Para-Medic

Well, I think that C-spine immobalization protocols are just sometimes to general. The biggest indications of a needed CSI for me are poor sensation/motor skills, visible damage, obvious MOI that is known to cause C-spine damage, head/neck trauma, etc. For example, if someone falls off a small ladder and hits a rock that breaks their arm (lets say he fell from 4 ft high) we would splint their arm. Obviously, this would be done after the proper examination. Let's just say the examination revels this patient to not have any other complaints or obvious problems besides the broken arm. On the other hand, some people could say well maybe this guy didn't show signs of internal nerve damage but it would be on the safe side to board him. That arguments is hard to counter because you can't prove them wrong or right. So most people would just say just to be careful board them.

Oh come on wendy, not to be cruel but that kid knew what he was doing. He was planning that jump out and all. I just hope he learns not to make such idiotic decisions like that anymore.

ok, here is a video that I saw that made me think about the question I asked: http://video.google.com/videoplay?docid=-3868751167005642764 Now, you must be laughing because I know I was. It's not exactly visible but lets just say the kid broke his leg. It was a fall, it was a cushioned fall, but basically a sudden stopping force can be considered the MOI in any situation. Now, the kid didn't hit his head or land on his back or anything. But he still sustained an injury, now if the kid said he didn't have any back/neck pain would you still c-spine immobalize him? I say yes because the sudden stop could of jerked something out of place. But I know some would say no becuase the kid wouldn't be complaining of neck/back pain and because he didn't really land or hit his back or head. So what would you all say?

Hi, Im trying to find if this could be a rule of thumb to determine if someone should get C-spine immobalization. Consider if someone's body was traveling at a rate in which the impact of a stop broke a limb or dislocated it, would you consider this as a rule to place someone in c-spine immobalization board? The acceleration could be caused my a fall, car, being thrown, etc.

quick question. If someone was showing poor MAP as you suggested you would commence CPR right? They would also have to be unconciouss and showing signs of poor perfusion too right? If this person was on a monitor and showed a heart rate of 10-15 would you want to do compressions as the monitor shows? Or just count every 2 seconds?

Just to be sure, only assist with BVM if signs of poor perfusion are present, right?

I was actually looking for this information. Could you tell me where you found this info?

During that moment is the parent or guardian withheld for any reason? Do you need to get any important information from the parent or make them sign a form?

Hi everyone, This might be random but since the news about abortions it got me thinking. I remember there was something about women who wanted to leave children/infants could go to fire departments to drop them off there. I'm guessing to reduce infant deaths from abandonment. So, I'm wondering if anyone here has had this happen at their fire departments. Also if you all have some sort of procedure to handle this situation.

Hi everyone, I remember we had a discussion about this is class about identifying which is the entry/exit GSW. Besides asking the patient or any witnesses how would you identify it? From what I have heard the exit wound is sometimes (or usually) the largest gap while the entry is small. Still, our instructor told us he has seen some GSW where the entry wound was bigger than the exit and vise versa. So I wanted to know if you all know how to properly identify them. Also, would identifying them change or influence the care of the patient (either BLS or ALS)? If yes, how? Just curious on these sort of things. If anyone has any advice please post. THANKS

What are your devices to use when a C-collar doesn't work. Living in Houston it's amazing how many people just have huge necks (of course when you are considered the most overweight city in the US it's not much of a surprise). I have seen some people role up towels and use them kind of like blocks. The problem is some partners of mine just get stressed and pretty much say f*** it and use tape to hope their head and head blocks. I wouldn't like for them to do this if there was a serious injury (which we never know when it could be) so I was wondering if anyone has some suggestions. Hope to hear from you all. THANKS : )

Yeah, that's what I thought. I really just do not know enough about it to make such a decision. What about lowering the LPM?

I think I understand evaluating a patient and supplying what is needed. Still, I don't think I would withhold O2 from a patient at the beginning of my assessment. I mean, let's say we have a call 78 YO Male with COPD who has a C.C. of SOB. As soon as I arrive. I ask what's wrong and listen to what they have to say while evaluating. I would check airway, breath sounds, O2sat (this wouldn't take long). Then as soon as Im done evaluating respiratory I would give them O2. While taking the rest of their vitals/history/meds/evaluation I would monitor how the O2 would help them. Depending on how the O2 affects them is when I would make the decision on keeping them on O2 or not. Still, I probably wouldn't take them off the O2 because our paramedic would immediately ask us why this patient that called with SOB didn't have O2 on. Would you all consider this to be a reasonable way of treating the patient stated above?

I found one but dunno if it's too explicit for ya or not: http://i23.photobucket.com/albums/b356/Mel...s/jennafire.jpg

That is exactly what I thought about afterwards. Seriously, I really do wish EMT-B classes were more detailed in things such as pathophysiology, more anatomy, etc. I mean, our class was like 4-5 months long. Personally I think the reason they don't go too much into detail about it is because it would confuse us. Remember how I said my partner got mad at me for giving them O2 through NRB instead of nasal? Well, I think she just studied too much on COPD and CO2 retention, hypoxic drive, etc. and now would think about limiting the amount of O2 to give patient. Like Asys said just give them O2, that is what they need. If you have someone thinking about hypoxic drive and etc. they loose concentration on the main issue. Still, I think with the proper education we would all benefit from it.