This week's game of "What's Wrong With This Picture?

[JPINFV]

^ :roll:

Damn Canucks! Don't you know that there is a world outside of North America.

8) :read2:

[jmac]

OK my reading of the pic,

the Pt, this was a mass cas incident so there were med teams there so the lady could have been cleared C-spine and only has the coller on for comfort and transport...she is on a blanket` so not on the plastic for legs up for shock, is nobody thinking MIMMS here ?

as for the pants, its easy to see that the guy is a firefighter and probably not all F/F's are trained up to EMT standard's so in poor visibility it makes sense that he is easy identified, also he could be a vol or part-time thus being supplied with all the Gucci gear.

that's my take and i find it a bit strange to be posting pics from around the world and then dissecting them and criticizing them, especially when you are exporting programmes like 911 emergency and the like

[SSG G-man]

"as for the pants, its easy to see that the guy is a firefighter and probably not all F/F's are trained up to EMT standard's so in poor visibility it makes sense that he is easy identified, also he could be a vol or part-time thus being supplied with all the Gucci gear. "

I wonder how a pair of pants that say EMT make it easy to see the guy is a firefighter? In my area lots of EMTs/ Medics where pants that pull on similar to turnout gear, just different materials. So I do not think that is an assumption you should make. Maybe the medics have the same pants with "MEDIC" on them so you know what level of training the person has. Similar to some fire Departments have rookies, regular fire fighters and officer wear different color helmets to make them stand out.

I think everybody cover the other issues.

[SC MedicMike]

Must not have been that big of an explosion - she still has her flip-flops on!

[rocket]

You guys are missing the forest for the trees.

What is wrong with this picture is the setting. When this photo was taken the EMS provider was actually wheeling the patient through the local fast food drive-thru lane rather than into ambulance or definitive care facility.

-Trevor

[Ridryder 911]

Another EMT that actually believes trendlenburg works..!

R/r 911

[fallout]

Another EMT that actually believes trendlenburg works..!

R/r 911

Hrm, elevating the feet isn't exactly definitive care, but I've definitely seen a change of > 10 mmHg systolic between non-elevated and elevated. /shrug.

[JPINFV]

The Trendelenburg Position: Another EMS Myth

http://www.merginet.com/index.cfm?pg=traum...lenburgPosition

[Just Plain Ruff]

I've never understood trendelenburg

The patient is in shock and having a hard time pushing all the blood out to the body and extremities. If we tend to shut down the peripheral circulation then if the legs were up wouldn't the heart have a harder time pushing that blood into the legs especially if the patients extrems were shut down basically.

to me it's like this, think of pushing a barrel up a hill, it's pretty hard, wouldn't it be more logical to keep the legs at the same level as the heart? It's easier to push that barrel on a flat surface than up a hill.

Just my thoughts.

[fallout]

Honestly, it sounds like the use of trendelenburg and modified trendelenburg needs more study.

I found a bit more indepth recounting of studies where they attempted to analyze the data of pre-existing studies

[web:f0d6e0bb03]http://www.findarticles.com/p/articles/mi_m0NUB/is_5_14/ai_n15950331/pg_1[/web:f0d6e0bb03]

and this study http://www.findarticles.com/p/articles/mi_..._n15950331/pg_1 seems a bit more damming.

Personally, I've been laying patients with hypotension supine and elevating 5-10 degrees on the lower extremities.

In the research I did in response to this, every study was rather quick to state they did not know the optimium position for shock managment. Hopefully there will be a clinical study that examines shock management from beginning to end.