Seatbelts are a Good Thing

This one was a nasty one. You have been warned.

It is one of those rare nights where Mrs RRD and I are alone in the house, with all of our kids elsewhere. At 2am the batphone rings (it's just my normal phone, but, after midnight, well, I'm sure you get the picture.). It's a call to an RTA in NearbyTown, 4 trapped. "Want to join me?" I ask Mrs RRD. "Why not?" Why not, indeed! Mrs RRD is more of a speed and car junkie
than I am, she just doesn't have the same ability in her job to be driving around on Blues - quick, I need an emergency photograph of my wedding!!

So, we BOTH get up and dressed, and both run out to the car. It's not the first time I have had observers, but for Mrs RRD it was a new experience, as we shoot through red lights and rush to the scene.

And, what a scene!! Let me try and describe what we were confronted with. We are on a dual carriageway. There is a great gouge cut out of the pavement to our left, running for about 100 metres. At the end of this trench is a tree. And, resting against said tree is a pile of twisted metal. It is unrecognisable as a car, although I am convinced that it once was. It looks as though it has been through a car masher, before being dropped from a great height. Oh, and it's screaming!!

I tell Mrs RRD to stay in, or at least near, our car, as I approach the wreckage. On closer inspection, the car was on its side, driver's side down. it had spun, so the front of the car was pointing back along the road. To be fair, there was no front of car: that was another 10 metres away. What was left at the front was the engine block.

Time to stop sightseeing and get to work. Time to find the victims and do what I am (not) paid to do.

Here's where it started to get complicated. Front seat passenger, still with seatbelt attached, at what is now the top of the car (remember, it's on its side.) A rear seat passenger, clearly without seatbelt, head and torso still in rear compartment, but legs and pelvis gone between front seats, and not actually visible. Another rear seat passenger, again no seatbelt, gone head first between seats, legs visible in rear compartment, head and one arm resting on engine block, unable to see rest of patient. Driver - no idea!!

Oh Lord, what are we to do here? All those visible are screaming in pain, so clearly have intact airway / breathing, but for how long? I go through the options; B-post rip, roof-fold, rear extrication; none will work here. I am stumped as to where to even begin. The fire crew are no closer to a solution, and we start, slowly, to dismantle the car. Meanwhile, I ask Control to find out if GasPasser, a very senior, experienced Basics doctor, (anaesthetist) is available to join me at the scene. He lives about 45 minutes away, but I don't think I will be done that quickly.

Meanwhile, I need to get started, and I begin with the rear seat passenger, whose legs have disappeared into the front of the car. We have peeled the rear of the roof forwards, allowing access to him. An IV line in his right elbow lets me give him some painkiller, but we are still unable to move him, because his legs are completely trapped. And I don't know where they are, because of the other occupants. Oh bum, bum, bum!!!

Ok, back to the front. We have one hanging from her seatbelt, but we can't see her legs. We have a head and right arm, from the other rear seat passenger. There are two legs somewhere, but we can't see them. And, not yet seen at all, is the driver. We are now almost an hour in, and I haven't made any significant progress.

Next step, try and peel the roof down. Only problem is that the front seat passenger seatbelt is attached to the roof, and if we bring the roof down, she will fall, but we don't have her legs free yet. So, we get a fire officer to hold her up while the roof is peeled down. She's now screaming even more, and in danger of falling. but at least things are beginning to be freed up - a bit. Suddenly the rear passenger's legs are freed, and he is able to be pulled out through the back of the car. He has two fractured femurs, and needs splinting of his legs, but is otherwise ok. The first ambulance departs the scene, nearly two hours after the accident.

Now, GasPasser arrives, and I breathe a small sigh of relief. He comes over and surveys the scene. "So, what are you going to do now?" he asks. I look at him, and see the twinkle in his eye - he's such a joker, is GasPasser.

Rapidly, he ascertains that the rear passenger who still remains in the car is lying under the lady still being held up by the fireman, and that the only way to extricate her is to get the fireman to lift the front seat girl up higher, and pull her out, over the engine block. A few screams later and she pops out like a cork from a bottle. That's 2 out of 4.

Oh dear!!! Revealed when she comes out is the driver. He is still sitting in his seat, seatbelt still on, and no obvoius injuries. Only problem, he is very, very dead. He has been smothered by the others lying on top of him, especially the rear seat passenger who we have just removed.

The girl glances down, and a look of horror and sadness comes over her face. She reaches down and brushes his face with her free hand. I quickly get a blanket, and cover him, but the damage is already done.

Two hours and forty-five minutes later, all the patients had been cleared, and Mrs RRD and I make our slow way home.