# 12 year old runs into pole



## nymedic9999 (Oct 17, 2013)

OK so I had this call the other day I want to know what other people think of my decision not to call ALS.

EMS gets dispatched for the 12 year old female with a back and shoulder injury.  A BLS rig responds to scene and finds the patient lying supine next to the rear entrance of the school.  Patient states that she was playing soccer when she ran into a goal post, resulting in her falling and injuring her shoulder and her back.  She then said that she was able to ambulate to a bench where she lay for 5 minutes prior to making her way to the school.  On her way to the school the patient said her back began to hurt severely resulting in her being unable to walk and EMS being called.  Patient was found lying supine in grass.  Patient was CAOX4 and did not complain of any LOC and was able to remember the entire event.  The thing is the patient did complain of dizziness directly after the event, and when we backboarded her.  So I asked if she felt like she was going to pass out when she was dizzy and she stated that she did not feel like she was going to pass out.  Based on her not feeling faint I deferred ALS.  Was that a reasonable call?  Other then that the patient was super BLS.


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## EMT B (Oct 17, 2013)

If she was hemodynamically stable and in minimal to no pain then by all means BLS it.


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## Akulahawk (Oct 17, 2013)

I'd have BLS'd this one as well. Hemodynamically stable, recalls the entire event, (hopefully it was checked) good distal circulation/sensory/motor function... Yes, BLS should probably be very appropriate.


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## NomadicMedic (Oct 17, 2013)

Unfortunately, many BLS providers would have ALS ride on this, "because it's a kid" 

Kudos to you for recognizing a BLS call and not falling into the "what if" trap.


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## EMT B (Oct 17, 2013)

i still don't understand the rationale that kid=als..is anyone on here able to advocate for that just so i can see where the other people are coming from?


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## chaz90 (Oct 17, 2013)

EMT B said:


> i still don't understand the rationale that kid=als..is anyone on here able to advocate for that just so i can see where the other people are coming from?



Don't ask for advocates for insanity. Kids can certainly be stable and BLS appropriate. In fact, the frequent lack of comorbid conditions or pre-existing issues means they're likely more often utterly stable and not in need of ALS.


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## Carlos Danger (Oct 18, 2013)

EMT B said:


> i still don't understand the rationale that kid=als..is anyone on here able to advocate for that just so i can see where the other people are coming from?



Pediatric = "harder to assess" + "decompensates faster" + "more difficult airway" = MUST ALWAYS HAVE A-L-S

Or at least that's what I was always taught early in my EMS career.


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## DesertMedic66 (Oct 18, 2013)

BLS all the way.


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## CFal (Oct 18, 2013)

I would BLS that, I don't see why an EMT confidant in their skills would call for ALS


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## Medic Tim (Oct 18, 2013)

BLS and transported in a position of least discomfort (no board)


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## NBFFD2433 (Nov 22, 2013)

Sounds like BLS to me.


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## Jawdavis (Nov 22, 2013)

BLS. Only reason most people freak out and ALS something like that is because kids are aliens and nothing means something and something can mean something but nothing then something then nothing always means something big.


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## Akulahawk (Nov 22, 2013)

Halothane said:


> Pediatric = "harder to assess" + "decompensates faster" + "more difficult airway" = MUST ALWAYS HAVE A-L-S
> 
> Or at least that's what I was always taught early in my EMS career.


While peds are harder to assess and they do compensate quite well until they crash, once you figure out how to interact with them, and you use your head in assessing them, it's really not all that hard. Therefore, an EMT can assess and care for a pediatric patient like this and not have to call ALS for them. 

Peds are a great reason to take a lifespan development class... as is the elderly. Knowing the norms for those populations can come in quite handy later!


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## Handsome Robb (Nov 22, 2013)

Peds are most definitely not ALS. With that said, depending on who I'm working with I'll take just about every kid unless it's absolute bogus or I'm with a select few partners.

Just because I attend the call doesn't make it ALS. I've sat in the back without doing nothing more than my partner would have done but I choose to do so for the simple fact that I have more education than many of the EMTs I work with. Kids are difficult the assess, the warning signs are subtle. Not every child is sick, far from it, but I prefer to attend them.


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