Wednesday, April 18, 2007
Life or death in 30 seconds
Yesterday, I met Matt Green and Matt Lewis, president and vice president of Virginia Tech Rescue Squad - volunteer, student EMTs as I once was.
They both put on their game faces as we approached with the camera.
"You guys saw things that were just awful," Dr. Sanjay Gupta told them. 'What was going through your minds?"
"This is what we train for," they told us. 'We just focused on one patient at a time."
Certainly a very humble account of what happened.
In my calls to area EMS squads in Blacksburg, they all told me the same thing - the campus rescue squad deserved all the credit. They took charge immediately and did an incredible job.
Approaching a scene as dangerous and gruesome as this, an EMT must first do two things: Stay out of harms way, and establish incident command with police and firefighters.
The next and most difficult task: triage. An EMT's best friend in this situation is protocol.
"If you can get up and walk out, do that now," you scream to the injured. Those who can walk out get tagged "green." They probably have bumps and bruises, maybe even broken bones, but they will be fine. They walk out to awaiting medical staff.
That's the easy part. Triaging the rest of the injured victims requires a life-or-death decision every 30 seconds.
The first question you ask yourself with each patient: Are they breathing? No? Can you fix that easily by repositioning the head? If not, you tag that patient "black" - a grim reminder of what you're dealing with.
The truth is, your best shot at saving the most people is to let those who truly don't have a chance of surviving die, and devote your resources to those who can be saved. Sounds reasonable on paper, but a very difficult decision to make in real life - especially in 30 seconds.
The next group: red. These are the most critical patients. After a few quick stabilizing measures, the "reds" go right to awaiting ambulances and helicopters. With luck, a life saved.
Next come the "yellows." These patients are not as serious as the reds, but if they don't get care soon, they may be headed for the red zone.
At Virginia Tech, rescuers triaged dozens of victims in only a few minutes - no easy task for the most seasoned medic, and certainly not for these students.
These are very difficult times for the Virginia Tech community, but these rescuers can rest assured that they did everything they could.
Protocols, years of training and gut-wrenchinging decisions helped save lives Monday. But the decisions of that day are likely to stay with Matt Green, Matt Lewis and their fellow rescuers for the rest of their lives.
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