massive aneurism

[DwayneEMTP]

I seem to be repeating myself. Maybe this is the wrong forum to request prehospital emergency care for an aneurysm victim. The death was not reported to the Coroner or the safety authority, therefore, no autopsy was performed. I am only a PCP student, which heard of this ignored 2006 incident. These workers are mostly immigrant workers and do not speak English. They rarely report hazards or refuse unsafe work. I took the initiative to report it to the Coroner's Office. Our Coroner is now investigating this incident. However, he is not a Doctor, and may conclude that that nothing could have been done for a victim.

I am ensuring that the circumstances surrounding this ignored death are thoroughly investigated, in the hopes that similar deaths can be prevented in the future. My original question was: what advance protocols can be used in the streets to address this emergency? I did not think that this effort would be taken in such a sinister way.

I can see your frustration man. I think much of it comes from dealing with the fact that sometimes people come here asking for 'medical' opinions when what they are really doing is trying to fortify a lawsuit, and most of us don't like giving trolls a bunch of half wit information they intend to use for purposes not in line with the purpose of this website.

My answers, to what I believe you've asked...

I think it should have been reported to a coroner. Every death here is reported to a coroner so I'm not sure how it works where you are. I don't understand though, if this was not investigated, with an autopsy done, how then are you certain that she died of an aneurysm? I wouldn't expect this to be outwardly obvious.

Not only is there little to nothing to be done prehospital for a pt identified to be in this condition, I can't imagine that this case would commonly be identified prehospital. I might have suspicions in a relatively new onset localized unresolving headache, but I would certainly never have a high level of confidence in my differential. We have a medic at our service that often has relatively severe headaches for days at a time. It's never occurred to me to report her to management believing that I've identified a newly emerging aneurysm. She's full grown, I've asked, as a friend, that she get it checked out, the ball is now out of my court.

Unrealistic case? Pt crawls into my ambulance and says, 'I'm a neurosurgeon and have, just moments ago, diagnosed myself with a cerebral aneurysm that I believe may be rupturing, please help me!' I'll but him on my cot, leave him sitting up, start him on Os, get a line, monitor his vitals until I get him to the hospital. Should he suddenly scream and become unresponsive then I'll open up the fluids and watch them run while he dies. That's pretty much it brother...my entire tool chest for this type of patient.

Unfortunately, some people are going to die no matter how much we'd like it to be otherwise, and unless this manager is going to force every headache, dizziness, general malaise, cough, shortness of breath, abdominal discomfort, leg cramp, to go to the emergency room, I don't really see what could have been done here, with the information you've given.

Not sure if this helps, but I do hope that you'll see that it's my best effort to answer your questions as I believed they were asked...

Dwayne