If I'm thinking tension pneumo, I'm probably not going to waste time burping a dressing
chest decompression
- Thread starter wdballer2431
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If I'm thinking tension pneumo, I'm probably not going to waste time burping a dressing
usafmedic45
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You mean thoracostomies? Right? I don't know of anyone that allows a non-physician to do a field thoracotomies (outside of some really sporty SF medical personnel)
Yep, thoracostomy is what I meant, dang my ADHD.
An open thoracotomy in the field would be uhhh, impressive to say the least...
usafmedic45
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The location is secondary. It's not the location that matters or the technical ability to do the thoracotomy itself, it's the judgment that it takes to make the decision whether to do the procedure and the skill and knowledge to deal with what you might find upon opening up the chest. As one of my trauma surgeon friends put it, "Thoracotomies are like discussing your girlfriend's prowess in bed in front of her father. Only do either if you really want to deal with the cluster:censored::censored::censored::censored: that might ensue."
Our Intensive Care Paramedics do needle thoracostomy (Turkel chest decompression) whereas the HEMS Doctors (in AU) can do an open thoracotomy.
Same with HEMS in London, they have published some research on it.
I would like to dispell this rmor immediately as it is one of my pet peeves.
Gross tracheal deviation is a late sign.
Tracheal deviation is defined as movement of 3mm or more from the line between the symphisis of the mandible and the jugular notch. It is not a late sign, it is just one that has to be actively searched for by actually attempting to measure it.
I agree it is not a finding suitable for field work.
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wdballer2431
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I agree with the trachael deviation being a late sign. Better signs to look for would be tachypnea, absent lung sounds, and hypotention due to pressure in the plueral cavity
causing a decrease in CO. Once again, sorry to anyone I offended with abbreviations, it is a forum not a job resume. I appreciate everyones opinions and feedback on treatment
causing a decrease in CO. Once again, sorry to anyone I offended with abbreviations, it is a forum not a job resume. I appreciate everyones opinions and feedback on treatment
Aidey
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I agree with the trachael deviation being a late sign. Better signs to look for would be tachypnea, absent lung sounds, and hypotention due to pressure in the plueral cavity
Huh?
Problem number 2 with abbreviations. Not everyone uses the same ones.
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I agree with the trachael deviation being a late sign. Better signs to look for would be tachypnea, absent lung sounds, and hypotention due to pressure in the plueral cavity
I like how you use the abbreviation for ease and quickness of writing, yet you then proceed to type out an entire sentence justifying it... Kind of defeats the purpose, huh?
Unless cardiac output is just too complicated to spell......
abckidsmom
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Cardiac Output. It's pretty standard, especially when viewed in context of the conversation.
Those are the signs I look for as well. If I'm worried about a tension pneumo, the patient is typically supine on a backboard. No need to cause further discomfort to a dyspneic patient by digging in to palpate their trachea.
If I believe a person has a tension pneumo and is unconscious, I might palpate for a learning experience, or a "gee that's neat" kind of thing, but I don't believe it's a helpful enough sign to cause that added anxiety in a conscious patient.
wdballer2431
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I like how you use the abbreviation for ease and quickness of writing, yet you then proceed to type out an entire sentence justifying it... Kind of defeats the purpose, huh?
Like abckidsmom wrote, CO is a very standard abbreviation, especially in the context of how I used it. Maybe we shouldnt use Bp or Hr because those might be too complex for everyone to understand. Medicine has endless amounts of abbreivations, so stop harping on it when I write one.
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I'm not saying it's not. I knew exactly what you were referring to as soon as I read it. CO is absolutely an accepted abbreviation for cardiac output, especially in the context it was used. I use abbreviations all the time, and am guilty of sometimes even over-using them in my reports
I just found it funny, and slightly redundant, that you used an abbreviation (which is generally used to save space or write quickly) and then followed it up with an explanation/justification of it's use. Again, kind of defeats the purpose 
Firemanfred55
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gsw cover, burb,then ALS
I'm probably going to cover with an occlusive taped on four sides, and needle PRN.
Smash
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Defib pads make great occlusive dressings for bigger/messier holes, just be sure to explain why they are in a strange place. Never even heard of "burping" the dressing; I can't imagine that it is any use, and I would be getting out my pneumocaths anyway. So I'll third usalsfyre's statement.
JPINFV
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Repeating yourself does not change anything...
Also, make sure to remind the physician to remember his "BLS" when he goes to put in a chest tube before burping the dressing. Please report back when you do.
M3dicDO
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LMFAO!:lol: