You’re rolling down the road about 50MPH and somebody pulls out in front of you. You have no time to react and smash in to them. The momentum of your vehicle pushes their vehicle 20 feet down the road, which it then spins around and separates from your vehicle and then everything stops. Your airbags deployed and you sit there somewhat dazed. You manage to get out of your vehicle and start wandering around the scene. You’re not all bloody and gory and your only injury is some scrapes on your face and arms from hitting the airbag.
Emergency Medical Services and Law Enforcement arrive. EMS personnel immediately start to determine who was involved in the wreck. Somebody starts tending to the people in the other vehicle while another EMS provider comes to you. They start to question you about what happened, if you hit the steering wheel, windshield etc. They consider you to be “walking wounded”. They’ll be trying to stand right in front of you and tell you to answer questions without nodding or shaking your head. (99% of the time when I instruct somebody like that and ask if they understand what do they do?? Nod their head!!!!)
You didn’t lose consciousness, you’re not intoxicated, your not drugged you were 100% fine before the wreck. You are a competent patient. The EMS provider asks to start performing an assessment on you. You tell the provider that you feel fine and you only have a few scrapes from the airbag. The provider tries to explain that you’re on an adrenaline high right now and that you won’t be feeling much if any pain until a few hours go by. You insist that you’re fine and refuse treatment. You voluntarily sign off on the EMS run sheet that you are refusing EMS treatment and transport. Still, the provider urges you to at least go to the hospital and be checked out just to be sure nothing else is wrong.
You go home and 6 hours later your adrenaline wears off. You start feeling some pain in your neck and in your back. Then you remember the EMS provider told you that. Still, you’re only a little bit sore and don’t need to go get checked out. Two days pass and the pain in your neck becomes so intense you can’t stand it anymore. You now decide to go to an ER and get X-rays. The X-rays show that your C6 and C7 vertebrae (in your neck) are not aligned properly. The ER physician isn’t going to start cracking your neck around. He’s going to be calling another doc who deals with that sort of stuff who will probably be doing CAT scans. Umm…this is starting to sound expensive isn’t it? They’ll be looking at every angle before making any “adjustments” on you.
Since you waited two days to go to the ER, it’s now quite possible that the auto insurance company(s) won’t pay out. If they do they will probably be quite reluctantly and will take a long time for the process to happen. Yes, EMS agencies and hospitals can and do bill auto insurance companies for medical services rendered from a wreck. You now face the possibility of getting stuck with the bills with absolutely zip from insurance.
Ok, now let’s rewind back to the crash scene. You’re wandering around and EMS arrives and begins to size things up. A provider comes up to you, introduces herself and asks for permission to begin an assessment. You’re feeling fine and refuse. The provider explains about adrenaline and that she was at a scene like this once and the victim was a “walking wounded”. They also said they were fine, but when they turned their head to look at something they dropped dead on the ground. The autopsy showed that they had a neck fracture and that the movement killed them. (Yes, this is a true story that happened with my ambulance service. A crash victim was insisting they were fine, turned their head and quickly became dead.)
Now this EMS provider has just scared the crap out of you!! You quickly decide you don’t want to take that chance even if nothing is wrong with you. You now happily agree to be assessed and treated. It’s better to be safe than sorry.
She tells you not to move your head. She tells you her partner is going to hold “C spine” on your neck. Her partner comes over behind you and carefully places his hands along side of your head. He is keeping it from moving in any direction. Another provider comes with a backboard and cervical collar. Since you are standing up they are going to do a “standing backboard”. The 3rd person applies the cervical collar. It’s somewhat uncomfortable, but they assure you it will help keep your neck from moving. Now the 3rd person stands the backboard up and positions it behind you while the other person is still holding your head. Once the board is positioned they each stand along side of you and now 2 people are holding your head, one with each hand. They position themselves and tell you that they’re going to lay you down backwards on to the board.
They lay you down and now you’re lying on the board. One person will now be holding your head since it’s not actually immobilized yet. The rest of the crew puts on head blocks and straps you to the board. You’re now immobilized.
They load you in to the ambulance and take you to the ER. The X-rays show the misalignment of C6 and C7. You’re now thinking it was a good thing that you let EMS do its job and immobilize you and get you to an ER
When EMS shows up, they are there for you. They’re not thinking about their paychecks (which isn’t much), they’re not thinking about the next day off, the only thing going through their heads is YOU and anybody else at the scene.
They are there to help you, treat you and get you to the ER in as best of a condition as possible. Let them do their jobs. Be honest with answers, if your ankle hurts, tell them.
If you are competent (like I mentioned above) and you absolutely refuse any treatment, don’t think you can sue the ambulance service when you go to the hospital 2 days later and find out you’re screwed up.
If you agree to go in the ambulance, but won’t let them properly immobilize you and then you become paralyzed because of a fractured back or neck, don’t think you’ll be suing them. They have tried to follow protocol to take care of you. You have refused, therefore it’s your own fault if the outcome is bad.
What about me? I’ve been in the EMS game coming up on 12 years. I’ve seen a lot of stuff. Fortunately I’ve never been involved in a crash and smash. However, if and when I ever am, I will be sure EMS is fully immobilizing me. This state has a spinal assessment protocol, which means immobilization can actually be ruled out and not done. I don’t care, board me anyway.
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