. After a few drawn-out minutes of the cops warning the perp to let the woman go, and our patient remaining lifeless and out of my reach on the ground in the near distance, I somehow dig up my most gentle tone and interject, “Sir, I don’t think you want to hurt her. Do you?” The perp jerks his head in my direction. Ten seconds tick by with him just staring at me as if pleading me to help him out of this. “Ah…no. No, not really.” “I didn’t think so. How about letting her go and we’ll talk?” Stop blocking me from my patient. If he’s not already dead, he needs me now. Needed me minutes ago.  “Talk? Yeah, yeah,” he nods, “I just need to talk.” Chest panting, arms shaking, the perpetrator shoves the woman aside and drops on the ground. All three cops pounce on him and drag his arms behind his back. I roll the front of the stretcher around the chaos on the ground; my partner pushes from the back. As...

read more

Motor Vehicle Collison

Posted by on Apr 22, 2013 in Blog, Medical/EMS | 0 comments

I love this post by Dianna Benson, EMT written in first person about the treatment of a patient involved in a MVC. A lot of information presented in such an interesting way. Dianna’s debut novel, The Hidden Son, released in March. Welcome back, Dianna! EMS #16 and #22 MVC at Park Avenue and Green Street. I toss the rest of my sandwich into a trashcan, and rush out of the fast food joint toward my ambulance, my partner behind me. Less than five minutes later, we roll up on scene behind an arriving ladder fire truck. I slip mybright orange reflector EMS vest over my head and lurch toward two cars mangled together in a huge intersection, their hoods now one. The EMS #22 crew heads to the one patient in one car, so my partner and I bolt for the two patients in the other. A civilian is leaning inside the driver’s door. “Sir?” I say, approaching. He looks at us, eyes wide, face pale. “Glad you’re here. I’m a doctor, an urologist, but I see patients in my office. I don’t deal with emergency—” “It’s okay. We got it.” Blowing out a sigh, he backs away. Unconscious, the driver’s face is buried in the deployed air bag, arms dangled around it in a laxhug. “Sir?” I feel his pulse. It’s thready and rapid. Blueness surrounds his mouth and colors his lips, his chest not rising and falling. “Respiratory arrest,” I say to my partner who’s assessing the unconscious passenger, the lifeless patient’s head caught in the shattered door window. Frowning, my partner shakes his head. “Cardiac arrest over here. Facial skin ripped away. Neck twisted 180 degrees and split open. Bled out.” Code for: We can’t do a thing for her. My partner rushes our equipment-loaded stretcher around the trunk to the driver door, as I wave a firefighter over to climb into the backseat. With both hands, the firefighter stabilizes the patient’s head straight against the headrest as I assess the minor facial wounds caused by flying glass. Another firefighter grabs the airbag, punctures it and rips it out of my way. I insert an oropharyngeal down my patient’s throat to protect his airway. I cover his mouth and nose with a BVM—bag valve mask—connected to oxygen tubing and a D-tank running at 15 liters per minute. As I squeeze the football-size bulb every five seconds to oxygenate his system,I assess his legs. Right femur appears fractured, left is covered with bleeding abrasions and lacerations, but no hemorrhage threat. I strap a C-collar around his neck. Keeping his spine in-line, my partner and two firefighters place his body on a backboard on top of the stretcher, as I continue to bag him. I check his pulse again. Still present. I check for spontaneous breathing. Still nothing, although cyanosis no longer blankets his lips. I brace his entire right leg in a traction split to assist with hemorrhage control. Inside the ambulance, my partner hooks our patient up to the cardiac monitor via a 12-lead, a firefighter bags the patient, and I perform a rapid trauma assessment, head to toe. After I find no other significant trauma or issues, I spike a bag. Less than a minute later we have an IV bolus in place, running high fluids. Spiked and dipped lines display on the monitor screen. “Normal sinus rhythm,” I speak out loud. “But hypotension and tachycardic.” Meaning low BP and high pulse rate. I’m thinking it’s possible this patient is headed to hypoperfusion (shock) due to internal blood loss. “Ready?” another firefighter asks from the ambulance’s driver’s seat. “Yep, take off.” I listen to our patient’s chest. Heart beating rapidly but strong. Lungs sounds absent on the left side. Diminished on the right. I eye...

read more

Cardiac Arrest in EMS Field

Posted by on Mar 11, 2013 in Blog, Medical/EMS | 0 comments

Dianna Benson writes a compelling first person account of a young woman in cardiac arrest. Dianna’s debut novel, The Hidden Son, debuts this coming March. Hope you’ll check it out. Welcome back, Dianna! Our station buzzer and waist radios go off at midnight. EMS 8. Cardiac arrest. Terminal C, near gate 34. My partner and I rub the sleep from our eyes and restart our brains. ​ On scene in a near empty airport terminal, a middle-aged woman waves us toward her. Four airport security officers appear relieved by our arrival. All four scramble away from the unconscious patient’s side as I radio for firefighter assistance. “Help my daughter, please,” the woman begs in a panic. “She just fainted.” The daughter appears to be in her early twenties. “Ma’am?” I say, touching her shoulder. Unresponsive. I feel her carotid artery. Pulseless. I begin chest compressions. “Does she have any health issues? Allergies?” I ask the mother. “No,” she cries out. “Nothing.” My partner presses defibrillator pads to our patient’s chest—one under her right clavicle, the other on her side over her left lower ribs. “What was she doing when she collapsed?” I ask the mother as I continue non-stop chest compressions. “Walking to our gate.” The mother pants several quick breaths. “We’re catching the red eye to Paris. Help her. Please. She’s only twenty-four.” I swallow the sadness clogging my throat. God, please give this mother strength. The cardiac monitor assesses the heart rhythm. The wave pattern displays on the screen, and I interpret it. “Pulseless ventricular fibrillation,” I tell my partner as he whips out our IV kit. We defibrillate the patient. A small crowd gathers near us as two firefighters arrive on scene to help us. “Take over compressions,” I say to the two males, and one of them does so, as my partner drills a hole into our patient’s shin for intraosseous access, the preferred and more effective route over intravenous in cardiac arrest. I dig into our airway bag for an airway adjunct, an oxygen tank, and a BVM—bag valve mask. Iinsert the oropharyngeal airway down the patient’s throat and connect the BVM to an oxygen line to oxygenate our patient. “Bag her,” I say to the other firefighter, and he grabs the BVM from my hand. I whip out our med box and spike a bag, as my partner finishes the IO (intraosseous) line. We push 1mg epinephrine and 40 unit vasopressin into the line; the firefighters continue with chest compressions and bagging. I prick the patient’s finger and a run a BGL—blood glucose level—for possible hypoglycemia.“Does she take any medications?” I ask the mother for information as well as to engage her in hopes of keeping her calm. “87 BGL,” I say, telling my partner it’s at a normal level. “No, she doesn’t,” the mother wails out, tears covering her face. “Why isn’t she waking up?” she screams, pulling on the jacket of the firefighter bagging the patient. “Ma’am?” I gain her direct eye contact. “Let us do our job, okay? We’re here to help your daughter.” “Yes. Sorry.” She releases her grip on the firefighter and backs up. “Not my girl,” she cries out. “Not my Hannah. God, take me instead.” “Ma’am, take some deep breaths and keep on praying.” She nods at me with the saddest smile I’ll never forget. I check Hannah’s pulse. Carotid pulse still absent. We repeat defibrillation then resume chest compressions and bagging. We add 300mg of Amiodarone to the line. Then sodium bicarbonate. “I took a first aid class,” some male in the near distance says. “Do you want my help?” “No, we’re good,” I answer loud enough for wherever he is to hear. We start another line, this one IV in the left arm, and run cold fluids in it. “Hey, you could use my help,” that male voice again says, although this time he sounds ticked. “Sir?” One of the...

read more

Gun Shot Wound

Posted by on Feb 11, 2013 in Blog, Medical/EMS | 0 comments

EMS expert and author Dianna Benson blogs today writing a first person account of caring for a gunshot wound victim. I love how she’s written this post with such detailed information that portrays the medical info so accurately. EMS 4. Gun Shot Wound. 123 Main Street, Apartment G.  I flip my book closed—Jordyn Redwood’s newest suspense—and zip it inside my backpack. I rush from my station’s crew quarters to the ambulance bay. My partner slips behind the steering wheel; I signal us en route to the call via our laptop nailed to the dashboard. “Twenty-nine year old male, GSW in abdomen, conscious and breathing,” I relate the facts as I read them on the laptop screen. “Raleigh PD already on scene.” I wait for further information to display; my nerves rev up. GSW calls often place EMS in deadly situations. Even if the scene is safe at first, bystanders, the shooter, even the patient can turn violent. Prepared for anything at any given moment is the hallmark philosophy to staying alive. “RPD in process of securing scene,” I read the new information out loud. “Stage near the manager’s office.” “Manager’s office?” my partner turns our ambulance left at an intersection. “That can’t be far enough.” I hear the fear in his voice. Only six months ago, he suffered a knife wound from a patient’s husband who didn’t want us to resuscitate his wife. “I know these apartments,” I say. “Building G is in the back. Furthest away from the office.” More information came across the screen. “Patient took off on foot. Stumbled away from the shooter. He’s down. Gas station on corner of Hill Street and Brown Avenue.” Once we arrive at the gas station and notice RPD has the scene in their control, I duck under the yellow tape blocking the public from our GSW patient lying supine in one of the parking spaces like a car. Five firefighters surround the patient, each one pressing towels to his abdomen, as countless cops hold the perimeter they’ve established. The firefighters step away, allowing us to take over medical care.  “Sir, can you tell me your name?” I yell over the chaos surrounding me. “Ronald,” he uttered with a flutter of his eyes. I peek under the wad of bloody towels to examine the wound in his upper abdomen. Since bullets often act like a plug, gun shot wounds often don’t produce heavy external bleeding. This one the exception. “Package and go,” I say to my partner. “Ronald, what medications do you take?” “Nothin’.” Gunfire whizzes near my ear, busts the car window next to us. My heart is pounding as cops tackle some guy behind me. The scene is safe again. With the help of the firefighters, my partner and I log roll the patient onto a spine board, place the backboarded patient onto our stretcher, and wheel it toward our ambulance. I lean my face near Ronald’s ear. “What about street drugs, Ronald? I’m not a cop, so it’s best for your health if you tell me the truth. I don’t want to inject any med—” “Nothin’.” “Okay.” We load the stretcher inside the ambulance. “Any health issues? Allergic to anything?” I continue to ask Ronald questions. “No, no,” he says, squirming. “The pain. It’s bad. Real bad.” “I’m...

read more

Author Question: Car Accident Injuries 1/2

Posted by on Oct 3, 2012 in Blog, Medical/EMS, Uncategorized | 0 comments

Author questions are some of my most favorite posts to do. How do you really write an accurate medical scene? Which injuries are plausible and which are not? Amy is visiting and Dianna Benson (EMS expert) and myself (ER nurse extraordinaire) are going to tackle her question. Dianna will be today and I’ll be Friday. Amy asks: I am putting one of my characters in a pretty major car accident — a rollover in which she lands on a broken window and ends up with a lacerated back full of broken glass, in addition to a broken leg, fractured ribs, etc. I need a scene to take place in the hospital where she is recovering. With those kinds of injuries, what treatments would she be under? More importantly, how exactly would she be laying in the bed? Obviously not on her back. But would she be on her side or stomach? Perhaps that depends on the other injuries she sustains… but the lacerated back is the biggest one I want her to have. Dianna Says: The story and the characters are first priority, so I’ll make the medical aspects fit into what you’ve explained. Since it sounds like you don’t have an EMS scene at all (no scene where rescue crews—EMS and fire—are present), it keeps it simple from my end, but I’ll give you pertinent background on what I’d do if I were the EMS crew on your scene. Also, based on the MOI (mechanism of injury) you described, I’ll explain what type of injures are possible. Every patient is different, every MVC (motor vehicle collision) is different, and every rollover is different, so that definitely gives you leeway. First of all: I like the scenario: Your character runs a red light causing another car to slam into hers, which causes it to spin then roll over while her back is dragged on the asphalt over the broken window. I also like the adding of a boyfriend; yes, he’d definitely worsen her injures by landing on her, so have him either land elsewhere inside the car or just have him belted in (unless you want her seriously injured to the point she’s in-hospital for a long while and possibly suffering with lasting effects). Just so you know: The reason for the seatbelt law is not just to protect the person wearing the seatbelt; it’s to protect others from being struck by that person propelling in the air (inside and outside of vehicles) like a weapon. Just a thought — if she landed on the driver window and it’s a rollover, then the car is on its side (driver side) upside down, right? Make sure you’re clear about that. Any rollover is a high index of suspicion of injury; meaning, severe injuries and death likely. You have two separate impacts in this story: 1) Smash from the other car 2) Rollover. Therefore, you have two separate MOI’s and both cause different injuries. Since fiction is about the story and the characters, make the speed of the car fit; meaning, if you want your character(s) to be seriously and extremely injured, keep the speed high. For a character who is injured and needing in-hospital care (not just on-scene EMS treatment and ED treatment) yet doesn’t sustain any life lasting effects...

read more

A Scoliosis Journey

Posted by on Jul 20, 2012 in Blog, Medical/EMS | 0 comments

If you want your character to struggle with a disease starting in childhood and worsening in adulthood, scoliosis may be the right one to choose to create long-term drama and conflict. At age nine my daughter was diagnosed with scoliosis with a twenty degree double curvature; meaning, her spine was S-shaped due to a thoracic curve and a lumbar curve jutted in opposite directions. For a year she only had x-rays every few months to monitor the curvature as she grew.   At age ten it increased to twenty-eight degrees, so she was placed in a full body (torso) bending brace twelve hours a day. The bending brace overcorrected her spine to allow only twelve hours per day wear versus twenty-four. She wore the brace for five years and had x-rays regularly to monitor the curvature. At age fifteen, an x-ray of her hip showed the growth plate closed, indicating she was nearly done growing. Scoliosis protocol at that point indicates the brace is no longer necessary.   Every patient is different, and for her the curvature worsened out of the brace, the first year to thirty-three degrees. An increase isn’t uncommon as the body adjusts to life without a brace, but unfortunately her increase continued and was rapid and severe. When she was seventeen, her curve worsened to thirty-seven degrees. Less than a year later to forty-four degrees, which led to her five-hour surgery May 2012 performed by the top scoliosis surgeon in America who operates on professional and college athletes. Her freshman year in college (fall 2011), she started to suffer with acute back pain. A full scholarship college swimmer, she pushed through the pain during the swim season, even at ACC Championships in February and NCAA Championships in March. From fall to spring, she endured three in-hospital spinal injections, plus took pain meds and an anti-inflammatory regularly. Due to the year of intense pain she suffered, her Virginia Tech coach was stunned by her performance at ACCs—she broke records, swam the fastest 100 backstroke time of the meet, and her performance qualified her for NCAA Championships, which is tougher to qualify for than US Olympic Trials. At NCAAs, her right leg numbed due to nerve involvement and her back muscles froze to protect her spine, forcing the need for the VT trainers to drag her out of the pool after her last event, the 200 backstroke. Soon after, an x-ray showed her curvature at forty-four degrees. Surgery from T5-L1 (thoracic #5 to lumbar #1) was now inevitable. The five-hour surgery on May 2 was successful—her spine is now straight and she no longer has a rotation. Due to the rotation of her curvature, her rib cage was concaved in four inches (think: thoracic spine curved to the side and twisted inward), which explains her respiratory issues through the years. Parallel titanium rods and twelve screws now hold her spine straight in-line. Less than a week post surgery, her body rejected some of the internal stitches and caused a three-inch infection along her thirteen-inch incision. Days later, her body rejected more stitches, but antibiotics cleared the infection and she’s now on the road to recovery. She’s battling pain as her body adjusts to the new positioning of her spine, scapulas, shoulders and rib cage as well as all the surrounding muscles, tendons and ligaments. She’s in the process of returning to her practice schedule to prepare for the US Olympic Swim Team Trials in June to compete for...

read more