# The Family that Plays Together......



## BossyCow (Sep 15, 2008)

Okay, here's one for the books.... 

Toned out to 36yo male, possible spinal injury from ground level fall. 

Arrived to find hysterical family, Mom, brother in law, sister, niece and nephew. They state pt was carrying a log aprox 1' in diameter x 10' feet long over his shoulder. Pt tripped over a piece of barbed wire and fell, trapped by log which rolled across his lower spine. Family states pt unable to move anything below the waist, however, pt is missing...... as in gone.. not there... MIA... 

As we ask questions, we piece together this story... Pt has a history with the local ER. Last time the family called 911 he ended up in the Psych room. He is convinced he's going to be put back in there if he goes in again. So he talks his kids (18yo male and 16 yo female) into moving the log and then lifting him onto a board and loading him into the back of his pickup. (I'm going to assume this was done without taking spinal precautions.. but I could be wrong)

When he hears the family calling 911 he becomes very agitated and upset. He calls his kids over and gets them to grab him by the armpits and yard him off into the woods to hide. (again I'm going to assume no spinal precautions taken) Family states he was dragging both legs and had no movement at all to the lower extremeties. 

At this point, I'm telling the mom, who called 911 that if he's really hurt, he'll probably change his mind about going in and she can call us back then, but we can't treat a pt who runs away from us and I'm not about to go running after him in the dark, in the woods. 

At this point the brother in law comes racing back from the woods yelling.. "He's got a knife.. he's treatening to kill anyone who comes near him".. then BIL runs back into the woods.. I'm guessing because he really wanted to be the first one to get stabbed! 

Now, as far as scene safey, I'm standing by the rig, guy can't see me, got lights turned off so he doesn't get more agitated and I'm thinking.. guy who can't walk or move his lower extremities is someone I can probably out run... But since there was a reported weapon.. we call LEO. 

The next thing I know, there are guys with guns all over the place, and the pt has suddenly become cooperative with EMS.After being cleared by LE for safety, weapons, I am now treating a guy who has aside from the initial injuries, the additional compromise from being lifted once and then lifted again and dragged 50 yards over rough terrain. He's found lying face down in a wet field where he's been for about an hour and a half.

Initial vitals were:

BP 138/70
Resp 20
Eyes ERL
HR 78

No visible trauma, bruising, redness swelling abrasions to spine. 
No movement to lower extremeties, no reaction to pain to feet. Pt complaining of pain to lumbar area and intense need to pee but unable to urinate.

Oh.. he said he had a 'few beers'


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## reaper (Sep 15, 2008)

Natural selection sometimes takes a few tries! Maybe next time it will get it right!!!!!!!


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## BossyCow (Sep 15, 2008)

reaper said:


> Natural selection sometimes takes a few tries! Maybe next time it will get it right!!!!!!!



Too late, he's got two kids, those genes are already in the pool! This is not the first time I've dealt with this guy. The last time I saw him and his kids, they had yarded him out into the yard after calling 911. They were concerned that EMS might report to the cops some of his household inventory. What really cheeses me off about this was I had a talk with those kids at that time about not moving a pt. How dangerous it was etc. I wish I could get that kind of obedience from my kids! Do you think I could get this guy to teach a parenting class for me?


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## Jon (Sep 17, 2008)

Bossy,

What's the ambient temp? What is the patient's temperature (at least roughly)? Lying in a wet field would probably not be so great, and you might need to take action to get wet clothing off of him and get him warmed.

Treatment:
Full Spinal precautions - Board, collar, straps, etc... O2, at least nasally (NRBM if hypoxic - by signs or SpO2) Add ALS, Aeromedical on standby. If ALS has an extended ETA, contact medical command and OK the flight with the doc, then fly the bird. My gut instict is that this guy should be going to the spinal center in the city... and that is a reasonable destination by aeromedical - but too far to ground too.

I don't have an X-ray machine in the ambulance... I've got to assume that the patient has some form of spinal cord damage in the thoracic/lumbar spine.


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