This is a scenario of a call I responded on as a brand new EMT-B. It was VERY confusing at the time and did not involve something that was taught in class. Just curious to see if those other EMT-B's can pinpoint "what killed him". This was a wonderful learning opportunity to me at the time and I am still fascinated at how sudden something like this happens....
It's about 23:00 and you're dispatched to an MVA w/injuries. Single engine, single ALS ambulance response. En route, your additional information is "2 car rear-end MVA. RP reporting that they are unable to get the driver of one of the vehicles out. Unknown extent of injuries". Due to the possibility of extrication, you start a rescue company.
U/A you find a 2 car MVA with heavy rear end damage to one car, and heavy front end damage to the other. The driver of the front car was able to get out, but due to the intrusion on the second vehicle, the driver is trapped. You have two ambulatory patients as well. You start two more ALS ambulances emergent.
Vehicle 1: Occupied x2 adults. Both complain of neck/back pain and are fully oriented. No complaints otherwise, stable vitals. Both self-extricated and were walking around upon your arrival. These two are transported first non-emergent due to prolonged extrication on the other vehicle.
Vehicle 2: Occupied x1 adult. He is fully alert/oriented. You examine the vehicle to find the dash intruded into the pass. compartment, intern trapping your patient from the waist down. He complains of severe pain to his lower back and also to his legs. You are able to gain access into the vehicle via the back seat and start treatment on this patient while the Fire Dept. is extricating him. You establish C-Spine, start an IV, assess vitals etc. Vitals are 150/palp, 106 pulse rate, resp 20 and normal. This patient stays alert and oriented throughout the extrication, which lasted appx 20 minutes. They are able to roll the dash and pop open the driver side door. You place a backboard end-first in the car underneath the patient and plan to move him onto it by pivoting him and scooting him onto it. You move the torso towards the head of the backboard and are able to pull out the lower extremities from the dash. You scoot him completely on the backboard while still maintaining C-spine and your patient is suddenly unconscious/unresponsive/not breathing. Full COR. You begin CPR. Your EMT-P intubated this patient nasally and he is given 3 rounds of COR drugs throughout your emergent transport to the trauma center that is appx 10-15 minutes away. Patient is PEA on the monitor and does not improve throughout transport. U/A to the ER, your patient does have a pulse but is still unc/unresp. He is immediately taken to surgery. End of call
If he was AA0x4 throughout the whole extrication, but suddenly coded when extricated, what was the cause of his death?
It's about 23:00 and you're dispatched to an MVA w/injuries. Single engine, single ALS ambulance response. En route, your additional information is "2 car rear-end MVA. RP reporting that they are unable to get the driver of one of the vehicles out. Unknown extent of injuries". Due to the possibility of extrication, you start a rescue company.
U/A you find a 2 car MVA with heavy rear end damage to one car, and heavy front end damage to the other. The driver of the front car was able to get out, but due to the intrusion on the second vehicle, the driver is trapped. You have two ambulatory patients as well. You start two more ALS ambulances emergent.
Vehicle 1: Occupied x2 adults. Both complain of neck/back pain and are fully oriented. No complaints otherwise, stable vitals. Both self-extricated and were walking around upon your arrival. These two are transported first non-emergent due to prolonged extrication on the other vehicle.
Vehicle 2: Occupied x1 adult. He is fully alert/oriented. You examine the vehicle to find the dash intruded into the pass. compartment, intern trapping your patient from the waist down. He complains of severe pain to his lower back and also to his legs. You are able to gain access into the vehicle via the back seat and start treatment on this patient while the Fire Dept. is extricating him. You establish C-Spine, start an IV, assess vitals etc. Vitals are 150/palp, 106 pulse rate, resp 20 and normal. This patient stays alert and oriented throughout the extrication, which lasted appx 20 minutes. They are able to roll the dash and pop open the driver side door. You place a backboard end-first in the car underneath the patient and plan to move him onto it by pivoting him and scooting him onto it. You move the torso towards the head of the backboard and are able to pull out the lower extremities from the dash. You scoot him completely on the backboard while still maintaining C-spine and your patient is suddenly unconscious/unresponsive/not breathing. Full COR. You begin CPR. Your EMT-P intubated this patient nasally and he is given 3 rounds of COR drugs throughout your emergent transport to the trauma center that is appx 10-15 minutes away. Patient is PEA on the monitor and does not improve throughout transport. U/A to the ER, your patient does have a pulse but is still unc/unresp. He is immediately taken to surgery. End of call
If he was AA0x4 throughout the whole extrication, but suddenly coded when extricated, what was the cause of his death?
