musicislife

You are in the store when an 80 year old woman suddenly collapses. No one catches her. Actions: Have cashier or anyone who is around call 911 Consider head stablilization Airway, Breathing, and Circulation are present Pulse is weak, rapid, and regular Breathing is regular and adequate with no noise Airway is unobstructed by any foreign objects Skin is pale and dry Maintain open airway using jaw thrust manuver Elevate legs using box or shopping basket to treat for possible hypotension Monitor breathing Start compressions/rescue breathing should it become necessary Ambulance arrives and takes over the scene I used the jaw thrut because the probability of someone hitting their head on the floor in the situation (since she was not caught) is high, and I want to ensure that the spine remains intact I know this is insanely simple, but ive been thinking a lot about unresponsive patients and being a lay rescuer (my town doesn;t use First Responders like me )lately...so I want to make sure I have my thoughts in order.

i believe we were taught to use the splint when the fracture is on the upper femur (not requiring traction).. I know im trained in the hip splint (the one where one board goes in between the legs and the other on the other side streching from ankle to waist)

on a good day ALS response is like 10 or 15 min..theyre a private hospitals service, not an FD or anything

i suppose if the bone is sticking outta your arm then ALS may come, but odds are you get a 10 min ride to the ER in screaming pain

im assuming ALS will not be called for most fractures (in my town we have a volunteer BLS Ambulance corps) so no pain meds would be given by EMT B's why would I leave the hip alone but not an arm or something like that? Is it because SAM splints would be ineffective on a hip (i only have experience practicing hip splints with rigid board splints)

haha..yes i know all about splinting and have sam splints and everything. we learned specificllay how to splint a fractured hip. given this knowledge, would I splint the hip (or any other bone that I know how to splint if needed)? My training level is a First Responder

thanks guys. one more...if materials avaliable, should I splint a suspected break (leg, arm, hip, ect) before an amblance arrives?

so i really should just forget about exposing either by lifting the clothes or cutting (unless its a small area because i notice severe bleeding during an initial assessment) until the ambulance comes, and support ABCs, and control any bleeding?

they never taught us when to expose people, unless it was a cardiac arrest. they just said "lift up the shirt and inspect the abdomen if a medical PT is complaining of abdominal pain) so i guess I am gathering that all medical patients, including unconscious ones are never exposed, am I correct? (as far as my first responder level is concerned) and un conscious trauma (or patients where you cannot determine medical vs trauma) will most likely be exposed in some way. correct? just because of my lack of knowledge of when to expose..thats why im focused on it..i dont want to expose someone when it is not required

i dont know, I was just providing an example..that and summer is coming, we always get at least one or two nasty heat waves

this fall..so damn excited so basicllay maintain/clear airway call 911 if not done, and cool down if heat emergency is indicated? and expose only if necessary (example paitient family says he is on a medicine patch, and the PT shows s/s of overdose/poisoning)

allright, what if the patient is not arousable? How would I go about treating an unconscious medical patient in this situation? I think I would maintain airway, and cool with water if S/S indicates it (ie profuse sweating, warm skin, rapid pulse, hot enviornment, ect) What about general treatment of unconscious medicals?

I guess I still cant find a clear answer to exposing an unconscious patient. It is my thinking that all patients, whether suspected medical or trauma with patent airway, present, adequate breathing, and circulation who are unconscious should be exposed to look for any signs of illness, or rule out trauma. Have I drawn the correct conclusion for unconscious patient?

trained as a first responder, acting as a lay rescuer. i should have been more clear, sorry. I think I would (considering my bag is in the area, and I have my shears) expose every unconscious patient. This is because I have no idea as to the reason for the unconsciousness...what if I notice (for example) a pulsating mass on the abdomen, or rigidity in the abdmomen. What if I notice signs of shock in the extremeties? Basically, I would expose because I have no idea what is happening, and exposeure plus PT history if obtainable will be a great help in helping the patient. Question now:..i know that syncope is a breif lapse of consciousness, but how long is "breif" (couldnt get a straight answer online, either that or my google skills suck)

Should a first responder like myslef expose and assess an unresponsive patient after the airway, breathing, and circulation are assessed (lets say I put him in the recovery position because no trauma was suspected) as a lay rescuer?

wise thinking sir

what about medical patients (again, no advice in my book, couldnt find much online either)

I am confused, because they never touched upon this in my class, nor is it in my book. Can anyone point me to some further reading on the subject? For instance, I am unsure wether or not to expose a patient on the side of a highway or some other public place. What are the general rules, and is there further reading online? I suppose (lets say in a street for a car accident) I would inform the conscious patient, boot any LEOs, firemen (if possible) and nosy bystanders away from the pt, use tarps or sheets held up by others to hide if possible, expose one area at a time then cover up by taping it with a couple pieces of tape, allowing for easy re exposure should a person with higher level care need it, and document the exposure of each area thouroughly. Am I correct here in my thinking?

15, why?

In response to the first reply...i would look around for things in the environment (ie smoke, bottles)...i would look for signs of intoxication, determine from dispatch info if they had a seizure, assess for hypoglycemia (no BGL avaliable sadly), bottles (mentioned earlier, overdose. Try to determine if theyre on medications like anti depressants and determine if they already took them that day....then I would look for obvious signs of trauma..this is me thinking of the possibilites that my book gives for mental status.

Doesnt say much in my book besides the many causes of it. Would I just monitor ABCs and do a physical examination of a patient who is unresponsive/ not alert an oriented. (with main focus on maintaining ABCs)?

well that makes too much sense, so why would they do it? Yea I agree it makes my job a lot harder...

thanks guys If I were to find a patient like this already passed out, and I checked the ankles, wrists. and neck for a medical alert and find one for diabetes, would the glucagon treatment still be indicated?

would OG been acceptable after he woke up, or maybe a peanut butter sandwich or something like that if avaliable (if the medics hadnt arrived before he woke up)?

You see a boy who was happily playing basketball, when suddnely he goes to the wall, looks weak. He is your little cousin You go over to him and find that he has a weak pulse, and he is shaking and dizzy. He forgot about his blood glucometer..but he did bring along a tube of oral glucose and glucacon kit. You say, "let me give you some glucose"...he yells at you and says "go away! I dont need you!"....He passes out shortly after, and you cannot arouse him. 911 is called as soon as he passes out. Treatment...check ABCs, lay the PT on his side and administer glucagon in the thigh 1mg (1cc). You take a set of vitals: BP is 98/72 HR: 112 bpm and his breathing is fairly unremarkable at a rate of 17 per minute. Response to this treatment: He wakes up right around when the Paramedic truck/ BLS Ambulance arrives. You are cleared to go by the responding crews, and no more info is obtainable. Reasoning: The glucose was originally indicated because of the known history, shaking, weak pulse, and dizziness..however the patient went unresponsive before it could be administered. The glucagon was then indicated because he became unresponsive. Considering it was not syncope (as he did not wake up shortly after on his own) I feel that glucagon was indicated My aunt taught me about the administration of glucagon, because her child is a diabetic, and she wanted more people to know what to do in case she wasnt around to help her child. (it is not contained in my First Responder course, only Oral Glucose is) Would this be acceptable to ambulance crews? I hope this is enough information for ya'll.