Would you ALS or BLS this patient and why?

[emt322632]

I probably would have ALSed the patient just for precautions. Some older people tend to be kind of stoic when it comes to pain/discomfort.

Just curious, you say the wound was 1" in length, was it more of a slash wound or a stab wound? I just noticed you said "stabbed", so was just wondering to cure my own curiousity...

[Arizonaffcep]

I don't remember seeing anyone respond who is a Basic provider. If there is, sorry about that, I'd be curious to see if any basics out there would be comfortable taking a patient like this. I'm looking for an honest opinion here, don't just "buy in" to the voiced thoughts.

[Arizonaffcep]

I probably would have ALSed the patient just for precautions. Some older people tend to be kind of stoic when it comes to pain/discomfort.

Just curious, you say the wound was 1" in length, was it more of a slash wound or a stab wound? I just noticed you said "stabbed", so was just wondering to cure my own curiousity...

It did appear to be more of a slash vs stab, hence the quotes. It was relayed to us as a stab wound.

[emt322632]

Slash with no deep penetration, no resp. difficulty, no severe hemorrhage = BLS. Monitor v/s enroute, tell the FFs to do a better job of describing the wound to the hospital next time they send a report in and maybe they could have BLSed him.

[Fox800]

ALS, definitely. The wound might look minor, but there is a significant potential for decompensation (pneumo, hemorrhage) that an ALS provider is better equipped to manage.

[mailmantech82]

ALS - No doubt

[emt322632]

It did appear to be more of a slash vs stab, hence the quotes. It was relayed to us as a stab wound.

If it is a superficial slash wound (laceration), I really don't see why ALS interventions would be needed.

[ERDoc]

If it is a superficial slash wound (laceration), I really don't see why ALS interventions would be needed.

How do you guarantee that it is superficial? Are you going to probe a wound in the field that may have violated the pleural space?

[emt322632]

Negative on the probing, but if it did enter the pleural space, wouldn't we expect to see some signs of a sucking chest wound, or a potential pneumo forming?

I don't have alot of experience with penetrating chest wounds, I'll admit, but to me from the OPs original post, it sounds like a laceration more than a penetrating wound.

[WelshMedic]

I'd have personally let him sign a treat and release and gone back to bed in the safe knowledge that his wife would finish the job properly in the meantime. Thus also hushing up my management of this particular patient.

WM