uglyEMT Posted April 13, 2010 Share Posted April 13, 2010 (edited) We were discussing this at the building the other day while working scenarios. This is a hypothetical call.... Dispatched to an MVA with injuries, time out is 0340. On scene you find a SUV on its roof off the side of the road partially submerged in a creek (rural area, late march, water around 40 degrees F). Water level is up to the headrests. No airbag deployment. Driver was unrestrained and ejected, skull crushed, obviously deceased. Front seat passanger is restrained and fighting to keep head above water. Rear seat passenger driver side, restrained, is unconsious head fully above water. Rear passenger, passenger side has self extracated and is sitting on the side of the road hysterical. Fire Rescue is on scene, vehicle stabalized, no fire danger. Front passenger, Female Numerous abrasions to face and arms BP: 148/96 Pulse: 120, bounding Resp: 28, deep irregular Rear Passenger Driverside, Male Laseration to the forearm, abrasion w/ swelling to the left scalp BP: 120/80 Pulse: 100, strong Resp: 12, regular Rear Passenger Passenger side, Female No obvious signs of injury, wet cloths Bp: 90/78 Pulse: 140, weak Resp: 36, rapid and shallow All patients are in their mid 20s. Second Rig On Scene Nearest ED: 30 min Nearest Level 1 Trauma: Over 1hr by diesil ALS is available 20 min out Edited April 13, 2010 by UGLyEMT Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted April 13, 2010 Share Posted April 13, 2010 We were discussing this at the building the other day while working scenarios. This is a hypothetical call.... Dispatched to an MVA with injuries, time out is 0340. On scene you find a SUV on its roof off the side of the road partially submerged in a creek (rural area, late march, water around 40 degrees F). Water level is up to the headrests. No airbag deployment. Driver was unrestrained and ejected, skull crushed, obviously deceased. Front seat passanger is restrained and fighting to keep head above water. Rear seat passenger driver side, restrained, is unconsious head fully above water. Rear passenger, passenger side has self extracated and is sitting on the side of the road hysterical. Fire Rescue is on scene, vehicle stabalized, no fire danger. Front passenger, Female Numerous abrasions to face and arms BP: 148/96 Pulse: 120, bounding Resp: 28, deep irregular Rear Passenger Driverside, Male Laseration to the forearm, abrasion w/ swelling to the left scalp BP: 120/80 Pulse: 90, tachy Resp: 12, regular Rear Passenger Passenger side, Female No obvious signs of injury, wet cloths Bp: 90/78 Pulse: 140, tachy Resp: 36, rapid and shallow All patients are in their mid 20s. Second Rig On Scene Nearest ED: 30 min Nearest Level 1 Trauma: Over 1hr by diesil ALS is available 20 min out OK. due to the water temp, everyone gets rapid extrication out of the car. Protect c-spine as best you can but get em out of the water. At 40 degrees they are gonna be dead popsicles in a few minutes. Why has ALS not been called? Get 3 birds if available and get em there soon. These all get a trauma center. You are gonna get cold, and wet, but hey, that's what makes this fun. Link to comment Share on other sites More sharing options...
uglyEMT Posted April 13, 2010 Author Share Posted April 13, 2010 Sorry should have made it clearer ALS is in route 20 min out. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted April 13, 2010 Share Posted April 13, 2010 (edited) Sorry should have made it clearer ALS is in route 20 min out. Ok, you are gonna need ALS for the patient who is unconscious first. That will be their patient first. Is it a dual medic truck or a single medic/emt truck? Thsi makes a difference. Have the helicopters been called? I would after review, I would call 2 birds Bird 1 gets this one Rear seat passenger driver side, restrained, is unconsious head fully above water Bird 2 gets this one Front seat passanger is restrained and fighting to keep head above water. Make sure you get the front seat passenger out of the car first - as they are fighting to keep their head above the water. If not you will have a cold, dead popsicle on your hands. Edited April 13, 2010 by Ruffems Link to comment Share on other sites More sharing options...
uglyEMT Posted April 13, 2010 Author Share Posted April 13, 2010 (edited) ALS is just a suburban, Medic rides in the back of the BLS rigs with ALS vehicle following. (thats the way we do it NJ ) ALS has 2 medics onboard. If need be LEO or FD can drive the ALS unit. Birds are in the air after your review. Ruff what about the third passenger? low bp and fast heart rate, sign of shock correct? Wouldn't she be the priority after the head injury for the bird? Thats after the rapid extrication of the other 2 of course Edited April 13, 2010 by UGLyEMT Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted April 13, 2010 Share Posted April 13, 2010 ALS is just a suburban, Medic rides in the back of the BLS rigs with ALS vehicle following. (thats the way we do it NJ ) ALS has 2 medics onboard. If need be LEO or FD can drive the ALS unit. Birds are in the air after your review. Ruff what about the third passenger? low bp and fast heart rate, signs of shock correct? Wouldn't she be the priority after the head injury for the bird? Thats after the rapid extrication of the other 2 of course Sorry didn't see that part. Of course she would need to go. If you can get 3 birds great. Do you have access to three birds? You first need to even before ALS gets there, get em out of the water and start your assessments. Patient 1 - what do you find Patient 2 - what do you find Patient 3 - what do you find? Link to comment Share on other sites More sharing options...
uglyEMT Posted April 13, 2010 Author Share Posted April 13, 2010 2 birds only All out of the water. Besides the above mentioned injuries.. Patient 1 Front seat: Abdominal tenderness ULQ Patient 2 Rear Driverside: Contusions consistant with seat belt placement Patient 3 Rear Passenger side: Pelvic instability right side Link to comment Share on other sites More sharing options...
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