cumcoemt84 Posted May 21, 2006 Share Posted May 21, 2006 good lord akflightmedic please forgive me-- I made a mistake, and hammer that pic is funny. I was thanking of that my little one loves that move. one more mistake to add to the list. but please forgive me Link to comment Share on other sites More sharing options...
akflightmedic Posted May 21, 2006 Share Posted May 21, 2006 Oh ok, I didn't know it was a mistake...just asked for clarification...that's all. Just kidding, I make mistakes all the time, but sometimes they are so damn funny, they need to be pointed out so that all may enjoy. Link to comment Share on other sites More sharing options...
cumcoemt84 Posted May 21, 2006 Share Posted May 21, 2006 no problem been some what busy around here today Link to comment Share on other sites More sharing options...
Dustdevil Posted May 21, 2006 Share Posted May 21, 2006 What exactly is a Patten airway? Is that the new quadra-lumen thing? :? Unless I was a very long way from the trauma centre, I see no reason for aeromedical transport. How long is it going to take to get this guy down? Will it require special resources that you do not currently have on scene? [stream:071694444c]http://www.destgulch.com/movies/luke/luke18.wav[/stream:071694444c] Link to comment Share on other sites More sharing options...
TZETAH Posted May 21, 2006 Author Share Posted May 21, 2006 Ok. The pt was found with in minutes of accident. pt was found lying on concrete in fetal position (knees to chest) entire body covered up to his ear lobe by this, what looks to be a crank wheel w/teeth. approx. 1 in gash (laceration), only blood, no other fluids or halo image found upon testing, no other broken bones found, do suspect possible broken spine in lumbar area due to the fact that hips and shoulder (not that the shoulder has anything to do with the lumbar) would take the brunt of claps. right??? MOI- (sorry) This piece of equipment was being removed and was attached to a huge chain that would carry it to where ever it was to be moved to, except the wrong chain was used and would only support up to 3000-4000lb and when the object came loose from the machine it was attached to it jerked and snapped the chain. This caused the piece of equipment to fall on the pt. Link to comment Share on other sites More sharing options...
vs-eh? Posted May 21, 2006 Share Posted May 21, 2006 This scenario makes zero sense. I hope this wasn't an actual call... a) Why is he prone? He has a chest injury from a 3-4 tonne object and he finds it EASIER to breath on his stomach? Who cares...why can't he breath on his back? Unstable chest? Because of the pain of this suspected rib fx? Why? I'd like to see how he is being ventilated while prone and while trying to maintain c-spine... c) Why is he being ventilated? He is talking and moving extremities in pain, he is tolerating bagging? If you suspect a tension pneumo, I would recommend you STOP ventilating him with PPV and needle the chest... d) Where exactly did this 8000lb object "crush" him? And what exactly was the mechanism? I assume it hit his chest...Could be a huge range of problems... Link to comment Share on other sites More sharing options...
Medic2588 Posted May 21, 2006 Share Posted May 21, 2006 Wasn't this an episode of "Emergency"? Didn't Johnny and Roy rescue someone who had an engine crush him in a car, and they boarded him prone, and tried to intubate and then the radio fell off the truck and they couldn't communicate with Rampart? Wow, I walk too much TV. I agree, first off, board supine to better manage the airway. The fact that he can't breath supine alone is a sign that advanced airway manuevers are necessary, in my opinion anyway. Devin Link to comment Share on other sites More sharing options...
TZETAH Posted May 21, 2006 Author Share Posted May 21, 2006 please see my edit on last pg for MOI. As to why prone, remember this is how we found pt upon arriving on scene not the way transported. We would not have been able to intubate the pt (using an AS) if things went bad anyway due to a previous neck surgery, sometime ago, because his esophagus is out of line. (Saw the x rays after arrival to hospital). Even though we didn't know this at the time, if he went unresponsive and we had trouble we would of gone for nasal (never my first choice). Link to comment Share on other sites More sharing options...
vs-eh? Posted May 21, 2006 Share Posted May 21, 2006 We would not have been able to intubate the pt (using an AS) if things went bad anyway due to a previous neck surgery, sometime ago, because his esophagus is out of line. (Saw the x rays after arrival to hospital). Even though we didn't know this at the time, if he went unresponsive and we had trouble we would of gone for nasal (never my first choice). What is an "AS"? What difference would it make if the pt. had previous esophageal surgery? Why would you not have been able to intubate the patient? Anatomy was messed up? I don't follow...Especially when you say you would have done a nasal intubation if he needed airway management. How would a blind technique with whatever complication that would have prevented laryngealscopy be better? Are you saying for decreased neck movement? I don't get it but anyway... Do your initial assessment - Needle the chest if needed (that is actually your first priority) - reassess - ABC's - package - later... Link to comment Share on other sites More sharing options...
hammerpcp Posted May 21, 2006 Share Posted May 21, 2006 Correct me if I'm wrong, but is it not a requirement that you have a mediastinal shift (hypotension, trach. dev. AKA a TENSION pneumothorax) in order to do a needle thorocostomy? Is the pt presenting with this? VS? Link to comment Share on other sites More sharing options...
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