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Posts posted by Matthew99

  1. So we studied how use defibrillators today. After class I thought it was kinda funny that we're only given a lousy shaving razor to shave the patient before applying the pads. I mean, what if he's really really hairy and all you got in this lousy shaving razor? it's gonna take forever before you can apply the pads. Shouldn't every defibrillator include a more serious razor blade? Maybe cold wax strips?

  2. I wonder if he was really feeling how strong/bounding the pulse was and when it came out of his mouth, he said rate? Did you happen to ask him to clarify for you his statement? Or, did you just accept what he said for gospel? (Yes, I know it's the latter based on your statement, "I just nodded.")

    You should get in to the habit of asking someone to clarify if something has been said or done that you don't understand. You will be a better student in the long run. (And this includes if you are a student/partner/commander/subordinate.) You can do it with tact so that it doesn't make you sound like you are challenging them. As a matter of fact, I would respect my student more if he/she did ask questions because, you see, we all are occasionally wrong and it keeps us all honest. :P

    Then, if it still doesn't make sense, do as you are doing now and do further research.


    You're absolutely right. I just needed to help with the transport of the lady to the ambulance so I didn't have time to talk it out. I told myself to ask my partner later (though my partner wasn't the one who told me that), but I forgot so I thought to ask you :) But I definitely never accept what people say for gospel unless A) It makes sense and B) More than one source confirms it

    This is a great quote

    Relationship between poorly perfused patients and their vital signs are dynamic, complex and different for each individual and cant be placed into canned responses like this fellow on scene has done.

    Also ashley-- thanks for your input.

    One thing the ambulance driver did that I forgot to ask him about is lower the patient legs from the stool. So in high-blood pressure you lower the legs of the sitting patient because that way the blood fights more against gravity and therefor there is less circulation in the blood and lower BP. That made a whole lot of sense. If anything is wrong with this statement I'd like clarification.

    Thanks regardless. :)

  3. So I was allowed to go help on an ambulance today and there was this old lady with really high blood pressure (sys 230!) having difficulty breathing. A person on the scene said she has rapid pulse rate and high-blood pressure. I asked him how did he know she had a high-blood pressure before we came and he said "well she had rapid pulse rate so that comes together with high BP". I thought for a moment and nodded, but later I thought of it more and while it does make sense, I don't think it's NECESSARILY the case all the time. I mean, what if a person has diluted blood? In this case tachycardia doesn't necessarily mean high-BP. Is that right?

  4. Note: chances are lower than mostly expected that you really do any more harm to the spine than already done by the accident. If you can care for c-spine, do it - if not, don't hesitate to focus on all the other things you can do for the patient.

    You also have to remember that less than 10% of patients with major trauma have a C-Spine injury.

    I didn't know that!

    Matt, you have suction as a 'first aider' but no collar? That seems weird...

    Yes, I agree. I even told it to my instructor and he said "it's a regulations issue, just wait for the ambulance and try to keep his neck in position."

    Grab a towel make a roll and tape, instant neck collar.

    I'll keep that in mind. Do paramedics improvise a lot?

    I have never encountered this from a car accident, but have encountered it with GSWs where the tried to commit suicide by putting gun in mouth or under chin.

    Aha, I knew my scenario was possible somehow!

    And, as others have explained...life before limb...Cspine makes no difference to a corps, right?

    Great questions man...

    Thanks :) And you're definitely right, I didn't plan the put his limbs first if he needs immediate life-care.

    You guys are terrific!

  5. Matthew if your worried about the C-spine due to the MOI (mechanism of injury) then collar and backboard the patient. Then as other have said let gravity do the work just tilt the backboard on its side and let the blood run out. I have been in this situation before and we did just that, backboard on the side with a few pillows holding it in that position while on the cot. Suction at the ready incase the blood blocked the airway. Thankfully we had ALS close by and got the patient tubed before long so suction wasn't an issue any longer.

    Yes but in my scenario there was no neck collar, the reason is that I'm going with the basics stuff they provide first aiders with. They usually just lug around oxygen, suction and bandages. Phili's neck collars and backboards are an ambulance thing already. But good point to those who have those stuff.

    In the second case, suction like hell, get a tube in all the while pumping like crazy. If the cardiac was during the accident then get him out as quickly as possible, have one provider pump like hell while a second gets the collar on and gets an airway.

    Speak of the devil, I thought that in the new CAB they've decided that those airway tubes are somewhat insignificant? We were told to give it a shot, but if one or two attempts don't go, to drop it and do without.

    Don't worry about thinking of worst case scenarios, we all do it. I actually think it makes you a better provider because if you can think of the worst and plan for it you can handle the day to day without much issue. In my case I always thought of the worst MCI I could which was a bus crash, one day I actually had it. School bus with 30 children plus 2 motor vehicles involved one with a mother with a 3 day old infant. Ran the call like I imagined and came out the other side feeling good, sometimes the worst does happen but usually its a stubbed toe at 3am :rolleyes2:

    Good luck in school.

    Thanks, and how does someone get a stubbed toe at 3 a.m? That's what I wanna know.... ;)

    Scenario #2: Pronounce and move on. There is nothing to do for this person, you are better utiliazed caring for someone else that may have a chance.

    Well in my mind he was the only patient, but yes, realistically in such a hard accident the driver may be hit hard as well.

    Thank you.

  6. CPR with a lot of blood running into the mouth and no other airway management device than suctioning? Bad, even if kinda unrealistic (read: most probably won't happen). Again: Suck like hell and get a tube as soon as possible.

    Never had it in this extreme, though. Always remember: all bleeding stops...eventually

    I suppose my mind can conjure up some pretty dreadful events. Is it just me or does everyone keep imagining car accidents, someone fainting, etc, in their mind while walking down the streets looking at the day to day event? That's how

    I came up with this scenario, and in this scenario, I wasn't 100% sure if I'd do the right thing!

    FireMedicChick your reply is great and makes a whole lot of sense to me, especially when mentioning nasal cannula. Would it be fair to say that using nasal cannula is recommended when the patient has lots of mouth secretions? What about using both nasal cannula AND oxygen mask? Is that even possible?

    Second scenario...if the patient is in cardiac arrest you will need to suction to clear the airway as well as do CPR. Hopefully if you have an ALS provider there so the patient can be intubated to protect and manage the airway.

    Yes, first move as always is call 911 :)

    Let gravity do the work - turn the patient to the side to let the blood run out. Otherwise suck like hell and get a tube as soon as possible.

    Valid point!

    My worry is causing neck injury if I keep playing with his position too much, but very valid point :)

  7. Hi. Am a first aid student but we're a bit on a break and I got a question I'm quite curious about so I thought to register here and ask :)

    Let's say someone got into a car accident and now his mouth is brimming with blood. You suction all the blood out, but the blood appears to refill the mouth every time. What do you do in such a case presuming you have ambo, oxygen, suction and bandages to work with, and nothing else? I think the best idea is to keep suctioning him, put oxygen in, and when the blood starts filling the mouth you suction him, then oxygen again.

    And what if the person is unconscious and has no heartbeat as well? I think in that case you do the chest thrust in addition to taking care of the airway.

    Does that all sound good?

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