# Screenwriter Keeping it real part 2



## goldenbram (Nov 23, 2009)

I have posted here before and your help has been amazing.  I am writing a screenplay with an EMT rescue scene and I want to run it by you for authenticity.

Here's an overview of what needs to happen.

EMT's rescue an unconscious man from an overturned vehicle.  During the extraction he remains unconscious, but his vitals are normal.  He is placed in the ambulance and I suppose by now he has a c-collar and IV in place and I guess he would also be put on an EKG.  During the ride to hospital, he awakes and is disoriented and agitated. He might try to pull out IVs and get up. EMT's settle him down. After some minutes, he begins to seize violently and his heart rate shoots way up....

That's the scene, now I have some specifics...

After being extracted from the car, would rescue perform any care outside or would they wait until he was in the ambulance? How soon would that c-collar be put on?  What would the protocol be for an unconscious man at the sceene of an accident.  What would you be looking for? When he awakes, would he have a tube in his mouth preventing him from talking?  What are some pieces of dialogue you might here EMT's yell out to each other during such a crisis. As the patient tries to escape, how easy is it to remove the c-collar?  This is going to be a big powerful guy...

Thankss so much.  Anything you can say which will prevent this from being one of those dumb Third Watch scenes would be most appreciated.

Thanks everyone

AB


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## Burlyskink (Nov 23, 2009)

goldenbram said:


> Thankss so much.  Anything you can say which will prevent this from being one of those dumb Third Watch Trauma scenes would be most appreciated.
> 
> Thanks everyone
> 
> AB



Fixed it for you.. 

 Also I would post but im on my way out of the door right now, I will post when I get home.


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## zappa26 (Nov 23, 2009)

After being extricated from the car, they might quickly check him over once again and make sure he's still breathing/circulating okay, but would want to move him to the ambulance quickly because of his potentially unstable condition - this is known as "load and go."

The c-collar would be put on while he was still in the car, before the extrication.  It is put on by a second rescuer after a first rescuer takes manual stabilization (holding both sides of the head with your hands to ensure the head or neck do not move).

The "protocol" would just to treat the patient.  Obviously get him out of the car ASAP, and because you have a bad general impression of the patient, this would require rapid transport, or possibly a helicopter as discussed in the other thread.

Our main concerns would be his airway, breathing, and circulation (ABCs), after that considering his c-spine, and after that dealing with any bleeding, fractures, head injuries, other trauma, or medical emergencies.

When he awakes, he could have been intubated by a paramedic depending on his condition, or he could have an oral or nasal airway in, these could be placed by a First Responder or EMT.  If he suddenly awoke though, the ET tube or oral airway would be gagged or pulled out, and the nasal airway as well may come out if he becomes aggravated - these can be painful.

EMTs on scene or in the back of the ambulance would be talking about his condition, what was going on, then talking to him to try and calm him down if he awoke.  Due to his serious condition, there may not be much humor present in the dialogue.

Anyone trying to escape could remove a c-collar easily.  As long as they got their hands out of the backboard or as long as they were not restrained, they could just rip the collar off, it's usually just secured by a velcro strap or straps.

Good luck with your writing!


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## DV_EMT (Nov 23, 2009)

one thing that you could do after the EMT's calm the pt down from his rage... is have the EMT or paramedic check his CSM... asking the pt to squeeze the emt's fingers simultaneously. and then push against the emt's hands with his feet... this checks to see if the pt has any cervical spinal damage. also have the EMT/Medic ask the pt if he feels numbness or tingling anywhere as this may also indicate cervical spine damage.

perhaps during the conscious assessment... he could seize then? It might take the audience by surprise?

as for the previous post about the Intubation... id say don't go there. because you state that the patient is stable.. more likely they'd use an oral airway and a bag valve mask (with oxygen attached) to help the pt breathe. intubation is more commonly used for difficult ariways.

and don't forget!!!! when whoever first gets to the Patient... 

Is the scene safe? - no EMT/Medic will ever run into an unsafe scene (gas spewing, armed gunman, whatever)

Body Substance Isolation - make sure everyone is gloved up!

and once you get to the pt.... sternal rub, or trapezious pinch to make sure that they're truly unconscious... they may just be sleeping... but by doing one of the following... you make sure that they're truly unconscious.

hope this helps!!!!!


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