Just Plain Ruff Posted April 19, 2008 Share Posted April 19, 2008 Does this qualify as the ends justfying the means Link to comment Share on other sites More sharing options...
AnthonyM83 Posted April 20, 2008 Share Posted April 20, 2008 Except it isn't really doing something wrong in order to reach the mean. If say you had to shoot another person in order to save your patient, that'd be more like it But by itself, amputation wouldn't be wrong to do...it's logically needed in order for him to live and you're doing to him who ended up in that situation...you're not putting a new person in danger/harm. Link to comment Share on other sites More sharing options...
HellsBells Posted April 20, 2008 Share Posted April 20, 2008 As stated before, do we even have the tools to preform such a procedure? I suppose one could try to use the scalpel in the surgical airway kit. Furthermore, if the car is burning, how long is the medic going to be able to hack away at the patients limb before he is either burned or overcome by smoke inhalation? I think I'd much rather spend my time trying to use the ambulance's fire extinguisher, then attempt an amputation. Link to comment Share on other sites More sharing options...
Dustdevil Posted April 20, 2008 Share Posted April 20, 2008 Exactly. While field amputations are a theoretically valid tool, it would not really be so in the "burning car" scenario presented. Unless you're using a chain saw, it's not as quick and easy as it looks and sounds. Even with the scalpel, you're only going so far before you need a saw. I submit that, even with the tools and the training, most paramedics could not muster the guts to do it. Trust me, it's a lot easier to listen to that kid scream from the fire than it is to listen to him scream from your barbaric, meatball surgical attempt. Link to comment Share on other sites More sharing options...
JPINFV Posted April 20, 2008 Share Posted April 20, 2008 I submit that a good medic, if he was able to reach the kid, would have giving a morphine bolus. If you can't save the poor kid, you might as well knock him out for the grim reaper. Link to comment Share on other sites More sharing options...
Dustdevil Posted April 20, 2008 Share Posted April 20, 2008 I submit that a good medic, if he was able to reach the kid, would have giving a morphine bolus. If you can't save the poor kid, you might as well knock him out for the grim reaper. Agreed, although -- as sad as it is to say -- the only sure way to keep your licence and stay out of criminal court is to stand back and watch him burn. It all comes down to what is most important to you: your licence or your mental health? Link to comment Share on other sites More sharing options...
aryan51 Posted April 21, 2008 Author Share Posted April 21, 2008 There's also the possible option of pushing some morphine, knocking the kid out, and going to town trying to pull his arm free. You might end up breaking some bones on the way out, but there's a possibility you could free it. Like you guys were saying though, who knows how much time you would have actually in the "hot zone" before smoke inhalation and flames drove you away. Link to comment Share on other sites More sharing options...
Asysin2leads Posted April 21, 2008 Share Posted April 21, 2008 Here's a better and far more plausible scenario. You are on scene with a person at an industrial accident with an almost complete transection of the lower leg, pinned under a heavy piece of equipment that isn't moving anytime soon. The lower extremity is obviously unsalvagable, however, there are a few small tendon and muscle attachments that are still connected to the patient, preventing him from being removed. You are unable to contact medic control and the patient is hemorrhaging profusely. The nearest field MD is more than an hour out. How would you deal with the last bits of tendon preventing the extrication? What would you use? How would you document? What if it was an artery? Link to comment Share on other sites More sharing options...
JPINFV Posted April 21, 2008 Share Posted April 21, 2008 How would you deal with the last bits of tendon preventing the extrication? What would you use? How would you document? What if it was an artery? Well, assuming that it's either finish the amputation or watch the patient die, I don't honestly see what the options are. Pre-medicate the patient and apply a tourniquet to the limb and clamp off any arteries that you can see (hemostats or the clamps from the OB kit). Cut through anything besides the vessels first starting with the hardest tissue first. I'd rather stop after a few cuts than stop with only a few cuts left. Sever the vessels last. Remove patient, bandage stump, transport. You would document the best you can. Link to comment Share on other sites More sharing options...
SSG G-man Posted April 21, 2008 Share Posted April 21, 2008 Oh God, this better not turn into a 'I would have done it with my 'Leatherman' thread. MRE Spoon!! Maybe the leatherman on hand as a back up!! Link to comment Share on other sites More sharing options...
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