Help, he's fallen

[Eydawn]

Damn! It was worth a shot. All I could think of improvising, really! Bummer.

Wendy

CO EMT-B

[CC64]

Damn! It was worth a shot. All I could think of improvising, really! Bummer.

Wendy

CO EMT-B

It's surprising, how much stuff you have to have in order to improvise...

[Just Plain Ruff]

The helicopter team came with all the bells and whistles but they forgot to put on a medically trained person.

So they also have a nice hoist for you to swing this guy around in.

You are hooked up to the hoist and along with two other rescue randy's from the helicopter you make it to the patient.

Once there here is what you find.

open fractures of both femurs and tib/fibs

open fracture of the upper arm and radius and ulna.

A large gash in the forehead and a gash with what feels like a fragmented area underneath the laceration - possibly indicative of a skull fracture

What else do you want to know.

[Chief1C]

Conscious? Estimate of blood loss? are the limbs viable, i.e. w/ pulse/sensation, any obvious internal problems, breathing still?

"Send down the MAST"

[Just Plain Ruff]

Conscious? Estimate of blood loss? are the limbs viable, i.e. w/ pulse/sensation, any obvious internal problems, breathing still?

"Send down the MAST"

Semi conscious

blood loss > than 2 liters - the sand is soaked

no pulses in left lower leg

pulses in other leg and arm

patient is breating but seems to be grunting and really working to breathe

and miraculously your studious EMT/volunteer fireman thought to bring the mast pants - they are being lowered down.

[CC64]

Vitals?

Breath sounds?

I'm worried about him having a collapsed lung. Any trachea deviation or JVD? Be prepared to have to do a needle decompression.

I'd disagree with the MAST pants. (people still use them?) Multiple open long bone fractures...this guy is sick. Easiest thing to do would be 2 large-bore IVs, pump him full of fluids and whatever else the ALS protocols call for and you can get away with from med command. The LBB is a whole-body splint, so put him on that, get him to a trauma center ASAP. Consider airway support.

[Chief1C]

I'd disagree with the MAST pants.

To splint the lower extremities, not for shock..

[Just Plain Ruff]

Vitals?

Breath sounds?

I'm worried about him having a collapsed lung. Any trachea deviation or JVD? Be prepared to have to do a needle decompression.

I'd disagree with the MAST pants. (people still use them?) Multiple open long bone fractures...this guy is sick. Easiest thing to do would be 2 large-bore IVs, pump him full of fluids and whatever else the ALS protocols call for and you can get away with from med command. The LBB is a whole-body splint, so put him on that, get him to a trauma center ASAP. Consider airway support.

Vitals

bp 60 palp

pulse 140

resp 8

pulse ox - cannot read

Cardiac monitor - sinus tachy

Trachea deviated to left

loc - near unconscious and unresponsive

You all see where this is goin

you put the pt. in mast pants

2 large bore iv's wide open

Do you intubate or not?

Stokes basket on it's way down

Now what?

[CC64]

Well, (being that i'm slightly tipsy at the moment, please excuse any gross misspellings)

needle decompression to treat the pneumothorax on his right lung. Where to stick the needle, I do not know. assist ventilations with a BVM; if they don't improve, intubate with the advanced airway adjunct of your choice (combitube, LMA, ETT).

Load him up, fly to the closest trauma center...if he becomes unstable en route, then divert to closest ED for immediate stabilization. However, that also depends on local protocols. Thank everybody for their assistance.

[Dustdevil]

I'd disagree with the MAST pants. (people still use them?) Multiple open long bone fractures...this guy is sick. Easiest thing to do would be 2 large-bore IVs, pump him full of fluids...

I'd disagree with the MAST and the fluids both.