# A Writer's Scenario



## pthalomarie (Nov 2, 2016)

Hi Everyone

'm a writer, and I am hoping to use authentic EMT procedures in a scene I am writing. Here is what the EMTs will be dealing with:

A thirty year old bride in a very intrusive gown (petticoat, train, etc - a lot of material that will get in the way of a quick exam.) She has fallen from a tall building and has suffered multiple broken bones (fore arm and neck fractures will be visible - the girl is immortal, which is why she is still alive, but the EMTs won't know that), There will be bleeding, but it won't be obvious where her wounds are due to the dress. Her pulse will be very rapid, her breathing slow but stable, and she will be groggy and her ability to talk will be limited (she can answer yes and no questions, and a few complete sentences when she realizes what has happened to her.)

Any advice will be appreciated!


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## NysEms2117 (Nov 2, 2016)

What are you asking for?? what we would do if we(EMS) showed up?


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## Handsome Robb (Nov 2, 2016)

The dress would be cut off her. 

Is that what you're asking? 


Sent from my iPhone using Tapatalk


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## StCEMT (Nov 2, 2016)

^These


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## Flying (Nov 2, 2016)

If you're a stickler for detail "authentic procedures" vary across  the country, and even between municipalities and hospital systems.

Otherwise, here is a sheet that is commonly used in training/testing EMTs: https://www.nremt.org/rwd/Content/documents/skills/E201_NREMT.pdf
This is a generic overview of how one could approach the scene.

The dress will invariably be cut off using these guys: http://www.cobratactical.com/assets/images/medical.jpg

We each could go over a very detailed narrative over what we would do in a hypothetical trauma scenario, lots of that has been done during schooling and on the job, but I think you would be best served by calling a fire department/hospital/private ambulance service and asking if you can be a ride-along.

There are also many years of posts in this forum that will give you a vague idea of what we're looking for and how we act: https://www.google.com/search?q=tra...e&ie=UTF-8#q=trauma+scenario+site:emtlife.com


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## OnceAnEMT (Nov 2, 2016)

Tell me more about the visible neck fractures.


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## NomadicMedic (Nov 2, 2016)

Grimes said:


> Tell me more about the visible neck fractures.


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## ERDoc (Nov 2, 2016)

DEmedic said:


> View attachment 3125



Radiology read:  PA, lateral and odontoid views show some distraction laterally towards the right.  There is a suggestion of subluxation at the C3-C4 level.  Definite fracture cannot be seen or excluded based on these images.  Please correlate clinically.  If there is concern for fracture or ligamentous injury, MRI would be recommended.


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## NomadicMedic (Nov 2, 2016)

radiology = hedging one's bet


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## pthalomarie (Nov 3, 2016)

NysEms2117 said:


> What are you asking for?? what we would do if we(EMS) showed up?




Yes. My story takes place in New York City, and I live in Pennsylvania. So I wasn't sure if procedures would be the same state to state. To be more specific, would the EMT cut off the dress before stabilizing the bride's neck? (DEMedic's photo is close to what I'm thinking of).Would the dress be removed after all vitals are checked and the neck is stabilized, or would it be disposed of beforehand?

And thank you all for the links!


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## akflightmedic (Nov 3, 2016)

Just get one of these which say "Don't worry, Immortal"

Attached image of my personal Life Alert Bracelet.


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## akflightmedic (Nov 3, 2016)

On serious note....the dress would most likely be removed immediately. If she is half awake and answering questions, then I know she has a pulse and a BP in theory. Those two things may be diminishing by the second due to an injury I do not know about, cannot see, and therefore cannot treat. Expose, expose, expose.

If her neck is as distorted as that picture....I would be stabilizing in place....I am unsure if I would be ballsy enough to straighten the neck when she is awake and still talking. Again, the science says we align and splint fractures (most times), I just would never do it on something that severe looking.  Save it for the ERDoc to do AFTER the x-ray report comes back.


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## EpiEMS (Nov 3, 2016)

pthalomarie said:


> Yes. My story takes place in New York City, and I live in Pennsylvania.



If you want to do it by the book, I suggest you reference the NYC REMSCO protocols. I've linked to the BLS version, but there is an ALS version on there. Also, for a call like that, I'd wager there's going to be a CFR engine on scene before a transporting unit. For your reference, here is a map of FDNY EMS and FDNY 911-participating voluntary units.


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## pthalomarie (Nov 4, 2016)

Thanks for the info!


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