spenac Posted December 3, 2007 Posted December 3, 2007 " I think we're alone now" sorry that came out loud. :oops: Sir I am with the ambulance is it OK for me to help you? Does he verbally respond? Or just more muttering?
AnthonyM83 Posted December 3, 2007 Author Posted December 3, 2007 He turns to look at you to say "Thanks for stopping to help," but his his cervical spine lacerates his spinal cord and he becomes a quadrapalegic. Fortunately, this is only a scenario. Your game was saved at the last checkpoint (last post), try again.
spenac Posted December 3, 2007 Posted December 3, 2007 OK I'll invade his space and grab him by the head so it doesn't move then introduce myself. Though I would introduce myself first in real life so I am not accused of assault/battery.
mobey Posted December 3, 2007 Posted December 3, 2007 "Sir if you can hear me do NOT move, my partner is going to hold your head to protect you from hurting yourself further." (Partner grabs manual C-Spine) My name is Mobey, I am with the ambulance is it ok for me to help you?
AnthonyM83 Posted December 3, 2007 Author Posted December 3, 2007 For this scenario, I would accept not securing the neck if one cited safety issues (though I personally think that's one of our job's risks when you come upon such a scene). I would not accept assault/battery defense, as (I think) it falls under implied consent and court would probably protect you. The patient says: "Yeah, it's fine." Anything you want to inspect, visualize etc must be stated specifically. Point is just to go over trauma procedures for practice...textbook way, but if it's a good textbook, it's also the street way (for the most part). I personally tell the patient not to move his neck, as I approach, then tell him I need to keep his neck still, as I apply manual stabilization. I don't technically ask, but if he's going to be combative I'm giving him a few seconds to react, say no, get verbally aggressive, give warning that I'm going to touch, before I actually touch...even if only a second or two, that's usually enough to see a reaction.
spenac Posted December 3, 2007 Posted December 3, 2007 For this scenario, I would accept not securing the neck if one cited safety issues (though I personally think that's one of our job's risks when you come upon such a scene). I would not accept assault/battery defense, as (I think) it falls under implied consent and court would probably protect you. The patient says: "Yeah, it's fine." Anything you want to inspect, visualize etc must be stated specifically. Point is just to go over trauma procedures for practice...textbook way, but if it's a good textbook, it's also the street way (for the most part). I personally tell the patient not to move his neck, as I approach, then tell him I need to keep his neck still, as I apply manual stabilization. I don't technically ask, but if he's going to be combative I'm giving him a few seconds to react, say no, get verbally aggressive, give warning that I'm going to touch, before I actually touch...even if only a second or two, that's usually enough to see a reaction. Implied consent would only apply if patient was not with us mentally. Since he answers you have to let him give approval to touch. Now what you say about telling him what you are going to do and doing it, thats OK as he had a chance to say no. Do I notice any bleeding, impaled objects, legs pinned, any angulated limbs, any obvious life threatening items I need to see as I look.
futuremedic3018 Posted December 3, 2007 Posted December 3, 2007 What does the following reveal? ABC's, AVPU, MOI, Physical Exam, Interior condition of the vehicle?
Just Plain Ruff Posted December 3, 2007 Posted December 3, 2007 I can't believe no-one has mentioned the Milli Vinilli cd in his hand.
AnthonyM83 Posted December 4, 2007 Author Posted December 4, 2007 Do I notice any bleeding, impaled objects, legs pinned, any angulated limbs, any obvious life threatening items I need to see as I look. You notice blood trickling from his hairline, though exact source is obscured by his hair. His right lower leg seems to be at an awkward angle, but no blood at this time. These are the only deformities or wounds you see as you visually inspect him. What does the following reveal? ABC's, AVPU, MOI, Physical Exam, Interior condition of the vehicle? Well, if I did all that you for you, there wouldn't be much of a scenario. The diagnosis of injuries isn't that complex, the purpose is to practice assessment skills of the things listed above. Right now, we've got scene-safe, BSI, c-spine, initial visual inspection for wounds. As far the side issue of holding cspine before asking for consent when there's a significant initial index of suspicion for cervical injury, all training's I've had here have told us to secure cspine before making verbal contact. I'm this varies by school....the explanation I was given was it's implied that if you might go paralyzed by moving your neck, you'd want EMS to immediately take measures to prevent it before asking for permission...especially if there's the possibility that you might be altered.
zzyzx Posted December 6, 2007 Posted December 6, 2007 Hey Anthony, Great scenario so far. I think we're all on the same page about basic treament (C-spine, etc.), so can you give us his vitals? GCS? Anything more you can tell us about mechanism? He is the only patient, right? So far this seems pretty straightforward, but I'm waiting for the zebra. :wink:
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