What would you do in this scenerio?

[hippocratical]

thanks bra lol ill try my hardest!

 

[Judeau]

Giggity!

 

[systemet]

* Is this my only patient? Confirm with bystanders.

This is gold, both for scenarioland and real-life. It is way too easy to show up to a scene with an obviously critical patient, run them to the ER and find out you've missed other patients because you focused on the first one you found.

It's amazing how people find their way underneath cars and into ditches in MVCs, just like stab wounds find themselves in axillae, or right in the umbilicus in someone obese, and small caliber rounds end up covered by hair.

Direct pressure, if that fails:
Pressure point, if that fails:
Pressure dressing, if that fails:
Elevation, if that fails:
Tourniquet (preferably after calling medical director at EMR level) and write on the pt.s forehead "T time"

This may be how they're teaching it still. For real life, understand that direct pressure is what you're doing while you're making a pressure dressing. Pressure points aren't generally used any more, and you should have a low threshold for using a tourniquet if a pressure dressing isn't adequate, or if arterial hemorrhage is present.

There we go. My interview is in the bag

Good luck!

 

[Jon]

I know lol, i won't spell 100 percent correct on the internet, its a start though. Also, how much money can you be sued for? Were you sued before, please state why if you were sued(if its personal i understand).

So... You pick and choose when you want to use proper grammar and spelling?

My iPhone has a built-in spellcheck and autocorrect. Yes, it's sometimes hilariously wrong, but it also works most of the time. My browser also has a spellcheck.

Ever heard the phrase: practice makes permanent? The more times you do something wrong, the more likely you are to keep doing it. If you always practice using proper spelling and grammar, it comes easier when it's needed - like the EMS charting software with a crappy spellcheck.

On top of that, what you post online is forever. I'm pretty confident that any employer doing a bit of google-fu investigation prior to hiring me will likely find this site and all my posts. Therefore I try to be courteous and professional in my dealings here.

Oh, and one more thing. It's much easier to understand what you are saying and respond with well-articulated answers if we don't need to try to understand what you wrote that is hidden behind spelling and grammar errors.

Jon

 

[Melclin]

Before anyone corrects me, yes i forgot to add in some words between my sentences. I do that occasionally because i type fast and don't review it. Its easy to spell incorrectly on the internet, but in real life its not the same. I generally don't care how i type on the internet and that is the general consensus on the net. I do realize that i have spell correctly and use lucidity on this forum though, so i can get my point across.

But it is real life. We are having an actual conversation. Yeah sure when you're on /b/ and you're launching the ROFLcopters at n00bs you can be as illiterate as you want.

But these types of forums are a bit different. Like I said we're having a real discussion and there are two reasons why you're style of posting causes issues.

1) If a group of people are sitting around quietly in the library seriously discussing intubation in the moribund haemorrhaging trauma pt, and some jackarse in a slipknot hoody runs up, stands on the table and shouts, "t00b em or loose em muthfockers!!!!", you will find that the people involved in that conversation get frustrated. Its the same here. He's not adding anything useful to the discussion and a comment that might have gone down fine in a less formal chat in a bar, in fact ends up making him a d_ck in the eyes of the people involved and future interactions don't go well as a result. In short, if your posts make you out to be an idiot, then you'll get treated like one and you won't get as much out of the forum as you could have.

2) MOST IMPORTANTLY: While the finer points of grammar aren't that important to getting a message across, if you completely disregard the basic rules and structure of the language, nobody can understand what you're saying. Firstly it makes you look like and idiot (see above). Most importantly though, I actually struggled to understand your posts to such an extent as to assume you were trolling. Its hard enough to communicate the finer points of patient condition and management in text over the internet even when grammar and syntax are your friend. You seem to legitimately want to get something out of this forum and I welcome that, but you can't really get involved in conversation if nobody has any idea what you're saying.

My own rule of thumb (mean though you might think it) is that if its that much of a struggle for someone to form coherent sentences with >90% success rate in regards to spelling, then that person it too stupid to warrant my talking to them. It would be a shame if we all disregarded you, a potentially intelligent contributor, because you couldn't see fit to spend 3 seconds proof reading your own posts.

 

[Handsome Robb]

awesome! What are you? Paramedic? Also how would you put this on a rapport? Please write it based on the procedures you listed

That was all BLS level stuff.

 

[jgmedic]

That was all BLS level stuff.

Sorry, I think I quoted the wrong post, but right after someone very nicely explains to you the importance of spelling and grammar, you misspell report as rapport again! Not to mention, the title of your thread, it's spelled scenario! Now, as a paramedic preceptor, I hammer home the importance of proper spelling in our PCR's as they are legal documents, and any lawyer worth his salt could use spelling as a possible reason why you are incompetent. Dude, I realize this is an internet forum, but(and I'm generalizing here) younger people such as yourself seem to have no regard for the English language. These are your future co-workers, bosses, instructors, etc. It's like I tell my intern "mistakes are fine, just not the same one twice", sorry if I came off like an ***, but this is a big pet peeve of mine. Good luck to you.

 

[the_negro_puppy]

I would intubate with a NRB @ 15 l/M then helicopter evacuate on a long spine board :rofl:

 

[hippocratical]

Now, as a paramedic preceptor, I hammer home the importance of proper spelling in our PCR's...

Part of the process for an interview I'm seeking at the moment was to write (not type... write) a 2 page essay on why I'm teh awesomestest EMT. I haven't written that much in 10 years! It sucked, but I'm positive it was to check for A) spelling, and B) legibility of handwriting for PCRs. Probably a good move on their part I guess, and I did manage to write it out in one go without any errors, which shocked me.

 

[Aidey]

Alright, I'll bite.

Yes, you can spell-check medical terms. Charting programs often have a variety of common medical terms within their spell check database.

That said, spell check only gets you so far. You've got to use the RIGHT word, too - Best example in the above?
Rapport: http://en.wiktionary.org/wiki/rapport
Report: http://en.wiktionary.org/wiki/report

Grammar is important, too. "I" should be capitalized. And "firemen/paramedic" isn't correct because the single and plural don't agree with each other. Further, in today's politically-correct world, the word "firefighter" is considered more appropriate because it is gender neutral. So the correct way to write that would be firefighter/paramedic, or the plural firefighter/paramedics.

awesome! What are you? Paramedic? Also how would you put this on a rapport? Please write it based on the procedures you listed

I'll make this easy. REPORT!

thanks bra lol ill try my hardest!

:glare: Things like this make me sad for my generation.

 

[Aidey]

And to respond to the OP:

I'm pretty sure immediate life threats comes above all else in the initial assessment, but it has been a while since I've actually looked at one of those skill sheets. That may mean controlling bleeding before you do anything else. If the guy is truly unconscious deal with the bleeding first, not c-spine. He is unconscious, it's not like he is going to be moving much.

Also, why does everyone seem to be assuming he is the victim of some massive trauma? He could have been hit in the leg with a baseball bat and be unconscious due to hypovolemia.

 

[hippocratical]

And to respond to the OP:
Also, why does everyone seem to be assuming he is the victim of some massive trauma? He could have been hit in the leg with a baseball bat and be unconscious due to hypovolemia.

Protocol-wise, an unconscious unknown pt is a candidate for c-spine control. Especially if they have a deadly bleed - that's a sure sign that they met 'some guy' and were attacked 'for no reason' ^_^

Getting you partner to hold his head while you check stuff out isn't the biggest hassle really.

 

[Aidey]

I didn't say don't hold c-spine, just that stopping the bleeding is the priority. If the pt is already holding still what good is your partner serving holding their head still?

 

[TheGodfather]

I didn't say don't hold c-spine, just that stopping the bleeding is the priority. If the pt is already holding still what good is your partner serving holding their head still?

if the patient is responsive to painful stimuli (which is likely with a possible open femur fracture) and he/she jumps.....hellooooo compromised c-spine!

(more than likely the patient, as you said, will be out completely, however in the rarer event they are not, that issue could have been easily avoided)

 

[JPINFV]

if the patient is responsive to painful stimuli (which is likely with a possible open femur fracture) and he/she jumps.....hellooooo compromised c-spine!

If a patient jumps, do you really think manual c-spine is going to stop cervical movement?

 

[TheGodfather]

If a patient jumps, do you really think manual c-spine is going to stop cervical movement?

i agree. i was, more-or-less, trying to word it towards less of a "jump" and more of a "twitch" or "jerk" i guess... i wouldn't expect this patient (the true neuro/multiple trauma patient with significant enough injuries to cause obtundedness) to have the strength to "jump up", but im sure they would be able to grudge their shoulders, twitch, or respond in any of those more subtle/controllable ways....