# Head truma



## falcon-18 (Mar 31, 2009)

Hi all 

I want to ask about the person being hit by a car. After the examination. He had a head injury and dilated pupile. Do I have to give him the solution.
Note the person excited.

i want ask this pt loos blood, how to compensate it?

ambulance car is BLS.

sorry i confused :sad: about it please help me.

thanks


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## el Murpharino (Mar 31, 2009)




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## nomofica (Mar 31, 2009)

el Murpharino said:


>




My thoughts exactly...


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## Ridryder911 (Mar 31, 2009)

falcon-18 said:


> Hi all
> 
> I want to ask about the person being hit by a car. After the examination. He had a head injury and dilated pupile. Do I have to give him the solution.
> Note the person excited.
> ...



Did you say; you had the head injury? Unless you are a foreigner (i.e Texan ) please proof read your posts. 

R/r 911


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## MSDeltaFlt (Mar 31, 2009)

falcon-18 said:


> Hi all
> 
> I want to ask about the person being hit by a car. After the examination. He had a head injury and dilated pupile. Do I have to give him the solution.
> Note the person excited.
> ...


 
I'm sorry, bro.  But this post is confusing.


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## 8jimi8 (Mar 31, 2009)

Ridryder911 said:


> Did you say; you had the head injury? Unless you are a foreigner (i.e Texan ) please proof read your posts.
> 
> R/r 911




Jealous of our national sovereignty, eh?


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## PapaBear434 (Mar 31, 2009)

8jimi8 said:


> Jealous of our national sovereignty, eh?



Much in the same way I'm jealous a bird that lives over a septic field.


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## artman17847 (Mar 31, 2009)

falcon-18 said:


> Hi all
> 
> Do I have to give him the solution.



What kind of "solution" do you want to give him. Not the final one I hope!


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## nomofica (Mar 31, 2009)

artman17847 said:


> What kind of "solution" do you want to give him. Not the final one I hope!



Take him 'round back and pull out the shotty...?


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## daedalus (Mar 31, 2009)

LMOA X1000

If the patient has a head injury with blown pupils, no you cannot give them the final solution. Out back with a shotgun.


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## exodus (Mar 31, 2009)

xDDDDDDDDDD


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## nomofica (Mar 31, 2009)

daedalus said:


> LMOA X1000
> 
> If the patient has a head injury with blown pupils, no you cannot give them the final solution. Out back with a shotgun.





... is what I just said.


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## jamiga (Mar 31, 2009)

falcon-18 said:


> Hi all
> 
> I want to ask about the person being hit by a car. After the examination. He had a head injury and dilated pupile. Do I have to give him the solution.
> Note the person excited.
> ...




Ohh! Ohh!! I like this... it's like a puzzle!!


Does excited = ejected??

And maybe, "If this pt becomes hypovolemic, how can I compensate for this?" 



You're WELCOME.



<3,

East Texas.


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## FTRPO (Apr 3, 2009)

Aright I think I got it. 

A call that we had the other day was a person that was hit by a car, after the patient examination(assessment) I concluded that he had a severe head injury and his pupils were missing. Do I have to tell him hes dead? Note the person was ejected. I wanted to ask, the patient lost a lot of blood, do I have to give him mine? Oh by the way we are Basic. Thanks. 

Thats gotta be it.


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## Ms.Medic (Apr 3, 2009)

FTRPO said:


> Aright I think I got it.
> 
> patient examination(assessment)



Why, howdy, and thanks for that clarification for this here Texan !!!

On another note,,,Im still confused. Maybe I'll haul a$$ to Florida so I can understand it all better....




.


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## Ms.Medic (Apr 3, 2009)

FTRPO said:


> Aright I think I got it.
> 
> A call that we had the other day was a person that was hit by a car, after the patient examination(assessment) I concluded that he had a severe head injury and his pupils were missing. Do I have to tell him hes dead? Note the person was ejected. I wanted to ask, the patient lost a lot of blood, do I have to give him mine? Oh by the way we are Basic. Thanks.
> 
> Thats gotta be it.



Pupils missing ??? How did you know he had a head injury if his pupils were missing???
Tell him whos dead ??? You gonna tell the pt he's dead ???
Give him yours ? Your blood ??? Ummmm
AND BASIC WHAT ???


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## nomofica (Apr 3, 2009)

FTRPO said:


> Aright I think I got it.
> 
> A call that we had the other day was a person that was hit by a car, after the patient examination(assessment) I concluded that he had a severe head injury and his pupils were missing. Do I have to tell him hes dead? Note the person was ejected. I wanted to ask, the patient lost a lot of blood, do I have to give him mine? Oh by the way we are Basic. Thanks.
> 
> Thats gotta be it.




LOL!
Oh God that's great...


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## Ms.Medic (Apr 3, 2009)

I think Mr. Falcon decided to go join another forum,,,he hasn't been back to clarify anything for us....hmmm.


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## fma08 (Apr 3, 2009)

FTRPO said:


> Aright I think I got it.
> 
> A call that we had the other day was a person that was hit by a car, after the patient examination(assessment) I concluded that he had a severe head injury and his pupils were missing. Do I have to tell him hes dead? Note the person was ejected. I wanted to ask, the patient lost a lot of blood, do I have to give him mine? Oh by the way we are Basic. Thanks.
> 
> Thats gotta be it.



As a basic, you can give a diesel bolus for hypovolemia... Unless your service recognizes an IV cert and IV fluids are in your protocols. I wouldn't transfuse yourself into him  Still not getting the pupils missing thing... are they constricted? Dilated? Uneven? Reactive equally? Unequally? At all?


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## nomofica (Apr 3, 2009)

Maybe the head trauma is so bad they went POP.


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## Tal (Apr 3, 2009)

If I understand tou right, you have a hypotensive pt with head trauma...(right?!) so...you need to give NaCl to keep the BP above 90 systolic to keep the CBF normal as posible


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## Sasha (Apr 3, 2009)

> He had a head injury and *dilated* pupile



Where are you people getting a missing pupil? I think falcon is a foreigner, so he may have difficulty with the English language (heck,  some Americans have difficulty, too!)


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## bonedog (Apr 3, 2009)

That's only because it is the English language, not the 'merican language 
I butcher it on a regular basis and up here in Canada we still have the Queen.


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## Ms.Medic (Apr 3, 2009)

Sasha said:


> Where are you people getting a missing pupil? I think falcon is a foreigner, so he may have difficulty with the English language (heck,  some Americans have difficulty, too!)



I dont know about anyone else, but this is what I was refering to:


Originally Posted by FTRPO  
Aright I think I got it. 

A call that we had the other day was a person that was hit by a car, after the patient examination(assessment) I concluded that he had a severe head injury and his pupils were missing. Do I have to tell him hes dead? Note the person was ejected. I wanted to ask, the patient lost a lot of blood, do I have to give him mine? Oh by the way we are Basic. Thanks. 

Thats gotta be it.


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## micsaver (Apr 3, 2009)

artman17847 said:


> What kind of "solution" do you want to give him. Not the final one I hope!



I just busted out laughing at that line!  LOL!:lol:


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## micsaver (Apr 3, 2009)

This is one of the best threads ever! Thanks for lifting up my dull Friday afternoon with this hilarious interpretation of the original post. :beerchug:


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## FTRPO (Apr 3, 2009)

Ms. Medic your reading too far into it. Nothing in the original post made sense and nothing that I said really did either. I didnt really think that I cleared up any confusion. Matter of fact I think I confused you even more. I wish you would have picked up the sarcasm I think you would of enjoyed it.


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## Melbourne MICA (Apr 4, 2009)

*Taking the piss*

I thought Aussies were good at taking the piss.

I think the poor guy was tring to enquire about management of traumatic hypovolaemia.

Well, first disconnect the radiator hose from your truck............., make sure the pts name is Spock because glycol is green.......

Sorry sport. You'll need a thick skin on this forum.

MM


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## Sasha (Apr 4, 2009)

Hey. He's attempting to ask a question in a language that is not his native language. Let's cut him some slack, please?


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## Melbourne MICA (Apr 4, 2009)

falcon-18 said:


> Hi all
> 
> I want to ask about the person being hit by a car. After the examination. He had a head injury and dilated pupile. Do I have to give him the solution.
> Note the person excited.
> ...




Sorry we were all taking the micky.

Head Trauma is a complicated subject with no definitive solution in the pre-hospital setting - it requires surgical interventions more often than not. Head injured pts as a general rule fare very poorly.

However secondary brain injury caused after the initial insult by poor perfusion can be partially and temporarily compensated by fluid administration and management of ventilation and is a good area of interventions by EMS if still controversial in many ways. 

Dilated pupils may well indicate a severe head injury with a poor prognosis but are not a reliable indicator by themselves. Management of pain, immobilisation and packaging, recognition of the pattern of injuries -(you said he had been ejected - not a good start for the pt), ventilation control and fluid and other drug administrations all help to some degree. Fluids will given as per your local protocol.

And don't forget, rapid transport to the nearest primary trauma receiving facility is always a good course of action.

A bit better Sasha?

MM


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## Melclin (May 9, 2009)

artman17847 said:


> What kind of "solution" do you want to give him. Not the final one I hope!



hehe lolacaust...man I'm ganna get flamed for that.


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## Jon (May 9, 2009)

OK. Not sure where the OP was going.... but this thread makes my head hurt.


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