When to cut away a patient's clothes?

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musicislife

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When is it necessary, and when should it not be done?
 
I cut a PT's clothes when I have to and I don't when i don't need to.
 
When they can't take them off for themselves. I always tell them "I need your shirt off" and if they refuse or can't help me get it off of them snip snip snip.

When you need to expose something and it isn't practical to ask them to remove that piece of clothing. I.E a leg injury and tight jeans.

Achilles, no need to be a smartass.
 
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When it's necessary for you to inspect or palpate an area of the body not otherwise accessible, or not easily accessible without exacerbating said injury. Unresponsive multi-trauma victim may be an example...

With all of that said, one rule. Never cut down-material. Ever.
 
Between the ages of 18-25 y/o f patient bmi of <20...

Only when it's a necessity to examine your patient, usually when the patient can't help you and you need to assess everything fast.
 
ABCDE's E is for environment/expose....

Cut to expose or otherwise necessary cut on a toe doesn't mean rip pants off
 
It's also worth mentioning that if time is not critical try and cut along seams or in non obvious spots if they're wearing nicer clothes. Slicing through someone's 150 dollar pair of jeans can be a little traumatic for some folks. If you tell them your're going to follow the seam so they can be repaired by a good tailor it is on less thing they have to stress about.
 
Any major trauma is going into the trauma room with only their underwear on... otherwise just expose the area of injury.
 
When I want to palpate their six pack and nice pectorals.
 
That aside, as I work IFT my patients often come pre exposed or wearing an easily removable gown. Sometimes the clothes are layered on and that's a PITA.

I remove it only as necessary for examination and treatment. Applying 12 leads or investigating complaints.
 
emt.dan said:
With all of that said, one rule. Never cut down-material. Ever.
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My number one rule is that you do not cut down anything in my amb. If you do, you are riding in and helping clean up. Period. Those little feathers are like :censored::censored::censored::censored:ing christmas tree needles. Just when you think you've got them like cleaned up, more come out of the woodwork.
 
You only cut when you need to bare something and it can't be conveniently bared by disrobing; to extricate; to decontaminate; and either if the pt has inability to consent (altered mentation or unconscious) and it is imperative that the area be seen/etc quickly.
And when local protocols demand.

I once cut the shirt off a guy in the ER. He was sitting quietly by himself, was pale, diaphoretic, holding very still and tripoding and said "I don't feel so good". He wasn't having a MI, he had a middle ear disorder and was waiting for his wife to pick him up. Had to go home with a hospital gown on as a shirt.
 
EMT John said:
Any major trauma is going into the trauma room fully naked (aka "trauma striped") and covered with blankets to prevent hypothermia... otherwise just expose the area of injury.
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fixed that for you.
 
EMT John said:
Any major trauma is going into the trauma room with only their underwear on... otherwise just expose the area of injury.
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yeah, i second this. It pisses me off when EMT-Bs call a trauma notification and bring me the patient fully dressed. They are basics, they weren't starting an IV. They should have already done a rapid trauma exam on scene before backboarding the patient. So other than getting a set of vital signs what the heck are they doing on the way to the hospital? Start cutting.
 
Trauma assessment def need to cut some clothes I would think...
 
EMT John said:
Any major trauma is going into the trauma room with only their underwear on... otherwise just expose the area of injury.
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If I'm cutting that much off they ain't gonna have underwear left.
 
medic417 said:
If I'm cutting that much off they ain't gonna have underwear left.
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Whats the point of bringing them in nude? Can you not lift a piece of underwear to scan an area? I mean if they're wearing some long johns and/or a corset, then sure cut those thing off. But I feel that people need dignity as much as the next person.
 
12-leads aren't usually a good reason to cut something either. I can place a 12-lead without exposing a woman's chest, or a man's chest for that matter and still get them in the right spot.

I'm with John, they can keep their underwear and women can keep their bra as well, if it's that bad that the bra needs to come off you can be sure I'm not going to do it until we are in the truck and then I'm going to cover her up with a towel or a scrap of her leftover shirt. Everyone deserves their dignity, even if they are in an ambulance.
 
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