Decline in Road Deaths Is No Accident

Two years later, Mike McCoy can still remember the head-on crash on the San Diego Freeway in vivid detail. McCoy, a battalion chief for the Orange County Fire Authority in charge of emergency medical services, has seen a lot in nearly 30 years as a paramedic. But the scene in front of him was chilling.

“The car was almost unrecognizable,” he said.

Paramedics ran up to the car, fearing the worst. Instead, McCoy said, he found an indication of how much has changed in his three decades on the job: a passenger compartment that was “virtually untouched.”

A mother and her two young children were alive.

“We were able to get them out and treat what turned out to be relatively minor injuries,” said McCoy. When it comes to saving lives on the road, paramedics play a critical but far from solitary role. Aided by safer cars, better road design, fewer drunk drivers and a higher rate of people using seat belts, paramedics have been able to save more lives than ever before.

Last year, California Highway Patrol statistics show, slightly more than 23,000 people were injured in traffic collisions in Orange County and 157 died. While injuries were up slightly over the previous year, the fatalities declined, part of a downward trend dating to the mid-1980s.

In Orange County, deaths in traffic accidents have declined by 40% in the last 10 years. Nationwide, traffic fatalities have dipped by nearly 12%.

While it is difficult to tell if any one factor has affected the fatality rate more than another, safety experts say better medical response has clearly played a large role. In Orange County, as well as elsewhere in the country, paramedic units have been restructured, equipment updated and philosophies changed.

In the last five years, at least 75 paramedics have been added to the ranks of the Orange County Fire Authority, McCoy said.

While all firefighters are trained in emergency treatment, paramedics have advanced lifesaving skills that allow them to provide more serious medical intervention.

The staff additions have made it possible to put paramedics on 29 fire engines in station houses countywide that do not have full-time ambulance units. By the end of the year, 30 paramedics will be riding on engines. The added personnel can put staff with advanced lifesaving skills on the scene of major accidents as much as three to five minutes sooner than ambulance units can arrive, McCoy said. The goal, officials say, is to have a paramedic within five minutes of responding to 80% of the county’s population.

The arrangement also has allowed the paramedic on the scene to wave off ambulances in cases of minor injuries, freeing those units to respond to more serious calls.

Sensitive to what medical professionals call the “golden hour,” the critical first 60 minutes after a traumatic injury, emergency personnel also have rethought how patients are treated at the scene and where they are taken for further care.

“In the old days they were taken to the closest hospital,” said Battalion Chief Scott Brown, a spokesman for the Orange County Fire Authority. “Now we know when it comes to major trauma, the best chance is surgical intervention, so we may go a little farther in an ambulance to get a patient to a facility with a surgeon standing by to help.”

Another significant change has been in the time spent at an accident scene. In the past, medical experts thought it was best to stabilize trauma patients before moving them, but the goal now is to get the patient on an operating table as quickly as possible.

“The guide we try to follow now is no more than five to 10 minutes at the scene with a critical patient,” said Rich Khoshaba, a paramedic on an Irvine-based fire engine. “We get their neck and head immobilized and we move them.”

Those who have been in the field for years know seat belts and car safety features help them save more lives.

A car that overturned on the San Diego Freeway on Friday morning looked bad to the emergency workers pulling up. This was one of the calls that could include major trauma, even death.

But when rescue personnel ran up to the vehicle, the driver was safe, strapped in by her seat belt.

“She would have gotten out and walked away if the paramedics had let her,” Khoshaba said. “All she had was a little bit of muscle pain in her legs.”

Even with safer cars making major accidents more survivable, officials say paramedics still have their work cut out for them.

“We still see accidents that 20 years ago those patients would have been a fatality,” Brown said. “I think our medical response absolutely makes a difference.”