Guard Rail Collision

[Arizonaffcep]

So, just out of curiosity, before we got her onto a LSB, did we walk her spine? Any step off's/deformities/pain/discoloration?

[jwraider]

She's 26 and there is a 12 year old in the car? Do we need to contact parents ? (assuming these aren't all her kids).

Any chance the left breast pain is from a broken implant? I'll let firedoc ask her that question for me =)

BP the same in both arms?

Any medical Hx of note?

Does pushing on the abdomen make her back pain worse?

She would get a code2 trauma activation in my system.

[firedoc5]

She's 26 and there is a 12 year old in the car? Do we need to contact parents ? (assuming these aren't all her kids).

Any chance the left breast pain is from a broken implant? I'll let firedoc ask her that question for me =)

BP the same in both arms?

Any medical Hx of note?

Does pushing on the abdomen make her back pain worse?

She would get a code2 trauma activation in my system.

BINGO on the breast implant. The opening of the airbag ruptured the implant. Don't know exactly why it was just the one and not both. Perhaps how she was sitting, maybe turned to the right just a little bit. It was believed that the airbag did more damage than the actual collision. Patient jokingly said that if maybe she went with a D+ cup it would have given her more cushion. One of the other guys commented saying that any larger, she wouldn't have been able to wear the tube top she was wearing.

The kids in the car was the adult passenger's kids. But I've known several gals at the age of 26 having a 12 yr. old child. (different thread possibility)

She also receive a flailed chest from the door arm rest. Lung sounds remained good bilaterally. Still increased pain upon deep inhalation. Went ahead and placed her on 12L O2 per NRM. Improved the support to site of flailed chest.

Did start an IV NS TKO. Patient denied enough pain to adm. MS.

As for the redness and burning of the legs and arms due to powdery substance from the airbag, evidently she had an allergic reaction to it. Copious amount of irrigating and Benadryl corrected that.

Due to using a KED to remove her from the vehicle and place on long spine board we were not able to fully inspect spinal column.

Enroute, no change in condition. Patient actually seemed relaxed and comfortable considering what she'd been through and her injuries.

[CBEMT]

MVA with chest pain, and a KED was used? Is this common?

[firedoc5]

MVA with chest pain, and a KED was used? Is this common?

To extricate an MVA patient while trying to maintain full spinal immobilize, a KED is useful to go from a sitting position to transition them to a flat lay on a full spine board. Also the tension of the chest straps can help stabilize any rib or sternal injuries. For the past several years they've had KEDs that can be x-rayed through.

If need be, once layed flat and properly secured onto the spine board, you can undo the chest straps to expose the chest to place a monitor or to auscultate the chest or any other examination.

All in all, a KED can be very versatile.

In this case, we were fortunate to have used a KED on her. Her breast implant was an older one made of the kind of silicone that they don't even use anymore. By applying pressure as we did prevented more of the silicone from leaking out.

[AnthonyM83]

MVA with chest pain, and a KED was used? Is this common?

We teach KED for stable patients. Though she had chest pain, the rest of her vital signs checked out and she seemed to be perfusing okay, right? No ABC compromise. KED only takes an additional 2-3 minutes to do it right.

[CBEMT]

I understand the rational for and use of a KED. Around here, it's taught that any signs and symptoms other than minor neck/back are contraindications. For example, I would imagine that a KED would get in the way of a chest decompression should that have been proven necessary for a trauma patient with chest pain.

[firedoc5]

I understand the rational for and use of a KED. Around here, it's taught that any signs and symptoms other than minor neck/back are contraindications. For example, I would imagine that a KED would get in the way of a chest decompression should that have been proven necessary for a trauma patient with chest pain.

If the patient is secure to the full spine board you can open up the KED if necessary. I've had to do it a half a dozen times or so. Just as long as your patient is secure one way or another the KED can be moved.

One thing to do is practice this in class over and over again. KED is one of those things that some people are intimidated by with all the straps and some may think that it's something that's no big thing. After a couple of times of hands on practical they will both change their minds. And it is a skill that has to be developed, especially if it's done right and in a optimal amount of time.