At mass-casualty incident, first responders delivered care when it mattered most
Rachel McDonald was just driving home when it happened just minutes in front of her.
Justin Doubrava was eating dinner.
Sara Kurz was getting off shift.
All three, and many, many more, there when the moment called for them — responding with others of their first-responder ilk to the bus crash last month that killed a non-passenger and injured several who were riding the transit bus.
Nov. 17, McDonald was returning to Craig from a doctor’s appointment in Steamboat Springs that actually had just released her from a period of light duty following a surgery. She was moments behind the wreck.
“I see these flashing lights and start running over parts in the road,” McDonald said. “I just think, ‘You’ve gotta be kidding me. I’m cleared and this is what I get? Oh my.’ The page hadn’t yet gone out, and I just realized, this is going to be a mess.”
McDonald parked and ran to the scene to discover the jeep driven by the Craig man who died on the scene on the road. It was dark, she was focused on what she was observing, and it took a moment until she even noticed the bus that was down a small drop off the side of Highway 40.
“I told someone to call 911,” she said.
McDonald set to work. First was triage and organizing the wounded. Her quick work, say those who came later, is a big reason the on-duty paramedics and others were able to do such a good job when they arrived on scene.
“She had done an amazing job,” Kurz said. “Separating everybody, thinking how do we triage everybody and she had already done it before we got there. It was just organizing the chaos a little more. MCIs (mass casualty incidents), no matter how much you practice, they’re chaotic, and they never go exactly according to plan.”
Kurz, who was weeks away from giving birth at the time — she had the baby last week — heard the page as she was getting off her shift and heading home. She met her colleagues at the gas station in town, got picked up in the ambulance and headed east to meet the scene. Kurz was the first on-duty paramedic to arrive.
The relatively newly minted paramedic had never been to an MCI before. She was trained, but she didn’t know what to expect, exactly.
“We’re thinking hopefully everybody’s OK and it’s just a slide off, but I didn’t think it was going to be,” Kurz said. “I’m really thinking, worst-case scenario, what do we have to do when we get there?”
Kurz admitted to some nerves, but said her training took over once she got on scene.
“Luckily we had so many extra hands,” Kurz said. “We were able to really focus.”
The size of the response — responders included Moffat County Sheriff KC Hume and his team, Craig Fire/Rescue, Craig Police, West Routt Fire, Colorado State Patrol and others — was not lost on Doubrava, either.
“What sticks out the most to me was how many people in a blink of an eye came together as a community for this,” Doubrava, who is the EMS manager for Memorial Regional Health’s ambulance service. “All the responders are there. Firefighters left dinner and family to respond, to be there in someone’s time of need. That helps. That’s the coolest thing.”
In the moment, though, Doubrava, who was off duty and eating dinner with his wife when the page came in, said there was plenty of concern on his part as he rushed to the scene about 20 minutes behind the first ambulance.
“You have no idea what you’re going into,” he said. “The way things get initially paged out, you get paged to something that sounds small and it’s big and vice versa. Paged that it’s big and it’s manageable. I think it shows how important training is. You have to stay on top of it and be refreshed”
Doubrava said leaning on training in that moment was critical.
“You can never train in a totally real scenario, but it does have a huge impact on you,” he said. “However, that doesn’t make decisions on scene any easier — having to triage people, deciding who needs to go first, and who you can’t save.”
Tragically, one man was dead on the scene, but fortunately, the bus passengers were all mostly OK, with only a few critically injured. Two ambulance loads of wounded were transported back to Memorial Regional Health, and the rest were taken home in a bus called to the scene.
Afterward, there were debriefs, discussions of what went well and what could be improved for the future, and a lot of emotions.
“It was kind of an adrenaline dump,” Kurz said. “You had this big rush and then you try to sleep and you can’t. ‘Oh my gosh that just happened.’ The next few days it’s about experience and going over how we can do better if and when something like this happens again.”
For McDonald, the incident became a bit personal as well.
“You start thinking about what could’ve changed and how close it was that it could’ve been me,” she said. “Had I left a minute or two earlier from Steamboat, I could’ve been involved in the accident, but then, if someone had not been there, how much more chaos would it have been for the crew that arrived?”
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