“Medic 9, respond in the cemetery for a motor vehicle crash with injuries.”

Size-up begins the moment we get the call and continues throughout the incident. Even if we aren’t conscious of the process, we use whatever information we have to formulate our plans. These change as the information becomes clearer.

Once we make patient contact, size-up will be replaced by patient assessment, but the process is the same. We take in information, evaluate it, filter it through our training and experience, and act upon it.

So, a motor vehicle crash in a cemetery. This one has our mental wheels turning, and most of the possibilities are entertaining. A fender-bender in a funeral procession? Quite likely, but the speeds should be low and injuries slight. A pedestrian struck? Possible, lots of people walk in cemeteries. Even with slow speeds, it could be a major trauma. Could be a bicyclist, too. Similar circumstances.

Then again, dispatch information tends to get distorted. It could be a simple sprained ankle or a fainting episode as well. People do get emotionally distraught in cemeteries.

“Medic 9 on an update: your incident is reported to be behind the maintenance building.”

Well that opens up a whole new host of possibilities! This could be some sort of industrial accident instead of a car crash. Visions of industrial lawnmowers, dump trucks, and backhoes dance in our heads.

We enter the cemetery in search of the maintenance garage. Over the first hill, there it is; and sitting next to it is our incident.

As advertised.

Two SUVs sit crunched together at an intersection. Two small roads intersect at a 90 degree angle; there are no trees or monuments in the area. Nothing taller than a headstone to block the view across the rolling green hills.

As we step out of the ambulance, a police officer is speaking to one of our future patients. “Well, there aren’t any stop signs. I’m not sure who’s at fault.”

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