the 100% directionless thread

[Rsxtacee]

Sending you many mental fist bumps in anticipation of your no doubt epic pass of the practicals.

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Thank you sir! I think it went well today. Now on to the practicals.

 

[shfd739]

Glad you had a good clinical!

Not to rain on your parade but I find it really hard to believe she was really hit at 40 mph unless she was "just" sideswiped and came away from it with minor abrasions. I know kids bounce but pediatrics aren't exempt from the laws of physics.

As far as stripping her, my personal opinion but I can do a pretty god job of visualizing without cutting by moving the clothes around, especially in the younger kids who's clothes don't tend to be as fitted as teenagers and young adults. I wasn't there so I don't want to monday morning quarterback but if she truly had no outward signs of trauma outside of mom/neighbor/bystander yelling about "THE CAR WAS DOING AT LEAST 40!" I wouldn't be all that quick to make this girl trauma naked. She was in a scary accident and ambulances and hospitals can be really scary as well, no need to add to it by stripping her all the way down. If it's necessary then by all means do it but it doesn't sound like it was in this case as you described it.

Someone else that isn't scissor happy!!

I was starting to think I'm the only one.

 

[lightsandsirens5]

BOOM! Goes the dynamite.

This started me on a three hour long youtube browsing session and now I am somehow watching Who's Line is it Anyway. Thanks Rob. I needed to laugh!

 

[JPINFV]

Since we're talking clinicals... got to help put in a femoral line and work up a urosepsis vs colitis patient.

 

[DesertMedic66]

Just heard that there might be a Supertroopers 2 movie sometime in the near future. About dang time

 

[8jimi8]

Since we're talking clinicals... got to help put in a femoral line and work up a urosepsis vs colitis patient.

did you use ultrasound? or landmarks?


don't for get NAVEL


Nerve Artery Vein Empty Lymph

 

[JPINFV]

We used ultrasound.

 

[Shishkabob]

So, let me get this right,


You don't know what ejection fraction or right bundle branch block mean, but you somehow think you can question why I want a 12lead on a patient, as if you know better?


Did I miss something?

 

[8jimi8]

We used ultrasound.

i got to put in a fem on a live goat at the Critical Care Transport Medicine Conference Procedural Anatomy course in 2011. Vanderbilt Life Flight hosts it every year. we used landmarks.

 

[shiroun]

Glad you had a good clinical!

Not to rain on your parade but I find it really hard to believe she was really hit at 40 mph unless she was "just" sideswiped and came away from it with minor abrasions. I know kids bounce but pediatrics aren't exempt from the laws of physics.

As far as stripping her, my personal opinion but I can do a pretty god job of visualizing without cutting by moving the clothes around, especially in the younger kids who's clothes don't tend to be as fitted as teenagers and young adults. I wasn't there so I don't want to monday morning quarterback but if she truly had no outward signs of trauma outside of mom/neighbor/bystander yelling about "THE CAR WAS DOING AT LEAST 40!" I wouldn't be all that quick to make this girl trauma naked. She was in a scary accident and ambulances and hospitals can be really scary as well, no need to add to it by stripping her all the way down. If it's necessary then by all means do it but it doesn't sound like it was in this case as you described it.

The parent was saying 30-40 mph, it was marked as >40mph. And you never know, I was hit by a car right next to a speed trap, he was marked at 35 mph, and I came away with a bruise on my shin and nerve damage in my knee, and nothing else.

Also, I can understand that, but she did have a one piece bathing suit on that covered her entire side. That's what I meant when I said expose. There's no way to visualize the skin under that.


By the way, a question:

The guy who drank bleach was considered unresponsive, but on a couple of occasions (when they shoved a foley in and pulled it out really fast for whatever reason, and a couple of others), pain made him jerk around. I saw them take a tube kit out, and then a minute or two later I heard a deep gurgling noise, and about 20 seconds after that a suction machine. I thought gag reflexes went to :censored::censored::censored::censored: when you were unresponsive?

 

[NomadicMedic]

Or perhaps he just had a oropharynx full of secretions?

Did they sedate and paralyze him when they intubated him?

 

[VFlutter]

Unresponsive does not automatically mean no gag reflex

 

[shiroun]

Or perhaps he just had a oropharynx full of secretions?

Did they sedate and paralyze him when they intubated him?

I wasn't working on him, so I couldn't tell you. I could tell you they had bilateral IV's in him, but I don't know what drugs they pushed.

 

[SSwain]

I just had a bi-colored bowel movement....

 

[firetender]

Please flush and get back off (this) topic!

 

[Tigger]

I love going in for clinicals whenever I want. Had a pt who was in-and-out A&O, was telling us her birthday was 1923 (and then when we explained to her, said her birthday was 1993, which it was, and followed that by saying her grandmother was in 1994...). She snorted adderal and drank a buncha alcohol, and I watched two of the IVs in her dig past the skin when she would sit up. She was also trying to seduce me at one point, which cracked me up. She was in trauma 1.

The guy in trauma 2 drank a full thing of bleach, 2 bottles of pills (not sure what kind), and said he wanted to die. This was all after he beat the :censored::censored::censored::censored: out of his wife and kid, who were in the room diagonally across from us. Deep laceration on L wrist, scratches (from his wife?) on his L arm, and at one point he started siezing. I couldn't keep up with him since I was dealing with the drunk girl .

Finally, my favorite call of the night was a 12 y/o girl who was on a bike and got hit by a car going 40. She had effectively NO injuries. I mean, a few abrasions and contusions (the same ones I had when I was hit, ironically), but effectively okay. She was absolutely the sweetest girl ever, and took needles like a champ. When asked if we could cut her shirt, she said "yeah sure why not."

However, WHY she wasnt naked when she came in is beyond me. She was hit at around 40 mph, on her left side. She still had all her clothes on, but was marked as a trauma from the moment EMTs were on scene. Maybe not naked, but more exposed would have been better. Hidden wounds = bad.

And speaking of the bleach guy, I saw an EMT who was on shift last night as-well. Asked him if his day was any fun, he said nope. He's the one who brought in the bleach-man. ahahha

Yeah I am not going to cut the clothes off of a little girl that has no visible injuries. You can move clothes without scissors in EMS too... Now if you find something that might be different. Blanket statements about what to do with trauma statements really do no good. Glad she was fine nonetheless.

 

[Handsome Robb]

First day in the field as a medic tomorrow.

Talk about nerve racking.

 

[bigbaldguy]

First day in the field as a medic tomorrow.

Talk about nerve racking.

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You wearing your "da man" name tag?

 

[Handsome Robb]

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You wearing your "da man" name tag?

Haha unfortunately not. They did embroider "Paramedic" on all my shirts though with a great parting statement, "You better not mess up otherwise we are going to have to send ALL your shirts back to get re-embroidered again!"

Thanks for the pressure... :facepalm:

 

[shiroun]

Yeah I am not going to cut the clothes off of a little girl that has no visible injuries. You can move clothes without scissors in EMS too... Now if you find something that might be different. Blanket statements about what to do with trauma statements really do no good. Glad she was fine nonetheless.

I didnt mean it as a blanket statement. but the MOI would indicate it to be a good idea. The was no chance in hell (s)he could visualize injuries on the abdomenal/chest area.

Regardless, I agree, it's a good thing she's okay.