Ops Paramedic
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The images below are from the CT-Scan performed on a patient that we treated some time ago, and are fairly visual in nature. The thread is aimed at showing you that patients don’t just die and to ask some question which may touch on the ethical side of things.
The patient’s injury was as result of an unfortunate self inflicted act. A 1.5 ton front end loader’s ( TLB ) scoop, together with a down force of 1.5 ton came down onto the patient’s head. Upon arrival at the scene, the question of: “Is the patient still alive?” was posed to the foreman by an ALS (Expecting to get the “No” reply). He said that the patient was still alive...
When I arrived the other ALS had initiated treatment after ensuring the scene safety was intact. At closer inspection, we could not believe that this patient was still alive. It was obvious that the prognosis was zero, and you need not be a neurosurgeon to see that, as the there was copious amounts of grey matter protruding from the massive scull fractures. We elected to intubate the patient and used 15mg Midazolam and 15mg Morphine IV to try and “induce” the patient who presented with trismus as well as a threatened airway resulting from fluid in the oropharynx. All I can think of to compare the head immobilisation is: Take a pumpkin drop it from the second floor and now try and immobilise it, its just moosh.
Vitals signs of the patient of the patient was well within normal limits, and showed SpO2 of >98% pre and post intubation with a good respiratory efforts by the patient self. The patient was taken to hospital for further management, and even tried to open his eyes in the emergency room. The patient was admitted in the morning and subsequently passed away some 8 hours later.
When you look at the images, can you see what I mean about the prognosis?? As stupid as it sounds, would you have also treated the patient to this extend, or would you have maybe just packaged and transported lateral, as all the vitals were intact and make it someone else’s discission as to what to do ? One of my main aims was to keep going with the necessary life support in order to possibly explore the avenue of organ donation (The family later elected not to give the patient up for organ donation). Or how about keeping the patient “alive” purely for the family maybe to come and say good bye?? Your thoughts are...
Please note that these are my own thoughts and views of this particular call and may not necessarily reflect those of any of the other practitioners involved in treating this patient.
The patient’s injury was as result of an unfortunate self inflicted act. A 1.5 ton front end loader’s ( TLB ) scoop, together with a down force of 1.5 ton came down onto the patient’s head. Upon arrival at the scene, the question of: “Is the patient still alive?” was posed to the foreman by an ALS (Expecting to get the “No” reply). He said that the patient was still alive...
When I arrived the other ALS had initiated treatment after ensuring the scene safety was intact. At closer inspection, we could not believe that this patient was still alive. It was obvious that the prognosis was zero, and you need not be a neurosurgeon to see that, as the there was copious amounts of grey matter protruding from the massive scull fractures. We elected to intubate the patient and used 15mg Midazolam and 15mg Morphine IV to try and “induce” the patient who presented with trismus as well as a threatened airway resulting from fluid in the oropharynx. All I can think of to compare the head immobilisation is: Take a pumpkin drop it from the second floor and now try and immobilise it, its just moosh.
Vitals signs of the patient of the patient was well within normal limits, and showed SpO2 of >98% pre and post intubation with a good respiratory efforts by the patient self. The patient was taken to hospital for further management, and even tried to open his eyes in the emergency room. The patient was admitted in the morning and subsequently passed away some 8 hours later.
When you look at the images, can you see what I mean about the prognosis?? As stupid as it sounds, would you have also treated the patient to this extend, or would you have maybe just packaged and transported lateral, as all the vitals were intact and make it someone else’s discission as to what to do ? One of my main aims was to keep going with the necessary life support in order to possibly explore the avenue of organ donation (The family later elected not to give the patient up for organ donation). Or how about keeping the patient “alive” purely for the family maybe to come and say good bye?? Your thoughts are...
Please note that these are my own thoughts and views of this particular call and may not necessarily reflect those of any of the other practitioners involved in treating this patient.
