What type of treatment would a trained medical professional give a small child who's been hit by a car?

Question

I am writing a story about a guy who went to medical school but decided not to practice. (complicated reasons).

A scene in the story has him responding to an accident where a young boy is hit by a slow moving car and falls and hits his head. For the sake of accuracy, how would someone who knows what they're doing respond to such a situation?

What sort of injury/scenario could the main character "treat" that would have the EMTs credit him with saving the child's life?

I appreciate any help those of you in the know can offer.

Answer 1

It depends on how accurate you'd want to go... The most likely scenario for an EMT or Paramedic to credit him personally would be to not know he was a trained medical professional ;-p  A public credit would only be likely if the child was the son of a very important person.  Otherwise, knowing he's a professional more or less means we (ambulance personnel) expect him to do his duty and typically aren't going to make any special remarks to him.  On top of that, if he completed med school and was responding to a scene unlicensed which will land him in front of a judge if anyone talks... (you use the word responding, if he witnessed the accident it's a different story.)  MDs actually aren't allowed on an ambulance crew unless they are specifically certified in pre-hospital care...  So... that said, he's more likely to miss something than to find a miracle cure.

Ok, in all honesty, if the guy is an MD nobody except the family is going to be patting him on the back unless he did something like 60 mins of CPR by himself.  But I'll give in to the improbabilities for a moment.  The type of scenario I think you are looking for is going to be less accurate than you'd like ;-)  I'm thinking he could find a pneumothorax (collapsed lung) and re-inflate the lung by releasing the pressure with a pocket knife and a pen?  Other than that, controlling a major bleed comes to mind as realistic.  But that's not very dramatic to read... Do some research, find a rare disease that could be complicated by trauma and have him figure it out before a shock from a defibrulator fries the circuits on his mechanical heart, which he has temporarily until he can find a suitable donor heart (which he preserves by cooling the body of the now dead driver out of sheer audacity.)  Can't really help you on the scenario, you're going to have to be creative ;-p

Accuracy: one place I can help you.  It's pretty simple, the first thing to do is secure the scene; find a way of stopping traffic or whatever to make it a (somewhat) safe area to work in.  After that, assuming one patient, make sure he's alive (breathing with a pulse)  If he's not breathing and/or his heart's not beating everything else is essentially out the door until those issues are managed.  Assuming he either 'fixed' that status or found him with an open airway, breathing, and a beating heart, the next down the line is technically mental status... is he awake and alert?  semi-conscious or unconscious?  (skipping some terminology)  find a way to secure his c-spine (make sure a broken neck doesn't get aggrivated/worse) and then assess for the presence of any obvious life threats like major bleeding internal and external, abnormalities like an open or angulated fracture, or possibly an environmental factor like the car just caught on fire or gas running down the street towards the hero and child.  Oh... he shoulda called for help if he witnessed the accident ;-p  Once you're clear of imminent death  a rapid trauma assessment is done, basically get them as close to naked as possible and very rapidly do a physical exam to find other less noticeable  threats or injuries.  Treat what you can and keep his spine stable and intact untill a method of transport arrives with a long board to strap him to... For sake of accuracy, if he just got whacked by a car with a known head injury you're not going to move the child until a transport ambulance arrives or that car does burst into flames...   Ummmm... that's mostly it ;-)  I may have missed some things, most of the initial assessment and emergency treatment is done out of habit without much real thought (it's better that way, you don't want someone working on you asking themselves what to do next every 3 seconds.)

Hope that helps a little, might have made things worse... good luck ;-p  and skip accuracy while being accurate... he's a trained MD not a combat medic (I think?) and isn't going to be exceptionally functional with no equipment and what amounts to almost no training on how to handle the scene of a traumatic and dramatic accident.

Answer 2

Funny you should mention it. I saw a similar scenario unfold. I had been out to lunch with a pulmonologist (yes, he practiced) and we saw a car back into an elderly lady in the parking lot. She was hit at a slow speed, but took quite the fall. His first reaction was "Oh, sh**!" His second was to yell to the people running to her not to move her. His third was to tell me to call 911 (I was already doing this). He told the witnesses to back away from the body, Crouched down, and said to the conscious woman "Ma'am? I'm a doctor. I want you to hold still for me. Do you know where you are?"

He asked her a couple more questions (her name and who the President was to establish orientation). While he was talking to her, he had gathered jackets from the onlookers, rolled them, and put them on either side of her head to help keep it from moving. He asked who he could call for her to tell them what had happened. Soon after, the EMTs did arrive. He filled them in on what he had seen, mentioned that one of her legs appeared to be shorter than the other, which is a classic sign of a broken hip, and said she appeared to be aware and oriented.  She asked him to hold her hand while the EMTs got her ready to go (which is really quite the production with a head injury).   That is realistic. :)

But not very good for a story, and not what you are looking for.  There is probably no treatment that a person on the street (doctor or not) could offer without some supplies in your scenario...other than keeping the kids head still. A doc's first instinct beyond that would be to look at his pupils to see if they were normal, or showed signs of an internal bleed in his head.  You could say the child's pupils looked fine, but he complained of eye pain...so the doc insisted that it could be an intracranial bleed...causing the EMTs to phone back for a neurosurgeon to be ready...You can always pull a "House" and come up with an unrelated, rare condition that the guy catches. Automimmune disorders and clotting disorders probably lend themselves best to this.

Hope this helps. Let me know if there is something specific you'd like the check the "accuracy" of :)

Answer 3

Make sure traffic is blocked or the boy is out of the street. first I would check his breathing and then his pulse. If the boy is not breathing I would do CPR. If there is any bleeding I would dress the wounds. If the appropriate materials arent at hand i would use cloth from a shirt to tie off wounds or bleeding areas