fiznat Posted October 8, 2009 Posted October 8, 2009 (edited) Please comment on what you think would be the most efficient way to handle these patients. Start to finish. You You are a double medic crew dispatched to a crash at a major intersection. On your arrival you find two vehicles, one ("CAR") with heavy 8" intrusion damage to the driver's side door and another ("SUV") with moderate front end damage. Both cars have airbags deployed. Patients: 1. Young male, driver of "CAR," out of the car and limping around, holding his head. BP 180/75, RR 22, HR 122, GCS 15, complains of head pain. Reports positive seatbelt, negative LOC. 2. Young male, front passenger of "CAR," still seated in the passenger seat. Screaming about pain to both legs, no obvious deformity on a quick exam. BP 110/82, RR 24, HR 100, GCS 15 but there is a language barrier. Reports positive seatbelt, negative LOC. 3. Middle aged female, driver of "SUV," leaning against passenger side of pain holding belly, 7 months pregnant. BP 134/68, HR 98, RR 20, GCS 15, complains of ABD cramping. Reports positive seatbelt negative LOC. 4. Young female, font passenger of "SUV," 15 feet away from car sitting in the grass. Neck and back pain. BP 114/82, HR 76, RR 18, GCS 15. Reports positive seatbelt negative LOC. 5. Infant in car seat, with patient number 4, reportedly secured in rear of "SUV." No obvious distress or complaints, HR 118, RR 24, skin warm/pink/dry. Resources Available ambulances are: 1. BLS ambulance with 12 minute ETA 2. BLS ambulance with 15 minute ETA 3. ILS ambulance with 15 minute ETA 4. Paramedic supervisor fly car with 10 minute ETA There are two level 1 trauma centers in town, both about 6 minutes away. Please describe what resources you would utilize, which patients would go in what ambulances and in what order. Also please describe the things you would get done while these resources are enroute. Edited October 8, 2009 by fiznat
BoCat9 Posted March 19, 2010 Posted March 19, 2010 Ok- Check for signs of unsafe scene, i.e. fluids leaking, smoke coming from under either or both hoods, etc. Check windshields for star bursts, lift airbags to check for bending of the steering wheel. Triage- Priority 1- -Passenger of car due to severe pain. Did his legs hit the dash on impact? Pt will be transported in first BLS unit. Attempt to find translator. -Driver of SUV due to Abd cramping and pregnancy. Pt's c-spine will be secured and transported slightly tilted to the left side. Pt will be transported in ILS unit to the hospital. Priority 2- -Driver of car, c-spine controlled with rapid take-down, transported on 2nd unit out due to elevated BP and complaint of head pain. -Passenger of SUV, c-spine controlled due to complaint of neck, back pain. Pt transported on 2nd unit out Priority 3- -Infant transported in car seat with towel rolls on either side of head until c-spine injury ruled out. Transported with driver of SUV. While waiting for back-up units I would check vitals and responsiveness again and depending on results order of transport may be changed. Also contact online medical control for orders for the passenger of the car.
ccmedoc Posted March 19, 2010 Posted March 19, 2010 Get the BLS, LALS and the paramedic flycar. Transport patient 1 and patient 3 together with the Basic truck and paramedic attending to level one center ALS. transport patients 4 and 5 together basic on the LALS truck to probably the same facility. transport patient 2 basic from the described assessment. Was this a problem in the real world?? The priority patient is the pregnant woman IMHO...28-30 weeks I am assuming...months is not something would be interested in as describing a pregnant woman, you should get used to speaking in terms of weeks. Not sure what orders online would give, or why to contact other than to give a heads up to the receiving facility and to see what they can take. I think I would not contact med control for any advice here..
DartmouthDave Posted March 20, 2010 Posted March 20, 2010 Hello, Hard, because, 3,4 & 5 are all a family I assume. I just would want the infant with family. #1 & #3 (one ambulance) #4 & #5 (one ambulance) #2 (one ambulance) I assume that #2 will be last due getting him out of the car he is in. Basically, a copy plans above. As for crew set up. Not a huge issue with a 6 minute ETA to a two different trauma ctrs. Cheers
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