.....You lose some

You win some. You lose some. That's just the nature of this line of work. Yet it can be so incredibly difficult to accept. We go through years of training, learning tricks that we *might* be fortunate enough to use once or twice in a career. We learn skills and procedures that are reserved for last-minute, do-or-die situations, hoping to never have to really do them. We were once again having a slow shift when we were called to "check code-4 on a MVC, complaining of chest pain" (check code 4 usually means everything is pretty much ok, they just want to get checked out.) We went en route to the call. Arriving on scene my partner and I were both impressed by the severity of the wreck. The first car we came to had a large man kneeling next to it, dazed. I checked on him, and he was awake and talking but confused. He would obviously need to go to the hospital. I went to the other vehicle, checked on that driver. He was out walking around and was on his cell phone. He was shaken up but unhurt. I went back to the first driver and he had already gone downhill. He was now very disoriented and kept complaining that he couldn't breathe. By the time we put him on the stretcher, he was ashen and his belly was rapidly doubling in size. His chest was becoming rigid. We got him in the back of the ambulance and I assigned tasks to everyone. Get him a couple IV's, put him on the monitor, put some oxygen on him. I opened the drug box without hesitation and looked for Excalibur- a HUGE IV needle we use for one of those last minute procedures. I palpated his chest and couldn't feel ribs through all the free floating air in his thoracic cavity. I pressed the needle deep into his chest and heard the hiss of air escaping. His breathing eased temporarily. I asked for a helicopter to meet us and we took off down the road. His eyes grew wide as he begged "don't let me die!". He gave me the name and number of his family and asked that they be called. We all worked to take care of his injuries, but also to do our best to calm him down and reassure him that he was going to be ok, that we would fly him to the trauma center and he would be taken care of. He would grow calm, temporarily believing our reassuring words. All the while the bruise in the middle of his swelling abdomen told a different story.

We met the flight crew, and they sedated him and intubated him. His belly was still growing, and was now round and tight. He was rapidly bleeding to death internally. He was loaded onto the helicopter and they got about four feet off the ground, before touching down again and motioning us over. He had gone into cardiac arrest and would have to go to the hospital by ambulance. In a matter of moments he had gone from awake and talking to us, to flatline. We all worked to save him. I pulled out all of those tricks that had been long tucked away. The flight crew rode into the hospital with me and they even resorted to some procedures that are reserved for last-ditch lifesaving measures. The ER did an ultrasound of his abdomen and confirmed what we already knew- it was full of blood. I wish this had a different ending. I want to tell his family that we did absolutely everything we could. I wish those drastic measures had made some miraculous difference in him, but the reality is that from the moment of impact he was dying. I can't stop thinking about it. About the details too graphic for this post. About the sound of his voice, the look in his face. About everyone working like a well oiled machine and his body failing despite our efforts. You win some and you lose some, that's the nature of this line of work. But the ones you lose....... There are no words that do it justice. I did everything I possibly could and that's just not enough.