scenario

[Kendall]

I wish I was ALS... **sniff**

Best I could do w/ pt is ABC's, patent the airway w/ opa, highflow o2, KED & board, monitor vitals and hope to god that ALS is down the road and STARS is on the ball w/ a less than 8 minute in the air time. I'd also be praying that a generous MD/neurosurgeon is onboard (Often, STARS has a EMT-P, RN and an MD/surgeon onboard their flights... I'm suprised the whole crew makes it out alive...)

So... what's the end result?

 

[FF894]

what now? Cancel Christmas, happen to have a Black & Decker Drill available?
what is happening? He's dying...
what do you want to know? Catholic, protestant, etc...

LMAO - true though

 

[PArescueEMT]

What now? You hope that helicopter gets there and you get him on the bird before he dies on scene with you.

What next? Get him intubated so you have a chance to protect his airway. And hope that helo isn't to far away.

Whats happening? He's having a very bad day. And I'm willing to bet nothing is going right in the back of your truck. Crap has been flung everywhere. Who ever you have bagging him is probably doing it about 50 times a minute. Your portable suction will probably choose this precise moment to stop working, only to mysteriously start working again once you've transferred him to the helo. And I don't care if its 10 degrees below, your sweating your butt off..

What do you want to know? How far out is that helo.

you forgot about the pouring rain and thunder that started about 30 seconds after the bird was launched...

 

[bunkerhillfire]

I would suspect TBI with the scenario especially with the Mastoid Process bruising and LOC. Respirations 34 is rapid and Capillary refill of 2 seconds is borderline. Do not delay transport and if extrication time is going to be lengthy, aeromedical should be utilized. This is just my opinion.

 

[FF894]

Helicopter, quickly!!!!! Your patient is about to die and needs a neurosurgeon like yesterday..........

The pt. has a basilar skull fracture with temporal bone involvement, probably a combination of transverse and longitudinal, hence the bleeding from the ear, the complaint of nausea and the "throbbing" sensation. Since otorrhea of CSF and blood is present, your patient has probably tore a suture or venous sinus groove and now also has an epidural bleed. A period of lucidity followed by a loss of consciousness is the classic epidural bleed finding. This guy is gonna die quickly if you don't get him to a neuro-trauma center rapidly.

Some good answers and thoughts, but most of the responses are items that just aren't needed until this guy gets stabilized. These delays can and will kill your neuro-trauma patients..................

Yup - direct to OR baby

 

[FF894]

*If I didn't have a medic handy, I'd check with command, then fly the bird...

Do your birds have stretchers? We gotta get some of those....