mysticlakecasinoemt Posted January 19, 2007 Posted January 19, 2007 Here's a hypothetical for you that's actually an EMS writer's current challenge on a fiction site. Current rescue in the ongoing public script so far is this. Child trapped by the left hand and dangling vertically when playground equipment failed. Thirty feet up. Unresponsive to verbal and pain. Severe arterial bleeding from the trapped hand and arm and the only paramedic access point is from a playground fire pole three feet away until the engine company, and a ladder bucket apparatus gets there in four minutes. An ALS rescue squad with full extrication and medical gear's on scene. (They were giving a school tour). A paramedic is currently up the pole and successfully holding a pressure point at the brachial. How would this child be rescued in detail and what would her detailed course of treatment be? See image. Sorry for the TV character paramedic, but that's where this scenario is needed, on a fiction site that writes new episodes of Emergency, the 1970s TV show for fun with other EMS/Fire workers with fans. Email me or leave post here with any and all ideas. Solution is needed by January 21st, 2007, the episode's airing deadline. Yes, I'm a working EMT but this is one I can't think out of past the usual limb trauma protocol after the fact. I'm being only the editor of this story. I'm just the webmaster here. That fiction website's here. http://www.voyagerliveaction.com/emergency.html Patti
Just Plain Ruff Posted January 19, 2007 Posted January 19, 2007 ok so this is fiction why is there playground equipment that will allow a child to climb 30 feet up anyway? Well let's deal with the scenario Arterial bleeding and the nearest rescue crew is 4 or so minutes away, the child will bleed out in that time. I say Yank that hand free and save her life. Not the best answer but hand or life, I choose life.
vs-eh? Posted January 19, 2007 Posted January 19, 2007 Absolutely ridiculous scenario... Potentially even more ridiculous are those that wouldn't wait the 4 mins for proper extrication equipment to get there. Way too dangerous... What is better, one or two patients? Remember the priorities people: 1. Yourself 2. Your partner 3. Your vehicle 4. The patient Shite happens, too bad. Heroes that you read risking doing stuff like this without proper safety components will eventually be the one's you see dead, adding more patients to a scene, and being read of in a newspaper by paramedics saying "Why the hell did he do that?" What do I win for the correct solution?
chaser Posted January 20, 2007 Posted January 20, 2007 What do I win for the correct solution? Tell him what he won Don...... A brand new playground set for your yard! Enjoy kiddies :wink:
mysticlakecasinoemt Posted January 20, 2007 Author Posted January 20, 2007 Looky all the people who aren't reading the paragraph details. 1. Fiction. 2. Writers script in progress inside the "reality" of FICTIONAL Emergency series. 3. No solutions offered, just questions from half the respondees. Heh. 4. Oh, and did I say this was fiction? *snark* ROTFLMLAO. Anybody game to write in the POV of this pretending used to be show, or not? Come on, I know there's a creative streak in somebody out there somewhere whose got imagination to fit the requested info sought. Consider it a tickle challenge and have fun. *playful jab to the shoulder. 100% mock.*
MedicRN Posted January 20, 2007 Posted January 20, 2007 Wether it's fiction or reality, it still reflects on our profession. The reality is even that fictional show was as close to reality as they could get it in that day and age. If you want ideas from us for your fictional story, then be prepared for some reality answers.
vs-eh? Posted January 20, 2007 Posted January 20, 2007 I know it is fictional. Even if it was posed in a more realistic scenario, my answer would still stand and still be the correct answer. But since you want a creative answer...Mine would involve a jetpack, a rusty spork (yes, spork), and the Canadarm (space shuttle arm). It basically writes itself. No need to go into details...
mysticlakecasinoemt Posted January 21, 2007 Author Posted January 21, 2007 Heh. Can sporks rust? I like the outer space arm concept. Only thing missing is Superman. Nah. So far, the most help has been this reply received from a far more appealing "cozy-er" forum than this particular analytical political monstrosity at EMT City. Thanks any and all for expending gray matter. Read below for an ace perspective on what we were looking for to hand over to the fan writers. "Providing the rescuer could get an anchor point established, and bridge across and set up another anchor point to work from, the sawzall would be a good bet. Once a safe anchor point has been established, prior to cutting the child free you would have to rig a shit sack or a soft style bosun's chair, get the child secured into it, all the while securing and maintaining the ABC's, the rescuer is going to have to rig up a secondary haul point, assuming the entire time that we can find acceptable anchors, haul the child up a slight distance to get the weight off the entrapped limb, and then begin the extrication. All this is assuming that the ladder crew isnt extended yet. Once the child has been extricated you will have to either lower via haul, or ladder, at the same time supporting ventilations, hoping by this time there is a second pair of hands helping with the mechanics of supporting life and extrication. Somewhere in the mix I would have established an airway with OPA/BVM, remembering that the need to ventilate is not always the need to intubate, if the child for some reason didnt tolerate the OPA, I would intubate. (My choice for OPA is solely based on the fact that a vertical intubation hanging on a rope, although not impossible, would involve too many mechanical pieces and actions requiring a high level of dexterity. Preferred method of laryngoscopy would be F2F or a modified skyhook..... The only thing you should focus on in the air besides rescuer safety are the ABC's, and getting to the ground. Once on the ground I would have another MICU crew take over patient care, and provide a hand off from the high angle rescuers to a crew who wasnt fatigued. Beyond ABC's tx for C/Spine, closed head injury, internal bleeding, and other secondary problems. You didnt say how old the child was, so Im gonna go with large bore IV access if possible in the air at two sites if possible, if not in the air, somewhere between arriving on the ground and being loaded into the truck/helo for rapid transport to a Level 1 Trauma center. I would also try and correct the shock related hypovolemia with every basic measure possible prior to using advanced measures such as pharm.... Bruce __________________ Director of Emergency Medical Services, EMT-Paramedic, PHTLS Instructor, AMLS Instructor, Technical Rescue Supervisor "
MedicRN Posted January 21, 2007 Posted January 21, 2007 He is correct in the technicality of the rescue. However, your scenerio is not practical as I doubt any playground would meet code if it were to allow a child to reach a height of 30 feet. If you want fictional reality, keep it practical and within the realm of possibility.
Richard B the EMT Posted January 21, 2007 Posted January 21, 2007 Wow, a "Spork"? The alleged invention of the NYC Board (now department) of Education's hot lunch program, putting fork tines on a spoon, so they only needed one eating implement at reduced cost from 2?
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