What is the Total Cost?

By Scott Abker

I would guess that very few people understand that an accident, especially one in which the vehicle occupants are ejected because they failed to wear their seat belt, has secondary costs associated with the resulting injuries. Oh sure, we can all think about the cost for medical treatment and transport, helicopter transport, emergency room treatment, hospitalization costs, and rehabilitation costs. The additional cost of vehicle repair or replacement and/or the cost of any legal actions resulting from the accident are easy to identify too.  We can even think of the cost for final expenses if the occupant does not survive.  But, the secondary costs that I think about have very little to do with the injured party or the damaged vehicle, yet there is a very real cost that I’d like you to consider. 
Have you ever thought about what happens to the body when it’s ejected from a moving vehicle? It is oftentimes crushed by the vehicle as the ejection occurs or trapped under the vehicle. Ejected occupants are four times more likely to suffer fatal injuries than occupants who remain in the vehicle. The injuries are much more severe for occupants who remain in the vehicle but are unbelted compared to those are belted. The body bounces around inside the vehicle, striking the steering wheel, the windshield, the dashboard, other occupants or anything else. 
I’ve worked in the fire/EMS field for 31 years.  In that time I have responded to more vehicle accidents than I’d like to admit. Most of those accidents were pretty minor.  Most of them did not result in serious injuries or fatalities. However, a few did.  We rarely think of the toll that caring for those injured takes on our emergency responders or law enforcement folks.  I’ve never really considered myself as a responder who suffers from Post-Traumatic Stress Disorder, or PTSD. Certainly, I have experienced and witnessed injuries and death over the years that have bothered me but not to the point that I felt any real distress about them. 
More and more though, probably because I am paying more attention, I have seen many of my fellow responders who have been struggling.  I’ve seen some coping in unhealthy ways. I’ve seen some leave their department early.  I’ve seen some who have tried to end their life.  And, I know at least one who did more than just try. The story that I want to share with you now is about a vehicle accident with a single occupant who was not belted in and was ejected from the vehicle. This story brought home to me the total cost.
Several years ago, my crew responded to a single vehicle rollover accident on a rural road.  It was early Sunday evening on a very nice day.  Weather was not a factor. When we arrived on the scene we found a single patient lying in the middle of the road.  The vehicle was a considerable distance from the patient and it was clear that the vehicle had rolled several times. There was a lot of debris flung out over a wide area of the roadway and in the ditch on both sides of the road.  The patient was not responsive and was barely breathing.  This patient had a critical head injury. Two members of my crew were assigned to treat this patient immediately.  The only thing was, we didn’t think that there could be only one patient. 
Before we even reached the first patient we could see that there were children’s toys and a child’s car seat flung from the rolled vehicle. When a member of the crew reached the car seat and turned it over, it was empty.  Oh how gut wrenching that feeling was.  The rest of our crew frantically searched through the debris on the road and in both ditches for a couple hundred yards without finding another patient.  Fortunately, there really was only one occupant in the vehicle, this time. 
As more help arrived, the patient was packaged for transport and my crew turned our attention to creating a landing zone for the helicopter. The critically injured patient was flown to Wichita and I’m told made a very good recovery. Seemed like a pretty happy ending but that isn’t the whole story or the total cost.  One of the youngest members of my crew had been assigned to help treat the patient. This was to be that crew member’s very first time of seeing a critical patient; the first time helping to care for a critical patient; the first time seeing a helicopter land and fly away with a critical patient. That crew member was just finishing an EMT class and was about to take the State exam. This call though, changed things. The firefighter never wanted to treat another patient. The firefighter never wanted to go to another wreck or see that kind of scene again…..
This job isn’t for everyone, yet someone has to do it.  Every day first responders, firefighters, EMT’s, Paramedics, and those in law enforcement see that type of scene.  According to KDOT’s 2013 Kansas Traffic Accident Facts, a rollover accident occurred every 2.21 hours in 2013.  In each of those accidents the chance that the occupants will remain in the vehicle is very slim if they are not buckled up. 
So what is the total cost?  You see the crew that day wasn’t part of a big city fire department.  It was a volunteer department’s crew. The crew that day was my family.  The youngest member of my crew was my youngest child. The firefighter that never wanted to treat another patient or see another wreck was my kid. That call changed how a member of my family looked at the future. My child is still a firefighter, but the EMT class was never completed.
    First responders face the worst situations on a daily basis but sometimes it gets to be too much. Sometimes, especially when they appear preventable, accidents like this really take their toll on those who respond to them. Seat belts save lives.  I have no doubt about that being a fact. They can save more than just the life of the person riding in the vehicle. 

Scott Abker is the Salina Fire Department Battalion Chief


  1. Your words have helped me see much more clearly into the world of a first responder. You face great challenges and stresses and they would definitely take a toll. Thank you for your dedicated service.

  2. Anonymous9/22/2015

    Thank you for sharing.

  3. Anonymous9/22/2015

    I can't imagine responding to a crash, especially one with people seriously injured or killed. You all deal with so much - I really appreciate your efforts.