If you're by yourself?

[ems94]

So I found myself in a predicament....as an EMR its highly likely that we will by ourselves for x amount of time on certain calls. For ex. A multiple car collision...eta for ambulance is 20 minutes where I live, there are more than one casualties....and I'm the only one on scene....when a collision were taught to expect trauma...now if there are two of us then one holds cspine and the other palpates and assess now were taught not to release c spine until the pt is packaged how do I deal with this if I'm alone

[TomP]

A pt's ABC's will always trump holding c-spine so if you have to take care of those then don't hold it, if those are all OK then hold c-spine until the medics show up, there the one who really need to asses the pt anyway.

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[ems94]

Thanks tom...the medics around here expect us to pretty much have a report ready for them....they want vitals, the pt assessed, and what we've already done.

[TomP]

If you are stuck holding c-spine you can still talk to the pt ask them if they have any other complaints and get a full SAMPLE hx

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You might not be able to give them a full set of vitals but at least your pt will still be able to move there arms and legs. Where do you work anyway?

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[ems94]

What about if I have multiples? I'm a volunteer first responder for my local fd....I don't get paid so its not work. Lol

[runswithneedles]

generally on scenes like those PD/SO/ state troopers will be there before the ambulance. First triage to determine what you have and direct SO/PD/ or state troopers as what is needed. If not than triage them on your own and provide minimal basic care until the ambulance arrives.

[emtandrea31]

Just was in this predicament with a NJ transit bus accident the other day...best thing to do after your triage is complete, Utilize the police officers on scene for the menial, easy to give directions on tasks such as holding C-spine. That way your hands are free to begin assessments call additional resources or deal with more acute pts. In a major event (especially MVCs) theres going to be a larger response of police then on a typical medical call. If you do not have a good rapport with your police officers (I know this is the case in some towns) your next best option is your FD. In the event that they are all busy, the riskier move is to direct willing uninjured bystanders to assist. You have the ability to instruct people on what to do. We should all be adequate in communication :-)

[ems94]

thanks for tips....now if I.can just get law enforcement to help it'll be great. They look at us like trash

[DwayneEMTP]

It's nearly impossible for me to imagine a multi casualty scenario where I would hold C-Spine. Triage needs to be performed, bleeding needs to be stopped, unseen patients need to be looked for, follow up assessments need to be done. C-Spine in such a situation is only valuable to people that don't know what else to do...

Even when you have your hands free and nothing else to do, stabilizing the spine is much more a verbal exercise than a physical one. Sit people down, lay them down, explain to them that help is one the way, put families together so that they don't feel the need to wander into the road looking for each other, remind them to lay still until they can be assessed by a medic, and continue on.

In every single patient, remember, "Life Before Limb"...Getting them to the hospital is what's most important, get them calm, organized, rate the injuries and WRITE THEM DOWN....then do it again, and again until the Calvary arrives...

And if your local law enforcement thinks that you're dirt? There's probably a reason for that. Instead of accepting it as fact, look for the reasons that that relationship exists...you'll be able to find them, and change them if you choose to.

[TomP]

If your by yourself and have multiple pts with serious injuries than its an MCI, remember and MCI is any incident in which the responder(s) are overwhelmed, it can be downgraded once help arrives but while it's an MCI, c-spine is not part of your trauma triage just check RPM and do what you can until help arrives.

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