Question about unresponsive patients?

[musicislife]

this fall..so damn excited

so basicllay maintain/clear airway call 911 if not done, and cool down if heat emergency is indicated?

and expose only if necessary (example paitient family says he is on a medicine patch, and the PT shows s/s of overdose/poisoning)

[paramedicmike]

You seem really focused on a heat injury. Why?

[musicislife]

i dont know, I was just providing an example..that and summer is coming, we always get at least one or two nasty heat waves

[nypamedic43]

And exposing patients as well. Why? Why would you expose an overdose patient? There's no reason too. There's also no reason to expose them if they have a medication patch on. Find it ( leaving clothes in place) and make note of the location for the ambulance crew. I'm a bit concerned about this unnecessary exposing of patients.

Also some poisons need to be brushed away, depending on what they are. However, don't put yourself in harms way just to prove a point. A patient exposed to poisons, dry or otherwise, need to be decontaminated by people trained to do so and the source used to Devon them needs to be contained.

Edited to add another thought

Edited June 8, 2012 by nypamedic43

[musicislife]

they never taught us when to expose people, unless it was a cardiac arrest. they just said "lift up the shirt and inspect the abdomen if a medical PT is complaining of abdominal pain) so i guess I am gathering that all medical patients, including unconscious ones are never exposed, am I correct? (as far as my first responder level is concerned) and un conscious trauma (or patients where you cannot determine medical vs trauma) will most likely be exposed in some way. correct? just because of my lack of knowledge of when to expose..thats why im focused on it..i dont want to expose someone when it is not required

Edited June 8, 2012 by musicislife

[nypamedic43]

The only thing that is exposed on a cardiac arrest patient is thier chest. Just for the record I never expose a trauma patient outside in front of bystanders, especially if i have nothing to cover them with. They get exposed inside the ambulance. Trauma is going to be obvious....a car wreck, a fall off the roof or down a flight of stairs. If a medical condition caused the fall or the wreck, it's for higher trained providers to sort out. Sometimes bystanders an give you a clear picture of what happened ie: gramps clutched his chest before he fell down the basement steps.

Abdominal pain isn't always going to be a dissecting AAA. It could be their gall bladder or thier appendix. Be careful of diagnosing someone. Supportive care at the first responder level is the best thing you can do for ANY patient, until the ambulance crew gets there.

[musicislife]

so i really should just forget about exposing either by lifting the clothes or cutting (unless its a small area because i notice severe bleeding during an initial assessment) until the ambulance comes, and support ABCs, and control any bleeding?

Edited June 8, 2012 by musicislife

[nypamedic43]

That's correct. If they've cut their arm, cut the sleeve until you can bandage the wound and control bleeding. Support thier airway and breathing. Whoever is on the ambulance, EMT or paramedic is going to do thier own assessments, regardless of your findings.

[paramedicmike]

Whoever is on the ambulance, EMT or paramedic is going to do thier own assessments, regardless of your findings.

This is an excellent point that bears repeating. No matter how thoroughly you assess your patient, the EMT or paramedic arriving on the ambulance should, and most likely will, do their own assessment. This doesn't mean they don't trust you. This is simply being thorough. Do NOT take it personally.

When the EMT or paramedic gets the patient to the hospital the RN and docs will do their own assessment regardless of what EMS tells them.

It's just the way it works. It's not personal. It's business.

[musicislife]

thanks guys. one more...if materials avaliable, should I splint a suspected break (leg, arm, hip, ect) before an amblance arrives?