the level of irresponsible...

Stogies

Stogies

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Medical examiner's report: Bystanders pulled UNC student from car after crash

An investigative report from the Office of the State Medical Examiner shows Molly Rotunda "was pulled from the backseat of the car by the bystanders who were traveling behind the vehicle before it crashed."
www.wral.com www.wral.com

1) they drank underage, not a wise move but hey
2) they drove drunk, very stupid
3) they drove drunk and raced, incredibly stupid

I have no words.
 
Pointing that out without explaining why is odd. IN general, don't move a patient unless they are in danger or you have to move them to treat them. Just stabilize them in place. But most folks don't know that. But not sure moving her would lead to cardiac arrest afterwards. But impacts and blunt force can do some weird things.
 
P01135809 said:
I don’t understand the article title. What does the bystanders pulling her from the car have to do with anything? How does the medical examiner report know this?

Cervical fracture that was destabilized?

Help me understand
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I’m guessing they may have initially thought she was ejected from the car during the crash?
 
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Goofyfoot2001 said:
Ugh, the thing that jumped out to me was an AUTOMATED 911 CALL FROM AN iPhone...wth is that all about?
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I think it’s an option.
This week I got an alert with a location that my son had been in an accident. He wouldn’t answer the phone for an hour, because it was left on the roof of his van & fell off while he was driving.
 
P01135809 said:
I don’t understand the article title. What does the bystanders pulling her from the car have to do with anything? How does the medical examiner report know this?

Cervical fracture that was destabilized?

Help me understand
Click to expand...
So this article is a badly worded update on the initial reporting, hence the focus on her getting pulled out of the car which really doesn't mean anything.
 
Button Pusher said:
All of them plus the bar keeps who served all of them should face the same charges.
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I'll agree but with an exception. If they presented ID that would pass scrutiny from a "normal" person then the bar isn't responsible. Now if the ID was obviously fake, or the picture doesn't match, then the bar shares the responsibility.
 
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chiefjason said:
Pointing that out without explaining why is odd. IN general, don't move a patient unless they are in danger or you have to move them to treat them.
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Sometimes the worst thing is a do gooder who wants to help. Had a coworker who was a surgical nurse in the army. He came upon a car crash in the early stages before the “officials” showed up. One victim was face down, but breathing and stable. This other last on the seen wanted to flip him over, but Cory told her to leave him be. A few minutes later after checking someone else out, he looked over and saw that she had flipped the guy into his back. She said she did it because he looked uncomfortable. Unfortunately, it killed him.
 
The whole C-spine and back thing has largely gone away. Just no clinical data to support those, and a lot of clinical data to support harmful outcomes if a C-collar or backboard is on too long. Seeing a patient in a C-collar is becoming increasingly unusual, a spine board is very rare.

Unresponsive patient in a vehicle, he/she need to come out.
 
Chuckman said:
The whole C-spine and back thing has largely gone away. Just no clinical data to support those, and a lot of clinical data to support harmful outcomes if a C-collar or backboard is on too long. Seeing a patient in a C-collar is becoming increasingly unusual, a spine board is very rare.

Unresponsive patient in a vehicle, he/she need to come out.
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Pretty wild that changed, seeing how hard it got beat into us and how much we worked on it. Interesting.
 
chiefjason said:
Pretty wild that changed, seeing how hard it got beat into us and how much we worked on it. Interesting.
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Yeah, same with me. I think it really started changing about seven or eight years ago, but has really picked up steam over the past couple years. Honestly, it does make sense, and now research is starting to support the changes.

I will say always found it very weird how It was beaten into us to use a long spine board on trauma patients when the first thing they do when they get to the ED is take the board out from under them.
 
Chuckman said:
Yeah, same with me. I think it really started changing about seven or eight years ago, but has really picked up steam over the past couple years. Honestly, it does make sense, and now research is starting to support the changes.

I will say always found it very weird how It was beaten into us to use a long spine board on trauma patients when the first thing they do when they get to the ED is take the board out from under them.
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Made more sense for me being ski patrol and outdoor medicine where a rough transport is the best you can do.

But front country ems, guess the juice isn’t worth the squeeze.

Wonder how much the GWOT played into that? Medical trauma dogma took some big hits once they cut drs loose to do what needed to be done.
 
Me. said:
An awesome use of technology.
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It is cool tech to a point. I tried to talk my mom into the android watch for the fall sensing. I tried to use it on my iPhone watch but I can't. I don't wanting it calling 911 every time I hit a stack of product with a hand truck, since I do that about 70 times a night. lol. First night at work I had to just disable it on the watch because it kept going off.

Looks like the crash detection is set for less false triggers with more inputs though. So I might look into that one. For the more paranoid folks it does access your microphone. But also says all info detected is processed on the phone and just used to initiate the 911 call prompt.

Use Crash Detection on iPhone or Apple Watch to call for help in an accident - Apple Support

If your iPhone or Apple Watch detects a severe car crash, your device can help connect you to emergency services.
support.apple.com support.apple.com
 
chiefjason said:
Made more sense for me being ski patrol and outdoor medicine where a rough transport is the best you can do.

But front country ems, guess the juice isn’t worth the squeeze.

Wonder how much the GWOT played into that? Medical trauma dogma took some big hits once they cut drs loose to do what needed to be done.
Click to expand...

One of my good friends is Seth Hawkins, He's an emergency medicine doc in the western part of the state, but he's also really big in the wilderness medicine scene and has endorsed a lot of these standards. I bring him up because he has background with ski patrol.

The first real big change was Gothic Serpent/Blackhawk down, those events led to TCCC and were foundational for rewriting trauma care, including spinal mobilization and trauma.
 
noway2 said:
Sometimes the worst thing is a do gooder who wants to help. Had a coworker who was a surgical nurse in the army. He came upon a car crash in the early stages before the “officials” showed up. One victim was face down, but breathing and stable. This other last on the seen wanted to flip him over, but Cory told her to leave him be. A few minutes later after checking someone else out, he looked over and saw that she had flipped the guy into his back. She said she did it because he looked uncomfortable. Unfortunately, it killed him.
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Had a man have a stroke on the beach when I was a lifeguard. A lady came up and said she was a nurse. Of course she has more training than me so I let her take over. She puts a rolled up towel under his head cutting off his airway. I jerked the towel off and told her politely I'd take it from here.
 
Goofyfoot2001 said:
Had a man have a stroke on the beach when I was a lifeguard. A lady came up and said she was a nurse. Of course she has more training than me so I let her take over. She puts a rolled up towel under his head cutting off his airway. I jerked the towel off and told her politely I'd take it from here.
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🧐
 
Chuckman said:
The whole C-spine and back thing has largely gone away. Just no clinical data to support those, and a lot of clinical data to support harmful outcomes if a C-collar or backboard is on too long. Seeing a patient in a C-collar is becoming increasingly unusual, a spine board is very rare.

Unresponsive patient in a vehicle, he/she need to come out.
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Remember back in the day we use to put EVER fall, wreck or trauma in a collar on a board, strapped down with head blocks and ride them in. That crap sucked!!! We had some folks end up with bad back problems from that mess… both providers and patients
 
Me. said:
I was I a pretty bad car accident once.

I don’t think I was hurt at all. Got out, walked into a nearby business, called for police and waited (pre cell days).

Ambulance came, guys strapped me to the backboard and carted me off for tests. I had been walking and sitting for 45 minutes before they did this.



The main thing I remember about that accident was the pain on the back of my head from that board!
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Oh yeah back in the dinosaur age of EMS, of which I guess I am part of at this point, we did mess like that all the time. We didn’t realize it wasn’t really helpful until 2010 or so when solid hard Data started to really prove we were actually harming more than we were doing good. In the last 7 years or so I can’t remember putting a patient on a longboard unless it was to move them around or if they were in cardiac arrest we will slide one under them to help facilate movement and give us a solid surface for chest compressions.
 
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noway2 said:
Sometimes the worst thing is a do gooder who wants to help.
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When I worked commercial EMS, we responded to a crash on the interstate one night. Guy driving with the cruise control on fell asleep. Girlfriend sleeping in the reclined front passenger seat. He went off the road at ~70 mph and just missed the beginning of the guardrail. Went into a rock face and flipped landing back on his wheels. He got out and tried to get his girlfriend out. She outweighed him 3:1. He dropped her on the ground half out of the car. When we got there, the back of her head was touching her back. She was alive but had no feeling from mid-sternum down
 
chiefjason said:
Wonder how much the GWOT played into that?
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My oldest brother was a trauma/ICU nurse at BAMC. He took a year off to do a post trauma study at Landstuhl Hospital. They followed treatments and outcomes from battlefield treatment > field hospital > theatre hospital > stateside treatment > return-to-duty/discharge. They studied what did or didn't work and made a lot of changes to treatment protocols based on that study.
 
Button Pusher said:
All of them plus the bar keeps who served all of them should face the same charges.
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Some form of homicide charges. Negligent Homicide would be a good place to start. DWI is a choice. No different than the choice to pull a trigger on someone. Of course it has to be followed up with a long sentence behind bars. Maybe the expected lifetime of the victim.
 
This has happened before and will happen again.

In HS the star softball pitcher died in a SVA - she hit a tree after getting hammered at a party.
I was outta town, came back to school, there were grief counselors and all kinds of hoopla going on.

I didn't get it - she drove drunk and they just glorified her life vs using it as a teaching moment to point out that drinking/driving can kill you or someone else.
They should have put her smashed up car out front of school for everyone to see.


kcult said:
This has to be on purpose.
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Probly because of the 'serving minors at a bar' part.

The people that served them should be held responsible IF they didn't have fake ID's
But there are lots of ways to skirt the 'showing ID' thing - I used to have older friends who would buy pitchers for example + my college roommate had a fake ID that was actually made at the DMV by a friend of her's - even the Atlanta PD couldn't tell it was fake unless they ran the DL# but they never bothered.
 
1075tech said:
He went off the road at ~70 mph and just missed the beginning of the guardrail.
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I was on hwy 64 (westbound) going into Siler City and saw a car (east bound side) go head on into the end cap of a guardrail. There was a BIG cloud of black smoke, the car went airborne, nose down, and crashed and then fell back on the wheels. It was several minutes later and I had reached the WM parking lot when I heard the first sirens of the responders. Those would have been some long minutes.
 
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1075tech said:
My oldest brother was a trauma/ICU nurse at BAMC. He took a year off to do a post trauma study at Landstuhl Hospital. They followed treatments and outcomes from battlefield treatment > field hospital > theatre hospital > stateside treatment > return-to-duty/discharge. They studied what did or didn't work and made a lot of changes to treatment protocols based on that study.
Click to expand...

There is more data now on trauma outcomes than at any other time. @363medic may have some insight as well. A lot of trauma implementations pre-hospital (or in the field re: military) you really can't replicate in a double blind study, but that does not mean there is not meaningful data.

A lot of sacred cows are going to the slaughterhouse, thank God. @Radar @NCMedic @phideux @chiefjason

C-collars/LSBs
pre-hospital intubation
crystalloids for fluid resuscitation
bumping up the BP in trauma
TQ use

And in cardiac arrest, every drug that we give (none has shown any efficacy or benefit in outcomes).
 
Chuckman said:
There is more data now on trauma outcomes than at any other time. @363medic may have some insight as well. A lot of trauma implementations pre-hospital (or in the field re: military) you really can't replicate in a double blind study, but that does not mean there is not meaningful data.

A lot of sacred cows are going to the slaughterhouse, thank God. @Radar @NCMedic @phideux @chiefjason

C-collars/LSBs
pre-hospital intubation
crystalloids for fluid resuscitation
bumping up the BP in trauma
TQ use

And in cardiac arrest, every drug that we give (none has shown any efficacy or benefit in outcomes).
Click to expand...
We are moving away from the board and collar, still big on pre hospital intubation. Fluid in small boluses, in trauma we don’t jack the pressure up anymore, we try to keep it around 80-90. TQ, still carry one on my belt, I’ve used a lot of them, mostly gunshots to the thigh. In arrests we don’t throw the whole drug box at them anymore, mostly just Epi and Amio.
 
Chuckman said:
There is more data now on trauma outcomes than at any other time. @363medic may have some insight as well. A lot of trauma implementations pre-hospital (or in the field re: military) you really can't replicate in a double blind study, but that does not mean there is not meaningful data.

A lot of sacred cows are going to the slaughterhouse, thank God. @Radar @NCMedic @phideux @chiefjason

C-collars/LSBs
pre-hospital intubation
crystalloids for fluid resuscitation
bumping up the BP in trauma
TQ use

And in cardiac arrest, every drug that we give (none has shown any efficacy or benefit in outcomes).
Click to expand...

So wait... you mean all those patients that got intubated, 2L of "pasta water", "intubated, boarded, collared, and flown to a trauma center didn't have good outcomes?

I suppose that @Chuckman is going to tell me next that all of those codes who were worked for a hour with gallons of epi, atropine, bi carb and everything else didn't leave the hospital with any neuro status?🤣🤣

I feel like there was a huge jump in pre hospital care from the late 90s to mid 2010s... things kinda stalled out except for some early innovators and now we are going to see the next big jump... TXA, pre hospital blood, POC ultrasound, evidence based resuscitation, ECMO / REBOA...and focusing on time to intervention rather than time to hospital and a whole slew of stuff coming down the pike.
 
NCMedic said:
I feel like there was a huge jump in pre hospital care from the late 90s to mid 2010s... things kinda stalled out except for some early innovators and now we are going to see the next big jump... TXA, pre hospital blood, POC ultrasound, evidence based resuscitation, ECMO / REBOA...and focusing on time to intervention rather than time to hospital and a whole slew of stuff coming down the pike.
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Before I got out of it in the 20 teens, there was a lot of ongoing research for pre-hospital blood. I know some air medical services were using it. Most of the attempted resuscitations were done to try to convince the family that we were doing everything we could. It usually stopped in the ambulance on the way to the hospital.
 
I feel like there was a huge jump in pre hospital care from the late 90s to mid 2010s... things kinda stalled out except for some early innovators and now we are going to see the next big jump... TXA, pre hospital blood, POC ultrasound, evidence based resuscitation, ECMO / REBOA...and focusing on time to intervention rather than time to hospital and a whole slew of stuff coming down the pike.

You can then guess how much it changed from in the 70s and 80s. ;)
 
P01135809 said:
I don’t understand the article title. What does the bystanders pulling her from the car have to do with anything? How does the medical examiner report know this?

Cervical fracture that was destabilized?

Help me understand
Click to expand...

OK.

The whole article, from the title to the closing paragraph, reeks of journalistic ineptitude on par with beginning freshman level high school writing skills.

That's really all you need to know about the writing skills of "WRAL Investigates" journalists.


THAT SAID (going back to @Stogies OP):

1. "they drank underage, not a wise move but hey" Yep. Definitely against the law, but the REAL issue is that this country's response to irresponsible drinking was to raise the minimum drinking age to 21 instead of promoting responsible adult drinking in the first place. My opinion here, but that's the nuts and bolts of it. Alcohol should NOT be a taboo subject to the point where it becomes the defacto avenue of social defiance. It should literally be something that's "no big deal" as just another aspect of adult responsiblity growing up.

2. "they drove drunk, very stupid" Absolutely. One thing I put otu to every Sailor under me, and even on the same level as myself, when I was in the Navy: If you're drinking, don't drive. Make arrangements for someone else to do so. And if they were ever in need...call me any time and I'd personally come out to pick them up and take them home, no questions asked. Apparently my own kids took that to heart, because they're all past legal drinking age and haven't done anything stupid (that I know of, anyway).

3. "they drove drunk and raced, incredibly stupid" No words for how stupid this is, but a bit of personal experience that, fortunately, didn't work out badly for me when I was younger. A friend had too much to drink and I couldn't get his keys away from him. (I hadn't been drinking.) So I tried what I thought was a "smart" thing to do: follow him to be sure he made it home OK. Well, it turned out his drunk *ss decided it was race time to see if he could ditch me and I was stupid enough to try to keep up. Fortunately it didn't end in tragedy and when it was over, I told him he could f*** off, he was on his own and I'd never try looking after his sorry *ss again.


Legal drinking age is a big deal for a lot of people...and so is circumventing it. Making it an age where young people will more likely be away from home (college age) as they approach it instead of an age where they're going to be more closely monitored/supervised is insane.

My opinion, of course.

Now the survivors have to live the rest of their lives with the very tragic consequences of their actions. And so will this young lady's family.
 
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