Motorway Tragedy

One Saturday evening several years ago, I signed on for my 1900-0700 night shift. I didn’t have a crewmate that night so I told the control room and left them with the task of finding another un-crewed person to put us up together.  A short while later, my partner for the night arrived.  Sue was a new technician who had not done many shifts since leaving training school; this was her first set of weekend nights, she was happy but nervous.  I did my best to put her at ease as we signed on and she put her personal gear on the vehicle.

The night started uneventfully, the normal hectic set of weekend night type jobs: mainly alcohol and drug related mishaps, with some normal medical problems mixed in too.  About 3 o’clock in the morning we did a transfer from our local hospital to a specialist urology department – an elderly gent whose urinary catheter had been causing problems needed a specialist review.  After we dropped the gentleman we cleared and were told there were no outstanding jobs so we could head back to station for now (this was in a time when we did have quiet patches during a night shift with no 999 calls, not like now where every minute of the day we seem to have calls waiting for us).

I was driving back on a short stretch of motorway and Sue and I were chatting about the job, I remember saying “This has been a typical shift; this is what weekend nights are like…”  Sometimes I should just keep my big mouth shut!

A few miles further on we noticed a crowd of people standing on the hard shoulder of the opposite carriage way.  This was a region of motorway with a sharp bend in it – lots of cars misjudge the bend here and lose control (not long after this incident a permanent reduction to 50mph was imposed on this stretch). As they saw us they started waving.  From a brief glance in the dark it was impossible to see what the problem was.  Sue contacted the control room to see if there was a call for the group of people we had seen – the answer was no.  I decided we should leave the motorway at the next exit and join the opposite carriage way and come back to investigate.  As we were rejoining the motorway, control called us up on the radio to tell us the job had just come to them from the call takers – it was an RTC – details were sparse but possible fatalities.

The motorway was fairly quiet, not too much traffic at this time in the morning.  As I approached I slowed down so we could take in the scene and pick the best place to park the ambulance.  From a distance we could see debris in lanes 2 and 3 with two cars at angles in lane 3.  A crowd of people and several parked cars were on the hard shoulder.  I left the ambulance a distance from scene straddling lanes 2 and 3, the blue lights left on to warn traffic and with our helmets and high visibility jackets on we approached on foot.  Sue said on the way that she had not had a job like this yet so I  said to stay close and follow my lead.

What had at first glance seemed like debris in lane 2 was actually a body, a young male in his twenties.  Two other bodies were in the carriageway between lanes 2 and 3.  One car had its nose in the central reservation barrier, a second car was parked in lane 3, its windscreen was broken in a ‘bulls eye’ pattern, a circular and radiating pattern of cracks from a central point of impact – typical of when a head hits the screen.  The screen was deflected inwards, implying that the car had hit someone who was outside the car rather than been hit by an un-restrained body inside the car as it crashed.

The first priority as I was assessing the scene was to start to triage the casualties in the road.  I was confident that we were as safe as we could be, the ambulance was protecting us, we just had to be mindful that cars were still using lane 1.  Sue updated control and requested police and back up vehicles as I quickly assessed each casualty in turn using the ‘triage sieve’ system we use for multiple casualties. This is a first triage system where a casualty can be assessed very quickly (mass triage has evolved since the incident to include a first step of addressing any massive bleed as a first step, this describes the triage sieve in use at the time).  The next step is to check is if a potential casualty is actually injured, if not they are directed to a clearing station area.  If they are injured but can walk, they are categorised as priority 3, the least urgent category of injured casualty. If the patient is not breathing despite an attempt to open the airway, he or she is classed as dead. For the breathing patient, rate of breathing, heart rate and capillary refill is quickly assessed and the patient is categorised as priority 1 or 2.

As I started to triage the police arrived and quickly closed the motorway, at least we were safe now and we knew the bystanders were safe from further injury.

Sadly, all three casualties all came out of the triage system as dead.

By now it was daylight and an hour past our scheduled finish time – quite a subdued end to what had started as such a routine shift.

The next night shift all the crews involved were called to a de-brief, a meeting where we have a chance to discuss the incident, run through the decisions made at each stage and also to get an overview of the whole incident.  When you are busy dealing with parts of a large incident you often do not know the whole story which is quite frustrating.  The de-brief is a very therapeutic thing and it helps to get things off your chest and have your peers and managers justify the decisions you made.

The three young adults who died were travelling in one of the cars and had lost control on the sharp bend in the motorway and had over steered and collided with the central reservation.  They were all fine at this stage.  They all got out of the car and were standing on the motorway looking at the damage when the second car came round the bend, didn’t see them in time and hit the three.  This explained the ‘bull’s-eye’ in his windscreen and why the three were widely scattered.  The driver of this car did not make himself known to us when we were on scene.

It still moves me how suddenly events like this can happen:  A moment of bad judgement by the three young victims and an instant of inattentive driving leads to such a sudden, tragic end to three young lives and three families devastated forever.

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