Car Crush

[firedoc5]

On my day off I went to my folks for the weekend. At that time my father was coordinator of the local vol. serv. Called out on a call of car on top of someone. Nineteen yr. old took two six by four boards and placed them over a ditch. He drove his car onto the boards and laid under it in the ditch for more room to work on it from underneath. The boards held until he got under it. When we got there only his legs were sticking out. Looked underneath and had obvious crushed chest and head injuries. Just knew it was a DOA. But found a weak radial pulse. Thought "CRAP". Used two hydraulic jacks to lift the car. Once lifted patient still had a pulse but much weaker. After two minutes lost the pulse. Evidently lost the tamponade. Started CPR. Unfortunately it was a BLS unit, no IV, no monitor. Used MAST device. We continued CPR, knowing we could only keep him viable for organ donation. Had a carotid pulse twice enroute but for a very short time. They did harvest almost everything but the heart.

Later on we found out that instead of calling EMS they called around to find someone with a tractor or something to lift the car for about 20-30 minutes. They didn't think the ambulance would have something to lift the car. I don't think that would have changed the outcome. But it's amazing how little educated some of the general public are.

[Richard B the EMT]

Was this call in an Urban, Sub-Urban, Boondocks, Farming country, or the middle of Nowhere setting?

I am urban, and am perhaps spoiled, that I can get a lot of help, EMS wise, Police wise, Fire and Fire-Rescue wise, in a short time. Plus, ain't nowhere in town more than 15 minutes from an ED, and usually no more than 35 from a Trauma Center.

Medevacs are already handled in a different posting.

[KSEMT122]

Sounds like a typical "Farmer Brown" situation to me. We used to experience this a lot when I worked at a somewhat rural service. Something critical would happen to someone, and they would either A) Throw the unconscious and pulseless person into the back of the truck and drive like heck to the nearest hospital. Or Do just what you described delaying critical care for up to 20 minutes. Of course then you have those that will call the Vet because they think the VET can help more than EMS or a Dr. This sounds like a good opportunity for some community education. I would hit the papers and TV stations and have a spokesperson for that department cause a stink about the way it was handled by the citizens on scene and "remind" everybody to call 911 first!

[firedoc5]

Was this call in an Urban, Sub-Urban, Boondocks, Farming country, or the middle of Nowhere setting?

I am urban, and am perhaps spoiled, that I can get a lot of help, EMS wise, Police wise, Fire and Fire-Rescue wise, in a short time. Plus, ain't nowhere in town more than 15 minutes from an ED, and usually no more than 35 from a Trauma Center.

Medevacs are already handled in a different posting.

It was in a town. Pop. 35. The only "businesses" there is a Post Office and a "Ceramic Shop". So, you could consider it in the middle of nowhere.

[gvandellen]

I'm just curious but isn't it contraindicated to use MAST pants with a chest and head injury?

[brentoli]

I'm just curious but isn't it contraindicated to use MAST pants[s:4c75568ada] with a chest and head injury?[/s:4c75568ada]

Classes here dont even teach about them anymore even though we still carry them by law.

[claas3120]

Only thing we've used MAST for lately was to stabilize the pelvis.

[EmergencyMedicalTigger]

I'm just curious but isn't it contraindicated to use MAST pants with a chest and head injury?

I was thinking the same thing.

[Richard B the EMT]

Before MAST was removed from protocol, the contraindication was a puncture wound to the chest, impaled object (don't inflate section where object is impaled), pregnancy (don't inflate the abdomen section).

[mobey]

. Used MAST device. We continued CPR, knowing we could only keep him viable for organ donation. Had a carotid pulse twice enroute but for a very short time. They did harvest almost everything but the heart.

I didn't realize there were still services out there using them. When I took my PCP one of the students asked "What are MAST pants used for?" My instructor replied "Collecting dust in EMS museums".

I have never seen them, and if I did from what I have read (see Dr. Bledsoe's personal website) I would throw them out the back doors at a high rate of speed.

Although I have had people tell me how many lives they have saved using them (Again see anecdote based EMS by Bledsoe hehe).