[screams]
Let's get going.
Time's [inaudible] auto versus pedestrian, let's go.
21st Street is a two-lane, southbound,
one-way only street.
Right there, on the sidewalk.
Streets like that, where they're not
used to the one-ways, car accidents happen all the time.
Rescue 4MC.
[bleep]
All right.
Load and go.
We get a call for auto versus pedestrian.
Has he spoken to you at all?
Somebody give me a collar, real fast, put it on him, let's
get the hell out of here.
There was a nurse on scene performing CPR when we arrived.
Right away, we know this is going to be a critical call.
Somebody feel for a pulse, real quick.
He's-- he's slowing respiration.
Let's go.
- Hey, come on, let's roll. - Let's go.
Let's get him up.
Going up, and wheeling.
Here's the deal.
Crepitus in the back of the head.
All right [bleep]
Crepitus in his left arm, his left leg, and his neck.
His neck?
We got a [bleep] collar?
Yeah, the collar is on him.
Dude, I need to see the back of that head.
Is it open?
Is it shut?
It's open.
I hope.
I saw blood on my hands, so yes.
Just [bleep] breathe for him, right now.
Let's get him hyperventilated, real quick.
You got an I/O in the right leg.
A lot of times, on a critical patient, we'll do I/O access.
That's basically an IV that goes into the bone
and we're able to administer the medications
down through the bone marrow.
No CSF, pupils are constricted.
OK.
We've got a broken left wrist.
All right.
This guy has multiple fractures all over his body,
but our number one priority is securing
an airway for this patient.
And this patient does not have a pulse and we don't know why.
Where's my two?
Good?
Fine.
That's all I ask.
[bleep]
He's clinched.
Somebody give me a little pressure, right here, brother.
We need to breathe for him, he's
unable to breathe for himself.
So we intubate the patient.
That was it right there, that was it right there.
Good, all right.
Look where his is ear at.
How's that feel?
Same, still same.
Resistance?
Yeah.
We get the patient intubated and something's not right.
His color's not looking good.
We're not getting the return that we
want from our intubation, from our airway.
Well, squeeze.
I'm 32.
He may be busted up.
Where we at, Bubba?
No good?
He's gone but he's got some fluid in there.
We have good lung sounds on the right.
We have bad lung sounds on the left.
So much resit that it's getting harder to bag, now.
Let me see.
Hey we're going to have to decompress this dude.
Yeah [bleep].
Yeah.
He has some sort of fluid in the lungs.
And he has pressure on the left side
of his chest, which is basically pushing his lung closed flat.
Decompress that [bleep].
[intense music]
Yup.
What have we got, Bubba?
Bag the [bleep] out of him.
That's better.
- Good? - Yeah.
OK.
But once we decompress, it allows
that left lung to expand.
Therefore, we're getting more oxygenated blood
through our compressions to the brain, to the vital organs.
Good.
Yeah.
OK.
Good.
Let's go.
Bag the [bleep] out of him.
He's starting to get a little color back, now.
Definitely, the next 24 hours is going to be
very critical for this patient.
But he does have a pulse.
He does have an airway and lung sounds.
Patient is better than when we found him.
CT, multiple bleeds.
Yeah.
C-spine's clear, up to now.
No, no, no.
C1, maybe.
Oh, that's right, hard to say when he turned his head.
Brain bleed, so he's got a little ways to go.
They say he just stepped right out.
Really?
So they were walking, him and his girlfriend?
That's what I got.
They just stepped right out, pop.
And, look.
Lucky he's alive.
[dramatic music]