# Hear's one



## trauma1534 (Dec 6, 2006)

You have a call to a 44 year old male patient with no PMHx, with altered mental status.  Dispatch advises you to come into the garage on the side of the house.  That's all you have.  What is your first plan of action?  From the dispatch information, what is your first thought?


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## sdadam (Dec 6, 2006)

from the dispatch info, I'm thinking:

carbon monoxide
un-Dx diabetes
etoh
cva

basicaly aeioutips but since he is in a garage I always worry about carbon monoxide.

adam


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## Medivixen (Dec 6, 2006)

same as any other call you would go on
Scene safety
LOC
D 
A
B
C 
RBS
Skin
O2 
Now its decision point...from your findings is this a load and go or stay and play. Depending on what I found in the primary assesement .
Since it is altered LOC this would be a protocol call before I can load up so I would have a set of vitals taken.
What are the vitals that I get? since this would effect what I do next in my protocol..


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## trauma1534 (Dec 6, 2006)

Ok... what you have is a man who is in his car in the garage... WITH THE CAR RUNNING!!!!!  So, yes, it is carbon monoxide poisening.  

So tell me... how are you going to safely get this guy out?  After you get there, you find out that he is now becoming unresponsive.


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## yowzer (Dec 6, 2006)

trauma1534 said:


> So tell me... how are you going to safely get this guy out?  After you get there, you find out that he is now becoming unresponsive.



If you're not already a firefighter with SCBA handy, get some. 

Failing that, open as many doors and windows as you can by holding your breath and running inside, and once there's ventilation, turn off the car and go look at your patient.


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## Anomalous (Dec 6, 2006)

Maybe you've got time to drive the car OUT of the garage???


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## Ridryder911 (Dec 6, 2006)

Open dah door.. and stand back!.. I will not enter until FD with SCBA. Co poison can occur even with seconds of exposure... 

R/r 911


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## jeepmedic (Dec 6, 2006)

Ridryder911 said:


> Open dah door.. and stand back!.. I will not enter until FD with SCBA. Co poison can occur even with seconds of exposure...
> 
> R/r 911



agree Do not enter if you do you may not come out upright.


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## Airwaygoddess (Dec 7, 2006)

jeepmedic said:


> agree Do not enter if you do you may not come out upright.


Sounds like good sense to me!!  Scene safety can NEVER be overrated!!^_^


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## trauma1534 (Dec 7, 2006)

Anomalous said:


> Maybe you've got time to drive the car OUT of the garage???



He is in the driver's seat and rapidly deteriating.


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## Jon (Dec 7, 2006)

If FD isn't alreay rolling, get FD rolling.

my former FD's ambulance has SCBA's on it for this reason (and others).

If I was on this call with the squad, I'm not sure what I'd do. One potential idea would be for ME to go in wearing a NRBM (and 100% O2) and at the least open the garage door and shut the car off... That wouldn't be perfect, but it would be "doing something" rather than sitting around for 10 minutes waiting for the FD to respond and arrive and watching the guy die.

Also... PD might just be dumb enough to bring the guy out for us 


Finially... I'd also request PD when I request FD, because we have a potential EDP with a suicide attempt... once they cease being hypoxic, they might become combative.


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## jeepmedic (Dec 7, 2006)

Let the Stretcher Fetchers get him out. This is a Haz-Mat Scene. OSHA will not like it very much if you go in with out the proper equip.. You will not do anyone any good if you are now a pt.. Stay out untill someone with a SCBA goes in and gets pt. out.


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## prizonmedik (Dec 7, 2006)

Never go in further than the first dead cop.


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## FFEMT1764 (Dec 7, 2006)

Let the police drag him out, get him air, and when he wakes up- press hard making 3 copies! 

Really though wait for the FD to get there, you aren't doing him any good when you become unresponsive yourself.  Remember that CO has 200x more affinity for hemoglobin than oxygen does.


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## trauma1534 (Dec 8, 2006)

Jon said:


> If FD isn't alreay rolling, get FD rolling.
> 
> my former FD's ambulance has SCBA's on it for this reason (and others).
> 
> ...



Number one, the NRBM will not help you here!  DON"T EVER DO THAT!!!  

Number two, do not ever send anyone in without proper equip.  Remember, the more people you send in, the more patient's you most likely will have, and that would suck!!!

Number three, if he codes, then he codes!  Woopy ****!  He shouldn't have been dumb enough to try something this stupid!  But, if he codes, you still can't worry about him at this point.  You think about yourself, and your crew!

Just remember, if he codes and you can't get in there to work him in ample time, you can sing this song.... "start your day with a DOA, doda, doda, pump and blow till they pass away, all the do da day!"


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## trauma1534 (Dec 8, 2006)

FFEMT1764 said:


> Let the police drag him out, get him air, and when he wakes up- press hard making 3 copies!
> QUOTE]
> 
> 
> HELL YEAH!!!  I like that one!


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## jeepmedic (Dec 8, 2006)

prizonmedik said:


> Never go in further than the first dead cop.



There you go.


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## trauma1534 (Dec 8, 2006)

jeepmedic said:


> There you go.




and............... press hard 3 copies!!!!!!!!


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## FFEMT1764 (Dec 8, 2006)

Its only against the law to attempt suicide, not complete it!


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## Anomalous (Dec 8, 2006)

trauma1534 said:


> He is in the driver's seat and rapidly deteriating.




Notice that was a 'Maybe" with a question mark.  

"Rule 1.- Safety is of the first importance in the discharge of duty."


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## BossyCow (Dec 18, 2006)

trauma1534 said:


> He is in the driver's seat and rapidly deteriating.




Better him than me! Gotta remember who's having the emergency here.  It's the guy in the car! First priority is making sure the number of victims remains the same!


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## Mercy4Angels (Dec 18, 2006)

trauma1534 said:


> "start your day with a DOA, doda, doda, pump and blow till they pass away, all the do da day!"



i fell off my chair singing that....hilarious..:beerchug:


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## jeepmedic (Dec 18, 2006)

Tell him that you are going to play through. Keep playing the golf game.


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## Fedmedic (Dec 18, 2006)

jeepmedic said:


> Tell him that you are going to play through. Keep playing the golf game.



Been drinking hooch with the inmates again....ey Brian.


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## jeepmedic (Dec 18, 2006)

Getting close to christmas. Don't want them drinking bad Hooch.


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## trauma1534 (Dec 19, 2006)

jeepmedic said:


> Getting close to christmas. Don't want them drinking bad Hooch.




Ok Barney!!!!


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## CotWoman (Dec 19, 2006)

trauma1534 said:


> "start your day with a DOA, doda, doda, pump and blow till they pass away, all the do da day!"



OMG - I was singing that in my head and nearly fell over... That is too funny.  Now I am going to be singing that all friggin day...

THANKS!!


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