question for medics

thatgirl00

thatgirl00

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if someone gets in a bad motorcycle crash and gets rocks/gravel stuck in their arm do the paramedics remove it, or do they just wrap it and transport?

i am asking cause i was talking about this with a friend, i would think they just wrap and transport cause I thought EMTs werent allowed to remove anything ever?
 
Roadrash and particles embedded it aren't removed on scene. Debridement of the wound would be best done under well-lit conditions. As a medic, I'd just do basic bleeding control... and let the ER do the painful work. Besides, I'd be more worried about other problems than a simple roadrash...
 
THat is what I thought, thank you
 
I would clean the best I can with the tools that I have (typically just a thorough rinse with NS or sterile water) and whatever comes out comes out but I wouldn't aggressively attempt to remove anything.
 
We remove the gravel, thorns, etc, if patient is stable.
 
medic417 said:
We remove the gravel, thorns, etc, if patient is stable.
Click to expand...

I agree, should have clarified in my post I will brush off what I can in that situation, thorns or insect stingers etc will be removed only the things that are buried will be left.
 
For me it depends on how much, how bad, and transport time. At the very least I try and dump some saline on it and get the large stuff off if I can. If it's a longer transport I'll spend more time on it. The reason is that once wounds like road rash (or burns) start to swell they can trap that debris in there, which leads to infection. If I can get some of it off I know it can help reduce that risk.
 
Whether or not I engage in wound debridement of any serious nature depends upon the setting and which "hat" I'm wearing at the time. I have been known to do some pretty aggressive work... resulting in some pretty clean wounds. However, in a motorcycle crash with serious injury, wound cleaning is about last on my mind and list of things to do...
 
Flush it with sterile water, wrap it, and move on. Mess with the road rash only if other more serious injuries have been tended to.
 
But paramedics are not to ever remove something stuck in the body right? Like a knife or something?
 
thatgirl00 said:
But paramedics are not to ever remove something stuck in the body right? Like a knife or something?
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Not quite the same as a small piece of wood or a couple chunks of gravel. You'd be amazed how much better people feel after you get some of that crap out of their wound and rinse it out with some irrigation fluid. A rough debridement, yes, but it helps. And not likely to start squirting arterial blood by removing a small chunk of road shoulder from a guys leg.

It also depends in the case. If there is a case where a guy lost a lot of blood or is in and out of consciousness, I'm not going to really worry about dirty road rash. If the guy is ok, in that he's sitting there talking to me despite the pain and I have nothing else to do on the way to the hospital (I am fairly quick with the paperwork), I'll try to clean him up on the way. Never delay transport, but clean him up the best I can.
 
thatgirl00 said:
But paramedics are not to ever remove something stuck in the body right? Like a knife or something?
Click to expand...

There are instances in which we remove penetrating objects. Few, but they are there. Interference with CPR, interference with airway management, and objects stuck in the cheek.

I like to think that a paramedic would try to do a rough debridement of gravel in my arm before transporting me as well.
 
Nah, bit of gravel rash wouldn't worry about it; some sterile water and a couple 4x4s

As to removing things stuck in people ... not unless it's in the airway

That said I've seen some interesting things stuck in people :lol: :lol:
 
Never seen gravel embed past the tissue level so cleansing with a cloth to remove loose is no problem. Seriously, use some common sense. The reason of not removing an impaled object is the danger that lies underneath or injury it caused while going into the body. If you can see the a piece of gravel (how big of a piece of gravel can it be?) it should be able to wiped off. If it appears to be embedded deep; simply leave it alone.

One has to use common sense. Alike a question asked to me, do you remove a bee stinger, it is an impaled object? No... immobilize it and allow it to continue pump its antigen into the body...Geez. Really, think of why and the dangers of object and removal.

R/r 911
 
Ridryder911 said:
Never seen gravel embed past the tissue level so cleansing with a cloth to remove loose is no problem. Seriously, use some common sense. The reason of not removing an impaled object is the danger that lies underneath or injury it caused while going into the body. If you can see the a piece of gravel (how big of a piece of gravel can it be?) it should be able to wiped off. If it appears to be embedded deep; simply leave it alone.

One has to use common sense. Alike a question asked to me, do you remove a bee stinger, it is an impaled object? No... immobilize it and allow it to continue pump its antigen into the body...Geez. Really, think of why and the dangers of object and removal.

R/r 911
Click to expand...

Classic. Gotta love Dr. Cox sometimes. :)
Exactly what needed to be said, rid.
 
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