At scene of fatal accident yesterday...

Barnstormin' PMHNP · Oct 21, 2012

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.

jamieslovingmom · Oct 21, 2012

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.

gonzo1, ASN, RN · Oct 21, 2012

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.

DizzyLizzyNurse · Oct 21, 2012

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.

martymoose, BSN, RN · Oct 22, 2012

just offering a ((((((hug)))))))). you did what you could.

Alex Egan, LPN, EMT-B · Oct 22, 2012

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.

Flare, ASN, BSN · Oct 22, 2012

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.

allnurses Guide · Oct 22, 2012

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.

nurse2033, MSN, RN · Oct 22, 2012

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.

tokmom, BSN, RN · Oct 22, 2012

(((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.

amerriott · Oct 22, 2012

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.