So disappointed...

Email 11/16/2024

Mr ______,

I am so disappointed in the hospital system. Last night, just after 2200, I had a 45 y/o male who ran into the back of a full size pickup truck on a motorcycle. The truck was stopped at a red light, and the motorcycle ran into the back of the truck going, guessing here, probably 50+ mph. The bottom half of his face, from the bridge of his nose down, was literally separated from the rest of his skull. We call it a LeFort fracture. His was a LeFort III fracture. Named after Dr LeFort, of course. Basically, the bones from the bridge of his nose, down, were separated from the rest of his skull from the impact of his face against the top of the tailgate of the truck. He was wearing a helmet, but it was a open faced, 3/4 helmet. The helmet had no damage at all. His face took 100% of the force. He was alert and oriented, but his right pupil was dilated and fixed at 5mm and the left was constricted at 2mm, but somewhat reactive (sign of probable brain bleed). He had a massive laceration that extended from one cheek bone, across the bridge of his nose (which was fully open and exposed), to the lateral reaches of his other cheekbone. Many missing teeth.

I'm being graphic on purpose. This is the picture I paint verbally when I call the hospital to make a "Trauma ALERT". The alert makes them get the on-call trauma surgeons en route to the hospital. We have the "golden hour" standard. From time of trauma to OR, it should be less than 1 hour. I was literally 2 blocks away from this guy when he became a patient. We were dispatched, on scene, packaged/treated, and were en route to the hospital all within 12 minutes. I am super proud of what we were able to do in that amount of time.

Here is the "but". We can't always get ALL vital signs. This guy's injuries were so severe, it was all I could do to maintain his airway while he was bleeding profusely from his face. Another firefighter, riding in as an extra set of hands, got the IV access for me. When I called the hospital, the nurse on the phone REFUSED to make a "Trauma Alert" unless she had a blood pressure. Mind you, this was after I told her everything I just told you. I made sure to confront her about that when we got to the ER.

This is what I was told. I didn’t use the magic word "unknown" when she asked for a blood pressure. I had all the other vital signs... pulse, spO2, blood sugar, respirations, GCS, EKG. Just not that blood pressure. The man OBVIOUSLY has a blood pressure if he's awake. Which he was, somehow. But because there was a box on the computer screen that she had to click, she refused to make the trauma alert call. And also didn't bother to tell me the magic word. Which severely delayed this man's trip to the OR. Which severely diminished his "Golden Hour", and diminished his chance of surviving this accident.

I said "I'm unable to get a blood pressure"... Isn't that the same as "unknown"??? This whole system is so broken. We try so hard, and it all goes to shit when someone like THAT is in charge. Yeah, she's the "Charge Nurse". I plan on talking to my medical director about this. Probably won't matter, but I will know I tried.

I'm so sorry to vent. I'm just sitting here so defeated. I have a motorcycle. I'm 45... that could be me. It could be ANY of us, and these people DO NOT CARE. They're the ones that made it through all the jab mandates. THAT is what is left. Yeah, it's a broad brush. Not EVERYONE is like that, but the majority left seem to be natured that way.

Attached is a picture of the truck’s tailgate. All of the damage at the top was made by his face. His helmet didn't have a scratch.

-Handy