itku2er Posted June 15, 2006 Posted June 15, 2006 Any kind of critters near him like a snake or anything like that?
Callthemedic Posted June 20, 2006 Posted June 20, 2006 So........... where's this going? It's been awhile since we offered input. If I'm in the ballgame with the venomous fauna just desribe the site of invenomation and suck it up. You can't think that you'll fool us all the time.
09E Posted June 20, 2006 Posted June 20, 2006 I would vomit and fake a seizure. R/O C-Spine on a dime, no indication of such. ABC's -123. If unable to intubate (GCS of eight) I would cric that bad boy.....like yesterday. B/L 14g wide open to begin with, one saline, one ringers. Cardiac monitor, 12-lead, BGL, perhaps hammer in some narcan. Drive with undo care and attention to the nearest trauma center (just in case). And that my friend is the Shiite.
EMS_Cadet Posted June 21, 2006 Author Posted June 21, 2006 Would scene safety include no brush/cover in that ditch where venomous fauna would be? Sorry.....Nothing in site. Rapid trauma assessment (to rule out and inspect the skin) Tell me what you want examined...I don't do it for you Contents of pockets,backpacks,etc You find nothing....No ID or anything....
EMS_Cadet Posted June 21, 2006 Author Posted June 21, 2006 Any kind of critters near him like a snake or anything like that? Just a hint....This has nothing to do with anything venomous
AZCEP Posted June 21, 2006 Posted June 21, 2006 Move to LSB, more for ease of moving the patient than for immobilization. BLS adjuncts, and bag-mask-ventilation as we move to the ambulance. Ambient temperature of environment? Any idea how long he has been there? ETOH? Evidence of drug use? Pupillary response? BGL? VS/ECG/EtCO2/SpO2? Bilateral IVs are a bit much, one would be good for now. 12.5 gm of Dextrose, reassess BGL, consider more definitive airway. Transport by ground.
SC MedicMike Posted June 21, 2006 Posted June 21, 2006 C-spine is a given. If I'm able to do a sternal rub, he's probably supine. Are initial ventilation attempts successful? Rule out and/or address airway obstruction. Return of spontaneous breathing? If not, intubate. If no witnesses to what happened, perform a rapid trauma exam (track marks? medi-alert bracelet or necklace? DCAP-BTLS...). Log-roll him onto an LSB and initiate priority transport. At this point my paramedic partner will take over in the back of the truck, while I drive to the ER.
MrSpykes Posted June 21, 2006 Posted June 21, 2006 Open his airway using jaw thrust give him two breaths with the BVM. If breathes went in fine do a rapid trauma survey and then log roll him while checking his back onto backboard give him extrication collar. Bag him at twelve a min. Check lung sounds and vital signs(P,R,T,BP,BGL, pupils, O2 sat) Move him to the truck. put him on monitor and get a large bore IV with NS at TKO. Lets boogie to the ER. Cut off all clothing reassess with head to toe survey. Keep him covered with a warm blanket He is getting tubed and check his capnography. Give him half dose of narcan and see if that improves his status at all. I dont want to give any sugar yet because of possible head injury i want to know his BGL first.
madmedic8522 Posted June 25, 2006 Posted June 25, 2006 unresponsive, "blue", no pulse and apnea.......sounds like cardiac arrest, what's the quick look??? 11 min response, does anyone know long he has been there? did any of the first responders start CPR? what is skin temp? are his arms straight up in the air or is he still bendable, LOL? madmedic
SA_Medic Posted June 25, 2006 Posted June 25, 2006 Ok, let me try and get in on this one. Obviously you have covered the primary survey. How about including the vitals right about now??? Since the patient is not breathing, I will take steps to secure the airway in the most reliable way for the moment. Whether it be invasive or non invasive will depend on the rest of the vitals. IV will be established (vitals will decide whether it be bilateral or not), all other necessary precaution will be taken in accordance with "rather over protect than under-protect" what c-spine is concerned. Vitals will also indicate what drugs, if necessary, will be administered.... Please do be so kind and supply us with vitals, this will allow us to treat the poor guy and get him carted off to casualties. Bear in mind though, he has been laying in said ditch for more than ten days (original date of this post). which means he is past saving and is most probably infested with "nasty little critters". Regards
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