Leaderboard

I live in an area with a large elderly population per capita. I've seen similar a couple of times because of this. We are instructed to lean to a worse case scenario if there's doubt. The pt hx of having been into the doctor for x-rays late the previous week would have me thinking as you did on scene. (Any known hx of osteopnea or osteoporosis? Pt on Ca+?) I would be worried about a non-displaced fx. While I may not have used a reversed KED, I would have prevented the number of moves you had. Here, our normal practice is to use a scoop (if possible and no chance of other injuries like in this situation). This would have prevented movement of the pt's hips after initial placement on the scoop and allowed movement to the cot and ER bed without extra movement of the body. On scene, did anyone attempt slight manual traction of the pt leg? I've done this in the past and was able to relieve the pain and was later confirmed that it was a femur fx. I've also had a pt with a hip and lateral pelvic fx who's pain was relieved by a traction splint, the ER here told me to leave it off the pt on ground transfer to higher level of care due to the pelvic fx, and I had an ortho PA tell me there that I should have followed my gut and put it back on her because it lowered the pt pain level even though the ER here told me not to. Moral, don't take for granted with elderly pts that pain without visible injury means that nothing's broken. Finding a way to make the pt comfortable and not have to repeatedly move them is the best thing you can do to prevent displacement if there's a chance of fx.

Are you saying this guy is your boss?

The shoe/boot cover is a nice, but probably expensive, item. I'll presume most of us have had the devout Jewish patient, who won't violate the religious laws, and "ride" in the ambulance during the Sabbath, Sundown Friday to Sundown Saturday. Aside from calling Hatzoloh Chevra Volunteer Ambulance (the biggest volunteer ambulance I am aware of, with International headquarters in Williamsburg, Brooklyn, NYC NY), all I can do is remind the patient that a "Grand Rabbi", some centuries ago, said that it was all right to break the Sabbath to save a life. For the uninformed, Hatzoloh seems to be equal parts EMS and religious practice.

I had to think about this alot before posting. I see we are all basically in agreement that we would take the service dog but not "Fluffy". In regards to what Dwayne has asked. Dwayne I see the point your making about what can the dog do that a nurse can't do but have to say, ever been in a hospital for more than an hour? I know in my father's case (he is a quad) they have left him sitting in his own "mess" even after multiple pushes of the call button, have placed the water glass just out of reach of the straw, the TV remote to far for his tool to touch it, the voice button for the phone way out of reach, ect. Now understandable he doesn't have a service dog but do you see where I am going? Say the person has the dog and the nurses do what I mentioned above, minus the mess, the dog would be able to provide for them. Thus removing the animal from the equation dibilitates them. I am not speaking of emotional ties just what the service animal can provide while in a hospital situation. Yes granted as others have mentioned if it will be a detriment to my actions or a threat to my crew then I would leave the animal and make arrangements to get the animal taken care of either by a family member or transported to the hospital by another crew, LEO, or even animal control. I think when you look at it unemotionally you can see where the service animal is actually a help not a hinderence. I think it all depends on the situation and one blanket statment will not cover everything but I do think that it would be a good idea to bring the animal along.

I agree with ER Doc to just take it off. You've got 6 hours of cold ischemic time before you have to worry about lactic acidosis that would be clinically significant. 'zilla

To this specific scenario, did they give any indication as to how long that tourniquet had been in place?