Lets try some scenarios..shall we

piranah

Forum Captain
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ok... you come across an MVA involving three vehicles. one is a minivan with a woman slumped over the steering wheel who is unconscious with some front end damage there are two children in the back of the vehicle crying but fine...one of the other vehicles is badly damaged and there is a conscious 17 yr old complaining of neck and back pain...and in the third vehicle there is a 74 yr old man with rapid shallow respirations and seems to be unconscious, diapheretic with cool skin...the steering wheel seems to have impacted his abdomen...(sorry bout any spell errors).......what are your coarse of actions and why ....you are the first EMS vehicle on scene...
 

John E

Forum Captain
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Is everyone breathing...

you didn't mention that.

As for the spelling errors, you might as well start working on writing better now, it only gets harder as you get older.

John E.
 

Emt /b/

Forum Crew Member
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you didn't mention that.

As for the spelling errors, you might as well start working on writing better now, it only gets harder as you get older.

John E.

The woman in the first van is the only one that we don't know is breathing or not.
 

Meursault

Organic Mechanic
759
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Your signature confirms what I had suspected. Did we forget Rule 1?

1. Additional units, preferably at least one ALS.
2. Get the woman's head stabilized and airway open.
3. Quick assessments and c-collars on everybody else.
4. Check to see if the 17 y/o can be extricated.
5. With help, who should have arrived by now, get the old guy with the likely abdominal bleed rapid extricated and on a backboard pending ALS attention.
6. I don't know the woman's status. If she's not breathing, ignore the previous steps and bag her while your partner makes sure no one else is critical.
7. Once more experienced providers are on scene, give them command and take the apparently non-critical 17 y/o in.
 
OP
piranah

piranah

Forum Captain
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well john im typing on a site...im actually quit a good writer just not a typer ( but thank you anyway)........the woman is breathing adequately...good....good....lol you didnt say scene safety BSI lol jk...(by the way i think it helps all of us to see other EMT explanations to scenarios...thats why i like doing this)......ok someone else
 

lcbjr3000

Forum Probie
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If i was the first person on scene i believe i would start to triage. You dont want to just jump right in and grab c spine cause once you do you got for the trip. Triage will allow you to determine who needs the most immediate attention and when your back up does arrive the perform there duties with that in mind
 
OP
piranah

piranah

Forum Captain
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also very valid point....actually i would have to agree with 3000...when your resources are not enough you need to triage to make sure that you dont miss a critical patient because you couldnt leave the c-spine because that would be abandonment...so in that case 3000 was correct but i also think that conspiracy had a great thought process....ok someone else create a scenario....keep it goin..:b
 

certguy

Forum Captain
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Scenerio

1. scene safety - Is my scene safe ? Where do I spot my rig for best protection ?

2. Size up - 3 vehicles , heavy damage on one ( possible pin - in ) , children crying in the minivan and unconscious driver . At this point you have at least 1 immediate ( if she's breathing ) , a rescue problem , and multiple pts. Time to order additional resources . FD rescue response , 2 additional ambulances , medivac on standby , CHP for traffic control .

3. Triage - Senior partner IC , junior partner triage officer . You have 2 immediates ( if female breathing ) launch medivac and make sure FD notified to set up LZ .

4. Begin initial treatment , starting with the immediates , do what you can till the calvary arrives . Put any spontaneous volunteers to work till you get help .

5 . Continue size up and retriage after initial treatment . Be ready to turn over IC when first responders arrive .


How's that ????
 

JPINFV

Gadfly
12,681
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Type of area(boondocks, suburban, rural, urban, etc)?
ETA to for additional units?
ETA to nearest trauma center?
Air ambulance available and ETA [dependent of course, on the above two factors?
Any extraction problems or is everyone easily accessible (if not,roll a fire engine)?
How many rescuers are on scene right now (is your crew a standard 2 man crew, 3 man crew, etc)?
Depending on ETA of additional resources, are there bystanders offering assistance?
Is minivan women breathing?
 
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certguy

Forum Captain
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Scenerio

Here's one for you guys and gals ,

It's 7:00 am on a weekday and you're driving the freeway to work when you suddenly see a large cloud of smoke and dust between 1/4 and 1/2 mile ahead . Immediately , the traffic comes to a complete stop . After several minutes a lone PD cruiser responds up the center divide to the scene . It soon becomes apparent the first responders are delayed getting to the scene due to traffic . You decide to respond and do what you can . As you approach the scene , you're shocked to see that a GTO that was going eastbound has gone through the center divider , gone airborne in the process , and pretty much head - on'd a transam with 2 women in it . There is debris almost 200 feet from the scene . The LEO tells you to start with the transam .
 

lcbjr3000

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Well some more info is needed. Are the vehicles on fire, if so not going near it till fire gets there. If im on my way to work then I am off duty and under no obligation to respond. And with that much mechanism your gonna need special tools for extraction. There isnt a whole lot you can do by yourself in my opinion.
 

JPINFV

Gadfly
12,681
196
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Laugh, go back to car, drive to work.

Without, at the very least gloves, it's not worth the risk to be exposed to their fluids.

Without c-spine gear, your not going to move them.

Without a portable suction, you aren't going to be clearing any airways.

Without a BVM you aren't going to be assisting any respirations.

Without a face mask, you aren't going to be helping a patient in respiratory arrest.

Edit:
Finally, -5 for thread jacking. A new scenarios by different person should get its own thread.
 

certguy

Forum Captain
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Scenerio

In the trans am you find both females pinned in . Driver is pinned in at mid thigh by the dashboard , restrained , resp. > 30 and labored , windshield starred , steering wheel bent , near amputation of right foot at the ankle , no access to lower extremities . Passenger is restrained , resp. > 30 , radial pulse very weak , decreasing LOC . Pt. complaining of severe abd pain . Abd. rigid . Door won't open due to damage .


1 occupant outside the GTO on your arrival , male , mid 20's , resp. < 30 , good radial pulse , obeys command to squeeze your fingers , 3 inch laceration on right forehead area , no other apparent injuries , but appears to be under the influence of alcohol ( strong odor ) and possible drugs . His vehicle also has major damage . Steering wheel bent , no starring on windshield , minimal space intrusion .
 

certguy

Forum Captain
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You have a well - equipped personal jump kit with o2 ( this happened before the FDA said we can't carry it off duty ) and c - collars , yes , you do have gloves , there is no fire and correct me if I'm wrong , but I think the post originator asked for more scenerios to keep things going so this wasn't a thread jacking HA !
 

JPINFV

Gadfly
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196
63
Sorry about that... I didn't see that the OP passed off the story line.


ETA of additional EMS crews as well as extrication?
ETA to trauma center?
ETA for air ambulance?
Number of available air ambulances [depending on ETAs and extraction times, both TransAms are worth of an outrageously helicopter bill. Neither are going to get better prior to reaching the hospital, especially the passenger.

Since you can't access the occupants of the TransAm, you won't be able to do anything for them till the fire department arrives.

So, pending any changes with the drunk driver, I'd c-spine and babysit him since, unless I'm missing a part of the scenario, he's the only one you can actually do something for prior to backup.
 
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certguy

Forum Captain
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No problem . You're forgiven . This was a real situation I came across on the way to work .
The freeway I drove was notorious for nasty accidents and I came across several . The GTO driver was drunk and wired on meth .
 
OP
piranah

piranah

Forum Captain
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good job guys exactly what i wanted to happen....ok next scenario...


your walking to your car with your buddy and you witness a sudden "man- down" you tell your friend to get your backpack out of your car containing gloves,pocket mask, and bp cuff, stethescope(lol what i carry) you run to the mans aide and find him in cardiac arrest... his wife yells he has a history of heart disease(non-specified)............on your mark.....get set........GO!!!



(by the way i like how this is coming out it shows constructive ideas along with strong opinions...i call it a round table....good study tool with some buddies.)
 

AZFF/EMT

Forum Lieutenant
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Call/have someone call 911
position airway
expose chest
check for pulses
begin compressions

u/a of buddy with some gear......

stop compressions and check abc's
have buddy take over compressions/verify they are adequate.
Place and OPA/NPA(prob not unless on duty, I'm not sure about the legalities of using an airway adjunct off duty) and ventilate at 30/2 until ems arrives
continue CPR.
 

TKO

Forum Lieutenant
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Witnessed man down? No pulse? Position and...

THUMP!


Unwitnessed and 9-1-1 not even dispatched? Check pt hasn't isn't dead. Position and...

THUMP!


Begin compressions. Rock-paper-scissors for who will do mouth-to-mouth. LOL! Then pull out the pocket mask. Do CPR until EMS arrives.

And that's all we can do. And some of you aren't even allowed to do that....who can't do a precordial anyway?
 
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OP
piranah

piranah

Forum Captain
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well...to reply to my own scenario..........

I would first have someone call 911 check abc's open airway asses breathing(absent) and check a corotid pulse(none) i would then give 2 rescue breaths (w/pocket mask )and begin compressions 30:2 i would allow my friend to give the respirations after 5 cycles i would switch to respirations and allow a break...after recieving the AED i would stop compressions and clear the PT for analyzation and if its a shockable rythm shock him and go further per american heart association protocol...:p

so..any other good scenarios?
 

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