Out of my hands...

Sometimes, even if you do everything right...
Last night a "child" came in, if you still believe that 16 is a child.
Snowmobile vs tree, helmet was worn, the partner was nearby...
CPR which may or may not have been needed was started, EMS enroute, first officer on scene confirmed no initial respirations.
When the pt arrived in the ED there was a strong Sinus Rhythm, RR 30+, limited facial bruising, trauma protocol followed to the letter...
A, B, C, D, E, F, G, H, I... Intubation, IV's, foley, scans, fluids, drugs as needed, information provided to the family timely, a well orchestrated team, ending with the life-flight transport.
The pupils were the key... right blown, left pinpoint. GCS of 3, blood from...
The damage was too great. Even with everything in line, perfect timing... no neuro, no peds unit....
sometimes it is still out of my hands.