Emergency responders and accident victims - share knowledge from your experience

April 15, 2009 12:20 PM

What happens after a serious, possibly fatal, accident or crash? NOT an insurance question.

Some time ago, Mr. TXVT wrote an "Emergency Information" letter and put a copy in our cars. It contains information on how to contact each of us, and how to contact our next of kin in case we're both in the same accident.

This got me thinking about how little I know about what occurs following an accident. So, I have a series of accident-related questions. I am in Texas, but could get into a car accident anywhere in the continental US, or fall off a ladder in my own front yard:

1. How is the responder determined? (Austin area Me-Fiers: I've seen the Hudson Bend Fire Dept responding to calls way out on Hamilton Pool Road a couple of times, and am confused because the Dripping Springs FD is a lot closer than Hudson Bend).

2. How do they decide what hospital to take you to? If we listed a preferred hospital in our "Emergency Info" document would that carry any weight? Does carrying an insurance card factor into the decision at all or is it usually just the nearest hospital?

3. Who tracks down next of kin and how do they find them? Do they even look in the glove compartment? What if, say, you are a single person living in a different state from the rest of your family? It seems like it would be nearly impossible to figure out who to call.

4. What other things should we do to prepare for the possibility of a serious accident, either an auto accident or one in your house or wherever? Other than trying to avoid them, of course.

Thanks!

posted by txvtchick to grab bag (29 comments total)

3. They definitely check your wallet if they can find it, so you could put a card in there with next-of-kin info. I guess someone might check the glove box eventually, but your wallet is more likely to make it to the hospital with you as it'd be in your purse or pocket.

4. You could leave your online passwords somewhere that your executor could eventually access them. After a friend's sudden death, many of his friends put money into his PayPal account to help his partner cover funeral expenses, but unfortunately she didn't know the password. I'm sure she sorted it out eventually, but it was stressful for her at the time.
posted by twistofrhyme at 12:28 PM on April 15 [1 favorite]

ICE your cell phones, also (in case of emergency). Responders are trained to look for wallets and phones during rescues/recoveries.
posted by peanut_mcgillicuty at 12:37 PM on April 15 [3 favorites]

They not only have to base it on which hospital is closest, but also which one isn't full, or which one can handle what's wrong with you. Example: in the Austin area, if you had serious trauma, they would get you to Brackenridge. If you were far from that hospital, you would be taken by helicopter.
posted by fructose at 12:37 PM on April 15

ICE is only a secondary means of listing contacts, see Snopes.
posted by fructose at 12:38 PM on April 15

Put your ICE (In Case of Emergency) contact info in your phone; I list mine as "ICE [Name] - Phone number." You can have several, in case one isn't answering.
posted by rtha at 12:38 PM on April 15

2. It depends on whether you need to be medivac-ed or not. After my accident, the driver was medivac-ed to the nearest trauma center and I was given a choice of local, non-trauma hospitals. The accident took place in a state that is not my own -- so I said "Whatever's closest."
posted by melodykramer at 12:39 PM on April 15

doh. Shoulda previewed.
posted by rtha at 12:39 PM on April 15

Re: ICE, I just wanted to point out that newer cell phones (my newish Motorola at least) has a spot in the Contacts menu where you can list a few emergency numbers. In my case, the numbers are listed under In Case of Emergency at the very top of the Contacts list, and the entries themselves show up bright red.

That was a long way of suggesting you (all) check your cell phones for good ways to list your ICE contact info.
posted by juliplease at 12:48 PM on April 15

4. Have you thought about organ/tissue donation? If you've decided one way or another, you must let your family know so they can carry out your wishes after you are gone. Some (most?) states make it legal to proceed without NOK consent, but it makes the process much more difficult for all involved.
posted by rhapsodie at 1:05 PM on April 15 [1 favorite]

I did admissions in an emergency room hospital. We always contacted next of kin via any information we could find in their wallet or purse. If that failed, and we couldn't identify the person, we would then have someone check the glove compartment for car insurance information hoping that would lead to a name.
posted by Ugh at 1:10 PM on April 15 [1 favorite]

1. varies widely - could just be who's closest or most available.
2. This also varies - if its a minor injury, we ask if the closest hospital (Hackensack Med Center) is ok. Usually it is. Sometimes they prefer to go elsewhere. Big trauma doesn't really get a say. Mental health issues as well.
3. Here, its the PD. As an EMT, I've never searched a car,phone, wallet, purse etc for ID info. Medical Alert necklaces and bracelets, yes.
4. Have a seatbelt cutter handy for everyone. Avoid travelling with things (particularly concealed) that could make a rescue more complicated or risky (no propane tanks in your trunk, please...)
posted by blaneyphoto at 1:10 PM on April 15

"Who tracks down next of kin and how do they find them? Do they even look in the glove compartment? What if, say, you are a single person living in a different state from the rest of your family? It seems like it would be nearly impossible to figure out who to call. "

I worked tow truck for a bit. No one checks the glove compartment if only because in the majority of accidents resulting in serious injury or death you can't get to the glove compartment and/or can't open it. Besides often the driver of a car isn't the owner. The police or EMTs will check you for identification and for donor information. Police will also run the plates or VIN in order to contact the owner.

Once you have a driver's license you can find an astounding amount of information on a person with government databases. With nothing else to go on they'll try contacting your parents and they'll send someone to your home to try to contact room-mates or SOs.

The best place to put ICE is on a post it stuck to the back of your D/L or on a laminated card carried next to your D/L. If you don't have State issued photo ID then you should have a picture of yourself with your name and ICE information on the back. Victims routinely get separated from their wallets and the picture allows authorities to match people with ID.

"What other things should we do to prepare for the possibility of a serious accident, either an auto accident or one in your house or wherever?"

I've got two first kits. A smallish one in the bathroom and a Level II kit in my shop. I've also got cordless base units on each floor and in my shop so that I can call 911 without having to go very far. EG: I'd hate to have to climb a set of stairs with a broken leg to call 911.
posted by Mitheral at 1:12 PM on April 15 [1 favorite]

Years ago I heard a story about a man who had a heart attack while jogging. No wallet with him and they had to wait until he was recovered enough to give his name and ICE information. After that, I bought a small, thin men's wallet where I carried DL, a credit card and some bills. I used to have a very small address book too but now I use my phone instead. So, whenever I leave the house, I take the wallet and phone - either in a pocket or in my purse.

However, as i write this, I am thinking about the fact that my phone is password protected. I plan to write out basic emergency information on a small card and put in my wallet.
posted by metahawk at 1:27 PM on April 15

Not actually answering your question, but this is what happens to your body after a serious or fatal accident.
posted by Midnight Skulker at 1:57 PM on April 15 [2 favorites]

1) Depends on who has the highest level of training on hand. Out where I am, the fire department shows up when it looks serious instead of EMS, since firefighter medics have paramedic training and not just EMT training.
posted by availablelight at 2:07 PM on April 15

1) The Hudson Bend FD is now actually the Travis County Emergency Services District 6. (or the Lake Travis FD). In Texas who responds to your emergency is determined not by how close you are to the fire department but by which Emergency Services District you happen to be in when the accident occurs. These ESDs are political subdivision.

If you are in a serious accident you will be taken to Brackenridge Hospital since I believe it is the only Level II Trauma Center in central Texas.
posted by neojoyo at 2:21 PM on April 15

Put a "vial of life" in your fridge, next to the mustard.
posted by The corpse in the library at 3:05 PM on April 15

Another issue that might affect which jurisdiction responds to your accident is what other emergency situations might be occurring in the area at the time. For example, if there is a big fire in my town, other towns' FDs will either help with that fire, or cover my town's stations while the local squads are at the fire. So even though it may look like the fire truck has come from three towns over, they may actually have been dispatched out of a closer location.

And per my ER nurse sister-in-law, and the Easter dinner discussion we had about this very topic, you are brought to the nearest ER in an emergency. Your insurance has nothing to do with it. If you are physically and mentally able to make decisions, you may decide to leave that ER to go to your preferred hospital, but you would be doing this "AMA" (Against Medical Advice).
posted by SuperSquirrel at 3:05 PM on April 15 [1 favorite]

1. This is going to vary widely based on where you are, how busy your area is, whether your system dispatches medics to every call, mutual aid agreements.
2. As people have mentioned, if you're alive and have serious trauma, you're going to the nearest trauma center. However, in NY state, cardiac arrests (even as a result of trauma) go to the closest hospital. Same is true for active seizures. It is not necessarily true, as SuperSquirrel states, that you are automatically brought the the nearest hospital in an emergency. Unless protocol dictates otherwise (as with a cardiac arrest, or active seizure), the patient or patient's family has final say, but if they are making a bad choice the EMS personel will strongly suggest a different hospital.
posted by brevator at 3:35 PM on April 15

In some states (including Texas) you can have both a driver's license and an ID. This can be useful if you want to have an easy way to prove your identity if your driver's license gets lost or stolen - you won't have to go digging for your birth certificate and stuff like that. It's also handy if you want to go out walking and have ID (and no wallet) on you, while not having to remove your license from your wallet (and thus prevent stupidity like I am prone to of forgetting to put it back in my wallet when I get back home).
posted by marble at 3:57 PM on April 15

Great answers, everyone, thank you. I will keep this unresolved for a bit longer in case anyone else wants to chime in. Will definitely put together a wallet card of some sort for me and the Mister. I had no idea about ICE, either.

Blaneyphoto said:
Avoid traveling with things (particularly concealed) that could make a rescue more complicated or risky (no propane tanks in your trunk, please...)

Sure, I can see how that would make your job a bit stressful...

Metahawk said:
Years ago I heard a story about a man who had a heart attack while jogging. No wallet with him and they had to wait until he was recovered enough to give his name and ICE information.

This askme prompted me to get an amphipod which is small but holds my phone okay - (soon it'll hold an ID and ICE card too). Highly recommended.
posted by txvtchick at 6:18 PM on April 15

I am not an EMS expert, but I am an EMT:

1. Dispatch is a complicated algorithm of who's closest, who's not busy, and who's best equipped to deal with the particular emergency. For example, in the situation you mention, Hudson Bend might have a better vehicle extrication setup than Dripping Springs. Dispatcher's are awesome and sorely under-appreciated!

2. The hospital is almost always what's most appropriate (i.e. trauma center, burn center, peds) and what's closest / open to receive patients. In one place I've worked, there are two hospitals and non-trauma patients are usually allowed to state a preference if they're both clear. In Baltimore, it's totally at the medic's discretion.

3. EMTs are not likely to be the ones poking around looking for ID, etc; usually it's PD. For everyone who thinks that EMTs go into people's pockets and wallets and cell phones and stuff, we are trained not to do that, due to the risk of a needle stick or similar (in pockets) and also the potential for accusations of theft. Also, we're usually pretty busy saving your life and stuff. We do look for medic-alert bracelets and necklaces. Hospital staff will do a more thorough examination of your belongings if you're still unconscious at that point.

4. Nthing figuring out organ donation / living will directives. And wear your seatbelt!
posted by charmcityblues at 6:41 PM on April 15 [2 favorites]

> neojoyo, this isn't always the case and, actually, is only true for rural/exurb areas that have voted an Emergency Services District into existence. If you are in a city, the fire department responding to you will either be that city's department or a neighboring department with which that city has a mutual aid agreement. For example, you might be in Sunnyvale proper, but Mesquite (who borders Sunnyvale) will likely respond to a major accident if you are on the far west end of town.

If you're not in a city and there is no ESD, the regional 911 district (most likely the county emergency dispatch office, but sometimes another city or a multi-entity agency) that answers your emergency call will determine which volunteer or other fire department is nearest to your accident and dispatch them. Counties themselves don't maintain fire departments in Texas, but there's lots of VFDs and private ambulance services around that respond to calls.
posted by fireoyster at 7:48 PM on April 15

It is not necessarily true, as SuperSquirrel states, that you are automatically brought the the nearest hospital in an emergency.

As SuperSquirrel's sister-in-law, the ER nurse states, not me personally. Sorry for not being clear, brevator.
posted by SuperSquirrel at 8:04 PM on April 15

SuperSquirrel- I didn't intend for that to come off personally. Sorry.
As a medic in nursing school who also works in an ER I can tell you that nurses (even ER nurses) often have no idea what EMS does.
posted by brevator at 3:16 AM on April 16

As to the running issue, I had a metal tag tied into my shoelaces with ICE info.
posted by Pax at 6:28 AM on April 16

Where did you get that, Pax? Is it just a dog tag, or something spiffier?
posted by The corpse in the library at 7:35 AM on April 16

I don't remember the company, it was years ago, but they're common.
posted by Pax at 8:16 AM on April 16

Midnight Skulker, that is a fascinating blog. Thanks for posting.
posted by txvtchick at 2:52 PM on April 16