At 4:17 am the tones went off at my paid department. My ambulance was the first unit out of the house and the first unit on scene. On the way, dispatch updated the initial report of car versus moose to multiple cars versus moose, one with rollover and ejection.
When we got on scene, the ejected person was curled up around their destroyed vehicle with a number of bystanders kneeling around. There was a lot of blood. I checked for additional patients; I was assured by bystanders that the other person who had hit the moose was fine with just cuts and scrapes despite the fact that they had gone down an embankment.
Somewhere during the roll/ejection, the primary patient had developed a big hole in the front of their head. This got my attention. The patient was conveniently laying on their side; I pulled out my shears and cut their clothes from neck to buttocks. I took a good look at the spine/posterior thorax; no penetrating injuries and no obvious spinal stuff. A quick rapid trauma assessment showed no broken femurs and a stable pelvis. The patient had at least one broken arm with a big rip in it and a few other lacerations that would have been significant on a healthy person but these did not affect my immediate treatment; no splinting or bandaging on scene in this case. Treatment for immediate life threats only.
With the help of my partner and a bystander EMT (both certificated as Basics) I boarded and collared the patient and we transferred to the back of the rig. While firefighters were loading the patient, I took a quick look at the passenger compartment of the patient's car. The roof was crushed partially. The airbag had deployed and had blood on it indicating that the patient had been injured even before the ejection. My guess is that the big head injury came from impact with the pavement, though.
By this time another EMT-Intermediate had shown up; someone who works with my paid squad but was on this scene as a first-responder. We cut away the rest of the patient's garments and then the other I-tech put the patient on the monitor while I started a line. We drove the quarter-mile from the highway through the emergency access gate to the hospital. My partner, driving, gave the emergency department a radio patch from the parking lot of the hospital; not a lot of time for them to prepare. The ED had one PA and one nurse at that time of the morning.
We got the patient inside and then I assisted the ED staff for about an hour until the helicopter turned up to take our patient to the level 1 trauma center.
So; wear your seatbelt.
Then I went home and had coffee.
Then I went to my vollie fire department and assisted in burning down a house.
Lots of small pictures here... My apologies if you are on dialup.