Psych Case, Scene not Secure

[Veneficus]

clarification of point

All the new practical skills sheets I have seen have "consider c-spine stabilization" as one of the very first critical criteria, for both medical and trauma. Maybe it is a state thing? It comes before the ABCs though.. so they're really trying to put some hardcore focus on it.


Also.. Veneficus I liked your point.

We had our regional EMS symposium last weekend and we had an instructor who really hit on the whole medical/trauma all being one big thing.

Maybe that MVA was caused by a seizure or a diabetic emergency, ya know?

Kinda hard to tell when they are FUBAR and unconscious whether the lack of consciousness came from the trauma or something else.

Similarly... Syncopal episode could mean injuries that the patient isn't really complaining about (as unlikely as it is for a patient to *not* complain).. Better to check and rule it out then go "oh crap" later...

My point was not that an incident involving trauma had a medical precursor. It was there is really no distinction between a medical and trauma pathology.

Let me offer some examples.

The thrombus or embolus leading to an infarction of an organ is caused by physical damage to the vascular endothelium or thrombus respectively.

An autoimmune disease is antibodies or cytotoxic cells physically destroying body tissue.

A neoplasm can cause pressure necrosis and obstruct airways and blood flow.
Interstitial pneumonia is physically damaging to alveolar structures.

Many microorganisms physically disrupt cells and tissue in addition to releasing toxins.

You can have fibrous scarring of organs such as the liver without ever suffering a blunt or penetrating injury from an outside force.

You can develop acute GI ulcers as a result of stress from outside injuries such as getting stabbed in the head.

Damage to muscle tissue from catabolic metabolism or outside injury can lead to renal failure by the exact same mechanism.

Cell lysis from hyper/hypotonicity/osmoality is physical damage caused by water.

PH abnormalities cause a physical reshaping and consequent loss of function of proteins.

The list can go on for as many pathologies as are known to man.

The distinction between “trauma” and “medical” is artificial. The cellular structures, cells, tissues, organs, systems, organism suffers the same type of damage and responds to any damage in exactly the same way for as long as it is able prior to decompensating. The difference in treatment comes in recognizing what the primary cause is.