Beautiful, windy day. On the radio, the landing zone is described to us as a “landfill”. Nothing in the way of landing. No trees, no high wires, no towers, nothing to get in the way. I couldn’t imagine where this landing site was, we’d never used it before despite numerous calls to this area.

As we circled over the landing zone, we could see a dumptruck that had rolled off the top of a slag pile. SUddenly I realized why we’d never used this landing zone before…because we were landing right at the scene!

We got out of the chopper and walked over to the ambulance where the patient was laying in the back. He had been the driver of a massive dump truck that slipped off the edge of a gravel pile about 30 feet high and rolled over and over, landing on it’s top. The driver was part in and part out of the cab, no safety belt on, and gasoline was pouring out of the engine on top of him. He was pulled out rapidly and then secured to long board. (Normally patients are secured first and then extricated, but with the gasoline pouring out, they wanted him out as fast as possible!)

His right leg had been bent at a right angle, but they said it straightened out when the pulled him out of the cab. He was awake, but pretty out of it. Never said he had trouble breathing, but something about him was very impressive to me and I couldn’t quite put my finger on it. I alerted the trauma team, (interupting the wednesday morning conference) and met them in the ED.

He ended up with a massive left hemothorax (blood in his chest cavity) requiring a chest tube, two broken scapulas, a broken right femur, two broken acetabulums (the hip socket), a crushed vertebrae and a handful of more minor scrapes.