irme Posted May 28, 2008 Share Posted May 28, 2008 Asys is putting foward the job he did that many would have "written off" the pt as dead. It is a seperate job to the one you posted originally just one with similar traumatic injury!! Link to comment Share on other sites More sharing options...
dahlio Posted May 28, 2008 Share Posted May 28, 2008 Based on the scene, are you going to wait until you finish triage to order additional units? How many, of what type are you going to order? How fast are you going to bring them? No, not waiting until after triaging, no reason why other ambulances can't be started while additional patients are found. As soon as I find one serious injury, on top of others, I'll start additional units. Unfortunately, ALS in NJ is usually non transporting. I see 3 patients, with another potential being the driver of the car. 2 ALS units, for three patients, and 3 additional ambulances. Keep one at a non-emergency response, as a just in case for the driver. Ok, are you going to do this yourself, delegate to your partner, what order are you going to treat and package him in? Should you consider that s/he might have other injuries besides the missing leg(s)? How are you going to delegate your resources? Once all triage is done, we'll go to the unconscious in the roadway, and find out his status, ABC's, and have my partner help me backboard this patient, while doing a rapid trauma assessment. After the patient is boarded, partner can go to the one next to the car and asses, as I preform a more thorough assessment. From what I can tell, the guy screaming with his leg off, is conscious, and these other two don't seem to be conscious, which is the reasoning for getting those to out of there immediately. 2 BLS and 1 ALS for these 2 patients, as the ALS unit can split up. The person with the leg injury would be third, do to him screaming and having a patent airway, and breathing. A more thorough assessment should be done on him, absolutely. Had some tunnel vision there. If the driver is not injured, my BLS unit can take the leg patient, and cancel the 4th responding BLS unit. ALS for the leg patient as well. Thanks! Link to comment Share on other sites More sharing options...
BEorP Posted May 28, 2008 Share Posted May 28, 2008 No, not waiting until after triaging, no reason why other ambulances can't be started while additional patients are found. As soon as I find one serious injury, on top of others, I'll start additional units. Unfortunately, ALS in NJ is usually non transporting. I see 3 patients, with another potential being the driver of the car. 2 ALS units, for three patients, and 3 additional ambulances. Keep one at a non-emergency response, as a just in case for the driver. I'm sure there are varying schools of thought on this, but just pulling up to the scene you would probably see the two patients who are obviously not doing well plus the driver who may have injuries. Based on the initial impression of the scene I would want another ambulance coming fast. If one or both of the guys on the ground ends up being dead then the priority of the responding ambulance can be adjusted (or cancelled if they are not needed). Link to comment Share on other sites More sharing options...
firedoc5 Posted May 29, 2008 Share Posted May 29, 2008 Good topic. Keep 'em thinking. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted May 29, 2008 Share Posted May 29, 2008 Good thinking all. you drive up on the scene and you see one person with no legs and another on the ground you better order an additional ambulance. If one person has no legs but should then you can bet the 2nd person on the ground is even worse off. Call for the 2nd ambulance, you can always cancel em. Link to comment Share on other sites More sharing options...
tamaith Posted May 30, 2008 Share Posted May 30, 2008 hi i am a student emt-b student. so i am inexperienced. but this is what i would do 1. size up the scene 2. call for additional resources more trucks and police 3. bsi gloves, mask. 4 triage 5. rapid trauma assessment 6 control the bleeding 7 transport immediately Link to comment Share on other sites More sharing options...
DwayneEMTP Posted May 30, 2008 Author Share Posted May 30, 2008 hi i am a student emt-b student. so i am inexperienced. but this is what i would do 1. size up the scene 2. call for additional resources more trucks and police 3. bsi gloves, mask. 4 triage 5. rapid trauma assessment 6 control the bleeding 7 transport immediately Hey, Good for you for participating!! Good answers, but let's get a little more specific if you can... And, pop quiz!! Without looking up the answer, (I'm a true believer that the scenarios is about pulling things out of your head, not out of the book. You then have a benchmark for what you know as well as what you need to study. Plus, if you're like me, looking foolish in the forums can be a lot of pressure! So it's good to think things through like that. No one expects you to know everything, we just expect you to learn everything!) We've decided we need to triage, but what criteria are we going to use to do so? Who can explain START triage? (No cheating now dang it!) Dwayne Link to comment Share on other sites More sharing options...
dahlio Posted May 30, 2008 Share Posted May 30, 2008 No peeking, lets see how bad this gets. If no pulse -> Black If pulse, but no breathing, position airway, give two breaths, if no ROSC/Breathing -> Black If breathing is over 30 or under 10 -> Red Anyone Ambulatory -> Green Everyone else is tagged -> Yellow Lots of gaps there I know, and then there is something called JumpStart Triage for Pediatrics, which gives more specific instructions for that age group. I believe the Triage for Pediatrics is a little more aggressive. In all the ambulances at work, we do have triage instructions on a small poster/decal on the side door. I also have it in my little notebook, that I use to refer to medications quite a bit. Still not a good excuse for not knowing it like the back of my hand, but it is not often used. Now that you've put us on the spot, I'm gonna go see what I missed. Good one Dwayne, really keeping us on top of this. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted May 30, 2008 Author Share Posted May 30, 2008 ...Still not a good excuse for not knowing it like the back of my hand, but it is not often used. You and me both....I'm going to have to go and look it up... :wink: I'll be gone most of tomorrow, but I'll try and come up with something new by then...Thanks for playing! Dwayne Link to comment Share on other sites More sharing options...
tamaith Posted May 30, 2008 Share Posted May 30, 2008 hi start triage hmm well we aren't going to learn that i know it has to do with color tags its in my text but not going to cheat. ha Link to comment Share on other sites More sharing options...
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