BloodNGlory02
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Male fall apprx 35 ft in a pump house pit. It's a building, but goes 35 ft underground. Dept. of Public Works confined space team immediately dispatched. Upon arrival 4 emt's race down the 4-5 flights of stairs under the 'ok' of the DPW supervisor. You find a 40 somethings male, left lateral recumbant, apprx 300cc of blood all around, some clotting. You roll your pt supine to find bilat hemorhagging from the ears, moderate amount from the nose, color- ashen/gray, pupils dilated non reactive, JVD, no trauma to any other body part. No pulse, no respirations. No shock advised.
STOP! Do you begin CPR knowing the MOI and amount of blood lost??
Ok, you insert an oral and someone begins chest compressions. Someone drops an ET tube, suction, secure pt to confined space teams' board and begin to hoist pt 4-5 storys to the exit. Resume CPR, one round of Epi, get in the squad, more suction, no changes. Helicopter overhead.
Do you REALLY do CPR or do you continue the motions?
I chose to 'do the motions' as we suctioned about 700 cc of blood from just his mouth and nose. Flight crew comes in, by this time the media is all over the squad and blankets are hung on the windows. About 10 more min of tap tap breath tap tap breath, ausciltate, no heart tones, no resps, PEA, Flight MD asks if we're all comfortable with ending. we all agree he didnt have a chance and let him go. Wait about 45 min for the ME, move him to her cot, it was like a blood river. I thought we had suctioned everything outta him, apparently not.
All in all everything went excellent and it was a good experience. The DPW guys did an incredible job and im very proud of them as this was the first time they've actually had to use the equipment outside of training, and given the looks of the patient, thats not something they're used to seeing, and it was one of 'their guys'. Im not so much 'upset' that he died. I knew he didnt have a chance, it was going back into the scene after OSHA had left and seeing the bloody finger marks 15 ft up on the wall where he tried to catch himself.
STOP! Do you begin CPR knowing the MOI and amount of blood lost??
Ok, you insert an oral and someone begins chest compressions. Someone drops an ET tube, suction, secure pt to confined space teams' board and begin to hoist pt 4-5 storys to the exit. Resume CPR, one round of Epi, get in the squad, more suction, no changes. Helicopter overhead.
Do you REALLY do CPR or do you continue the motions?
I chose to 'do the motions' as we suctioned about 700 cc of blood from just his mouth and nose. Flight crew comes in, by this time the media is all over the squad and blankets are hung on the windows. About 10 more min of tap tap breath tap tap breath, ausciltate, no heart tones, no resps, PEA, Flight MD asks if we're all comfortable with ending. we all agree he didnt have a chance and let him go. Wait about 45 min for the ME, move him to her cot, it was like a blood river. I thought we had suctioned everything outta him, apparently not.
All in all everything went excellent and it was a good experience. The DPW guys did an incredible job and im very proud of them as this was the first time they've actually had to use the equipment outside of training, and given the looks of the patient, thats not something they're used to seeing, and it was one of 'their guys'. Im not so much 'upset' that he died. I knew he didnt have a chance, it was going back into the scene after OSHA had left and seeing the bloody finger marks 15 ft up on the wall where he tried to catch himself.