firedoc5 Posted July 4, 2008 Share Posted July 4, 2008 Called to a concrete plant. Report of worker struck by concrete slab. When arrived pt. was on a twenty foot cat walk. Evidently they were swinging a concrete covert by a crane when the operator lost control of it, striking the pt. when he was crossing the cat walk. Pt. was a male, mid-20's. Fork lift was used to lift equiptment and myself along with two others. Not much room for anyone else. Very obvious deformity to chest. Covert hit him while he was turned side ways. Upon further assessment his entire torso had been rotated. We considered it as almost a trauma asphyxiation. Pt. was conscious, alert x 3. Much pain. Diminished lung sounds bilaterally. Placed on 15 L O2 per NRM. Two large bore IV's LR. Vitals: Base line BP 110/ 94, Pulse 130, Resp. 45-labored. Lung sounds on left greatly diminishing rapidly. No tracheal deviation noted. Monitor showed sinus tach, no ectopy. Adm. 5-10mg. MS slowly. Prior to transport Medical Control ordered additional MS prior to transport. Full spinal immobilization. MAST applied with dead air. Lowered patient by fork lift. Limited room so it was just the pt. and I. Talk about multi-tasking for about 2-3 mins. Rapid transport. Flight not available. Link to comment Share on other sites More sharing options...
reaper Posted July 4, 2008 Share Posted July 4, 2008 Did you decompress? Link to comment Share on other sites More sharing options...
HellsBells Posted July 5, 2008 Share Posted July 5, 2008 You still use MAST pants? Link to comment Share on other sites More sharing options...
CBEMT Posted July 5, 2008 Share Posted July 5, 2008 You still use MAST pants? Required equipment here (I dunno about there), but I'm trying to figure out what I would've used them for in this situation. Pad voids maybe? Link to comment Share on other sites More sharing options...
Kaisu Posted July 5, 2008 Share Posted July 5, 2008 we consider mast pants to control abdominal bleeding OR to stabilize a fractured pelvis - BUT ONLY IF THERE IS NO CHEST INJURY. I'm not monday morning quarterbacking here, but I don't think I would have taken the time to apply the pants.... Did you ever wind up inflating them? Link to comment Share on other sites More sharing options...
DwayneEMTP Posted July 6, 2008 Share Posted July 6, 2008 How do you administer 5-10mg of MS? Link to comment Share on other sites More sharing options...
Asysin2leads Posted July 6, 2008 Share Posted July 6, 2008 Sedate, intubate, decompress, board, collar, transport, bilateral NS rapid infusion PRN. Get patient to surgery in quickest fashion possible. Link to comment Share on other sites More sharing options...
firedoc5 Posted July 7, 2008 Author Share Posted July 7, 2008 You still use MAST pants? You have to take into consideration this was about 21yrs. ago. MAST was primarily used for the pelvic and lower body injuries stabilization for him. We did inflate to 15 in legs and 10 in abd. We had a system to place a pt. into MAST with little effort and time. MS given IV, slowly until loaded for transport. Transport was over very rough road from the plant. I was sort of hoping his LOC would decrease so he wouldn't have to feel every bump. But he remained alert and I didn't want to knock him out. In the ER they did sedate and tube him. Three ortho's called in, all shaking their heads. Chest tubes placed. A lot of blood from left side tube. Only spinal injury not sustained was to C-spine. In surgery they did have to remove spleen. Pelvis repaired in six places with several plates. Rods were inserted down spinal column. Total surgery was 17 hours. He was then air-lifted to St. Louis. After nine months rehab he was confined to wheel chair. He was neurologically intact but do to crushing injuries was not able to walk or stand. Link to comment Share on other sites More sharing options...
jwraider Posted July 22, 2008 Share Posted July 22, 2008 Just curious how you got him on the board and fully cspined with two people. Thanks interested in case I'm in that situation someday. Link to comment Share on other sites More sharing options...
Christopher.Collins Posted July 22, 2008 Share Posted July 22, 2008 Just curious how you got him on the board and fully cspined with two people. Thanks interested in case I'm in that situation someday. Not that difficult depending on the size of the patient and the area your working in... one person maintains c-spine and calls the roll as usual, the other rolls and slides the board (place the board opposite side of the patient and roll them twords you). At least thats how Ive seen and done it, its kinda tricky but it can be done. Link to comment Share on other sites More sharing options...
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