Mom is sitting on the couch looking haggard, she see's me walk through the door and starts to to stand up. Her tired face has broken out in a very tired looking smile.
"Mom, sit down" I said, smiling back at her.
"How is he doing?" As I ask it, I cringe for a moment when the smile disappears off of her face and her eyes start to tear up. I sit next to her on the couch and take her hand in mine and put my arm around her shoulders. I need to change the topic quickly and put her back in "mom" mode.
"I am starving, what do you have to eat?" She casually wipes her eyes on her sleeve and stands up and smiles again. She is telling me she can make me a quick burrito and I thank her for that. When I hear her moving pans and plates in the kitchen, I look up the staircase to the upper level.
Mom was 16 when she got pregnant with my older brother. Three years later she had me and 2 years later my younger sister joined the family. Mom's first husband joined the Navy just prior to me being born. He never came home after that and except for the brief trip to San Diego, he did not see Mom again until we were all over the age of 10.
I met him for the first time just before my 16th birthday as a favor to my mom. I did not want or attempt to stay in contact with him after the initial meeting. He remained a stranger for me for my entire life.
The man who is on the upper level is her second husband Stan. I do not have any details on how they met, became husband and wife and decided to have 2 more children for a total of 5 kids.
Stan and I had on our very best days, a contentious relationship. While his life lessons were in very short supply, the discipline for minor / major infractions was swift, demeaning, and physical in a way that is difficult even now to say out loud or write about.
"I am going to go up and check on Stan" I said as I pass the kitchen on the way upstairs. Stan has stage 4 colon cancer and after an aggressive year of treatment he is under the care of Hospice.
Stan and Mom divorced 5 years prior to his diagnosis. He became involved with his secretary at work and initiated the divorce with mom. A couple of years after the divorce, Stan was diagnosed with cancer, and it ended his new relationship. Based on necessity, he moved in with his daughter and her husband, until further treatment was stopped due to his failing health.
When his daughter could no longer provide care, he asked to move in with mom and she agreed. Hospice nurses came in and provided care during the time he was with mom.
In the Fire Service the Simple Triage and Rapid Treatment (START) system is used to quickly triage multiple victims in the shortest time frame possible. It is set up to find the most seriously injured patients and prioritize their care and transport. There are tags with specific colors that you can identify how patients have been triaged for first responders that are on scene and new crews that are arriving their care and transport. There are tags with specific colors that you can identify how patients have been triaged for first responders that are on scene and new crews that are arriving to assist.
The four colors of Triage are green, yellow, red, and black. Green designated as minor injuries and is not used. When arriving on scene, the firefighter doing triage will ask everyone who can, to walk to a safe area. Everyone who can do this easily is a trauma green. A trauma yellow is urgent and basically used to indicate that patient will need specific care within an hour. A trauma red requires immediate care and a life threat. Black is a designation for death in the field. Triage is used to bring the appropriate resources to the scene so that patients can be taken care of based on their injuries.
I am standing in front of the door to Stan's room and thinking yellow, red, and black. I want to deal quickly with any rapid change and not have my mom have to make any decisions on how to proceed if things have taken a turn for the worse.
Engine 3, Paramedic 4, and Engine 1 respond to Weld County Road 3 and Weld County Road 34 for rollover injury accident" the dispatcher says over the radio as the green plectron light comes on in the living room of station 3. I turn off the TV in the TV room and grab my radio.
"Engine 3 responding status 4" I say into the handheld radio while the crew is walking out to the bays to get into their gear and get on the engine.
"Engine 3, parties on scene reporting that parties have been ejected" the dispatcher says in a remarkably calm voice.
"Engine 3 copies, please put Air Life on airborne standby" this will dispatch the air ambulance to the site of the accident. They will not land until they are instructed to do so but they will be in the air right above us if we need them.
Fuck
Mead High School graduation was today, and it is early evening and just starting to get dark. I am hoping it is not anyone from the graduating class today.
When we arrive, I see a heavily damaged red station wagon on all 4 wheels. The windshield is on the road, there is a body in the road, one at an awkward angle half in and half out of the passenger window.
"Engine 3 arrival, this will be Road 34 command, I have ejected patient on the road, and a partially ejected patient on the passenger door. We will be investigating" I say on the radio. I tell the crew to pull the jump kit, backboards, c-collars, and the oxygen kit from the engine. I will do quick triage.
I am thinking red, yellow, and black. All of the incoming apparatus will be listening to the inflection and tone of my voice. I need to do this quickly and not miss a thing.
The 1st patient closest to me is lying face down in the road with massive head injury. Both legs and one arm are bent at awkward angles. I reach down to check for a pulse and see his eyes fixed and dilated. The head injury has exposed brain matter that is on the road. No pulse and based on the injuries - BLACK. I look up at the crew walking towards me and say BLACK.
I walk towards the 2nd patient, and I can hear his agonal breathing. He has a closed head injury and one leg, and an arm are bent at awkward angles. RED, he needs immediate care, we need to land the air ambulance right away. I look up at the crew, motion them over and say RED. I tell Chris to work with Tom and Christopher to handle this patient and advise them I am going to have Engine 1 land the air ambulance.
"Engine 1, you are the contact for Air Life, we have a trauma red and need to land them to take this patient". I move to a tactical channel and give a quick status on our trauma RED patient.
I look in the backseat and see a restrained 3rd patient. His nose is bleeding, and he is crying but able to answer basic questions about how he feels. YELLOW, he needs care, but our trauma RED is going to get taken care of first. I cannot evaluate the extent of his injuries but believe is he a true trauma yellow. I will get on the radio and tell Engine 1 to take care of our Trauma YELLOW. Paramedic 4 has arrived, and their crew is walking towards our Trauma YELLOW with the Engine 1 crew.
I step back to assess the scene. Air Life is landing in a field next to WCR 34 with the help of Engine 1's Lieutenant. Engine 3 crew is getting our Trauma Red onto a backboard, putting him in a c-collar and taking care of him in the best possible way. I walk over to the Paramedic and tell him I have a code black and ask him to take care of this. He will get on radio with the Emergency Room doctor, explain the extent of the injuries and get permission to call a death in the field. I see him on the radio, look at him and he nods his head towards me.
"WCR 34 command, please dispatch coroner to our location" This will extend the call because our teams will have to assist the coroner.
I can see the flight medic's and Engine 3 crew loading our Trauma Red on Air Life. The doors on the back of Paramedic 4 are closing and they are heading to the Emergency Room. The dispatcher advised me that coroner is on the way with an ETA of 45 minutes.
We can start to pick up and work on getting the Engine back in service.
Triage is one of the most stressful and important tasks to perform on a scene like this. These kids for the time we have them are our kids. I think about the news each set of parents will receive shortly and it makes me pause. I take time to go through the triage that was performed, and I look for the things I may have missed. I will check in with the flight medics and paramedic later to confirm I did not miss anything. Every single life that I touch out here, deserves to be treated like my very own family.
I open the door to Stan's room. His breathing is very labored, and his eyes are half open. I see the note on his bedstand and see he was given a heavy dose of morphine about an hour ago. I am thinking YELLOW, RED, and BLACK. I am not thinking about Stan and our contentious relationship.
The life lesson today is that one of the most stressful and important tasks I have learned in my Fire Service career has allowed me to approach this difficult time for my family with a bit of patience I would not normally have in this circumstance.
Today, the life that I am touching is being treated like he has been part of my very own family and not the person that wreaked havoc for all of us for so many years.
I walk downstairs and see mom putting a plate on the table with a huge burrito.
"He's good mom, he is resting quietly" I said, and I see her smile broadly.
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