Just Plain Ruff Posted August 18, 2008 Author Posted August 18, 2008 Air does go into the chest via auscultation. ETCO2 is very good Abdomen is still rising albeit not so fast now.
itku2er Posted August 18, 2008 Posted August 18, 2008 hepatic tear causing the abd swelling? Busted diaphram
Just Plain Ruff Posted August 18, 2008 Author Posted August 18, 2008 Terri you are close. Keep digging and you will come up with the answer This was a actual call I ran a number of years ago.
mshow00 Posted August 18, 2008 Posted August 18, 2008 If is abd is getting bigger just drop a OG/NG tube(depending on if he is able to tolerate either) that should help with the air in the stomache, as for any "free air" in the abd couldn't you just put a "loose" compression bandage on it? What about trying to transport with the head of the bb slightly elevated(gravity working for you)? other than hauling butt and or calling for a helo maybe i dont know what else to do for this pt.
Just Plain Ruff Posted August 18, 2008 Author Posted August 18, 2008 You do not have a ng tube to drop
mshow00 Posted August 18, 2008 Posted August 18, 2008 What about one or both lungs having a "bow out" in the lower lobes from impact on the cinder block? I agree with Itks post of what is going on, taking it a step further though, when was the last time he ate? did he rupture his stomach and is spilling out all of his digestive enzymes? What about his descending aorta, did that get damaged in anyway(check for pedal pulses and injury site below perfussion)?
Just Plain Ruff Posted August 19, 2008 Author Posted August 19, 2008 ok this guy fell from 24 feet he landed directly on a cinder block dead(no pun intended) in the chest he suffered a traumatic rupture of the aorta a traumatic rupture of the esophagus and a tramatic tear in the trachea after multiple views of the trachea and looking at the tube going thru the vocal cords not until autopsy did we realized the damage to this guys internal setup. The reason why the belly kept getting bigger was that the air was going in the lungs (hence the appropriate readings of the etco2) and it was going into the belly thru the tears. This guy was dead when he hit the ground but our service required all traumatic arrests with any type of rhythm to be worked.
CBEMT Posted August 19, 2008 Posted August 19, 2008 You're not alone, he certainly doesn't meet any of my state's criteria for Incompatible With Life- we'd be working him even without a rhythm.
Just Plain Ruff Posted August 19, 2008 Author Posted August 19, 2008 I agree Cb I'd have worked him even without my service requirements.
letmesleep Posted August 19, 2008 Posted August 19, 2008 Go figure, I get started on this scenario yesterday, only to run my a** off and return to it being over!!!! We would have worked him as well depending on obvious signs of death being present such as pooling, skin temp, rigger, yada yada. Obviously, I know! Interesting call Ruff...........
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