firedoc5

We had one Medic report an MVA patient had good pedal pulses bilaterally. Got to the ER and a nurse checked. He had a prosthetic leg from the knee down. I think they still make jokes about it to this day. So you're not the first and won't be the last.

A tap/bop on the nose works pretty consistantly. I might have missed it, but what kind of puppy is it? How big will it get? Sounds like you might have your hands full.

My best guess is Rheumatic fever, maybe?

As far as exposure to the first rescuers there, I've known some guys that would think, "So what? I'm already contaminated. No one else come around us and deal with my illness later." And I've known some that would totally back off until an actual HazMat crew arrived. I'm guilty of doing a little of both. In this instance, if I was the first to make contact, I would have wound up in the shower with him getting soaked. I was fortunate enough to have a few partners that wouldn't back off if I told them to and wind up in the same boat. Luckily as of '89 we were all HazMat certified and had complete HazMat Responder kits on every unit. They were bulky, but worth it a number of times. We had intercepted with other units for meds and other equipment, even with other agencies. We had very good cooperation with each other.

As stated, tube, Atropine, open IV WO. Send fire crew to where he and the dog slid of water and soil samples. Have police completely barricade the house due to possible contamination there. Rapid transport. Check status of air lift. If possible, intercept down the road. Unless that will take longer than your ETA by ground. Sedate once tubed. Visteral 75-100mg. IM if carried for vomiting and cramps. Oh, and call a vet. Unless it's too late for the dog.

You're welcome. Keep 'em coming, Bo.

Between treatment in the ER and then up in ICU, my partner and I helped with a patient that was defibed 52 times. But in the end he didn't make it. It got to the point that one of the ICU nurses (actually I think he was the supervisor that night) almost begged the doc to stop. But for some reason the doc just kept going. We said the patient had "Kentucky Fried Heart".

Amen

"American Pie" - Don McClean

So true...

Tough case.

Naw, he got heavy and I doubt he could make it to half court. :roll:

Yes, O2 sat. before and after placing on O2. Thanx, Terri.

Any headache, neck pain? Other than the sandwich, what else had he eaten that day, and when? Appearance of emesis? Any hx. of kidney or liver disease? Is the cough productive? If so, any blood? Any increase in pain upon deep inhalation or deep cough? Place on O2 12 L per NRM. IV NS TKO Vitals? Heart monitor. BGL when able to. In this case I'd draw a red top for lab at hospital to show what was going on right then. O2 sat? If covered in mud, did he fall while walking the dog? Or could the large dog have jumped on him, or pulled him down? Exactly where did he jog? Any toxins on farm? Very possible of a toxic exposure. Especially inhalation. Go to nearest facility. Try to nail down illness, transfer to larger hosp. if needed. Maybe by then the Air lift would be available. BTW: Very good scenario!

The volunteer service here doesn't have facilities for a crew to stay over night, unless they stay up. The one couch could be a little crowded with three people. At least any night crew lives in town. Very small town.

Which ever way they are most comfortable. Unless they are a trauma patient.

"Rock Me Amadeus" - Falco

I had one partner that had to stick his tongue out the side of his mouth. He also had shaky hands, but he was probably above average on first sticks.

"Would someone grab the hacksaw."

Of course I was offended. Seems like you were implying that my post was detrimental to those with less experience. Who wouldn't be? But I was not angry. It takes a whole lot more than that. You asked my explain myself of why I posted what I did, and that's what I did. PM'ing is not pampering. Many have used it, and still will. Like you said, this is a learning forum. If they've learned something from it, great. Nobody else has posted, or PM'ed, me with having a problem with what I posted. And there is a difference between asking about the reasoning of a post and putting the post down.

GREAT news! Welcome back. Take it easy. Make the hubby wait on you hand & foot, which I'm sure he's already doing. You'd be proud of him the way he kept us updated. I'm sure you're glad to be back. Let us know about the baby regularly. We're all concerned.

Ugly women (and men) need love too. :read:

You are called to the scene of a 49 y/o male He is on the ground unconsious, he is laying next to a large dumptruck, with a wrench a few feet from him, and the hood is up. He is bluish purple from the nipple line up He has no pulse, and no one saw what happened, they only guess he fell Upon opening his airway you find a lot of blood and what appears to be a traumatic injury to the back of the throat, with the appearance of bloody hamburger meat. What is your assessment, what would you do, but the main thing I'm looking for, is why is this guys throat like this, what could it possibly be? This call threw us for a loop until someone told us something that made it make sense. After a couple responses i'll post the answer. ------------------------------------------------------------------------------------------- I don't believe I was way out there. Like described, "Bloody hamburger meat" appearance in the back of the throat. With "a lot of blood" in the mouth. How much is a lot of blood? You never did state if there was any emesis noted on the ground. Is the blood pooled in the mouth or coming from the mouth? Maybe since I've been around it a lot, but, I can't see where chewing tobacco can be mistaken as bloody tissue. Why can't you visualize the epiglottis or Larynx? Don't you have intubation equipment? Is the cancerous tissue blocking it? If it is, then he must have already been having a lot of raspatory problems already. I have seen where a patient has had epiglottis and had been coughing so hard that it caused trauma to the esophagus, epiglottis, and tongue. If you've ever tubed anyone with epiglottitis you can see where it can be very inflamed, making everything look like a raw oyster. Severe irritation can cause that inflamed tissue to bleed, hence bloody meat. Many times with throat cancer, what comes along with it? Esophageal Varices. Whether it be from tobacco use or chronic alcoholism. Again, another post to call someone out instead of PM'ing to ask personally. :roll:

"Rider's Of the Storm" - The Doors

We're in the same neighborhood. BJC was our main destination usually from Mt.Vernon, IL. Barnes is where I got most of my experience with burn patients in a clinical setting. Keeping things sterile is very difficult, especially in the field. But I was always told to strive to do your best to keep things as sterile as you could when it came to burn patients. You may not be able to keep things absolutely sterile, but considering the circumstances keep things as clean as you can.