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Yesterday myself and WhackerDude <PARESCUEEMT - old partner> were out ice skating with my family - my dad is a ex-CPR instructor, and my brother is a Boy Scout First Aid Instructor. I was there to watch, as my balance isn't stellar, and I tend to FDGB on less slippery surfaces than Ice rinks. Well, maybe I'd have skated, but I can't find skates large enough 
- I digress
So, I'm sitting there, watching the pre-teens make out on ice skates to bad Britney Spears Music (is there good Britney Spears Music??) when I notice a pile of people kneeling on the far end of the rink. I look around, and can't see PARESCUEEMT anywhere - he's got to be somewhere in the pile of people.
My dad skates over and says PARESCUEEMT needs me, and he's thinking transport. I get keys and go an get my little bag from the car. On my way, I let a rink employee know that I don't know whats going on, but my friend, an EMT is back there invsetigating, and I'll let them know if theres an "ecnalubma" on the way.
I go back to the back end of the rink and got the story:
14 year old Female. Fell, hit her head. Confirmed LOC by PARESCUEEMT - 30 seconds or less. Pt. insisted on standing and trying to walk it off, PARESCUEEMT didn't disagree, because he was seriously worried about a 2nd injury from another skater, as sevral seemed to think buzzing the group down on the ice was a cool idea. As soon as they got the Pt. off the ice she complained of loss of sight and hearing. I'm not sure if they were transient, or just partial, as the patient seemed to be able to see and hear me. PARESCUEEMT had one of her friends holding C-spine - poor kid was scared to death about screwing up.
Pt. complains of 7-9/10 pain in back of head. her neck hurts alot, as does her back.
Vitals - 132/84, pulse 100 S/R, resps 24-26 shallow (pt. very anxious and upset). Lungs CTA. After BLS arrived, pulse ox was good. On initial exam by PARESCDUE, R pupil was fixed and midposition, L reactive. on second exam, PEARLA.
Anyway - we confer and agree that BLS and ALS are needed, and someone states they already called. I send my dad to be sure, and he gives loss of sight and hearing as current events.
BLS crew rolls in 5-10 minutes later, and are rather confused (they were hit for an injured subject - if I'd had a pager I would have called immediatly after dispatch and upgraded to ALS), but agree when I metion the 30-second LOC that ALS is VERY warrented, and is enroute 30 seconds later. Medic gets there, and he confers with his doc, who leaves the local hospital vs Trauma Center descion to the family's preferred hospital, where they sometimes act as a truama center, and sometimes as an acute care clinc when you talk of their "trauma acceptance." it all very much depends on which doc is working, and what sort of day they are having (Ya'all know how that is).
My worry was I did not want to put a bird on standby bexcause A: then the medic will think that I'm more of an *** than he thinks I am, and it dosent help that I seem to always try to fly my "simple" patients - as I've had my hands smacked by more than one ED attending for brining "that" patient in,
So, what do we all think.
- I digressSo, I'm sitting there, watching the pre-teens make out on ice skates to bad Britney Spears Music (is there good Britney Spears Music??) when I notice a pile of people kneeling on the far end of the rink. I look around, and can't see PARESCUEEMT anywhere - he's got to be somewhere in the pile of people.
My dad skates over and says PARESCUEEMT needs me, and he's thinking transport. I get keys and go an get my little bag from the car. On my way, I let a rink employee know that I don't know whats going on, but my friend, an EMT is back there invsetigating, and I'll let them know if theres an "ecnalubma" on the way.
I go back to the back end of the rink and got the story:
14 year old Female. Fell, hit her head. Confirmed LOC by PARESCUEEMT - 30 seconds or less. Pt. insisted on standing and trying to walk it off, PARESCUEEMT didn't disagree, because he was seriously worried about a 2nd injury from another skater, as sevral seemed to think buzzing the group down on the ice was a cool idea. As soon as they got the Pt. off the ice she complained of loss of sight and hearing. I'm not sure if they were transient, or just partial, as the patient seemed to be able to see and hear me. PARESCUEEMT had one of her friends holding C-spine - poor kid was scared to death about screwing up.
Pt. complains of 7-9/10 pain in back of head. her neck hurts alot, as does her back.
Vitals - 132/84, pulse 100 S/R, resps 24-26 shallow (pt. very anxious and upset). Lungs CTA. After BLS arrived, pulse ox was good. On initial exam by PARESCDUE, R pupil was fixed and midposition, L reactive. on second exam, PEARLA.
Anyway - we confer and agree that BLS and ALS are needed, and someone states they already called. I send my dad to be sure, and he gives loss of sight and hearing as current events.
BLS crew rolls in 5-10 minutes later, and are rather confused (they were hit for an injured subject - if I'd had a pager I would have called immediatly after dispatch and upgraded to ALS), but agree when I metion the 30-second LOC that ALS is VERY warrented, and is enroute 30 seconds later. Medic gets there, and he confers with his doc, who leaves the local hospital vs Trauma Center descion to the family's preferred hospital, where they sometimes act as a truama center, and sometimes as an acute care clinc when you talk of their "trauma acceptance." it all very much depends on which doc is working, and what sort of day they are having (Ya'all know how that is).
My worry was I did not want to put a bird on standby bexcause A: then the medic will think that I'm more of an *** than he thinks I am, and it dosent help that I seem to always try to fly my "simple" patients - as I've had my hands smacked by more than one ED attending for brining "that" patient in,
So, what do we all think.
