The Patient-Provider Experience: What I Learned from Busting My Head Open

Have you ever been a patient in an ambulance, before or after becoming an EMS provider? Have you witnessed a loved one become a patient? How did it alter your perception of patient care? EMS World’s newest series, “The Patient-Provider Experience,” shares the stories of both patients and providers who have been impacted by their respective experiences with EMS—on or off the cot—and how these experiences changed the way they provide care.

I was out on an urban exploration venture recently with my wife and oldest son, and we found an abandoned railroad track and a bunch of boxcars. Being the explorers we are, we immediately set about climbing all over the cars to investigate. Like any good parent, I’m slightly paranoid about anything dangerous my kids get into. Not so much that I helicopter-parent, but enough that I’m full of various “be careful” kinds of statements.

I wanted to be the first one to climb up on a steel catwalk structure to beat my son up there, so off I went. One minute I was on my way up the metalworks and then…smack!

I hit a beam with my head so hard it made me go blank for a second. I never lost consciousness, just lost a second or two as the hit registered. I was up on a ladder at the time. I don’t remember coming down. At the bottom I reached up to touch my head and check the injury, and I felt my fingers go into the wound. That was when I dropped to my knees and the blood started pouring out.

As you all well know, head injuries bleed a lot anytime, so much they sometimes appear worse than they are. Mine was worse. I found out later that my superficial temporal artery was severed on the left side and there was an eight-inch opening across the top of my head.

My wife is a medic as well, and my son has been brought up learning first aid and CPR since he could say “Someone get an AED!” She quickly bandaged my head with the gauze from my IFAK, but it bled through in seconds. Then she took off her shirt, zipped her coat back on, and bandaged it with that. My son calmly watched the whole thing.

I repacked my IFAK, because I’ve always hated it when people throw jump bag contents everywhere. Then we had to hike out to a road somewhere. We sent my son ahead to find houses or a road with a name so we could call an ambulance with a location. It took a while. It turned out the closest way out was over the tracks, through a muddy field, over several ditches, and across two fences. Thankfully I didn’t pass out. My wife isn’t a weakling, but it’s not easy for anyone to carry 230 pounds of man.

But we made it.

Lessons Learned

An ER visit and 17 stitches later, I have a nice scar developing on my melon and a great story to tell. You’ve just read the story, so now let me throw you a few lessons from my experience that will help you in life and EMS.

Wear a helmet. There are times in life where you should take extra precautions. I should obviously wear a helmet around big metal things. You decide when you need some extra margin in your life.

Pay attention to signs, but do not necessarily obey them. I cannot tell you how many Danger and No Trespassing signs we passed that day. They did not stop me, but I should pay more attention next time and be better prepared. When people throw you caution flags, take note and go from there.

Make every opportunity a chance to learn something new. At the ER, while she was sewing up my head, the doc brought my son over and showed him all the layers inside my brainbox. He enjoyed it, as he’d never seen the anatomy of the skull other than in scientific illustrations.

Dress appropriately. I always wear dark colors, usually black, because I get into so many activities that leave me filthy or bloody. Dress the right way for what you’re doing. It bothers me when EMSers wear white shirts.

Find the funny. After she saw the pics of my open head, my sister asked if it was too early for Phineas Gage jokes. Always look for humor in any situation.

Go minimalist. So little is actually needed in trauma events. Outside of more definitive care in the ER, all we needed to hike out was a bandage and pressure. Do not complicate things with stuff. It does not always help and sometimes hurts.

Train your team right. My wife is a former paramedic. My 14-year-old son has multiple certifications in wilderness first aid and CPR. He’s also in good shape and pretty fearless. He never freaked out a bit.

Be ready to hike out. Had I not been able to hike out on my own, I would’ve been in serious trouble. Always have a plan B and enough margin to get out and get safe.

Problems make the simplest things difficult. I have to be careful about scratching my head, showering, and putting a shirt on, at least until the stitches are out. I have only one hat I can wear that doesn’t touch the stitches. Plan for problems before they occur.

Take care of yourself. At the hospital we talked the doc into giving us a suture-removal kit. It makes pulling the stitches out way easier. My wife will do it, and the kids will probably enjoy watching. Do not always depend on outside resources to help you. Have the gear, team, and training to do it yourself.

As a last bonus lesson, do not ever let something stop you from adventuring! Less than 12 hours after the injury, I was on a stage delivering a lecture. Another day later I was back on my workout routine.

And a bonus bonus: Of course it’s always wrong to post photos of patients online. But also know that sometimes Facebook and other outlets frown on trauma pics of any kind, even if they’re yours.

David Powers, ThD, BCETS, BCECR, is a decorated veteran of the U.S. Marine Corps and U.S. Army and a founding member of the Department of Homeland Security, where he participated in disaster planning and helped war-game scenarios and responses. He is a popular speaker at public safety conferences and for various government agencies. Contact him at redteamgoals.com.