trauma1534
Forum Captain
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Here is a call that I ran about 2 months ago. tell me what you would do... and what you think is wrong with the patient.
You respond to a call to a gravel road, eta 32 min. from the nearest ER... no trauma center available by ground. The dispatcher says that it is a female thrown from a horse drawn trailer.
Upon arrival, you find a 64 year old female patient lying on the ground. Resp. 34, pulse, 120, B/P 230/118. Upon assessment, there is major bleeding comming from the head, LOC: Awake, confused, does not know her name, etc. Lung sounds: wheezes in left side, rales to the right side. There is a Paramedic on the scene who is telling you that everything is ok, just keep bleeding under control and apply copious amounts of diesal fuel and get to the ER. He refuses to ride in. You fully trauma package the patient, apply 15lpm 02, NRB. You get in the back of the truck, you only have 1 BLS provider to assist you. As you head up the road, you notice that your patient is becoming combative, heart rate is now 150, ST on the monitor, you cannot get an IV established due to crappy veins, respirations are now climbing to 44, you have deminished breath sounds on the right side. You are calling for additional ALS with no response enroute. Your partner exposes the patient and it appears that you have bilateral deformities to the lower legs, there are lacerations throughout the upper and lower extrimities. You still have 15 min. eta. You try to call the hospital, no one answers the radio. You try to call by call phone, you get put on hold. No one ever anwers that you need to talk to. You are now bagging your patient, and she is combative, not tolorating. She is 66 breaths a min, and you now have no breath sounds to the right side. Still no IV access and you cannot do an EJ without direct orders. You still have ST on the monitor... what would you do? After a few of you take a shot at this, I will tell you the rest of the story. :blink:
You respond to a call to a gravel road, eta 32 min. from the nearest ER... no trauma center available by ground. The dispatcher says that it is a female thrown from a horse drawn trailer.
Upon arrival, you find a 64 year old female patient lying on the ground. Resp. 34, pulse, 120, B/P 230/118. Upon assessment, there is major bleeding comming from the head, LOC: Awake, confused, does not know her name, etc. Lung sounds: wheezes in left side, rales to the right side. There is a Paramedic on the scene who is telling you that everything is ok, just keep bleeding under control and apply copious amounts of diesal fuel and get to the ER. He refuses to ride in. You fully trauma package the patient, apply 15lpm 02, NRB. You get in the back of the truck, you only have 1 BLS provider to assist you. As you head up the road, you notice that your patient is becoming combative, heart rate is now 150, ST on the monitor, you cannot get an IV established due to crappy veins, respirations are now climbing to 44, you have deminished breath sounds on the right side. You are calling for additional ALS with no response enroute. Your partner exposes the patient and it appears that you have bilateral deformities to the lower legs, there are lacerations throughout the upper and lower extrimities. You still have 15 min. eta. You try to call the hospital, no one answers the radio. You try to call by call phone, you get put on hold. No one ever anwers that you need to talk to. You are now bagging your patient, and she is combative, not tolorating. She is 66 breaths a min, and you now have no breath sounds to the right side. Still no IV access and you cannot do an EJ without direct orders. You still have ST on the monitor... what would you do? After a few of you take a shot at this, I will tell you the rest of the story. :blink:
