Dispatched to.............

Pablo the Pirate said:
obviously if he coded 30 min later this was an ALS run. regardless of how good of a historian this guy was you knew you were missing something important right from the begining. and since the thought of chemical burns came up right away you have to remember how caustic some chemicals can be and you are just seeing the "minimal" damage on the outside not nessicarily the nasty stuff goin on on the inside. and its better to be safe and transport ALS to the hosp. doing all you can and find out it was nothing than to have had him sign off or not do anything for him and face a law suit. personally id have taken him in quick and quiet ALS. just my $0.02
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I am a paramedic so technically he was transported ALS. He just wasn't treated ALS.

We don't routinely place everyone we transport on high flow O2, start 2 large bore IV's, and do a XII Lead............ :)
 
i'm not saying do the whole 2 large bore ivs and high flow O2 and 12 lead. i would just start iv for access, 3 lead just for the record, maybe nasal canula but that would depend. im just sayin i would do something so i can say i tried. then i have my paperwork to say see i dont know what was wrong with him but i at least started something. :)
 
Pablo the Pirate said:
i'm not saying do the whole 2 large bore ivs and high flow O2 and 12 lead. i would just start iv for access, 3 lead just for the record, maybe nasal canula but that would depend. im just sayin i would do something so i can say i tried. then i have my paperwork to say see i dont know what was wrong with him but i at least started something. :)
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If there is NO pain, V/S are stable patient is CAOX3.......... how do you justify an IV for a few blisters?

Starting IV's and you can't document "why" will lead to trouble.
 
DT4EMS said:
If there is NO pain, V/S are stable patient is CAOX3.......... how do you justify an IV for a few blisters?

Starting IV's and you can't document "why" will lead to trouble.
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you already have your justified answer in possible exposure to chemicals and any other possible differitial diagnosis. and one question i have been wondering about but havent asked if if the blisters were circumfrential. if they were and they were burns thats emergent enough in itself due to the possibility of compartment syndrome. anyway this has been quite interesting and defenately a learning experiance for everyone. I know grangreene would likely have never come up as a differential diagnosis. now i can try to remember to keep it in mind. :P
 
Pablo the Pirate said:
you already have your justified answer in possible exposure to chemicals and any other possible differitial diagnosis. and one question i have been wondering about but havent asked if if the blisters were circumfrential. if they were and they were burns thats emergent enough in itself due to the possibility of compartment syndrome. anyway this has been quite interesting and defenately a learning experiance for everyone. I know grangreene would likely have never come up as a differential diagnosis. now i can try to remember to keep it in mind. :P
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The blisters were small...... there was maybe ten or so each smaller than a quarter. Trust me......... I never forgot to think of gangrene even if there was a known origin after that. :)
 
Very good post. But I will say if Pt. did not insist on going to the ED I would have had him sign a Refusal. Then I would have been in front of the OMD.:wacko:
 
Wouldn't the mere fact that there are so many unanswered questions and unknowns make it ALS? Alot of posters are saying it's obviuosly BLS, but I work a dual system, every truck has 1 CCNREMT-P, 1 EMT-A. I wouldn't want to make any call BLS until ALL my little neck hairs are flat.
 
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