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When to cut


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Ah shit. Lost the content.. We're having a snowy-ice storm, and there seems to be a delay between lights out and generator take over. Anyhoo.. Nawt directing this at Ruffticles. The noob with the eager shears. Cut with a purpose.

If you cut some old lady's coat off to take a BP, because she has leg pain, and is stable.. You have no business in the back of an ambulance. I've lobbed clothing off patients for various reasons, unrelated to trauma. Unresponsive diabetics, profusely diaphoretic. What do wet patients do? Cool off quickly. The best and only way to warm with my new, favorite tool, the Ready Heat; is if they're pretty damn near naked. But stewing in wet clothing won't help. But if the patient was alert, I'd pull the clothing off. Again.. Nawt directed at Ruffticles. My auto spell check isn't working, so forgive any accident mistakes. Some things I spelled wrong on purpose.

And I'm tired. So you'll have to throw me a bone today.

Absolutely, cut with purpose.

If the clothes don't have to come off????? DO NOT REMOVE THEM. Broken ankle, I'm not gonna take the shirt off unless it's a hot babe from victorias secret and then it better be in Vegas because my wife's gonna be super super pissed.

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If I don't have to take them off I don't. If there's no worry of spinal precautions I try to remove them without the cut. If the pt is conscious I usually ask them how attached they are to the item of clothing I am thinking of cutting. Most people are more worried about their health than their clothes but if they ask me not to cut I try everything I can do not to. If its unavoidable I explain why. Most people understand.

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You know, I don't like to cut anything 'cool', but have rarely had issues with that. And most times that I've needed to decide to cut clothes there's been little time for or question about debating it. Most often you can pull tshirts, button shirts, jackets, etc over the head with very little body movement if you just grab the back/middle of the garment between the shoulder blades and pull them up over the head.

The only times that I've really had personal/emotional issues with cutting people's clothes is with homeless people that had stuff that looked like it would be hard to replace. An insulated or leather jacket, a halfway decent looking shirt/pants, etc. I'm always careful to preserve as much as I can and transport all of their belongings with them regardless of the value that others may place on them.

Again, as mentioned above, it's about respect. If I pull you out of your new car I'll likely give little thought to cutting off your Levis because I'm confident that replacing them won't be terribly taxing. If I pull you out of a box, I'll try and remove them in one piece instead when practical.

Dwayne

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You know, I don't like to cut anything 'cool', but have rarely had issues with that. And most times that I've needed to decide to cut clothes there's been little time for or question about debating it. Most often you can pull tshirts, button shirts, jackets, etc over the head with very little body movement if you just grab the back/middle of the garment between the shoulder blades and pull them up over the head.

The only times that I've really had personal/emotional issues with cutting people's clothes is with homeless people that had stuff that looked like it would be hard to replace. An insulated or leather jacket, a halfway decent looking shirt/pants, etc. I'm always careful to preserve as much as I can and transport all of their belongings with them regardless of the value that others may place on them.

Again, as mentioned above, it's about respect. If I pull you out of your new car I'll likely give little thought to cutting off your Levis because I'm confident that replacing them won't be terribly taxing. If I pull you out of a box, I'll try and remove them in one piece instead when practical.

Dwayne

You just like seeing naked rich people :punk:

There are advantages to working PNG. The patient is already naked!

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You know, I don't like to cut anything 'cool', but have rarely had issues with that. And most times that I've needed to decide to cut clothes there's been little time for or question about debating it. Most often you can pull tshirts, button shirts, jackets, etc over the head with very little body movement if you just grab the back/middle of the garment between the shoulder blades and pull them up over the head.

The only times that I've really had personal/emotional issues with cutting people's clothes is with homeless people that had stuff that looked like it would be hard to replace. An insulated or leather jacket, a halfway decent looking shirt/pants, etc. I'm always careful to preserve as much as I can and transport all of their belongings with them regardless of the value that others may place on them.

Again, as mentioned above, it's about respect. If I pull you out of your new car I'll likely give little thought to cutting off your Levis because I'm confident that replacing them won't be terribly taxing. If I pull you out of a box, I'll try and remove them in one piece instead when practical.

Dwayne

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The MOI dictates whether we cut the clothes off or not, we do try to remove them in some cases without cutting, and always trying to preserve the dignity of the person.

First of all, where in the bloody hell is my cookie and is it a chocolate one? :D

Missed injuries are one of the biggest causes of preventable trauma death but I don't think the mechanism alone can be used to determine whether or not clothes are cut off. You have to use clinical judgement and what benefit its going to give you.

I've never cut anybodies clothes off and I don't really think it's very common here.

Excellent work on preserving the patient's dignity and privacy; the high tech ambo blanket or sheet is a great bit of kit! It also helps to keep the patient warm

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Im pretty sure this has been a thread before way back when. I try not to cut off the cloths of the homeless or if in reality I dont need to. There are those times that I am recieving a pt that has been packaged by a first responder (exp a logger) if their cloths are not off when I get them I dont take them off until in the ER (be aware my ER is about 5 min code three away from where I get them) where I have alot of help because most of these guys are spinaled and very large men and I would cause more damage.

You have to be aware of the settings, if it is 40 below are you cutting someones cloths off in the street, or waiting until your in the ambulance.

As for patient dignaty it is a pretty big deal in our little world and there are those times it is out the window but it can be handled well for example, I had a lady that was nudged by a car while walking with a walker. She didn't have the time or ability to put her hands out to protect her neck. She went face first and her neck was broken. Now since we had to start CPR and we had alot of FF to help, they grabbed blankets and made barriers so that the general public couldn't see us cut off her shirt and bra, it worked well for that scene.

When I do have to cut off the cloths in general I will go and find new stuff for the pt. (there are those exceptions to that rule)

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But...but...that's why I got in to this business. Where else can I strip someone and get paid to do it?

Seriously, I only cut when I need to for treatment or assessment. Sometimes I don't cut enough and I need to get better. And, if the patient is conscious and the need is REALLY there, I explain to the patient prior to cutting precisely WHY.

And, sometimes, the wife is ELATED when I have to cut that one particular shirt off her husband. :D

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