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trauma1534

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You have a call to a 44 year old male patient with no PMHx, with altered mental status. Dispatch advises you to come into the garage on the side of the house. That's all you have. What is your first plan of action? From the dispatch information, what is your first thought?
 
sdadam

sdadam

DialedMedics.com
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from the dispatch info, I'm thinking:

carbon monoxide
un-Dx diabetes
etoh
cva

basicaly aeioutips but since he is in a garage I always worry about carbon monoxide.

adam
 
Medivixen

Medivixen

Forum Crew Member
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same as any other call you would go on
Scene safety
LOC
D
A
B
C
RBS
Skin
O2
Now its decision point...from your findings is this a load and go or stay and play. Depending on what I found in the primary assesement .
Since it is altered LOC this would be a protocol call before I can load up so I would have a set of vitals taken.
What are the vitals that I get? since this would effect what I do next in my protocol..
 
OP
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trauma1534

Forum Captain
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Ok... what you have is a man who is in his car in the garage... WITH THE CAR RUNNING!!!!! So, yes, it is carbon monoxide poisening.

So tell me... how are you going to safely get this guy out? After you get there, you find out that he is now becoming unresponsive.
 
yowzer

yowzer

Forum Lieutenant
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trauma1534 said:
So tell me... how are you going to safely get this guy out? After you get there, you find out that he is now becoming unresponsive.
Click to expand...

If you're not already a firefighter with SCBA handy, get some.

Failing that, open as many doors and windows as you can by holding your breath and running inside, and once there's ventilation, turn off the car and go look at your patient.
 
Ridryder911

Ridryder911

EMS Guru
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Open dah door.. and stand back!.. I will not enter until FD with SCBA. Co poison can occur even with seconds of exposure...

R/r 911
 
jeepmedic

jeepmedic

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Ridryder911 said:
Open dah door.. and stand back!.. I will not enter until FD with SCBA. Co poison can occur even with seconds of exposure...

R/r 911
Click to expand...

agree Do not enter if you do you may not come out upright.
 
Airwaygoddess

Airwaygoddess

Forum Deputy Chief
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jeepmedic said:
agree Do not enter if you do you may not come out upright.
Click to expand...
Sounds like good sense to me!! Scene safety can NEVER be overrated!!^_^
 
Jon

Jon

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If FD isn't alreay rolling, get FD rolling.

my former FD's ambulance has SCBA's on it for this reason (and others).

If I was on this call with the squad, I'm not sure what I'd do. One potential idea would be for ME to go in wearing a NRBM (and 100% O2) and at the least open the garage door and shut the car off... That wouldn't be perfect, but it would be "doing something" rather than sitting around for 10 minutes waiting for the FD to respond and arrive and watching the guy die.

Also... PD might just be dumb enough to bring the guy out for us ;)


Finially... I'd also request PD when I request FD, because we have a potential EDP with a suicide attempt... once they cease being hypoxic, they might become combative.
 
jeepmedic

jeepmedic

Forum Captain
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Let the Stretcher Fetchers get him out. This is a Haz-Mat Scene. OSHA will not like it very much if you go in with out the proper equip.. You will not do anyone any good if you are now a pt.. Stay out untill someone with a SCBA goes in and gets pt. out.
 
F

FFEMT1764

Devil's Advocate
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Let the police drag him out, get him air, and when he wakes up- press hard making 3 copies!

Really though wait for the FD to get there, you aren't doing him any good when you become unresponsive yourself. Remember that CO has 200x more affinity for hemoglobin than oxygen does.
 
OP
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trauma1534

Forum Captain
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Jon said:
If FD isn't alreay rolling, get FD rolling.

my former FD's ambulance has SCBA's on it for this reason (and others).

If I was on this call with the squad, I'm not sure what I'd do. One potential idea would be for ME to go in wearing a NRBM (and 100% O2) and at the least open the garage door and shut the car off... That wouldn't be perfect, but it would be "doing something" rather than sitting around for 10 minutes waiting for the FD to respond and arrive and watching the guy die.

Also... PD might just be dumb enough to bring the guy out for us ;)


Finially... I'd also request PD when I request FD, because we have a potential EDP with a suicide attempt... once they cease being hypoxic, they might become combative.
Click to expand...

Number one, the NRBM will not help you here! DON"T EVER DO THAT!!!

Number two, do not ever send anyone in without proper equip. Remember, the more people you send in, the more patient's you most likely will have, and that would suck!!!

Number three, if he codes, then he codes! Woopy ****! He shouldn't have been dumb enough to try something this stupid! But, if he codes, you still can't worry about him at this point. You think about yourself, and your crew!

Just remember, if he codes and you can't get in there to work him in ample time, you can sing this song.... "start your day with a DOA, doda, doda, pump and blow till they pass away, all the do da day!"
 
F

FFEMT1764

Devil's Advocate
565
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Its only against the law to attempt suicide, not complete it!
 
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