FRANKENSTEIN Posted January 7, 2006 Author Posted January 7, 2006 These are all truly excellent answers I like the response of "treat your partner because he's the only one in the safe zone" Hate to think what would happen if your radio suddenly shorted out... :x
FRANKENSTEIN Posted January 7, 2006 Author Posted January 7, 2006 Ok here's one I saw last month A guy tries to have a little competition between his SUV and the city's light rail, light rail wins (it's a train after all) and his car is totaled with him inside it. You pull up alongside fire, scene is relatively safe (no fire, basically sharp wreckage), but the guy inside is morbidly obese. The vehicle is crumpled on its side. You can't get someone in there to hold c-spine, and no size collar will fit on his neck (giant roll of fat). It's gonna take 40 mins for the fire guys to cut him out of his car (he's too fat for any other solution.) Oh yeah, and since his SUV's on the side, his spine isn't in-line, his head is tilted towards the ground. How do you make it so this guy doesn't go home a paraplegic? bonus points: what would you do if he stopped breathing? (this didnt happen)
MedicRN Posted January 7, 2006 Posted January 7, 2006 These are all truly excellent answers I like the response of "treat your partner because he's the only one in the safe zone" Hate to think what would happen if your radio suddenly shorted out... :x So how did this one turn out???
Dustdevil Posted January 7, 2006 Posted January 7, 2006 ...no size collar will fit on his neck (giant roll of fat). It's gonna take 40 mins for the fire guys to cut him out of his car (he's too fat for any other solution.) Oh yeah, and since his SUV's on the side, his spine isn't in-line, his head is tilted towards the ground. How do you make it so this guy doesn't go home a paraplegic? Textbook answer is maintain manual stabilization, utilizing towels/blankets/sheets or other adjnucts as appropriate. Real world answer is, "who cares?"
Just Plain Ruff Posted January 7, 2006 Posted January 7, 2006 Let's not forget the Amtrak Train that derails with a bunch of Nuns and Priests on board. After the train derails three planes in midair crash and fall on top of the building therby collapsing the building. You take your 4x4's and epipen and run to the nearest bar, get loaded and then run to the local church and confess all your sins and convert to buddhism and move to Tibet to be the next Dahli Lama But seriously - Triage, call for all the help you can get from 10 counties away and pray man, PRAY!!!!!
vs-eh? Posted January 8, 2006 Posted January 8, 2006 Ok here's one I saw last month A guy tries to have a little competition between his SUV and the city's light rail, light rail wins (it's a train after all) and his car is totaled with him inside it. You pull up alongside fire, scene is relatively safe (no fire, basically sharp wreckage), but the guy inside is morbidly obese. The vehicle is crumpled on its side. You can't get someone in there to hold c-spine, and no size collar will fit on his neck (giant roll of fat). It's gonna take 40 mins for the fire guys to cut him out of his car (he's too fat for any other solution.) Oh yeah, and since his SUV's on the side, his spine isn't in-line, his head is tilted towards the ground. How do you make it so this guy doesn't go home a paraplegic? bonus points: what would you do if he stopped breathing? (this didnt happen) You assess what you can and let whoever does your extrication do it. You do your best. In these situations you can never be faulted. If extrication is going to take 40mins regardless of anything and the guy goes apneic...well....if you could potentially get a collar on him (even though you couldn't) and you are ALS you can try to digitally intubate. I doubt you'll get a laryngealscopy in this scenario. I assume you can also check for a pulse... Try that...again if the guy arrests and you still have a prolonged extrication time, get on the phone, and call for potential pronouncement. Obesity aside (which I'm not doubting could compound this guys problems, especially the apnea issue) it is a blunt trauma problem.
FRANKENSTEIN Posted January 8, 2006 Author Posted January 8, 2006 So how did this one turn out??? Um, they got him out after about forty mins, but failed to C-collar him at all. He was paralyzed below the nipple line.
kevkei Posted January 8, 2006 Posted January 8, 2006 You can't get someone in there to hold c-spine, and no size collar will fit on his neck (giant roll of fat). It's gonna take 40 mins for the fire guys to cut him out of his car (he's too fat for any other solution.) Oh yeah, and since his SUV's on the side, his spine isn't in-line, his head is tilted towards the ground. How do you make it so this guy doesn't go home a paraplegic? (this didnt happen) Based on the above information you provided above, why then do you post the following below? Um, they got him out after about forty mins, but failed to C-collar him at all. He was paralyzed below the nipple line. How did they fail to C-collar him at all? It would be physically impossible to do this. Did he have neuromuscular defecits before he was moved?
Dustdevil Posted January 8, 2006 Posted January 8, 2006 Based on the above information you provided above, why then do you post the following below? I understood him to be saying that they did NOT "make it so this guy doesn't go home a paraplegic," which would be consistent with the outcome, albeit a bit confusing.
MedicRN Posted January 8, 2006 Posted January 8, 2006 So how did this one turn out??? I was referring to the first scenario.
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