# Fall victim with ETOH history and head injury



## DrParasite (Jun 4, 2012)

Initial dispatch was for a fall victim on the 2nd floor of the train station that has no working elevator.  BLS crew arrives to 50 year old man lying on the ground, witnesses say he collapsed and started shaking.

Pt is know to EMS, has a HX of seizures and extensive alcohol abuse.  Pt weighs about 275 lbs

he is not responsive to any stimuli, he has blood coming out of his right ear.

you are 2 blocks from a trauma center, 1 miles from a local hospital, and ALS was not dispatched on the initial call.

what would you do for this person?


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## truetiger (Jun 4, 2012)

Do a quick trauma exam/quick assessment, find out why blood is coming from ear. Correct anything that needs to be corrected.  Trauma package, load, and go. Take a d stick en route. Transport to trauma center. No ALS.


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## JPINFV (Jun 4, 2012)

Trauma assessment, package, transport to trauma center. Unless there's a delay on scene, there's no reason to request paramedics when the closest hospital is 2 blocks and/or 1 mile away. However the call should have gotten paramedics on initial dispatch if they were available.


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## DesertMedic66 (Jun 4, 2012)

JPINFV said:


> Trauma assessment, package, transport to trauma center. Unless there's a delay on scene, there's no reason to request paramedics when the closest hospital is 2 blocks and/or 1 mile away. However the call should have gotten paramedics on initial dispatch if they were available.



Exactly what I would have done on a BLS unit.


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## DrParasite (Jun 4, 2012)

truetiger said:


> find out why blood is coming from ear.


blood is coming from inside his head. 





truetiger said:


> trauma package, load, and go.


I'm assuming this means board and collar right?


JPINFV said:


> Unless there's a delay on scene


the only delay was having to run up and down the stairs to get equipment, and carrying this heavy gentleman down the stairs. 





JPINFV said:


> However the call should have gotten paramedics on initial dispatch if they were available.


I didn't take the original call, but around here, alcohol related calls or fall victims don't get paramedics on the initial dispatch.


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## JPINFV (Jun 4, 2012)

DrParasite said:


> blood is coming from inside his head. I'm assuming this means board and collar right?


In an evidence based medicine fantasy world, a c-collar... maybe.

In the real world, yes. 



> I didn't take the original call, but around here, alcohol related calls or fall victims don't get paramedics on the initial dispatch.



I can understand that a normal FDGB inebriate doesn't need paramedics. An inebriated FDGB normally just needs a checkout. Unfortunately this wasn't a normal FDGB, but provided the patient doesn't deteriorate further there isn't much need more than a quick horizontal taxi service ride anyways.


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## Tigger (Jun 4, 2012)

JPINFV said:


> Trauma assessment, package, transport to trauma center. Unless there's a delay on scene, there's no reason to request paramedics when the closest hospital is 2 blocks and/or 1 mile away. However the call should have gotten paramedics on initial dispatch if they were available.



I probably would have called and asked if another unit was available considering the carrydown. Can we two-person a carry a backboard down a story? If I have too yes, but if there's another truck three blocks away you bet I am asking for some help. If it's ALS all the better, but as noted with the proximity of the trauma center it's not like anyone needs to be sticking around on-scene.


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