If it is going to take 40 minutes to extricate him, hes not making it.
What, exactly, lets you say that? I've had vehicle extrcations where the second patient cannot be accessed until the first is packaged and removed, dramatically increasing the exrication time. Also, out here, the VFD often arrives after us, and if it is an exended extrication, it can take a few minutes for them to stage their tools and crib the vehicle... increasing your extrication time. I know that the NYPD ESU guys are great
(FDNY's Rescue and Ladder guys are also great
)... but even the best take time to do it RIGHT. A 40-minute extrication time is unusual, but not automatically fatal.
reach in through the 1 ft of clearance you have though the windshield. Now really, we got to stop this. And by the way, I've had calls like this. You better get this straight in your mind before it happens. You're going to feel pretty bad when someone dies for no reason other than your inability to see protocols for what they are. I know this probably goes against you marginal emt training, but now that you here, you should try and open you mind up to new ideas. They can't say enough good things about tks since the war started in iraq. It can take hours to do any major harm with tks. Read and know that this world isn't black and white and protocols.
Right.... however, some folks will use the arguement that the MAST-Pants were "the next great thing" duing the Vietnam era.... and look what happened to them.
I agree that tourniquets have a place for use by trained professionals, and even boy scouts, when ALL OTHER METHODS fail... BSA still teaches Tourniquets, as a last-ditch measure after direct pressure, elevation, and pressure points fail to stop the bleeding.
Exactly. New Jersey (or at least the part where I work) has the same protocol because within a 10 mile radius, we have 5 hospitals including a trauma center. The rule makes sense. For the same reason, we don't carry activated charcoal on our rigs and we don't get medics half the time we need them because the ride is too short for us to bother waiting for them once we're on scene.
The idea that "you're 5 minutes from the hospital" works just fine... until the fecal matter hits the ventilation device... then you are up a creek without a paddle, and open to lawsuits.... Can you see youself on the stand: "Why did my client die? Becuause Joe EMT decided that they didn't NEED to carry actvated charcoal because they were close to a hospital.... but during the blizzard, after my patient ingested 400 tylenol and the ambulance broke down in the middle of the Blizzard... They failed to have the appropriate medication on hand, and my client died... The family needs 50 Million dollars for pain and suffering."
I realize it isn't your choice, really, as to how your service stocks their rigs... but as Guardian already pointed out... a prolonged vehicle extrication can make your time in contact with the patient invcrease dramatically.
