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Technology, training kept pileup from being worse

Apr 14, 2014 - By Eric Blom, Staff Writer

Two killed, eight hurt March 6

Officials say advancements in equipment and training prevented further deaths after a two-vehicle wreck March 6 on Togwotee Pass.

The crash claimed two lives at the scene, and eight other people were sent to area hospitals for treatment.

Officials had indicated that another fatality was possible immediately after the crash, but several weeks later they said no one else had died.

In the crash, an eastbound 2006 GMC Yukon carrying 10 people lost control at about 12:50 p.m. March 6 on the snow-packed, icy highway and collided with a westbound tractor-trailer combination

The semi truck's driver and one passenger were uninjured.

Eight of the SUV's passengers were transported to local and regional hospitals. Two others, including a 4-year-old and her grandmother, were ejected from the vehicle and pronounced dead at the scene.

Injuries included fractured bones, ruptured organs and closed-head injuries.

Six victims were treated and released, but two others were in the hospital for long-term rehabilitation, according to Valerie Whisler, clinical nursing director for Riverton Memorial Hospital.

Response

Two ambulance crews from Riverton, two from Lander, one from Dubois and two from Teton County responded to the accident. A second Dubois ambulance was driven to the scene to provide extra transportation for victims, and crews were split to staff the extra vehicle, Fremont County Ambulance division supervisor Todd Smith said during a public meeting April 10.

Local fixed-wing and helicopter ambulances flew victims from the Dubois airport to regional hospitals, and emergency medical responders rendered aid to crash victims before the transport was available, Smith said.

He said his crews received training in recent years to enable them to perform more advanced procedures confidently in the field.

"Two or three years ago, same injuries, same location, there would have been many more people expired," Smith said.

Riverton ambulance captain Patrick Kappus agreed.

"When the time comes, they're not afraid of pulling the trigger and doing what they need to do," he said of his crews. "They don't hesitate anymore."

Trauma treatment

During the Togwotee response, Smith said, one technician was required to perform a needle decompression to help save a victim who had suffered a lung puncture. Each time the victim took a breath, Smith said, air was entering the space surrounding the person's lungs. The situation causes pressure to build up, eventually leading to lung collapse or death.

To save the victim, the EMT on Togwotee inserted a needle with a one-way valve into the space surrounding the lungs, allowing the air to escape and thereby giving the lungs more room to inflate.

While all of the on-duty crews were committed to the crash, Smith said, emergency medical service personnel maintained 911 coverage for the rest of county, calling up a crew to staff another ambulance in Riverton and one in Lander.

Equipment

The recently installed Wyolink radio system brought radio communication to the remote location 25 miles west of Dubois where the collision occurred, Fremont County Dispatch Center supervisor Carl Freeman said.

After several years of expansion, the radio system now covers nearly all of the state.

In the past, the loss of radio communications in the Togwotee area would have meant some victims could have experienced hours of delay in receiving services, Freeman said.

If an ambulance had responded to a crash there a decade ago, emergency medical technicians on the scene would not have been able to call for more help.

Instead, the EMTs would have had to stay with their patients, only sending for assistance after leaving the scene and reaching a radio signal again, Freeman said.

Personnel

The Fremont County Ambulance department also had more personnel based closer to the March crash than it would have had in the past.

Four personnel were on duty at the Dubois ambulance station and responded to the Togwotee collision within a minute of the initial call, Smith said in an interview.

Before budget and staff changes were implemented last fall and summer, only one EMT was stationed in Dubois. I

f that had been the case in March, the ambulance department would have had to page on-call personnel to respond, or draw on more resources from Riverton and Lander.

Both alternatives would have resulted in increased response times.

"It would have taken 15 to 20 minutes to get an ambulance to respond," Smith said. "These people would have been called from their jobs, their homes, their days off."

Deficiencies

An analysis of the incident also found communication deficiencies that local agencies plan to address through education and new policies.

The gaps that arose during the event did not impact the outcomes for victims involved in the crash, Fremont County Ambu-lance director Joseph Zillmer said.

The main deficiencies identified were gaps in communication, mostly with agencies in Teton County and Idaho.

In one instance, an air ambulance was called in from Idaho but was sent back mid-flight when local officials realized it would not be needed, Smith said.

Zillmer plans to work with Teton County emergency medical services to familiarize personnel with operations in both jurisdictions.

"We're going to do cross training every 60 to 70 days," he said. "There will be a lot more communication and teamwork."

He also plans to have an ambulance department staffer in the dispatch center to help coordinate communications and calls for more resources.

"We will keep a status board...so as the situation changes we are continually matching the best level of care to the patients in need," Zillmer said.

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