Question about unresponsive patients?

[nypamedic43]

materials available?? liiiike....sticks and the shirt that you've cut off them? or a board splint or a boot splint and ace wraps or cravats. Do you carry splints in your jump bag? Have you been taught how to splint a fractured bone? Have you been taught how to reduce a compound fracture or how to splint an angulated fracture in place? Have you been taught what to look for with a possible fractured hip? I usually use an upside down KED to stabilize a hip...I don't think you have one of those in your bag. My suggestion for this is make note of the possible fracture and make the ambulance crew aware of it.

I once had a sports trainer tell me that one of the students that was playing basketball had fractured her tib/fib. I asked her how she knew that. Her answer was " I can see it and its swollen" I couldnt help myself and asked if she had x-ray vision. I splinted the leg anyway just because I was concerned that it was fractured and by the students description of what happened. It turned out to be a fractured ankle, in the joint. I still laugh when I think about the look on her face when I asked her that.

Edited June 8, 2012 by nypamedic43

[Bieber]

Recovery position, protect airway, compressions if indicated, call 911.

That is pretty much what I would recommend doing as a lay person. As far as splinting, I would just offer to assist the patient to manually hold their injured limb, but they'll know what's most comfortable and what hurts and they'll probably do a good enough job maintaining that position of comfort themselves

No offense, man, but I think you're over thinking this. As a lay person, the most important things you can bring to the scene of an illness or injury is a knowledge of how to do CPR and a cell phone--off duty, I wouldn't do much more myself (maybe get a name, DOB, and history).

Addendum: I recommend not doing any real in depth splinting with any materials on hand because A, the EMS crew may want to resplint it themselves, and B, because the EMS crew may want to give pain management before they do any splinting/manipulation. I had an open radial/ulnar fracture this week and the patient was supporting the limb just fine on his own and I didn't even touch it until I got some fentanyl on board.

[musicislife]

materials available?? liiiike....sticks and the shirt that you've cut off them? or a board splint or a boot splint and ace wraps or cravats. Do you carry splints in your jump bag? Have you been taught how to splint a fractured bone? Have you been taught how to reduce a compound fracture or how to splint an angulated fracture in place? Have you been taught what to look for with a possible fractured hip? I usually use an upside down KED to stabilize a hip...I don't think you have one of those in your bag. My suggestion for this is make note of the possible fracture and make the ambulance crew aware of it.

I once had a sports trainer tell me that one of the students that was playing basketball had fractured her tib/fib. I asked her how she knew that. Her answer was " I can see it and its swollen" I couldnt help myself and asked if she had x-ray vision. I splinted the leg anyway just because I was concerned that it was fractured and by the students description of what happened. It turned out to be a fractured ankle, in the joint. I still laugh when I think about the look on her face when I asked her that.

haha..yes i know all about splinting and have sam splints and everything. we learned specificllay how to splint a fractured hip. given this knowledge, would I splint the hip (or any other bone that I know how to splint if needed)? My training level is a First Responder Edited June 8, 2012 by musicislife

[nypamedic43]

I would leave the hip for the ambulance crew to be honest. As long as you have checked for a pulse before and after splinting of a wrist or an ankle and it looks like you have done a good job with it, the crew isnt going to unsplint it to check. They will recheck pulses and neuro though. I'm not a big fan of SAM splints. I like the boots for lower legs and ankles and board splints for wrists and arms. But that is me. SAM splints just seem....flimsy to me. They are good for knees in a bent position though but thats about all I have ever used them for.

[musicislife]

Recovery position, protect airway, compressions if indicated, call 911.

That is pretty much what I would recommend doing as a lay person. As far as splinting, I would just offer to assist the patient to manually hold their injured limb, but they'll know what's most comfortable and what hurts and they'll probably do a good enough job maintaining that position of comfort themselves

No offense, man, but I think you're over thinking this. As a lay person, the most important things you can bring to the scene of an illness or injury is a knowledge of how to do CPR and a cell phone--off duty, I wouldn't do much more myself (maybe get a name, DOB, and history).

Addendum: I recommend not doing any real in depth splinting with any materials on hand because A, the EMS crew may want to resplint it themselves, and B, because the EMS crew may want to give pain management before they do any splinting/manipulation. I had an open radial/ulnar fracture this week and the patient was supporting the limb just fine on his own and I didn't even touch it until I got some fentanyl on board.

im assuming ALS will not be called for most fractures (in my town we have a volunteer BLS Ambulance corps) so no pain meds would be given by EMT B's

I would leave the hip for the ambulance crew to be honest. As long as you have checked for a pulse before and after splinting of a wrist or an ankle and it looks like you have done a good job with it, the crew isnt going to unsplint it to check. They will recheck pulses and neuro though. I'm not a big fan of SAM splints. I like the boots for lower legs and ankles and board splints for wrists and arms. But that is me. SAM splints just seem....flimsy to me. They are good for knees in a bent position though but thats about all I have ever used them for.

why would I leave the hip alone but not an arm or something like that? Is it because SAM splints would be ineffective on a hip (i only have experience practicing hip splints with rigid board splints)

[Bieber]

im assuming ALS will not be called for most fractures (in my town we have a volunteer BLS Ambulance corps) so no pain meds would be given by EMT B's

No... pain meds...?

I weep.

[musicislife]

i suppose if the bone is sticking outta your arm then ALS may come, but odds are you get a 10 min ride to the ER in screaming pain

[Bieber]

Damn man, that would blow. How far away is the nearest ALS unit? I assume you guys get mutual aid from the nearest ALS service?

[musicislife]

Damn man, that would blow. How far away is the nearest ALS unit? I assume you guys get mutual aid from the nearest ALS service?

on a good day ALS response is like 10 or 15 min..theyre a private hospitals service, not an FD or anything

[nypamedic43]

Hips are very painful when fractured and depending on where the fracture is ie: femur head or the socket itself...a SAM splint would be ineffective. Thats why I use an upside down KED. They support the hip and upper thigh very well.