When to cut away a patient's clothes?

[shannonlovesth]

Anytime I bring a pt. to our Level 1 Trauma center there clothes are getting cut. Pt. that are unconscious. Also if your not able to get large hoodies jackets off and impedes me from hearing an accurate blood pressure than i'm will cut the sleeve to get the cuff on.

I have a question though. Can someone explain to me what is the big deal with using Trauma Shears? People in my department always get all excited when they hear someone got to use trauma shears (even if its for something stupid.) for example I was cutting a kravat off of the stretcher once and a crew member saw me do it and shouted "No fair she got to use her shears".

 

[medichopeful]

I have a question though. Can someone explain to me what is the big deal with using Trauma Shears? People in my department always get all excited when they hear someone got to use trauma shears (even if its for something stupid.) for example I was cutting a kravat off of the stretcher once and a crew member saw me do it and shouted "No fair she got to use her shears".

Although using them can be enjoyable, people in EMS are obsessed with equipment and tools (whatever it is). For many of the people I know who work EMS, it's all "TOYS!!!" not "knowledge," as sad as it is.

 

[shannonlovesth]

Although using them can be enjoyable, people in EMS are obsessed with equipment and tools (whatever it is). For many of the people I know who work EMS, it's all "TOYS!!!" not "knowledge," as sad as it is.

Agreed. I sometimes forget that the shears could fall under "Toys".

Also love the signature quote.

 

[medichopeful]

Agreed. I sometimes forget that the shears could fall under "Toys".

Also love the signature quote.

Thanks!

Nothing wrong with toys, the problem is when they replace knowledge.

 

[the_negro_puppy]

In major traumas you need to be fully exposing and examining your patients, particularly if they are unconscious. Its not cold here so major trauma pts generally are transported in their underwear with a sheet.

 

[Tigger]

Anytime I bring a pt. to our Level 1 Trauma center there clothes are getting cut. Pt. that are unconscious. Also if your not able to get large hoodies jackets off and impedes me from hearing an accurate blood pressure than i'm will cut the sleeve to get the cuff on.

I have a question though. Can someone explain to me what is the big deal with using Trauma Shears? People in my department always get all excited when they hear someone got to use trauma shears (even if its for something stupid.) for example I was cutting a kravat off of the stretcher once and a crew member saw me do it and shouted "No fair she got to use her shears".

There are many in EMS that are still wondering why the job is different than what they thought they were getting themselves into. Too many people think EMS is all about grievous traumas and everyone is sick or hurt enough to have their clothes cut off so the EMT can provide that life saving treatment. Unfortunately there are not enough people attempting to quash this expectation by any means necessary.

 

[flhtci01]

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.

I have found they are usually very cooperative when I ask them "Would you like to take it off or have it cut off? They like to cut things off in the ER."

It's amazing how cooperative they are taking off hoodies and pullovers when they have a fractured arm or clavicle.

 

[Tigger]

Also if I might add that if the patient is conscious maybe ask them before cutting of their clothes? Many people are willing to cooperate with you if you just ask, even if it means they're putting themselves in some discomfort. I'd rather suffer for a minute than have to suffer watching someone cut off my favorite (and not cheap) ski jacket or something like that.

 

[emt-slick]

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.

Hahaha I made that mistake once, the truck looked like we sacrificed a chicken

 

[beefaroni]

All which can be done with underwear on. One snip bra comes off and there's your chest tube and X-ray. People don't need to be paraded around like some kind of show. Dignity is going to lessen stress and provide trust/repor with my pt which in the long run helps the pt. I don't need to continuously stare at someones goodies. I can palpate a chest through a bra and check a pelvice through some chones.

The trauma room cannot do that "special" finger sweep with the pt underwear on.. Sorry.. Put a sheet over them as they come in through the er..

 

[ZootownMedic]

I dont care if they are conscious or not. If it is a trauma with any serious mechanism the clothes are coming off. Are you guys spinaling these patients? You need their clothes off but your not spinaling them? Doesn't make sense. The patients whose clothes come off for me are patients who are having c-spine held, and being spinally immobilized. That means they aren't moving(ie taking their own clothes off) whether they are conscious or not. I am not a veteran of the streets by any means but this is how I do it. There are exceptions of course but if need to examine them from head to toe it means HEAD to TOE.

 

[WestMetroMedic]

Sorry to join the game late...

Where do all of these down coats exist? I live in Minnesota (and have worked 5 winters for a cold weather camping program for the boy scouts), which is, by common definition, rather cold in the winter, sometimes the summer too, and i don't know anyone who owns a down parka, nor have i ever encountered a trauma patient wearing one of these fabled coats. Perhaps it is all of you southerners who cannot tolerate a "frigid" 45 degree day (after a long winter, that is shorts and t shirt weather). I did however realize, that i own a down sleeping bag and a couple duck down pillows, they are wonderful.

Next up, a blanket or Bair hugger in the back of an ambulance does wonders. Lose all of the clothes for someone who is a red patient, but if we can take them of the old fashioned way, that's cool, but clothes are wet and they get in the way, and you probably have timed to do out on the way to the doctor place. If i cut then off and i for some reason decide the archaic backboard needs to be used, i have found amazing results with citing up the back off their shirt when you have them log rolled over. Much easier than cutting up the front and down each arm.

 

[Tigger]

I dont care if they are conscious or not. If it is a trauma with any serious mechanism the clothes are coming off. Are you guys spinaling these patients? You need their clothes off but your not spinaling them? Doesn't make sense. The patients whose clothes come off for me are patients who are having c-spine held, and being spinally immobilized. That means they aren't moving(ie taking their own clothes off) whether they are conscious or not. I am not a veteran of the streets by any means but this is how I do it. There are exceptions of course but if need to examine them from head to toe it means HEAD to TOE.

The first part is no good here. If you're using MOI to determine who gets their clothes cut off, issues may arise. If the patient is concious, ask them to help. I hit a tree skiing six months ago going fast. No one cut off my clothes despite me being on a board. They asked first, and I helped them remove my ski stuff. Cut my jacket off and you just cost my 400 dollars when I could have done it myself.

 

[Handsome Robb]

Cut my jacket off and you just cost my 400 dollars when I could have done it myself.

Where do all of these down coats exist?

I was a pro ski patroller so I had to deal with down coats all the damn time.

 

[emt-slick]

Boston area, anyone wearing a puffy winter coat it is usually filled with down or some other sort of fluff

 

[Deuce]

Here in Santa Clara they tell us Pretty much never to cut clothes unless its a major trauma

 

[phideux]

Anytime I bring a pt. to our Level 1 Trauma center there clothes are getting cut. Pt. that are unconscious. Also if your not able to get large hoodies jackets off and impedes me from hearing an accurate blood pressure than i'm will cut the sleeve to get the cuff on.

I have a question though. Can someone explain to me what is the big deal with using Trauma Shears? People in my department always get all excited when they hear someone got to use trauma shears (even if its for something stupid.) for example I was cutting a kravat off of the stretcher once and a crew member saw me do it and shouted "No fair she got to use her shears".

Benchmade rescue hook beats the hell out of trauma shears.

 

[bahnrokt]

I learned that you never cut a bikers leathers without premission. The guy dumped his bike and chewed his left arm up pretty good between the road and the bike. Since the leather was torn from the crash I didnt even think twice about cutting. Cutting his leathers was meet with the same reaction as a surprise circumcision.

 

[Bluegrass]

Whatever you don't strip in the field, we have to strip in the ER.
If its serious.... Go full Monty!

 

[Bullets]

Sorry to join the game late...

Where do all of these down coats exist? I live in Minnesota (and have worked 5 winters for a cold weather camping program for the boy scouts), which is, by common definition, rather cold in the winter, sometimes the summer too, and i don't know anyone who owns a down parka, nor have i ever encountered a trauma patient wearing one of these fabled coats. Perhaps it is all of you southerners who cannot tolerate a "frigid" 45 degree day (after a long winter, that is shorts and t shirt weather). I did however realize, that i own a down sleeping bag and a couple duck down pillows, they are wonderful.

Next up, a blanket or Bair hugger in the back of an ambulance does wonders. Lose all of the clothes for someone who is a red patient, but if we can take them of the old fashioned way, that's cool, but clothes are wet and they get in the way, and you probably have timed to do out on the way to the doctor place. If i cut then off and i for some reason decide the archaic backboard needs to be used, i have found amazing results with citing up the back off their shirt when you have them log rolled over. Much easier than cutting up the front and down each arm.

Spend some more time in urban areas in the northeast. Big puffy coats are a fashion statement, hip hop culture and all that jazz

I deal with them all the time, but its never feathers, its usually some synthetic stuffing