is a broken arm an ALS or BLS call?

is a broken arm an ALS or BLS call?

  • ALS (with Paramedics)

    Votes: 33 29.5%
  • BLS (EMT only)

    Votes: 79 70.5%

  • Total voters
    112

MackTheKnife

BSN, RN-BC, NREMT, EMT-P, TCRN, CEN
520
128
43
Be sure to tell all your nursing instructors this philosophy and share widely while on clinical...it will bring you much success. :)
BTW, pain has been removed as the 5th vital sign.
 

RenegadeRiker

Forum Lieutenant
149
28
28
I’m pretty sure shoving a Tylenol suppository into a rednecks bum for his broken leg or pancreatitis is going to get me punched.
I’m also pretty sure that people in acute pain typically want some help.
 

Peak

ED/Prehospital Registered Nurse
860
474
63
I’m pretty sure shoving a Tylenol suppository into a rednecks bum for his broken leg or pancreatitis is going to get me punched.
I’m also pretty sure that people in acute pain typically want some help.
Well you should be getting consent before any intervention.
 

E tank

Caution: Paralyzing Agent
969
770
93
That's the attitude that a lot of people have, and it is actually a big problem. Physical pain is a normal part of the human experience and we should be able to deal with fair amount of it. The expectation of never having to tolerate any discomfort and catastrophizing about it and refusing to cope with it psychologically when it inevitably does happen is very self destructive - even if it doesn't ultimately lead to opioid addiction, which is of course the worst outcome and a shockingly likely one among patients who have the highest expectations for not experiencing pain. The medical community makes it worse by allowing patients to have unreasonable expectations and reinforcing the cognitive distortions that create further anxiety about pain and making it even more difficult for people to cope with. Then they throw opioids and anxiety meds at the the problem and everyone wonders what went wrong.
There is an entire medical sub-specialty that depends on "catastrophizing" pain for it's success with the complicity of OB doctors...it's labor analgesia. I've even had OB's request epidural catheter placement before induction of labor so that at the very first indication of discomfort, the epidural can be bolused with medication. Never had the heart to tell a mom that the pain of a teenager was far more intense than labor (and booze only makes it worse....)
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,097
2,796
113
There is an entire medical sub-specialty that depends on "catastrophizing" pain for it's success with the complicity of OB doctors...it's labor analgesia. I've even had OB's request epidural catheter placement before induction of labor so that at the very first indication of discomfort, the epidural can be bolused with medication. Never had the heart to tell a mom that the pain of a teenager was far more intense than labor (and booze only makes it worse....)
OB call is the bane of my existence.
 

Carlos Danger

Forum Deputy Chief
Premium Member
4,097
2,796
113
I thought all the moms love anesthesia since y’all give the epidurals.
Oh they do love us. To death. It's not usually the moms who are the problem, though they certainly can be difficult. It's just that OB is a strange world where the rules and expectations are different. Anesthesia providers tend to love OB or hate it. I……do not love it.
 
OP
DrParasite

DrParasite

The fire extinguisher is not just for show
5,222
1,409
113
BTW, pain has been removed as the 5th vital sign.
according to whom? I saw many who wanted it removed, and recommending it be removed, but who actually made that decision, and where is it documented?
 

Kevinf

Forum Captain
356
136
43
In that case BLS is more than appropriate. Our EMTs aren’t even trusted with oral glucose
I love our fractured EMS systems. For quite a while in PA, EMTs were trusted with oral glucose but not finger poke CBG. Even before that, there was a time where you could apply oxygen, but might not be able to check on SpO2.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
244
40
28
What if the hand was pulseless as presented?
I think we all can hear a physicians review; "So you have a displaced FX. In the off chance that the artery was only constricted and not lacerated, which it was, you chose to return the arm to a neutral position?"
 

RenegadeRiker

Forum Lieutenant
149
28
28
I think we all can hear a physicians review; "So you have a displaced FX. In the off chance that the artery was only constricted and not lacerated, which it was, you chose to return the arm to a neutral position?"
As opposed to leaving it in a position with impingement? I know you’re not actually trained, certified or educated in emergency medicine or basic anatomy, but even a cursory Google search explains this concept quite well.
 

E tank

Caution: Paralyzing Agent
969
770
93
I think we all can hear a physicians review; "So you have a displaced FX. In the off chance that the artery was only constricted and not lacerated, which it was, you chose to return the arm to a neutral position?"
Don't know anything about some "physicians review"...but just for argument's sake...how many arteries are in an arm? And what role might collateral arterial flow play in the setting of an arterial injury? And what might someone do to optimize collateral flow in a pulseless limb?
 

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