A lacerated artery

[SpecialK]

And how long is all of that going to take? What is calling for backup going to achieve? How far away is your backup vs how far is the hospital?

I think we sort of "call for backup" as a bit of an instant knee-jerk reaction without actually considering why. The better question to ask is "what does the patient need and how can they get it most effectively" i.e. considering the larger context.

In this case, the patient needs resuscitation with blood. I wouldn't call for backup, even though HEMS could respond by road with blood, it is going to be faster to take him to hospital.

 

[EpiEMS]

And how long is all of that going to take? What is calling for backup going to achieve? How far away is your backup vs how far is the hospital?

I think we sort of "call for backup" as a bit of an instant knee-jerk reaction without actually considering why. The better question to ask is "what does the patient need and how can they get it most effectively" i.e. considering the larger context.

In this case, the patient needs resuscitation with blood. I wouldn't call for backup, even though HEMS could respond by road with blood, it is going to be faster to take him to hospital.

Calling for backup in the case of many systems is required...for some reason. In this case, unless they're a minute away and can meet you en route, a BLS ambulance could (should) transport emergently.

Then again, 15 minutes away, no palpable pulse (BLS -- so I don't have a monitor)...why would this not be a candidate for field termination?

 

[SpecialK]

Then again, 15 minutes away, no palpable pulse (BLS -- so I don't have a monitor)...why would this not be a candidate for field termination?

Because the patient is not dead. They have no palpable pulse but they still have mechanical output (on the monitor) just very little blood volume to pump mechanically!

If one recognises what the patient needs early and rapidly ensures they are delivered somewhere they can get it, then it is entirely possible their life can be saved.

As I have said previously, the most important thing we can do is formulate a diagnosis, decide what the patient needs and how best to ensure they get it as efficiently as possible. Calling for backup and waiting on scene will achieve nothing. This patient is truly time critical and needs to be transported to hospital.

 

[EpiEMS]

Because the patient is not dead. They have no palpable pulse but they still have mechanical output (on the monitor) just very little blood volume to pump mechanically!

If one recognises what the patient needs early and rapidly ensures they are delivered somewhere they can get it, then it is entirely possible their life can be saved.

As I have said previously, the most important thing we can do is formulate a diagnosis, decide what the patient needs and how best to ensure they get it as efficiently as possible. Calling for backup and waiting on scene will achieve nothing. This patient is truly time critical and needs to be transported to hospital.

Right, I follow given that you have monitoring capability -- I'm curious as to whether BLS can say "Alrighty, this is incompatible with life" or not. I certainly agree that rapid transport makes sense here, if you can ascertain that there is cardiac output.

 

[Specialized]

Right, I follow given that you have monitoring capability -- I'm curious as to whether BLS can say "Alrighty, this is incompatible with life" or not. I certainly agree that rapid transport makes sense here, if you can ascertain that there is cardiac output.

For BLS, that would be hard to determine. I certainly wouldn't make that call myself. Unless I see decapitation or rigor mortis present. They aren't dead until they're warm and dead with zero cardiac output.