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Probably died of hypoxia (because they literally could not breath) and mass vasodilation?

The story we got from flight crew and how it played out in the ED was:

pt was in cardiac arrest upon arrival of chopper, EMS had person intubated and full ACLS in progress. pt got pulse back in flight and was in sinus tach upon their arrival at the ED, i dont know vitals. we packaged pt up to go CT & ICU and the pt brady'd down to like 30 kept on down, CPR began again, and never got cardiac activity back.

i know parkland in dallas requires nurses to ride out with dallas fd, but the next county over where i work, there is no such program.

Cause of death listed as: "ATLANTO-OCCIPTAL SUBLUXATION WITH CORD INJURY Due to:MOTOR VEHICLE-MOTOR VEHICLE COLLISION (DRIVER)"

what is: ATLANTO-OCCIPTAL SUBLUXATION WITH CORD INJURY??

this person was flown to the ER where i work. they rearended a parked semi carrying telephone poles and this persons head was squashed.

and, yes i noticed that occipital is missing the second I.

I bought one for my mini mag AA light, made by niteize

im looking for one for my 3D cell light i keep in the truck, niteize makes one, and ive found a few others advertised out there, was wondering if any of you have tried any of em and what u think?

i love the one for my mini mag, just want a few opinions if they're out there.

thanks.

what about thorogood boots?

they have a 6" Waterproof Side Zip Composite Safety Toe with:

75 -Safety Toe

BB -Blood Borne Pathogen

EH -Electrical Hazard

ESR -Electric Shock Resistance

NM -Non-Marking

SR -Slip Resisting

WP -Waterproof

that im gonna go look at i think.

anyone ever seen one? I havent, was sittin here thinkin about it. I would think it would be a good setup seein as how the cummins is an excellent engine with a ton of power and the dodge interiors arent that bad either.

anyhow, just a thought.

whats gonna happen with all the AEDs programmed with the old ACLS (3 stacked shocks, and 15:2 compression:breaths) are they gonna recall and reprogram or what?

We're starting to do a few transfers and looking into getting a pump. I was wondering what kinda pumps ya'll use? Obviously we're looking for something with good battery life, easy to program, and that can handle at least 3 lines. also, one whos casettes/pump tubing isnt too expensive and is available in an extension as well as the full drip set. and one thats ruggid is always a plus.

I don't think that would even be legal. :?

As a mobile hospital, sure. As a transport vehicle, I doubt it.

i dont know anymore details, so it very well could be a mobile hos[ital. all i was told is that they were makin a mobil MCI type of medical trailer.

we have an 04 on an E350 chasis and we've had a ton of electrical problems as well. also with the air suspension but i hear thats a chronic ford problem.

i saw those on the manufactures website, always wondered what the inisde looked like. all i can think of is extra money and they could use em for transport during an MCI but then you always get the problem of that truck having lines on the ground.........kinda like those medium duty boxes on freightliner chasis that have a pump & like 300gallons. great for a car fire & transport the patients, right? well youd have to just drop the hoses on scene, and what about overhaul? and ive heard some people say that extrication tools should be on ambulances. well if youre busy cuttin the car apart, whos takin care of the pt? im fine with ff/paramedics, but trying to combine 2 totally different pieces of apparatus into one....no go there buddy.

It's a lot like Quints in the fire service.

They learned 50 years ago that 50 foot aerials aren't long enough.

Also learned that insufficient amounts of water, like 300 gallons, isn't enough for firefighting operations.

But, 50 years later they can be placed back onto the SAME vehicle, and they're like, the greatest thing since inhalators.

::shrug::

Quint dosnt mean shorter than a 50' aerial, and they do have their place, expesially for aerial master stream operations. also, trucks and quints with 300gallons of water or so, are ok for rubbish and car fires. the purpose of a truck isnt to have water, plus, in most citys, where water supply isnt a problem, who cares how much tank water you have. rural situations are another thing though.

What a dumb idea. Only carries two firefighters and the stretcher. So you are short staffed and the patient gets to enjoy the stink of a smokey cab while riding to the hospital. Not to mention all that gear piled onto the stretcher. Where is all that crap going to go once you have a patient?

that is a 4-man cab, whihc is the norm unless for FDNY but they do everything their own way. so for national standards, its a normal sized cab, not a small one.

the hospital I work at (level II) we like 2 large IVs on all bad trauma pts, GI bleeds, anemics and others who will probably need blood. we dont hassle EMS for not getting 2 lines, although i think we should sometimes. we have a couple of flight crews that come in with a 20g in a hand and I float in 16's with my eyes closed.

anyhow, yes, i think trauma pts need 2 large bore IVs locked. i dont know how many times we've gotten a pt in, seemed stable, got the go ahead from the doc, threw in the 2 large bores, locked em, and bee bopped to CT with a nurse and myself and the pt crashed in the scanner.

go poke your head in the jeep if you can, at least go to the edge of the water and shine your flashlight over there to see if you can see anything. get a look at everyone first before you start assigning anyone a priority. also run over to the bush and see whats up, they have at least somewhat of an airway since theyre making noise so from what i know now, id be worried about bloody trail girl and jeep occupant(s).

i dont know how your boxes are, but with truck boy in the front seat, i could fit 3boarded pts in my box, and one in the captains chair if possible.

stop worrying about if the hospital has a helipad or not, the way this scene seems to be going, our main goal is going to get the pts transported to the local ER to get stabilized enough to where they can live long enough to stick around until troops can be ralleyed up to transport these people to a trauma center.

I really don't care about V/S on him, he is the least injured. Taking a BP is going to just delay me from getting on the road and treating the other patients.

Dont take a BP, palpate pulses, if he has a radial, then you're ok. at least get SOMETHING on him, you can palpate the radial for 5secs and at least tell if he's tachy as hell or not, or if theres even a pulse present.

start tx, and get FD enroute for extrication. plan to be on scene for a while, get on the horn with the ER and let them know the situation. get back up enroute with more O2 cylinders and get ready for the long haul.

i heard oklahoma city had an 18-wheeler trailer set up the same way.

ive thought it would be cool for a large city to have 1 or 2 of these buses, and then one that is a mobile OR to handle very critical pts like in a place crash or another terrorist attack.

Got them today. tried em out on some old socks. cut through them like a hot knife to butter when i wadded the socks in a ball and cut em in 2!!

heres pics of them and the holster(arent good pics of the holster on the website). this thing is as bad ass as the shears!

check out http://www.conterra-inc.com/

Great shears, no doubt. But a total waste of money for the job you work.

I never had a problem getting fabric, or any other clothes off of anybody in the ER with regular shears.

My money says you won't have them in your scrubs for more than one shift before sticking them in your jump bag and leaving them there.

well, im also a firefighter, and will wear em with the sheath thats coming with them, while im on duty, i just have more oppertunities to use them at the hospital. from cutting the umbilical tape we use to secure ETTs, to cutting cravats, casts, and splints off pt's, to cutting chaps off that are never cut in the field.

I recieved a set as a Christmas present. They cut through everything. Yeah, they're heavy, but it's the bulk that bugs me. It tends to snag or bang against things if you've got them on you. If it's in a jump bag, no big deal. If you're going to carry them on you, take into account the bulkiness of the things.

I've yet to use them on a call though.

Big Shears.com has a holster that carries them horizontally in the small of your back so they're outta the way. i just ordered a pair so ill post pics & review when they're in, and bein that I work at a trauma center, it won't be long 'till i test them out on all kinds of fabric.

Anyone have a pair or tried a pair? Im seriously looking into them. So far, the only bad things I have heard are:

1. The price

2. The size

3. The weight

Well I can afford the ~$60 and the size & weight (almost 1lb.) are not a big deal to me.

Just wanting some opinions from ya'll.

they can be seen and purchased at:

www.bigshears.com

www.aeromedix.com

I work for the local police department as a CAHOOTS medic that deals with high risks groups; drug addicts, homeless, runaways etc. and the rise in the number of untreated cases in this population is frightening. Recently my partner and I arrived for a police assist at a local run down motel. When we pulled into the parking lot an experience officer was leaning out of his car vomiting. He told us "this is the worse thing I've ever seen." My partner and I tried to imagine what could possibly be wrong. Our patient was alert, oriented, in good health except that both of his arms had been eaten away down to the bone. He was an admitted IV drug user and had been for years. A few months back he developed an abscess that went untreated and eventually spread. He reported no pain, just a general irritation and a constant weeping which was actually the flesh turning liquid and sliding off his body. I cant possibly express what this looked or smelled like in words. My partner and I did everything we could to get him to go to the hospital with us but he refused care and the police eventually arrested him for public health reasons. Get this, the guy was working detailing the interiors of cars and didnt want to miss a day to go to the hospital.

i SOOOOOOOOOOOOOOO wish u could have gotten a picture of that guy. and how bad was it to not make his arms useless?

I wouldn't let anybody from Harris hear you say that. :?

LOL well ok, the only one thateveryone except CF likes going to.

i work at the only trauma facility for approx 4 counties, we got a transfer from another hospital. pt had Necrotizing fasciitis to the R arm and it extended to his R pectorial muscle as well.

the story other hospital gave us was IVDA and they missed. we were told "i think its a bug bite", either way ot dosent matter. we took 'em straight to the OR.

my question is, how many of ya'll have seen Necrotizing fasciitis? the nurse who had this pt said shed seen 3 cases in 20 or so years, and that this one wasnt that bad(as far as NF goes). arm was just really swollen and a lil bit of compartment syndrome going on. had palpable radial pulse upon arrival and when going to OR approx 30min later there was not one and cap refill was about 3secs.

she said the other case she had seen was in the lower abd and groin that spread down to the proximal theighs bilaterally.

i wish i could have gone and watched in the OR.

[edit]for those who dunno what Necrotizing Fasciitis is, http://www.nnff.org/ [/edit]

feed me brisket.....just not cooked on nasty rotten wet wood like last thing i went to for free...that sucked, i walked out.

i have assisted or observed about half a dozen RSI's. all the ones in the ER went horribly. too many cooks in the kitchen, and the nurses got very excited and fumbled everything. the MD took too long to get the tube....just a cluster all around.

all of the successful ones were in the field, with 2-4 personell on scene, they went smoothly and quickly.

i am VERY firm in my opinion that hospitals cluster situations like this because they cram too many people in the room, too many nurses and MD and techs trying to get in and do it their way, or just trying to do something.