Need info about ER procedures

Before you get to ER procedure, my question would be whether it's even possible for the man to do what you're describing. Jumping into a river in Massachusetts in January, dragging an unconscious woman to the bank, pulling her out, and doing CPR seems pretty close to impossible to me: it's hard enough to drag an unconscious person out of a river in good weather, let alone to do all this in the winter. If the water is as cold as it ought to be in Mass. in January, the man would be overcome by hypothermia very quickly. I just don't think he would be able to get into the river, get ahold of the woman, swim her to the bank, haul her out, get himself out, and deliver CPR while soaking wet in January temperatures. That's extremely strenuous and it requires more energy than I think a person would have under such conditions. (Note that it's not just the exposure to cold water that's giving them hypothermia, it's also exposure to January air while soaking wet when they come out of the water).

So, can you have her fall very close to the bank, or something? I mean, can you have her fall or be pushed by the current to within a few feet of the bank, so the guy could get her out just by wading in, without having to actually swim out to get her?

Here's a link to a page that describes hypothermia due to cold water. Note that people can become hypothermic from water under 70 degrees (!)--the water you're describing is a hell of a lot colder than that, probably under 32 degrees (below freezing--but not frozen solid, because it's moving; I'm assuming this is a river you're describing, since there's a bridge over it).
http://www.seagrant.umn.edu/tourism/hypothermia.html

Also, while I can imagine someone jumping into the water in January to save their child or spouse or a beloved friend, I have trouble imagining someone doing that for a complete stranger--seriously, I think their innate survival instinct would kick in and stop them, because there would be no powerful love/emotion/etc. to overcome the survival instinct. If you want him to do this, you're going to have to come up with a reason that he does it--it could just be his character, whatever, but you're going to have to know what his motivation is and convey it to the reader, because I think the natural response of a reader is to not believe a person would do this... UNLESS you make it clear that he's in some way not a normal person. It could be anything: maybe he's depressed and doesn't care if he lives or dies himself, so he's more prone to take risks. Whatever. But it has to be something that takes him a little out of the ordinary.

It would require a lot less explanation--I mean it wouldn't be nearly as hard for you to convince the reader that he would do this--if she's close to the bank so all he has to do is wade in. Then he could still become hypothermic because he still gets wet and then sits on the bank while wet--particularly if it's harder to get her out than he anticipated and he slips, gets wet up to the waist, etc.

By the way, how does the ambulance get there: does someone else witness all these events and call 911?

As far as shoulder dislocation is concerned, what you're describing is possible with a couple of caveats.

There is a fairly wide range of what's possible in shoulder joints. As an example, my shoulders come out of joint very easily. I can do it simply by lifting something heavy the wrong way. But then, they also go back in very easily and painlessly. My ligaments (I think it's them, not the other things - uh, tendons - I get them confuzzled easily) are loose, and how loose they are also varies with my hormone levels. It's a genetic thing.

You could have the woman have looser joints by nature, but of course, not as loose as mine. Or you could give her a previous shoulder injury which would cause her joint to come out easier.

I'm suggesting those as possibilities because it might be the only way to plausibly have the guy accidentally pop her shoulder back in.


Disclaimer: I'm no medical expert. I'm only an expert at the funny things my own body does.

A stranger diving in to save someone else is, to me, perfectly plausible. People do it all the time--and die, themselves, as a result. (When a plane crashed into the Potomac River, a man did just that--dove into freezing water--to try to save some of the passengers. I think it happened in the late seventies or early eighties.)

The rule with submersion patients is "they aren't dead until they're warm and dead." Warming can be done with I.V. fluids that have been heated; with heat packs placed at armpits, groin, behind the knees; and with heated blankets. If she has been submersed for ten minutes, I can't imagine they'd get her back to conscious in the back of a squad, though, or even breathing on her own if she was in freezing water for that long.

There's not necessarily a mandatory hold on someone who has tried suicide, unless he/she is refusing voluntary admission. If she agrees to sign herself in, the stay can be as little as one or two days, depending on how she appears to be doing and if she can vouch that she is safe from herself.

My husband is a professional paramedic (I used to be an EMT) and if you want more detailed info either about ER procedures, rescue, or psych inpatient procedures, just PM me and you can pick his brain.

I agree that for the sake of the woman's recovery it needs to be very cold water. I think having her closer to shore could work very simply: just have the current push her close to shore. Have you ever seen floating objects (branches, etc.) kind of stuck against the shore, repeatedly pushing against the shore as the water rushes past? And then other floating objects that come near them get kind of caught on them and slowed down? It's very easy, happens all the time--it just depends on the direction of the current and the shape of the bank at that particular point. She could've jumped in at the middle, bobbed to the surface, and been swept right over to the bank, or very close to the bank. You could have the guy see her go in and head over towards the river, not sure what the hell he's going to do but unable to just watch her die, and then when he sees that the current has pushed her close to shore the decision is easy--he just has to walk out a few feet or whatever and grab her. She could easily be unconscious almost immediately due to the fall, the shoulder pain, and the cold, so she would just be lying there, not fighting the current or the man.

Tornadoboy,

Not a problem! Whenever you're ready.

just the shoulder piece

A very interesting discussion here, and it seems like things are shaping up.

Just wanted to comment that I think it is feasbile for him to put her shoudler back into place as part of the rescue. My husband dislocated a shoulder playing flag football. When he got to the ER and went for pre-treatment X-rays, the tech asked him if he was okay to stand up. He said yes, then proceeded to pass out. The tech caught him underneath the armpits and voila! shoulder was put back in place. My husband isn't particularly loose-jointed and the force wasn't that great.

For what it is worth!