JPINFV Posted May 22, 2006 Posted May 22, 2006 I would not give up on the patients in the jeep, if at all possible. Even if they have been submerged for 15 minutes plus, the extremely cold water might be enough to trigger their Mammalian Diving Reflex, which might make for viable resucitation up to 60 minutes after immersion, especially in children. We had a case up here about two years ago with a child trapped under 2 meters of meltwater for over 25 minutes befiore rescue. He recovered completely, and was home within three days. Heres the problem, though. How effective are YOU going to be once you get out of the water. Its not like you're going to be able to change clothes or that there is going to be a hot cup of coffee waiting for you when you get out.
medik8 Posted May 22, 2006 Posted May 22, 2006 I guess it's not fair for me to play...since PRPG told me this story and I know all about it... *8 walks sadly over to the corner and sits indian-style ...big sigh...waiting and reading all that is posted...* :wink: xoxo 8
SingleLovingLife Posted May 29, 2006 Posted May 29, 2006 I agree with MedicNorth - if they are a drowning they are not dead until they are WARM and PULSELESS. Of course scene safety is going to be your first and foremost priority - we are talking about four feet of icy water - no info on whether there is a current, etc. NO ONE should be going in unless they have proper water/rescue training. This being said, with your time limited resources, prioritize ALL patients but do not delay transport of those who are accessible given the weather conditions. Focus attention on drownings when they can be safely extricated. Agreed that an EASY button would be nice here! So glad I reside where the winter temperatures rarely dip below 25'F. Thanks for the posting PRPG.
Spazz3z Posted June 12, 2006 Posted June 12, 2006 im gonna assume i have almost everything that you havent mentioned... therefore get onscene and start prioritizing victims after of cours bsi and scene saftey grabbing blankets and insta-heat compresses to cover the living victims... and call for assistance no matter what the distance... you can only do so much... its ashame gods so damn unfair...
stcommodore Posted June 25, 2006 Posted June 25, 2006 With the current lack of fire-rescue to get jeep people out of the water there probaby going to get black tagged. I would feel odd about leaving someone on scene so if possible everyone on scene outside the Jeep is going with me and we are hauling ass Or we are going to stay and play this one out until someone/anyone shows up
canuckEMT Posted June 26, 2006 Posted June 26, 2006 There is me and my partner right? On a BLS unit, so anyone that can walk on arrival is a green, truck guy if he has a pulse and is breathing is a red, moaning bush is also a red, the occupants of the jeep will have to wait until the arrival of other resources. Get the walking Pt to control bleeding on the Pt in the truck if possible and me and my partner will c-spine the unconcious female and get her into the unit. We will then get moaning bush c-spined and into the unit, followed by pt in the truck and the walking Pt. Having them all in the unit will protect from the enviroment and give us some time until the arrival of other resources. You cannot transport these pt's until there are other resources arriving to take over. That would be abandonment as you know they are there, even though they are probably going to be tagged black in this situation due to lack of resources. But even then, when they do finally get extricated they would be candidates for resussitation due to the freezing water and " they're not dead 'til they're warm and dead" addage. See if you could get the chopper to the pad that is 10 min away and advise them of your situation. Also, see if the responding Fire Dept could pick up the chopper crew enroute to the location, this would give extra hands, then when they arrive you could transport to the pad and they could take 2 of your red pt's, then transport the walking Pt and the pickup Pt to the local ER and return to the scene to deal with the Jeep occupants post extrication. Rescue should have a minimum First Aid training and if they have them extricated prior to your return could start CPR and basic resuss efforts.
primemedic01 Posted September 12, 2006 Posted September 12, 2006 Sorry to open up an older thread, but I'm curious as to what actions were actually taken and what the outcome for the patients were. PRPG?
Mastabattas Posted September 12, 2006 Posted September 12, 2006 Prime You're not alone in wanting to hear more...great scenario...or maybe my brain is just starting to know more what to be doing...colour me intrigued! And Medicnorth...I had not heard of that Mammalian Dive Reflex before. That's something that will likely stick with me for life.
uglymedic Posted September 12, 2006 Posted September 12, 2006 Dispatched via county for BLS mva with injuries. Your the EMT on a limited MIC ambulance, dumped for the call, in your moderately rural district. While enroute, call gets upgraded from BLS to ALS, from ALS to rescue, and from one vehicle to two, to three, to four, with multiple ejections and entrapments. Its -10deg, middle of a blizzard, on Christmas day, and many of your local services are off status for lack of staffing. Your closest ALS next due is roughly 20 minutes drive away, your 20 miles from a trauma center, and suddenly, you feel like going home. But your not even there yet... Lets take this one conservative. What do you want to know so far? This my friend is known as the "Kobeyashi Maru" scenario. If you are not a Star Trek fan, this is a scenario that a starship captain is put in and no matter what happens, he loses. It is to test your character and resolve as well as how you react to losing. I participated in a BTLS course where I was a victim that had multiple GSW, multiple stab wounds, and a CHI due to a baseball bat. No matter what any crew did, I died. I'll add to your scenario. You forgot your boots, your partner is 40 wks pregnant and contractions are two minutes apart (her water broke on the way to the call), one of the vehicles is overturned, glowing, with a "live radioactive material" placard on it, your partner flushed the toilet while you were showering and scalded you, and it burns when you urinate. That should put you in a better spot! :headbang: ug
Just Plain Ruff Posted September 12, 2006 Posted September 12, 2006 and lets' not forget to add that there is a small commuter plane that crashed 100 feet from the wreck and a train carrying nuclear liquid waste derailed and the entire scene is covered in about 2 inches of green glowing soup. To top it all off there is a greyhound bus about to come up on you at 80 miles an hour without properly working brakes. Glad I wasn't there.
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