Columns, Rescue & Vehicle Extrication

The Food & Ketchup Conundrum for EMS Responders

I had a strange thought today as I was put together a lecture for an upcoming conference on situational awareness and patient assessment.

I was wondering how many of you have responded to a serious motor vehicle collision involving a driver with serious injuries or, worse yet, fatal injuries, and during your scene assessment found a sandwich on the floor or remnants of a sandwich such as ketchup, lettuce, onions, pickles, etc. (you get my point) splattered on the dashboard or steering wheel which could possibly indicate that your victim had been eating while driving and then crashed.

We hear a lot about distracted drivers as a result of cellphone use, but I’ve personally seen evidence of distracted drivers from eating and driving at the same time, particularly eating a messy sandwich or other food that can fall apart and distract them.

EMS finds signs of distracted driving in fast food wrapper inside wrecked car.

The photo here was from a call I responded to and found a patient in traumatic cardiac arrest. As we worked this patient, bystanders reported that he had crashed, exited the vehicle, took a few steps and them collapsed to the ground. He had a crushed chest and ultimately succumbed to a flail chest and hemopneumothorax. We were aware that the driver probably was not buckled into his seat because the steering wheel was bent significantly from his body impact.

The police officer investigating the incident radioed me when I cleared the hospital and asked me to return to the scene. They then pointed out a “spray” of lettuce, meat, bun and onion on the steering wheel and dashboards, as well as an open Big Mac container on the floor (see photo).

Their theory (and mine) was that he was eating a messy Big Mac when the crash occurred. We have no way of knowing if he was truly distracted, but it was an interesting observation and possible cause. By the way, he was not wearing his seatbelt and his daughter—who was buckled into her car seat in the back of the vehicle—did survive. A second, more profound, teaching moment.