mgarner123 Posted April 29, 2007 Share Posted April 29, 2007 hey guys im currently 17 years old with a wide knowledge of first aid, cpr and life guarding. just 2 days ago i was driving when i witnessed a car accident and immediatly said i knew first aid and everyone grabbed me to go and help out basically an old woman drove into the wrong side of the road after a left turn and crashed into a minivan. the only injured person was the woman driving the vehicle. basically when i ran up to the vehicle i made sure it was off and turned the e-brake on. ordered one man to hold her neck still and another to dial 911 she was lying there completly limp and unconscious, about 70 years old. there was a large pool of blood at the base of the seat, drool coming out of her mouth and no pulse. one person already at the scene said she just had a seizure. by the time i assesed the situation the paramedics had arrived as the fire station was 3 blocks away. im wondering what i did right, wrong and what i should do if the paramedics had not arrived for a while. even though i knew my basics i really eflt that i was not prepared. what woudl you have done in the situation. i felt that i was not as prepared as i could have been adn if this ever happens again i want to know what do. thanks alot guys!! :!: :!: :!: :!: :!: Link to comment Share on other sites More sharing options...
Timmy Posted April 29, 2007 Share Posted April 29, 2007 You did a good job! Your scene safety is the most important thing, seems you did a pretty good job. With an unresponsive patient in this situation tilt their head back to open the airway. You did good with that C spine support. If the paramedics were going to take a while you could carefully taken her out of the car with the help of bystanders making sure you supported her head and started CPR. Other than that control the bleeding and get as much info as possible that may help peace things together a little clearer. Don’t beat yourself up about it, you did your best! Link to comment Share on other sites More sharing options...
parabrandi Posted April 29, 2007 Share Posted April 29, 2007 first of all...thanks for stopping and caring at all. next always remember to protect yourself! good job making sure the car was off, and beware of un-deployed airbags. excellent next step of taking control of that c-spine! Last, great job not making any further attempts since you were unsure of the next step! Thanks for being conscientious...we need alot more first responders like you. Last little bit of advice, beware of "old-lady" blood....they have cooties too. Link to comment Share on other sites More sharing options...
Ridryder 911 Posted April 29, 2007 Share Posted April 29, 2007 Ditto from what others have said and described. As a first responder, you may feel the need to "do more", in reality even with the additional education many of us, there is nothing more we could had done either. We are all first responders no matter what education level, license, etc when we are off duty.. Again, thank-you.. in case no one told you out there. R/r 911 Link to comment Share on other sites More sharing options...
BEorP Posted April 29, 2007 Share Posted April 29, 2007 she was lying there completly limp and unconscious, about 70 years old. there was a large pool of blood at the base of the seat, drool coming out of her mouth and no pulse. one person already at the scene said she just had a seizure. by the time i assesed the situation the paramedics had arrived as the fire station was 3 blocks away. im wondering what i did right, wrong and what i should do if the paramedics had not arrived for a while. even though i knew my basics i really eflt that i was not prepared. what woudl you have done in the situation. Since you asked what if the paramedics had not gotten there so fast I will provide some input. It is a nice thought to get the old lady out and start CPR but remember that you come first. That means that if you don't have a face shield (you don't sound like the type to have a BVM on your belt) then you might want to consider compression only CPR. The unfortunate truth is that if this lady is dead from the trauma there is almost zero chance of getting her back. You did the best you could, but even more importantly than than, you were critical of your performance and looked for ways to improve. Good work. Link to comment Share on other sites More sharing options...
JCicco345 Posted April 29, 2007 Share Posted April 29, 2007 With an unresponsive patient in this situation tilt their head back to open the airway. With this patient you do not want to tilt their head back, trauma patients require the jaw thrust instead of the head tilt. I'm guessing you were taught this at some point. Anyways have someone take c-spine and then extricate the patient out of the car and on to the ground. Have the person at the head control c-spine and open the airway, if the patient is pulseless then start cpr, if you don't have a face mask or anything similiar and EMS is that close then just do compressions @ 100/minute until EMS arrives. Link to comment Share on other sites More sharing options...
mgarner123 Posted April 29, 2007 Author Share Posted April 29, 2007 hm thanks a lot guys i actually do have a mask except i did not have it on me!! can someone explain to me what c-spine is?? thanks guys Link to comment Share on other sites More sharing options...
BEorP Posted April 29, 2007 Share Posted April 29, 2007 With this patient you do not want to tilt their head back, trauma patients require the jaw thrust instead of the head tilt. I'm guessing you were taught this at some point. Anyways have someone take c-spine and then extricate the patient out of the car and on to the ground. Have the person at the head control c-spine and open the airway, if the patient is pulseless then start cpr, if you don't have a face mask or anything similiar and EMS is that close then just do compressions @ 100/minute until EMS arrives. Lay rescuers should no longer be taught the jaw thrust. And to the OP regarding C-spine. By "taking C-spine" we just basically mean holding the head in line until the pt can be fully secured to a backboard. You basically instructed the bystander to take C-spine when you told them to hold the head still. And if you just meant what is C-spine... it means cervical spine. Link to comment Share on other sites More sharing options...
pacman Posted April 30, 2007 Share Posted April 30, 2007 Just being curious, do you know if the patient made it? It sounds like she must have had severe trauma ( especially if she wasn't wearing her seat belt). What I would have done without gloves, masks, suction, backboard, the works: 1. Scene safety ( you turned off the car and had the e-brake applied. Kudos to you. My only other suggestion would be to have someone "direct" traffic temporarily, and only if there was someone just doing nothing. 2. 9-11 call. Its important to understand that you can't do much without additional resources. Thumbs up! 3. BSI- I know you probably didn't have gloves or a pocket mask on you, most of us don't while off duty. You made your judgement call to treat regardless. Thats admirable. 4. C-spine precautions - You assigned this to someone, good! 3. Airway - You didn't have a suction device. Moving the head to the side would have been a big no because of the probable damage to the c-spine. If the paramedics didn't get there sooner, a rapid extrication would have been okay with the help of bystanders. If there was a towel or jacket available, there is a way to somewhat immobilize the head and neck by wrapping it around the neck, crossing behind the neck, and then going under the armpits from behind enabling you to use the ends to extricate. In your situation, the Jaw Thrust would have been the most appropiate thing to do. 4. Breathing - You didn't have a BVM, Pocket Mask, or Microshield. Don't beat yourself up because of it. There was drool and blood coming out of the airway so putting your mouth directly over this would have been dangerous to yourself. 5- Circulation - You noted a pool of blood meaning that this lady was losing plenty of blood externally. She was most likely in hypovolemic shock because of the drastic fluid loss. If any of the bleeding could have been controlled, that would have been great. There was probably massive internal bleeding as well. ALS for fluids and rapid transport would have been key. There was no pulse. Did you check the carotid? Otherwise CPR without ventilation would have been good. Luckily, paramedics came! There was no way or need to take vitals. This lady was probably in hypovolemic shock and was in urgent need of advanced care. If she survived, you contributed to helping her get stabilized. Good job, I would pat you on the back if I could. I don't think there was much else you could do. It is important to do the most you can, in good faith, with regards to your own safety and with respect to your scope of practice. Just remember not to do any further harm. Link to comment Share on other sites More sharing options...
mgarner123 Posted April 30, 2007 Author Share Posted April 30, 2007 ahh tahnks alot pacman that was good help! sadly she did not survive as i read in the newspaper Link to comment Share on other sites More sharing options...
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