the 100% directionless thread

[STXmedic]

Are you planning something.......

:rofl:

 

[the_negro_puppy]

Had a good trauma the other day...

40 y.o M motorcyclist collided with a car going approx 80 km/h.

On scene pt GCS14, BP 90 systolic in extreme pain.

Sadly for us (but good for the patient) we had lots of resources including our med director. Partner and I pretty much organised equipment and prepared drugs.

FAST scan performed, positive for significant bleeding around spleen. Suspected pelvic fracture , # L) ribs and pneumothorax. Lost radial pulse shortly after

Pt was given fentnyl for analgesia before he was RSI'd with 80mg ketamine and rocuronium. Tubed, with thoracotomy peformed.

Enroute he received 2 units of packed red blood cells, 1 L NS, and Tranexamic acid. Got him to hospital, HR 136 not sure of what BP was sitting at, very very grey in appearance. Bypassed ED went straight to theatre. Apparently he's still alive.:wacko:

 

[NomadicMedic]

Does the medical director routinely respond to calls of that nature? Did he (or she) bring the blood products and TXA? Is that normally stocked on the doctors car? Sounds like an excellent run...

 

[shiroun]

Does the medical director routinely respond to calls of that nature? Did he (or she) bring the blood products and TXA? Is that normally stocked on the doctors car? Sounds like an excellent run...

x2, I'm curious. When I used to volly I never had the MD come on scene, even when we had some seriously nasty stuff go down (5 year old with four GSW, MVA headon at 80mph each car, or a flipped car that had been going around 120 from what the leo's told us).

 

[Anjel]

The people from down under get all the cool stuff.

 

[shfd739]

The people from down under get all the cool stuff.

Yes they do...:glare:

 

[BandageBrigade]

x2, I'm curious. When I used to volly I never had the MD come on scene, even when we had some seriously nasty stuff go down (5 year old with four GSW, MVA headon at 80mph each car, or a flipped car that had been going around 120 from what the leo's told us).

..you've seen quite a bit for a 17 year old student..

 

[Shishkabob]

I understand you've been a nurse since the beginning of time, and when you started, EMS was really nothing more than 'ambulance drivers', but 40 years later, we have an education and we have aggressive treatment regimens. You may not agree with what Paramedics can do today, but you have no say otherwise.

 

[EpiEMS]

Does the medical director routinely respond to calls of that nature? Did he (or she) bring the blood products and TXA? Is that normally stocked on the doctors car? Sounds like an excellent run...

To add to this, was the FAST performed on scene?

 

[lightsandsirens5]

Hmmmm....used to like iOS a lot. Am kind of hooked on Android now. Remains to be seen how this one plays out.

 

[the_negro_puppy]

Does the medical director routinely respond to calls of that nature? Did he (or she) bring the blood products and TXA? Is that normally stocked on the doctors car? Sounds like an excellent run...

Yep, our boss routinely responds to calls. His car has warmers which contain blood as well as other geat. Here's a vid of him in action lol

http://www.youtube.com/watch?v=i_sDhcB7kSI

x2, I'm curious. When I used to volly I never had the MD come on scene, even when we had some seriously nasty stuff go down (5 year old with four GSW, MVA headon at 80mph each car, or a flipped car that had been going around 120 from what the leo's told us).

We have several MD's working for us who specialise in pre-hospital trauma. There is usually always one on duty to respond to major trauma in our capital.

The people from down under get all the cool stuff.

Indeed the Doctors and Intensive Care Medics get good stuff but on these major calls, the stock standard medics get pushed out of the way.

To add to this, was the FAST performed on scene?

Yes, once we had him loaded the FAST scan was performed on scene while he was being RSI'd

 

[bigbaldguy]

Yep, our boss routinely responds to calls. His car has warmers which contain blood as well as other geat. Here's a vid of him in action lol

http://www.youtube.com/watch?v=i_sDhcB7kSI



We have several MD's working for us who specialise in pre-hospital trauma. There is usually always one on duty to respond to major trauma in our capital.



Indeed the Doctors and Intensive Care Medics get good stuff but on these major calls, the stock standard medics get pushed out of the way.



Yes, once we had him loaded the FAST scan was performed on scene while he was being RSI'd

Words fail me

 

[bigbaldguy]

Yep, our boss routinely responds to calls. His car has warmers which contain blood as well as other geat. Here's a vid of him in action lol

http://www.youtube.com/watch?v=i_sDhcB7kSI



We have several MD's working for us who specialise in pre-hospital trauma. There is usually always one on duty to respond to major trauma in our capital.



Indeed the Doctors and Intensive Care Medics get good stuff but on these major calls, the stock standard medics get pushed out of the way.



Yes, once we had him loaded the FAST scan was performed on scene while he was being RSI'd

Words fail me

Oh wait I thought of some.

Holy :censored: :censored: that is bad:censored:. Dr Rashford should wear a cape!

 

[JPINFV]

Oh wait I thought of some.

Holy :censored: :censored: that is bad:censored:. Dr Rashford should wear a cape!

 

[bigbaldguy]

Who wants a contest? Don't forget to go to the lounge and subscribe to the contest thread for up to the minute info on EMTLIFE contests. Don't miss your chance to win cool EMTLIFE swag.

 

[EpiEMS]

Oh wait I thought of some.

Holy :censored: :censored: that is bad:censored:. Dr Rashford should wear a cape!

Agreed, it's badarse (does arse get censored?), but I wonder how much of a difference it makes in survival and quality of life post-hospital.

 

[bigbaldguy]

Agreed, it's badarse (does arse get censored?), but I wonder how much of a difference it makes in survival and quality of life post-hospital.

Who cares? Lol c collars and back boards and flashy lights probably make no difference and they aren't half as bad :censored:

 

[DesertMedic66]

Really want to get an off-road prerunner style bumper for my truck. Only issue is, it's illegal to have them per the wonderful California vehicle code :angry:

 

[medic417]

I sure hate when a good thread gets locked. Ruins all the fun, I mean discussion.

 

[the_negro_puppy]

Agreed, it's badarse (does arse get censored?), but I wonder how much of a difference it makes in survival and quality of life post-hospital.

Well for the guy in the vid, if he was GCS3 on scene it probabl wouldnt have made much difference.

But to the trauma patient I had the other day, I can honestly say its quite likely he would have died without the interventions.

The scene time was 36 mins including FAST scan, RSI etc. If it was just my partner and I plus a few bystanders the scene time would have been similar.
We essentially brought the ED/ER to the patient and bypassed it taking patient straight to theatre. Without these interventions with the scene time plus 25 minute transport time, plus full workup required in the trauma room, I think this patient probably would have bled out and arrested either as we arrived or while being assessed in the trauma room