When Kiley Nygren was 13, her brother's best friend was hit by a car in front of their house in Harvard, Massachusetts.
"I wished I had known more, and I wished I could have done more in that situation to be able to help at that time," Nygren said.
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The friend ultimately survived, but the experience left an impact on Nygren.
"After that, I was like, 'Yes, 100%, I'm going into medicine,'" Nygren said.
Because Harvard is a small town and relies on an all-volunteer ambulance service, a state waiver program allowed Nygren to train to become an EMT at 16. Now 29, Nygren is a second-year emergency medicine resident at Temple University Hospital.
Nygren was able to use her extensive training when she and her fiance, James Koch, were driving back to Philadelphia from a wedding in Vermont on June 23 and saw three vehicles crash ahead of them on a rural highway – with one lane in either direction – near the Vermont-New York border. Nygren and Koch, a resident of physiatry at Einstein Medical Center, stopped at the scene, triaging and caring for 14 people, including eight children.
Nygren said she had the sense of "being in the wrong place at the right time, the right place at the wrong time, who knows what it was. I was just thankful that I was able to be there and to help out."
Nygren couldn't open any of the doors of the first vehicle she approached.
"Half of the car was up against the guardrail, and then the other half was all smashed in," Nygren said. "So I opened the trunk, and … it was like a wave of screaming children. … I said, 'Hi, I'm Kiley. I'm an emergency medicine doctor. It's OK. Are you OK?'"
Three children under age 5 climbed out through the trunk. Then the mother and father, who were trapped in the front seat, passed Nygren their fourth child – a baby – before crawling out of the trunk themselves.
After seeing that family to a safe side of the road, Nygren opened one of the back doors to the second vehicle.
"There was an older woman in the backseat who was very sick and in bad condition," Nygren said. "I looked beyond her, and her granddaughter was in the seat next to her, and her granddaughter was awake, and I asked, 'Are you OK, honey?' And she said, 'Yeah, my hips hurt.' But she was able to crawl out."
Nygren and Koch continued to help people out of the cars as they waited for first responders to arrive. Nygren assessed people's conditions, and she and Koch took care of everyone as well as they could with supplies from an EMT bag that Nygren had in the trunk of her car.
When the first police officer arrived, "I was able to say, 'We need multiple ambulances,'" Nygren said. "'We need the helicopter. This guy is trapped in the car. He needs firefighters – jaws of life – to get him out.'"
Jaws of life are hydraulic rescue tools that emergency rescue personnel use to help extricate individuals involved in vehicular crashes.
One person died at the scene of the crash. Nygren learned that another person died after being taken away in an ambulance. Everyone else, including all of the children, survived.
When Nygren returned to work at Temple University Hospital's emergency department two days later, she was able to talk about the crash with her co-residents and attending doctors and review how she handled the situation. Her colleagues' reassurance and support helped her process what she had experienced, Nygren said.
One of the families recently called Nygren to thank her.
"The mom told me that her daughter talks about me often as the nice lady in the pink dress who helped her," Nygren said. "Just to have a nice impression on a little girl who was in a horrible car accident, to be able to have her have a smaller, nicer memory of what happened, as opposed to just the horrendous scene that she saw, that means everything."