anyone ever have a job with a ruptured breast implant ?

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medicstudent101 said:
That whole post. Or at least I hope you are.
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Not kidding at all.

I personally know of 4 EMT's that were charged with Sexual Assault for checking femoral pulse with not being able to prove medical need.

Breast implant failure is 1%. Even if it does occur, an EMT has no training to do anything about it. An EMT also has no need to feel the breast.

My experience in the doctors office was real. I had a blast and so did my wife. We threw them against the wall, hit them with books, a hammer, jumped up and down on them, and finally cut them with a knife. (These were samples of course)

The first thing I see most newbies do is try to go above and beyond their training and/or SOP. Trying to play hero does nothing but get you into trouble.
 
crazycajun said:
We have a label for people like the OP. "A sexual harassment lawsuit waiting to happen". You seem very concerned about Femoral pulses, breast implants, etc. The facts are simple, you will likely never have the need for checking femoral pulse. If you feel the need and cannot justify your actions the term "Sexual Assault" comes to mind. Same as with implants. You have absolutely no training or tools in your little bag to help a woman with this type of injury. Furthermore with a little research you would find that implants are very tough. It takes an extreme amount of injury to burst one. My wife has them and I can tell you first hand we did everything we could to destroy them at the doctors office before she had them implanted and it was nearly impossible. It took a very sharp knife several attempts to pierce it and most will auto seal. No offense but I am glad you don't work in my department. The legal troubles you are heading to could bring down an entire EMS system.
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Did the OP say anything about touching people inappropriately?

anyone ever have a job with a ruptured breast implant ?
Please tell all.

As always, leave out any information which would identify the patient in any way, violate HIPAA, your local protocols, or your agencies policies.
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...Nope. He's looking for advice on what to do if a specific situation were to come up. How is this any different than asking about a rectal bleed or an abscess on the labia?


As far as a ruptured implant, if there's external bleeding, do your best to control it with direct pressure. Avoid unnecessary touching (includes palpation of the breast, you're not going to learn anything useful) and explain everything you're going to do before you do it. And do your best to keep your patient covered up if you can.
 
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crazycajun said:
We have a label for people like the OP. "A sexual harassment lawsuit waiting to happen". You seem very concerned about Femoral pulses, breast implants, etc. The facts are simple, you will likely never have the need for checking femoral pulse. If you feel the need and cannot justify your actions the term "Sexual Assault" comes to mind. Same as with implants. You have absolutely no training or tools in your little bag to help a woman with this type of injury. Furthermore with a little research you would find that implants are very tough. It takes an extreme amount of injury to burst one. My wife has them and I can tell you first hand we did everything we could to destroy them at the doctors office before she had them implanted and it was nearly impossible. It took a very sharp knife several attempts to pierce it and most will auto seal. No offense but I am glad you don't work in my department. The legal troubles you are heading to could bring down an entire EMS system.
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Dude, it was just talk. I was just curious because of my saline question in another thread. When I did a online search I got a lot of hits on ruptured breast implants.

Regarding the femoral pulse. I was trained to check in severe trauma cases, with shock, and a means to establish a quick systolic, in a mass casualty.

If the scenarion warrented it, according to protocols, and no female member present, I would do a quick head to toe on a trauma patient in front of a partner or patient's family member and the intention would be to asses condition and not gratify myself.



There is a gross distinct difference in asking a question about a real potential scenario and assaulting someone. And also kidding around online with anonymous strangers.
 
emt seeking first job said:
Regarding the femoral pulse. I was trained to check in severe trauma cases, with shock, and a means to establish a quick systolic, in a mass casualty
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Absence of femoral pulse on one side =

Aortic bifurcation occlusion
Cardiac Arrhythmia
Cardiac Tamponade
Aortic coarctation
Diabetes

It is definitely not valid to check every patient but I was taught to check Radial, Femoral, Carotid and Dorsalis Pedis for all traumas and diabetes

Source: My mind and Google
 
emt seeking first job said:
Dude, it was just talk. I was just curious because of my saline question in another thread. When I did a online search I got a lot of hits on ruptured breast implants.

Regarding the femoral pulse. I was trained to check in severe trauma cases, with shock, and a means to establish a quick systolic, in a mass casualty.

If the scenarion warrented it, according to protocols, and no female member present, I would do a quick head to toe on a trauma patient in front of a partner or patient's family member and the intention would be to asses condition and not gratify myself.



There is a gross distinct difference in asking a question about a real potential scenario and assaulting someone. And also kidding around online with anonymous strangers.
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Your original question regards something you are not trained to treat nor does it have any relevance to your job.

If you are wasting time looking for femoral pulse in a severe trauma you are putting your patient at risk. If it is a lower extremity bleed, use tourniquet and rapid transport. If no lower extremity bleed treat other severe trauma and rapid transport. Using for systolic has been shown to be ineffective.

If you think for one minute a family member that has been convinced by an attorney that you crossed the line in treatment is going to take your side then you are in the wrong field. I also doubt your partner will jeopardize his/her career to save yours.

Although you may see a gross distinct difference, a jury of 12 may not.
 
OP, sorry I ever suggested this.

I suggested this, since the question was raised if saline was better than sterile water, and I mentioned the aspect of whether the contents of a breast implant (cosmetic or reconstructive) could be considered sterile "forever" (versus other medical liquids in containers), and suggested he ask the forum. Not like I tied a hot dog to him and sent him into a pitbull rodeo, I thought at the time. :o

Would the subsequent "questions" and replies been as barbed had this been about a male buttock repalcement, a glass eye, or prosthetic arm?

Personally, I have not responded to a case with ruptured implant. My wife had a coworker who had a localized andgeneralized syndrome which was hypothesized to have been linked to her very old silicone implant failing decades after implantation.
 
crazycajun said:
Your original question regards something you are not trained to treat nor does it have any relevance to your job.

If you are wasting time looking for femoral pulse in a severe trauma you are putting your patient at risk. If it is a lower extremity bleed, use tourniquet and rapid transport. If no lower extremity bleed treat other severe trauma and rapid transport. Using for systolic has been shown to be ineffective.

If you think for one minute a family member that has been convinced by an attorney that you crossed the line in treatment is going to take your side then you are in the wrong field. I also doubt your partner will jeopardize his/her career to save yours.

Although you may see a gross distinct difference, a jury of 12 may not.
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The gross difference I mentioned was in discussing this and doing it.

I probably would not do anything in the field that violated protocols.

I work in a system where hospitals are less than 10 minutes away so we tend to just load and go.

I was really just curious. It is a 100% appopriate question for this forum.
 
It's the apocalypse. I agree wholeheartedly with crazycajun.
 
To answer your question, yes, I have had a job with a broken breast implant... Now the rest of the story... We had a surgical tech who worked with us, and he brought in some silicone breast implants, they were played with soooo much, that they eventually both ruptured... :D Don't worry, these were non-implanted implants. :D
 
I personally know of 4 EMT's that were charged with Sexual Assault for checking femoral pulse with not being able to prove medical need.
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I call bull:censored::censored::censored::censored: until I see the case citations. However the comment about newbies playing here was great. I could not have said it better myself.

To the OP, I've seen a ruptured breast implant a few times, but they were all in deceased persons as part of my research into injury patterns. It takes a LOT of force to rupture a flexible bag of liquid implanted into (or behind, depending upon the particular procedure used) a compressible and somewhat mobile chunk of fat.
 
usafmedic45 said:
I call bull:censored::censored::censored::censored: until I see the case citations. However the comment about newbies playing here was great. I could not have said it better myself.

To the OP, I've seen a ruptured breast implant a few times, but they were all in deceased persons as part of my research into injury patterns. It takes a LOT of force to rupture a flexible bag of liquid implanted into (or behind, depending upon the particular procedure used) a compressible and somewhat mobile chunk of fat.
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I am just guessing it would only happen with older implants ?

Everything decays.
 
There is a defined product life for them, but it's more a matter of sufficient force than anything else. If you hit someone in the chest hard enough to rupture them, chances are good that you're going to do some other serious injury to them. The cases I mentioned were all the result of aircraft crashes.

There are spontaneous ruptures but I thought you were asking about traumatic rupture since I doubt a spontaneous rupture would present to EMS or even to the ED.
 
usafmedic45 said:
There is a defined product life for them, but it's more a matter of sufficient force than anything else. If you hit someone in the chest hard enough to rupture them, chances are good that you're going to do some other serious injury to them. The cases I mentioned were all the result of aircraft crashes.

There are spontaneous ruptures but I thought you were asking about traumatic rupture since I doubt a spontaneous rupture would present to EMS or even to the ED.
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I was thinking a traumatic rupture in an older implant.

But as I said, the thought just came to me after my thread about saline and sterile water for external use.
 
Yeah, even if you were to be able to tell a difference, it's not going to matter one damn bit in the field since you can't do anything about it. In other words, note it, report it and move on.
 
HotelCo said:
The technique of using the presence of a radial, carotid, or femoral pulse as a means to estimate the level of a systolic blood pressure has been proven false.

Check out this thread on the subject:

http://www.emtlife.com/showthread.php?t=23426
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A study of 20 people is hardly proof. Given that statistically, there are always outliers in a sample group, it is possible that the majority of the 20 sampled were outliers. This is not to say that the study has no merit, rather if anything, it shows that current practices involving palpation deserve reevaluation.
 
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