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Monday, December 20, 2010

A Monday Afternoon "Lessons Learned"

This is just to share what I went thru just some hours ago.

I just came out of a mall for some Christmas shopping. The local jeepney transport was crawling thru traffic in the late afternoon. I sensed something was wrong since people were looking up ahead at the source of the bottleneck: a mishap with two bikes banged-up. I saw a body lying in the middle of the road along with the typical usiseros. 

Having had a brief background in first responder training, I quickly found myself "reacting" and jumped out of the vehicle. Like I said, it was reaction without much conscious thought going on. 

As is expected in crisis situations, you begin to have a focused mindset, even a "tunneling" of your perceptions. Not so bad and not so good either. The taking-over of gross motor movements along with the adrenaline dump was steadily building too. I couldn't even wear my gloves properly the first time! Good thing there was a pulis nearby and little later another one came.

Here's some of what I went thru along with some realizations: 

1. Scan and secure the area - We were in the middle of the road and vehicles were dangerously skirting us from both lanes. I shouted to someone who looked like he a gave a damn and ordered him: "Control the traffic! Redirect the vehicles!" so as afford us some safe space to address the victim. Besides the mangled metal of the bikes, sharp shards of plastic and glass from the lights were strewn all around. I cleared as much as I can, especially a large 2" triangle piece from a tail light.    

2. CROWD CONTROL - As expected with usiseros, they were enveloping the victim, choking the space to work with and causing even more traffic. Now I've never been the alpha-male, "he-man" kind of guy as those who know me will agree, yet there are also certain times when even some who know me best say that I can get a wild, crazy look in my eye. Maybe this is what the crowd saw when I barked at them to "GET BACK, NOW!" 

3. Rapid Assessment and Call for Help - The man was lying face down in prone position. Kneeling down, I saw red on top of his head, but NOT gushing. A coagulated puddle of blood also formed in pavement below his mouth. As is protocol, DO NOT MOVE THE VICTIM IMMEDIATELY. He might have unseen internal injuries, especially a broken spine. In this particular case thankfully it was a good sign that he was able to lift his head and feet up. The victim was a large "tubby" man and seemed conscious yet difficulty with talking. I did a global assessment feeling with my gloved hand throughout his body (DCAPBTLS). I had taken into consideration how thick my gloves were but it was sort of balanced by his shorts and thin boxer shirt he was wearing. As the policemen were there, I immediately asked them to radio for the ambulance.  

4. Assure the victim/patient - An important in all of this was I was constantly assuring and telling the guy "Kuya, don't worry. WE'RE (as opposed to just YOU) all here to help and take care of you. WE (again, several not just you) can't move you but the ambulance is on its way" while I ask the police officer "Sa'n na ba ung ambulansya!?" 

5. STAND YOUR GROUND - You are the light to bring order into the chaos so to speak. In all of this I was resolute in my voice and bearing. By resolute I mean knowing when to bark/shout orders, when to talk in a straightforward manner to my co-responders and bring assurance to the "victim." When I finally heard the ambulance finally coming in the distance, it was kind of funny when I barked at the crowd trying to envelope us again to "GET BACK!" around 60 pairs of feet immediately stepped back at the same time! I told the EMT's what I figured in my assessment (suspected internal injury with tenderness and swelling in the lumbar region, probably because of the the fall).

6. Equipped - As I wanted to go ultralight for my EDC that day, my bare minimum would always be my large folding knife, mult-tool, led/incan-combo flashlight, and work gloves. Gloves are a regular part of my EDC and mine were sturdy, rubber-lined and bright yellow for color contrast. Besides for handling hazards, these prevent direct contact from any liquids or substances that could infect you (BSI in medical terms). A bandanna or large kerchief is also a regular part of my EDC. Makes for serviceable, though not perfect, pressure bandage/sling/tourniquet in a hurry. 

7. DAMAGE CONTROL - Not really part of the equation but at least some semblance of it afterwards. As the ambulance was leaving, the splatter and "blob" of gooey blood was still on the road. Knowing human nature, there will always be that kind of gawker who'll be drawn to the lurid and macabre (again, another damn traffic hazard). I saw a bank security guard nearby who looked willing to help and told him: "May hose ba kayo? Paki-hose mo naman yun!" He immediately reacted and came out with a bucket of water, but I told him to ask the two pulis's "OK" first since one was taking photos with his phone and the other making his incident report and asking the witnesses/spectators.

As in most cases afterwards, I found myself just a tad shaken and my gut felt acidic, though I didn't feel the need to throw-up. In fact I found myself very calm now. It's the skills you know and default back to when a crisis happens.

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