Reports/rumors: Serious accident at 2019 Easter Jeep Safari

[TennesseePA]

I’m all about a conservative approach to air transport due to cost and availability but for this I absolutely agree with the decision to fly. As mentioned earlier, the distance to a road is several hours and then you have the transport time to a faculty that can accommodate. In Moab you’re in the middle of nowhere when it comes to advanced levels of care. They didn’t know the severity besides I’m assuming a fx of the leg. Could be a tib/fib, could’ve been the femur and concerns of damaging the femoral? We don’t know since we weren’t there. If I had been and made the call, I would’ve given our gps coordinated and request a life flight or whatever helicopter medicvac was available and secured an LZ based strictly off the mechanism and distance to definitive care

Brett

If you rupture the femoral artery ON the helicopter it is very bad news. My biggest concern for her injuries if it was indeed a closed fx is compartment syndrome, which is limb threatening. It is very easy to spot, everything will look like a normal closed fx but the patient will be in excruciating pain. Compartment syndrome is when the vessels inside the muscle fascia rupture and since the fascia is so tough the bleeding will eventually build so much pressure that it works like a tourniquet an if the facia is not opened the resulting ischemia will kill the limb. If I was sitting with my feet on my desk and you called and said that a lady was run over by a Jeep and she has been screaming in pain I'd send you a helo too! Two years ago one of the Nashville Predators players was injured in the second period that resulted in compartment syndrome of his quadriceps muscle and he somehow managed to finish the game and overtime before goin to the ED at Vanderbilt. He had an emergent fasciotomy that night. And I am proud to say that it was a fellow PA that he saw that night...not me but someday it will be.

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[roaniecowpony]

I'm a jamoke with no medical training, but I gotta go with a helo for anything serious enough that could or did bring on shock, could have spinal injury, etc, especially so many minutes from an ER. whats the downside? A few bucks? you better believe thered be a huge lawsuit if no helo was called and the victim had a time related complication.

 

[Shenanigans]

To add some minor details, the JL has been known to act weirdly in certain situations (documented on video) where in certain instances, it will, for no apparent reason, simply cut power. To an unsuspecting driver, they may be tempted to slam on the gas thinking they aren't hitting it enough, and when power resumes, the vehicle launches forward. We can all play monday morning quarterbacks, but it's pointless. It's a freak accident, which is terrible, but considering what could have been (Imagine with was on a trail like top of the world or chicken corners where you can plummet off a cliff), both the driver and bystander are "lucky." When woman could have been pushed into the ravine with the jeep pinning her against the rock, possibly killing her. Looking at the smidgeon of facts presented, there is most likely driver error, as well as bystander error but filling in details doesn't do anyone any good. Maybe when the time comes, AJeeper can share what happened this day, but until then, we can be thankful that both people were able to survive a no doubt terrible ordeal.

I pondered the same theory.

Experienced those power issues twice now. Most recent time was Saturday.

 

[TennesseePA]

I'm a jamoke with no medical training, but I gotta go with a helo for anything serious enough that could or did bring on shock, could have spinal injury, etc, especially so many minutes from an ER. whats the downside? A few bucks? you better believe thered be a huge lawsuit if no helo was called and the victim had a time related complication.

Once again I agree with the decision for the air evac. I was referring to the rather benign description of her injuries and implying that the description was understating the severity of her condition. Shock can be treated in the field and in transport with fluid resuscitation. Shock is defined as a lack of perfusion and is classified as Hypovolemic (ex: blood loss or sever dehydration), cariogenic (ex: by cardiac arrest), obstructive (caused by pulmonary embolism or cardiac tamponade) and neurogenic (ex: spinal cord injury). Considering the mechanism of injury if the latest account of a closed fracture the biggest things to consider are compartment syndrome, pulmonary embolism or spinal cord injury. With an accident like this that will gather a crowd and the volume of people at Moab for EJS I would bet a decent amount of money that someone with medical training was on site and knew what they were seeing and communicated it to EMS who made the call for air evac. My argument about asset allocation was in reference to asset allocation in the area. A pt in pain is not life threatening and the decision to dispatch your aircraft could bite you in the butt if another emergency occurs in your area. So I contend that she did indeed have much more serious injuries than the latest update suggested based on the fact that she was transported via helo and she already had two surgeries within two days of the accident.

 

[JimLee]

Once again I agree with the decision for the air evac. I was referring to the rather benign description of her injuries and implying that the description was understating the severity of her condition. Shock can be treated in the field and in transport with fluid resuscitation. Shock is defined as a lack of perfusion and is classified as Hypovolemic (ex: blood loss or sever dehydration), cariogenic (ex: by cardiac arrest), obstructive (caused by pulmonary embolism or cardiac tamponade) and neurogenic (ex: spinal cord injury). Considering the mechanism of injury if the latest account of a closed fracture the biggest things to consider are compartment syndrome, pulmonary embolism or spinal cord injury. With an accident like this that will gather a crowd and the volume of people at Moab for EJS I would bet a decent amount of money that someone with medical training was on site and knew what they were seeing and communicated it to EMS who made the call for air evac. My argument about asset allocation was in reference to asset allocation in the area. A pt in pain is not life threatening and the decision to dispatch your aircraft could bite you in the butt if another emergency occurs in your area. So I contend that she did indeed have much more serious injuries than the latest update suggested based on the fact that she was transported via helo and she already had two surgeries within two days of the accident.

Just because things are done one way in your profession where you live and train, doesn't mean they are done that way everywhere. I was air evac'd for a tibial plateau fracture after crashing my quad about 7 miles outside of town. There was no medic on site, just me on my cell with the hospital, they just thought a ambulance would get stuck trying to get to me. I had two surgeries to fix my leg. Was I in "life or death" danger? No, most certainly not, I almost got on and rode out. Maybe we should wait for the details of this accident to come out instead of trying to fill in all the blanks based on how someone was removed from a shitty situation in a remote location.

 

[Rahneld]

In a post I wrote earlier, that I think respects everyone's input above about what mode of transportation takes you to the hospital, the decision for a helicopter rescue is multifactorial one based upon:

• Severity of issues
• Severity that time may or will complicate
• Distance from appropriate care
• Land capable access, in terms of closest roads, traffic and the above distance.
• Weather
• Ability for a helo to land, and if not, pros and cons for ground transport to a site where a helo can land.
• Others

 

[four low]

Cabelas and Bass Pro Shop has a deal going on the Spot Gen 3, 50% off mail in rebate for the spot, plus 50% off instant yearly activation. It can track down to 5 minutes, can send canned messages, can send a break down message or send the SOS message. I got it specifically for my Colorado trip this summer, that way my wife and mom can track my trip and the peace of mind if something happens.

These should be required for remote/back country exploring, no one expects a life threatening emergency. Could save lives, time, money

 

[rustyshakelford]

Ive

If you rupture the femoral artery ON the helicopter it is very bad news. My biggest concern for her injuries if it was indeed a closed fx is compartment syndrome, which is limb threatening. It is very easy to spot, everything will look like a normal closed fx but the patient will be in excruciating pain. Compartment syndrome is when the vessels inside the muscle fascia rupture and since the fascia is so tough the bleeding will eventually build so much pressure that it works like a tourniquet an if the facia is not opened the resulting ischemia will kill the limb. If I was sitting with my feet on my desk and you called and said that a lady was run over by a Jeep and she has been screaming in pain I'd send you a helo too! Two years ago one of the Nashville Predators players was injured in the second period that resulted in compartment syndrome of his quadriceps muscle and he somehow managed to finish the game and overtime before goin to the ED at Vanderbilt. He had an emergent fasciotomy that night. And I am proud to say that it was a fellow PA that he saw that night...not me but someday it will be.

I’m very familiar with compartment syndrome. Until you’ve been to the scene you won’t grasp the remoteness of where you truly are. Once you leave town, you turn right and go 29.7 miles to the trail head. This drive alone is every bit of 45 min hauling butt as it winds along the Colorado. Then the fun begins. I’d have to do the drug calc but the amount of ketamine would be huge to manage pain on the way down. This is a very rough trail. All they know is a female was run over twice. What I’m finding out is it is common procedure to dispatch a helicopter with or in lieu an ambulance depending on the location. I’m this rural setting they are used more frequently for inaccessible incidents. Again goes back to transport time.

Medics are dispatched. They leave, with the call notes they call for a UTV. Figure an hour to the trail head, now comes the 3-4 hr run to the incident site. We’re already 4-5 hrs after the first call. Stabilize the pt, then let’s come down. Figure 30 mins on site getting a line going, vitals and secured to the board we begin the decent. Can’t go as fast now so we’re going to add an hour. You’re close to 10 hrs before transport has begun from the scene.

Here’s the icing on the cake, I don’t know the level of ems. It could be a BLS which would be even worse as the best they can do is give oxygen.

Unfortunately I’ve studied up on resource allocation and risk management. Send the helicopter is guaranteed to help someone. Holding it back for a “what it” has a higher probability of nobody being helped especially in this low volume rural setting.

Guys and gals that are in the ED have either forgotten or don’t know what it’s like in the field sometimes. I don’t say that as a slight but a fact. Everything is clear cut and more times than not an update is given prior arrival from someone with some training atleast. In the field it’s unreliable information by untrained people and unusual circumstances. A lot of adapting and overcoming just making things work. Could you imagine an unstable fx of the femur and bouncing down poison spider Mesa for 4 hrs after waiting 4 hrs for help only to find out its a bls service that has some O2 for your pain?

Yuck

Brett

 

[srt20]

Ive spent alot of time in the Mtns. It takes forever for anything.

Last year hunting in WY, one guy had a Spot. He unknowingly hit the button. At least 3 hrs later, (he figured out when he must have hit it) USFS cop, local dnr, and sheriff all show up. We were only 3 miles off the paved highway.
Now imagine trying to evacuate a person that is hurt.

 

[IronScott]

Just because things are done one way in your profession where you live and train, doesn't mean they are done that way everywhere. I was air evac'd for a tibial plateau fracture after crashing my quad about 7 miles outside of town. There was no medic on site, just me on my cell with the hospital, they just thought a ambulance would get stuck trying to get to me. I had two surgeries to fix my leg. Was I in "life or death" danger? No, most certainly not, I almost got on and rode out. Maybe we should wait for the details of this accident to come out instead of trying to fill in all the blanks based on how someone was removed from a shitty situation in a remote location.

I had a TPF 15 months ago after being hit by a SUV while riding a bicycle. Still painful. Horrible injury.

 

[roaniecowpony]

These should be required for remote/back country exploring, no one expects a life threatening emergency. Could save lives, time, money

I agree with your statement that these could save lives, time and money. But totally disagree on "required". Too much big brother in our lives today. If you require an expensive piece of equipment, you curtail the freedom of those that may not be able to afford such things.

 

[MtCamper]

I've been following this thread with great interest. I'm very disappointed with both the hijacking of the thread and with the armchair quarterbacks on the victims care and air evac. Please start a new thread if you want to express your opinion. My thoughts and prayers are for both the victim and Jeramy. The victim faces a long and difficult recovery regardless of the nature of her injuries. Jeramy faces not only the loss of his Jeep, but also damage to his reputation and potentially years of litigation. Please post updates on what is happening to both parties if you know something to be fact. We can all benefit from Jeremy's experience. There, but for the grace of God, go all of us. Every time we turn off the pavement anything could happen. I await factual updates.

 

[JimLee]

Disregard, I'll play nice.

 

[Shenanigans]

Let’s put an end to Monday morning quarterbacking the first responders actions.

We were not there. We did not receive the 911 call with the initial details.

 

[brazos]

Clearly, what is needed here is more self-righteous scolds telling others whether, what, and when to post.
The shortage of such guidance seems to be getting filled up right smartly lately, though.

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