New to the Forums---a scenario that gave me some problems.

[xselerate]

Anywho, for this last patient I gather the best thing I could have done was Assess baseline LOC, make sure the ABC's were in order with a quick glance (he was walking around and in no obvious distress) and gather the best history I could.

Whoa Juilin... this strikes me as something to touch on. ABCs are your initial assessment but used to be called the primary survey due to there importance. Some important things can be missed by a "quick glance". It's important to listen to lung sounds, you never know what you will find. It's also important to check the rate and quality of your patients pulse as well as their skin color, temperature and condition in the C step. This can tell you an entire textbook worth of information... shock (I'm not talking about hypovolemia... EMTs equate shock with hypovolemia too often... their are many types of shock including septic i.e. warm skin), cardie history and/or acute cardiac events (dysrytmias i.e. a fib, a flutter or worse) clued in to you just by checking a pulse and skin condition.

Good luck in the field!

[cosgrojo]

The best part was he lived up four flights of stairs and everytime we tilted the stairchair back he would scream and flail around as if we were twisting his head off. Eventually we got him to walk down, albeit very very slowly. Thanks for the help!

Juilin

Stair Chair straps go over the arms, stops them from reaching out and flailing. Oh, and Real tight. If they kick with their legs, tie the legs to the chair with a flat sheet and tuck the ends in so they don't trip you. Safer than walking down stairs with unpredictable patient.

Sounds like you have a good head on your shoulders. The advice given by those ahead of this post are right on. Focus on everything, write down everthing, assess everything, report everything. Eventually you will be able to do a detailed assessment on someone passing you in the mall. That's when you know you have major issues....

[Juilin]

Cos,

I honestly never thought of that and will definetly be doing it on all my patients in the future. I've probably used the thing over a hundred times and this was the first patient who couldnt be coerced with simple verbal remediation. Funny, because I've used the shoulder straps (and restraints) on the gurney to keep patients arms down but never put two and two together on the stair chair. Thanks!

Juilin