At scene of fatal accident yesterday...

  1. 8 Yesterday afternoon, I heard a bang outside my window and soon hubby came into the house to let me know that there had been a head-on collision outside of our house. I went outside immediately to offer assistance. When I arrived on scene, I saw a badly crushed small SUV on the side of the road with a young woman lying beside the vehicle. I didn't realize it at the time, but she was a passenger... her mother (driver) was killed on impact and trapped in the vehicle.

    My neighbor was already out there and on the phone with the 911 dispatch. There was also a young boy in the car, but other drivers that had stopped when they saw the accident had him out pretty quick...he was not badly injured as he had been strapped in his carseat in the rear seat. I went to the young woman on the ground, assuming she had been ejected from the vehicle. She was face down on the ground, not moving. I shook her and tried to rouse her...I saw her back move slightly twice...about 30 seconds apart...as though she was trying to breathe, but when I checked her pulse, there was nothing and she didn't move at all after that.

    The neighbor handed me the phone and I spoke with the dispatch who asked me if I could do CPR. The girl was on her belly and when I tried to find her face, all I could see was blood and dirt. At that time, our local dentist came on scene and also checked the girl's pulse and couldn't find anything. I asked him if we should do CPR and he said he didn't think it would help...she looked beyond saving to him.

    Today I feel awful...I feel like I should have tried to do CPR anyways. This girl was a young teenager and a member of our church and high school. I just didn't see how I could roll her over without making her injuries worse...I suspect she had a broken neck and/or severe internal injuries. The vehicle that hit them was a large pickup and the combined impact was at least 120 mph. It didn't help either with my neighbor hovering over me saying "You're a nurse right?" (I'm an LPN). I have just been second guessing myself all day and didn't sleep last night...kept having flashbacks every time I closed my eyes.

    Thanks for letting me vent.
    Last edit by Joe V on Oct 23, '12 : Reason: spacing
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    Visit  jamieslovingmom profile page

    About jamieslovingmom

    From 'Washington'; Joined Nov '06; Posts: 33; Likes: 33.

    42 Comments so far...

  4. Visit  barnstormin' profile page
    7
    I too have been at an accident scene with fatalities, although not as a nurse, it was years ago. I can still see everthing and still wonder if I could have done more. I think though that there is a certain "feeling" that you get as that tells you when someone is beyond your help and your instinct was probably telling you this was the case. I'm sorry you have to live with this, please don't blame yourself.
    Davey Do, Anne36, BonewaxRN, and 4 others like this.
  5. Visit  jamieslovingmom profile page
    4
    Thanks barnstormin,

    I did have that feeling...like her soul had already left her body if that makes sense. I was just under a lot of pressure to do something and felt very ineffective.
    Davey Do, BonewaxRN, KbmRN, and 1 other like this.
  6. Visit  gonzo1 profile page
    24
    I am an ICU/ER and trauma trained nurse. You did everything exactly right. The first and most important thing is to call 911. You checked for pulse and didn't find one. It is best to not move or turn an accident pt because you can do more harm. Also, you said her face was all blood and dirt. It is not a wise decision to do mouth to mouth rescue breathing on a person who most likely had very bad facial injuries. You could possibly do more harm. Not to mention the fact that you could have harmed yourself.

    The first rule of thumb is protect yourself first, because if you don't take care of yourself you won't be around long. Scene safety is very important. I applaud your soundness of mind and knowing that you probably didn't have the training to be doing a lot at the scene.


    You can always hold pressure on bleeds. you can help the person remain calm until help arrives. I came upon a highway accident where the two people had gone through the windshield, had teeth missing etc. They were both walking around on the highway. I didnt try to do any first aid. I just had them sit down on the side of the road so they didn't wander into traffic.

    And I totally understand what you said about the young girl "being gone". Seen it many times. Quit beating yourself up, keep learning all you can about nursing and you are going to save many lives.
    FoodieJ, icurn99, Krystalanne, and 21 others like this.
  7. Visit  DizzyLizzyNurse profile page
    12
    Quote from gonzo1
    I am an ICU/ER and trauma trained nurse. You did everything exactly right. The first and most important thing is to call 911. You checked for pulse and didn't find one. It is best to not move or turn an accident pt because you can do more harm. Also, you said her face was all blood and dirt. It is not a wise decision to do mouth to mouth rescue breathing on a person who most likely had very bad facial injuries. You could possibly do more harm. Not to mention the fact that you could have harmed yourself.

    The first rule of thumb is protect yourself first, because if you don't take care of yourself you won't be around long. Scene safety is very important. I applaud your soundness of mind and knowing that you probably didn't have the training to be doing a lot at the scene.


    You can always hold pressure on bleeds. you can help the person remain calm until help arrives. I came upon a highway accident where the two people had gone through the windshield, had teeth missing etc. They were both walking around on the highway. I didnt try to do any first aid. I just had them sit down on the side of the road so they didn't wander into traffic.

    And I totally understand what you said about the young girl "being gone". Seen it many times. Quit beating yourself up, keep learning all you can about nursing and you are going to save many lives.
    Exactly. Just because you are a nurse doesn't mean you know what to do with someone injured so extensively. Some people think a nurse is a nurse is a nurse, which is NOT true. You did the best you could do with your current knowledge. At least the girl had someone with her when she died.

    If you keep having trouble sleeping or it's affecting your day to day life, don't be afraid to seek someone to talk to about this.
    BonewaxRN, myelin, DroogieRN, and 9 others like this.
  8. Visit  jrwest profile page
    6
    just offering a ((((((hug)))))))). you did what you could.
    jamieslovingmom, timmedico, prmenrs, and 3 others like this.
  9. Visit  big al lpn profile page
    11
    General practice Nurses receive next to no emergency training beyond Cpr. They have no training or expearence with the nuances of working at the scene of accidents. It is unrealistic to expect others or yourself to feel knowledgable or comfortable in these situations. So that the long way of saying font feel bad you didn't react with the instincts of a street hardened paramedic. YOU DID NOTHING WRONG. I would have done all the things you did. In fact I would have spent much less time on the fatality than you did. I have been an EMT for eight years and a nurse for six, and I can say that you did a good job of representing nurses.
  10. Visit  Flare profile page
    5
    Wow! What a terrible scene. Don't beat yourself up over what you could have done, you did what you could, and from the way you described it, you did the best you could - that's all you can ask of yourself. Each and every one of us can give our "monday morning quarterback" opinion on what we would have done or what you could have done, but the bottom line is nobody on here but you was there.
    jamieslovingmom, BonewaxRN, Esme12, and 2 others like this.
  11. Visit  NurseCard profile page
    2
    Wow... just so sad and horrible. Two young lives lost, as I'll bet the
    mother wasn't that old... and a little boy who has lost his momma and
    sister... so so sad.

    OP, don't beat yourself up at all; you did everything you could, which
    was sadly, not much at all.
    DeLanaHarvickWannabe and lindarn like this.
  12. Visit  nurse2033 profile page
    9
    Your first thought was correct. No one comes back from blunt trauma arrest. Even if this was in the parking lot of a level 1 trauma center, her odds of survival are just about zero. She would have had catastrophic injuries to die so quickly, especially given her age (these kids have amazingly strong hearts that just don't quit). It is frustrating that there was nothing you could do, but you have to accept that you instincts were good. Sorry for the loss to your community.
    jamieslovingmom, bbmtnbb, BonewaxRN, and 6 others like this.
  13. Visit  tokmom profile page
    1
    (((hugs))) to you for having to witness this and the people that were killed. That breaks my heart.

    You did what you could, so don't beat yourself up.
    DizzyLizzyNurse likes this.
  14. Visit  amerriott profile page
    24
    This is horrible situation to be in, and I have been there myself several times, both while working and as a witness. I am an FNP but have also been a paramedic for 14 years. I think that you did everything you could and it sounds like the outcome would have been the same no matter what. However, as a paramedic, I will say this. If she was pulseless at the scene and lying on her belly, would it have really done more harm to turn her over? I mean she is already pulseless, how much worse off can she be?? As for worsening of internal injuries, remember, nothing really matters unless she is breathing. Always remember, life over limb. Did she have a c-spine injury? Probably. Are you going to make it worse by turning her? No. She is already pulseless. What would I have done? Turn her over and start compressions. It doesn't sound like rescue breathing would have done her any good, but if you had a mask or something I would have done that as well. Like everyone has stated, pulselss traumatic arrests in the field rarely have good outcomes. But don't ever worry about doing more harm to a patient that is already pulseless. The one thing that did catch my eye in your story was the fact that the child was removed from the car before resucers arrived. Unless the child was in imminent danger, he should have been left alone. I know it our natual instinct to pick up the baby, but what if the baby had a spinal injury? A car seat helps but is not 100% effective. Just my 2 cents worth from being a paramedic (which I loved and miss, but the pay sucks).

    Also, I just wanted to tell you that after my very first traumatic arrest in the field, I had nightmares for about 2 months and had to sleep with the light on. I kept seeing his body shoved down in the car. It will get better, I promise. If it doesn't, talk to someone about how you are feeling. Don't keep it bottled up inside.
    BrnEyedGirl, klone, ElSea, and 21 others like this.
  15. Visit  mmutk profile page
    3
    What did EMS do when they got there? Did they start CPR or just cover her with a blanket.

    I made the mistake as a firefighter once doing CPR on a MVA victim who was clearly dead. It created a mess, then EMS had to continue it, then the hospital had to "try" when she got there. A waste a time and resources, all because I started CPR at the scene. If she was already dead, you made the right choice.


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