I came up on a multiple vehicle collision last night. I'm still counting up all the stuff I did wrong. I work in LA County as an EMT, and have been on the job for about a year and a half. 99% of the time it's boring dialysis runs... it's not like the East coast at all. The only time we see trauma is either through the glass in the ER or off duty. It was a four-car pileup, one car flipped. I pulled in, jumped out, and headed for the smoke. Left my fire extinguisher in the trunk. Got to the scene and there were a bunch of people huddled around the car. I started asking people, Are you medical? As they said No one by one, they moved aside to give me room. One occupant in the car, nice big laceration on the top of his head. Another guy was on the other side of the car trying to unstick his leg from between teh dash and the steering wheel. His leg looked a little bent, I figured a simple fracture to the tibia and fibula. The guy manipulating the leg said he was a lifeguard. The lifeguard was trying to get the guy out of the car. I kept telling him to let the guy lay down on the roof and wait for the paramedics to come and extract with a spine board but couldn't get him to listen. I did get the guy to take a doralis pedis and extend/flex his foot, so that was good. He was A&Ox4... good again... no neck pain, PERL, the blood had pretty much stopped running. I headed back to my car for... what's in my trunk again? I had a hospital blanket that I figured would make a pillow until FF got on scene. The lifeguard tossed it in the car and the guy was like, what's this for? I heard the fire trucks coming and saw that my car was kind of in the way, so I headed back to the car. I saw one FF approach on foot and tried to give a quick report but he just wanted to make his way to the scene. Not so good last night. My lack of experience on an accident scene was showing up how much I need to learn yet. The last time I stopped at an accident I was on the spot. Held inline stabilization and talked the LEO through doing a quick assessment, the fire chief shook my hand and said I did fine. Well, I guess there's always a next time. Tomorrow I pick up a box of road flares, a couple more blankets, and I'll throw a SOL hat in the trunk so I can be identified as medical easily. I guess a Hawaiian shirt and sandals doesn't do the same thing. I took off when I got back to the car. Was that abandoning my patient, or was he the lifeguard's patient? I'll talk to the medic at work when I get back on Sunday. Bottom line though is that I should have told the lifeguard that the patient isn't in a pool, we don't have to drag him out.