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Patient impaled ... decision time ...


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I would say it was a freak of nature that this occurred and she survied. I did think that since her body was supporting the weight and the airway appeared flexed. I am more surprised the neuro was intact especially requiring so many PRBC's.

I still stand behind my decision to call it, as well it is a potential crime scene until otherwise proven. The Detectives and M.E. would have my arse for moving the body..

R/r 911

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In my neck of the woods, she'd have been called no matter what due to the fact that the nearest trauma center is 1 hour away by air.

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I'm with Ruff on this.

Pulseless/apneic with extended extrication is dead in my area. Add penetrating trauma to the chest to the mix, and I doubt many would be willing to work this.

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What makes you think I'm joking?

For those services carrying plasma, could you not cut the fence post with this? 8)

Seriously, folks... that crew is getting a lot of back slapping congratulations now, but had this patient not lived, they may well have been strung up by their epaulettes for violating the prime directive from school, which is to never remove impaled objects. At least in the US, they would have been. They -- and the patient -- got lucky, in that by some fluke of nature, it all worked out.

This is like the old, "well I once dated the cousin of a guy who knew a guy, who had a friend whose uncle survived a car crash only because he wasn't wearing his seat belt and was thrown clear of the car before it exploded underwater" story. Yes, freak things happen that violate the law of averages. But if you go breaking that law on a daily basis, thinking you are some sort of exception, you're going to lose.

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"well I once dated the cousin of a guy who knew a guy, who had a friend whose uncle survived a car crash only because he wasn't wearing his seat belt and was thrown clear of the car before it exploded underwater" story.

You dated her too, huh?

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Seriously, folks... that crew is getting a lot of back slapping congratulations now, but had this patient not lived, they may well have been strung up by their epaulettes for violating the prime directive from school, which is to never remove impaled objects. At least in the US, they would have been. They -- and the patient -- got lucky, in that by some fluke of nature, it all worked out.

I agree they went outside the "never remove an impaled object" protocol, however, and as they stated, the patient was already in cardiac arrest. How is removing the object/s going to make this patients condition any worse?

Had they transported to hospital and the patient bled out and died the outcome would still be the same - for the patient. I think you would be able to defend these actions in that they were in the best interests of the patient. What was the alternative? Leave the patient impaled on the fence and still dead?

Let's look at this from the patients perspective, imagine you are this patient. What would you want done?

For the record, I personally would have called it based on the facts given.

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