DrankTheKoolaid
Forum Deputy Chief
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Day 1. Single vehicle over the bank 25 feet or so, unknown rate of speed with 3 occupants and nobody restrained. I do a quick triage and 1 is walking wounded talking with a CHP officer with a small laceration right forehead with bleeding self limited no other complaint. Second patient is unconcious late teens obese female lying stretched out in the back seat of the midsized sedan with a CHP holding manual cspine with a RR of 12 or so with purposeful movement to deep sternal rub. Patient 3 is a mid 30's male pale cool cyanotic with the appearance of a 70 year old man on his deathbed, found outside vehicle sitting upright on the ground leaning on the right front tire.
RR of 12 guppy breathing with left tracheal shift and sub-q air from the right nipple up to his right ear with NO chest wall movement with respiration attempts. Manual cspine and NRM until BVM and multiple needle kits tossed down to me. Decompress right mid clavicular with minimal change and FR begins bagging. Decompress left mid clavicular with noted decrease bag resistance, while the patient was awake for this he barely flinched and never attempted speech. cspine and up the hill we go. get in truck re decompress right mid axillary again this time with dramatic results, patient now pink with O2 sat from 82 to 93 and HR now 148. Right pectoral area ribs oblitered with no paradoxical movement and rigid distended abd noted. IO placed left leg and 18ga LAC. Patient now starting to actively pull at responders and the decompression sites. No RSI here so was manually restrained and I orally intubated. 4th decompression attempted right mid axillary with the catheter collapsing around the needle agaist the thick leathery cutaneous membrane. Flight crew arrived patient then sedated and paralyzed. away they went. died in ED about an hour later. occupant 2 ended up with a depessed skull Fx and the walking wounded with just the lacerations
Day 2 start the day with a 25 male gcs 4 last seen 11 hours prior with complaint of headache and growing mass at the base of his occiput. Thankfully only 4 minutes from ED. patient hot to the touch and jaw clenched. suction bag and deisel therapy was all i had time for. after he was xfer out of local hospital he awoke at the receiving facility a few hours later and self extubated. they think he was initially an OD, aspirated and had a laryngospasm resulting in gross amounts of pulmonary edema. he's now in cardiac and renal failure
Day 3 starts with an agency assist for the removal of a body from a motor home....... hot summer 400 pounder down for at least a week......... lots of flies and lots of maggets and ill leave it at that
Anyways i just needed to vent this somewhere to get this off my chest so i can now enjoy my fathers day with my daughter
Corky
RR of 12 guppy breathing with left tracheal shift and sub-q air from the right nipple up to his right ear with NO chest wall movement with respiration attempts. Manual cspine and NRM until BVM and multiple needle kits tossed down to me. Decompress right mid clavicular with minimal change and FR begins bagging. Decompress left mid clavicular with noted decrease bag resistance, while the patient was awake for this he barely flinched and never attempted speech. cspine and up the hill we go. get in truck re decompress right mid axillary again this time with dramatic results, patient now pink with O2 sat from 82 to 93 and HR now 148. Right pectoral area ribs oblitered with no paradoxical movement and rigid distended abd noted. IO placed left leg and 18ga LAC. Patient now starting to actively pull at responders and the decompression sites. No RSI here so was manually restrained and I orally intubated. 4th decompression attempted right mid axillary with the catheter collapsing around the needle agaist the thick leathery cutaneous membrane. Flight crew arrived patient then sedated and paralyzed. away they went. died in ED about an hour later. occupant 2 ended up with a depessed skull Fx and the walking wounded with just the lacerations
Day 2 start the day with a 25 male gcs 4 last seen 11 hours prior with complaint of headache and growing mass at the base of his occiput. Thankfully only 4 minutes from ED. patient hot to the touch and jaw clenched. suction bag and deisel therapy was all i had time for. after he was xfer out of local hospital he awoke at the receiving facility a few hours later and self extubated. they think he was initially an OD, aspirated and had a laryngospasm resulting in gross amounts of pulmonary edema. he's now in cardiac and renal failure
Day 3 starts with an agency assist for the removal of a body from a motor home....... hot summer 400 pounder down for at least a week......... lots of flies and lots of maggets and ill leave it at that
Anyways i just needed to vent this somewhere to get this off my chest so i can now enjoy my fathers day with my daughter
Corky
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