Administration and Leadership, Ambulances & Vehicle Ops, Rescue & Vehicle Extrication, Trauma

Spurs and Backboards: Working the NASCAR of the West

Issue 7 and Volume 34.

It was clear from the moment I saw the bucking bronc_s rear hoof come down on the rider_s chest that we had a patient. A quick assessment confirmed at least two fractured ribs, but was this cowboy going to let us carry him off this freshly fertilized field of glory? Stupid question. Like a true gladiator he waved us off. While self-splinting his right chest with one hand, he turned his wave to the applauding grandstands.

Rodeo is the NASCAR of the west, and what better way to celebrate Fourth of July weekend (if you have to work) than to “yippee kai yay” your way through your shift? It_s a no-brainer that in a sport with a probability of injury 10 times greater than hockey, you_ll treat and care for up to 3,000 rodeo participants. (Cowboy clowns, aka, rodeo lifeguards, are at greater risk for being injured because, well, let_s face itƒyou don_t have to be human to hate clowns.)

I was hoping the majority of our standby care for rodeo athletes this day would involve only splinting and RICE (rest, ice, compression and elevation) therapy for extremities that were injured by a species specifically bred to prance, buck, kick and breathe fire.

Our rib-injured cowboy was only 33, but an overall epidermal survey revealed a history that would impress even a professional boxer. It_s understood rodeo culture expects its wounded warriors to tough it out until the rodeo_s conclusion, or at least until they_ve finished their deep-fried Twinkie. But this cowboy needed to be transported to the hospital immediately. Once we separated our patient from his peers, he was more willing to be treated. He still, however, wouldn_t let us cut off his designer plaid shirtƒa similar trait found in bikers refusing to let you cut their leathers with trauma shears.

I was amazed at his ability to tolerate the pain as he removed his arms from their sleeves. I looked at him empathetically as I palpated his contused chest, saying, “That_s gotta hurt.”

He smiled and said, “It_s not a question of if you_ll get hurt, but rather a question of when and how badly. You can_t be afraid of pain.”

“Yeah,” I said as I prepared the fentanyl. “But you should be afraid of not breathing.” Even as the ambulance backed up to the first aid station, our cowboy refused to be put on the cot. Placing his cowboy hat on his head, he shuffled himself and his wrapped ribs to the back doors. He waved us off as he pulled himself up and in. I could hear him ask for a light (denied) as I was transferring his O tank and IV to the transporting crew. Incredible.

It was then time for the bull riding event, and my partner and I were granted permission to hang out near the chutes. You could almost taste the tension as they began preparing for the one of the most dangerous and exciting competitions ever to be had between man and beast. And if you couldn_t taste it, you could certainly smell it.

Whatever you think about America_s original extreme sport, until you_ve witnessed rodeo live and up close, you can never truly grasp the violence the human body endures. I get neck and back pain just thinking about the whipping and snapping, and the torque placed on the human spine. Not to mention the sensation of both kidneys being driven into the thyroid gland, or of joints being twisted into positions only Gumby could appreciate. It_s bad enough being tossed like a Caesar salad, but to then be thrown downƒor worse, stay attached to a one-ton thrashing, flailing hamburgerƒjust adds to the anxiety of bearing witness to the potential for catastrophic trauma.

Sometimes you want to turn away and not look, but of course you can_t. Jim Shoulders, a 16-time world rodeo champion, once said, “The American people don_t want to see anybody get killed, but if somebody gets killed, we don_t want to miss it.”

Back at the rodeo, a voice from behind asked me, “So, what do you think about all this?” I recognized the plaid shirt immediately. It was our broken-rib cowboy, already back from the hospital. I looked at my watch, but before I could say a word, he said, “DocsƒI ain_t got no time for _em. Besides, I had worse.”

“Well, cowboy, we have a lot more in common than you may think,” I said as I scraped a mixture of sand, mud, manureƒand maybe even bloodƒoff the bottom of my shoe. “We both thrive on brief runs of adrenalin. We abuse our bodies. We make squat for money. We deal with a lot of bull. We_re pros at restraint application. Our olfactory systems are way over stimulated. People tell us they could never do what we do. We trust few outside our circle. We live out of a truck. We don_t trust doctors. And we_re not smart enough to know when we_ve had enough.”

With a tip of his hat he said to me, “See ya tomorrow.”

Until then, cowboy up!JEMS

Steve Berryhas been a paramedic for the past 25 years in the southern Colorado region. He_s the author of the cartoon book series I_m Not An Ambulance Driver and invites you to join him and others of the EMS community to ride in the 2009 National EMS Memorial Bike Ride ( Visit his Web site to purchase his books or CDs.