Author Question: Pedestrian vs. Truck 1/2

Luna Asks:

I hope you can help me with my writing. I need some details for my character.

She is a 24 year old girl that was hit by a 4×4 pickup truck while crossing the road. She was thrown and her head hit the road divider. She was bleeding moderately (not too heavy) from her head injury. She was conscious when her friend sent her to the hospital where later the doctor said she had brain hemorrhage as a result from that accident.

Can I have the details for:

  1. Will she have shock and shortness of breath on her way to the hospital?
  2. What will the doctor check or say when she first arrives at the emergency department?
  3. Is surgery needed?
  4. Does she require blood transfusion for the surgery?
  5. What type of machines would be used to keep her alive?
  6. How long will she be in the hospital? I am writing for two days.

Jordyn Says:

Hi Luna! Thanks so much for sending me your question.

First off, this is a VERY significant trauma to this young woman. There are some specifics missing from your scenario that would be helpful in answering your questions such as how fast the truck was going when it hit your character. The fact that you mention that the victim was thrown indicates a higher rate of speed. Being thrown coupled with the fact that her head hits a very hard surface (the concrete divider) doesn’t bode well for your character.

From your questions, it sounds like you want this to be a more minor injury. If you want this to be a survivable injury (which could be doubtful) you would need to change the nature of this accident and make it less lethal. For instance, the character isn’t thrown a distance. The truck isn’t traveling at a high rate of speed. Or, your character is in a vehicle of her own.

I will answer these questions based on your scenario as is, but keep in mind, this is a very serious accident and if the character survived, she would likely have an extensive hospitalization.

Will she have shock and shortness of breath on her way to the hospital?

You don’t specify in your question whether or not 911 was called and the patient was transported via EMS to the hospital. I would recommend that you do this. You also outline in your scenario that her head wound isn’t bleeding a lot. This is another part of your question that will need some revision. Head wounds do bleed extensively and heavily. If you’ve ever seen a minor laceration to the head you’d be impressed. The scalp is very vascular (meaning lots of blood vessels supply the area and therefore a much higher rate of bleeding).

Yes, this character could be in shock likely related to the blood loss from her head wound, or her head injury, or psychologically from the fact that she’s just been hit by a truck. Keep in mind, the head injury may not be her only injury. Anyone hit by a vehicle and then thrown will likely have other injuries such as broken bones, possible internal injuries, other cuts, lacerations, and abrasions.

If the patient was transported by EMS, they would first provide for C-spine stabilization (placement of a C-collar and backboard) while simultaneously assessing her breathing. Whether or not she’s breathing would be up to you. I could see it either way in this scenario. If she’s not breathing, then they would assist with her breathing. In addition, they would control any visible bleeding by applying pressure and dressings. She would be placed on a monitor to track her vital signs. An IV would be placed and IV fluids would be started.

Since this is a lengthy question, we’ll conclude tomorrow.

Disaster Status: Part 3/3

Dianna Benson returns to conclude her fascinating three part series on hazardous materials. You can find Part 1 and Part 2 by following the links.

I was on-shift the night an industrial hazardous waste plant burst into flames. I have all the inside information, but it won’t be released to the public, so I’m sorry to say I can’t share most of it with you. What I can say— inside the facility was stored toxic material that ignited.

The fire quickly grew to a plume of smoke then the entire facility erupted into a fireball with several rapid fire explosions. This swift and extreme domino of events occurred simply because the burning toxic chemicals were stored right next to oxygen cylinders— and oxygen feeds fire. You guessed it, properly stored oxygen is essential.

The reverse 911 system was activated. Recorded messages called all nearby residents and warned them to evacuate. View the photos included here— it was an intense explosion and the burning toxic chemicals created a massive haz-mat situation.

The chemicals involved in that explosion react negatively when mixed with water, so we were forced to allow the fire to burn itself out. Two days post the onset of the incident, a foam application extinguished the remaining flames.

Even though this makes for boring fiction, emergency agencies that night proved pre-planning and inter-agency training and execution results in excellent emergency incident response outcome. My crew along with many other emergency crews, successfully worked the potentially deadly incident— no loss of life and only minor exposure issues occurred. But think of the endless possible dramas that could have happened.

All photos are courtesy of Apex Fire Department.

Disaster Status: Part 3/3. Write realistic hazardous materials scenes. 
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*Oringinally posted January, 2011.*

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Dianna Torscher Benson is an Award-Winning and International Bestselling Author of suspense. She’s the 2014 Selah Award Winner for Best Debut Novel, the 2011 Mystery/Suspense/Thriller Genesis Winner, a 2011 Genesis double Semi-Finalist, a 2010 Daphne du Maurier Finalist, and a 2007 Golden Palm Finalist. She’s the author of The Hidden SonFinal Trimester  and Persephone’s Fugitive. The 2nd edition of The Hidden Son released in 2016.

An EMT in Wake County EMS since 2005, and a victim advocate practitioner since 2016, Dianna authentically implements her medical, rescue, and crime victim advocacy experience and knowledge into her suspense novels. She loves helping people in need, often in their darkest time in life. Dianna and her husband live in North Carolina with their three children.

 

The Good Doctor is Bad Medicine Part 1/3

The Good Doctor is a medical drama that’s first season just started airing on ABC. Of course, anytime a new medical drama hits the airwaves I get messages from people curious about my opinion.

The drama focuses on first year surgical resident Shaun Murphy who has autism. I’ve watched the first two episodes and though the premise of the drama is mildly intriguing— I don’t find the medical aspects or interactions between the medical staff worthy enough to keep watching. Unless, I keep analyzing episodes for this blog. We’ll see.

Episode 1 features the fight of a hospital administrator to get him accepted into the program. On Murphy’s way to the hospital for seemingly his first day, of course, he saves a life at an airport.

A teen is showered with glass and suffers life-threatening injuries to the neck and chest. An older male, who identifies himself as a doctor, begins to render aid by putting pressure on the wound. The doctor says, “His jugular vein has been cut.”

Issue #1: Placement of direct pressure. Murphy chastises the older doctor for holding direct pressure improperly (for a pediatric patient) and for occluding the patient’s airway because of it. The doctor adjusts and the patient begins to breathe again. Truthfully, there are differences between the adult and pediatric airway, but I’ve never heard of adjusting pressure d/t anatomy. You have to put pressure on what’s bleeding. If that causes problems with the airway, then the patient requires intubation to protect the airway.

Issue #2: Doctors having sex in the call room. Can we please just get rid of this stereotype? Please, just please. There is never as much rampant sex as portrayed on TV in hospitals. In my almost 25 years of nursing, I’ve heard ONE rumor.

Issue #3: Airport Security. I cannot believe in this day and age that, regardless of what someone says, hospital security would allow anyone to grab a knife and run wildly through the airport without being arrested— even if a patient’s life is in danger.

Issue #4: EMS response. Considering this is an airport, the EMS response time is laughingly long.

Issue #5: Chest tube. Of course, Dr. Murphy places a chest tube in the patient as well as makes, MacGyver style, a chest tube drainage system. Once this is done, he triumphantly raises it above the patient and the patient dramatically improves. Just, no. Drainage systems should always be level or below the patient to drain. Never above. Like never. You can check out this nifty nursing video that explains just that.

Issue #6: Direct OR admission from the ambulance. The now stable patient is met by a surgical resident and goes straight from the ambulance to the OR. No, just no. First of all, why does a stable patient need to go to the OR? Secondly, everything first to the ER. The ER attending will make a decision to consult surgery and a plan will be made to take the patient to the OR.

Honestly, there’s more in this episode. Can we talk about the language the doctor uses to get consent? I’ll spare you until next post where I examine episode 2.