You respond to 40 y/o with chest pains and coughing

jhall98

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respiration 24.. oxygen saturation is 85%, bp 100/75 chest rise and fall is diminished on left side of chest, c/c is coughing up blood.. hes having a hard time breathing.. Your partner then goes into sudden cardiac arrest and you two are the only ones on scene.. Mind you I am a student so im still kind of a newbie at this.
 

chaz90

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What are you looking for here? Triage priority? This sounds like a mass casualty drill, but a ridiculous realistic scenario.
 

jhall98

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Yeah pretty much.. Would you treat your partner first? And what if there were no other units available.. in a very rare scenario
 

jhall98

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yeah just think about it.. The guy is going into hypovolemic shock.. Its a rural area and theres only 2 crews you and another.. Hes lost so much blood from coughing up so much and your partner is in cardiac arrest.. what do you do?
 

jhall98

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Ill make it a little more simpler.. If you are out on a call.. and something happens to your partner.. no help whatsoever.. and you have a patient.. Do you transport them both? Its one of my biggest questions ive had
 

DesertMedic66

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Ill make it a little more simpler.. If you are out on a call.. and something happens to your partner.. no help whatsoever.. and you have a patient.. Do you transport them both? Its one of my biggest questions ive had
You're not even going to be able to transport one of them. Who is going to drive if your partner is down? If you drive then who is going to do patient care? I like Casper and all but he has never been much help on any of my calls.
 

RedAirplane

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Strict triage says black tag your partner. However, he's probably viable.

I would ask for any help I can get. You can't go anywhere so work the arrest and wait for another ambulance even if it's coming from afar.

If you have more than two arms, get your original patient on oxygen. What else can you do for him?
 

BOS 101

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Playing along with the bs of that scenario, Idk about legal things, but IMO you have 2 patients
Not an MCI so you can't black tag anyone, call for backup (hell ask a pedestrian if they can do compressions 4 u) and use time that you aren't shocking or bagging pt 2 (maybe just hands only no bagging if necessary) to put #1 into motion
what you think?
 

Jim37F

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Hopefully you've already put the original patient on a non rebreather or CPAP (depending on severity of their SOB and local protocols). In that case, call for help, at least one, if not two additional ambulances plus PD and FD assistance and work on chest compressions until the cavalry arrives.
 

Jim37F

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Playing along with the bs of that scenario, Idk about legal things, but IMO you have 2 patients
Not an MCI so you can't black tag anyone, call for backup (hell ask a pedestrian if they can do compressions 4 u) and use time that you aren't shocking or bagging pt 2 (maybe just hands only no bagging if necessary) to put #1 into motion
what you think?
In my area an MCI isn't defined by a specific number of patients but instead where the initial first response is overwhelmed which I'd say the lone EMT is most certainly overwhelmed at this point. Not that I'd personally pull that trigger in this case (we always have an engine company auto dispatched to all medical with us plus being in an urban area I can have lots of resources in a few minutes with a single radio call)
 

Gurby

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Guy with SOB coughing up blood, partner just went into cardiac arrest for no apparent reason... My first thought is that there is some sort of airborne chemical or something, and I need to get out right now. Screw the patient, I'm dragging my partner's body out of the area if possible (and certainly not going back in for the patient...), calling for additional resources and notifying of potential hazmat situation, then CPR/defib on my partner.

Hopefully you've already put the original patient on a non rebreather or CPAP (depending on severity of their SOB and local protocols). In that case, call for help, at least one, if not two additional ambulances plus PD and FD assistance and work on chest compressions until the cavalry arrives.
I don't feel so good about CPAP given "chest rise and fall diminished on left side of chest" and "c/c is coughing up blood". If he's got a pneumothorax, CPAP is going to finish him off pretty quickly. Also if there is a lot of blood in the mouth/oropharynx you could cause some problems.
 
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Gurby

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Ill make it a little more simpler.. If you are out on a call.. and something happens to your partner.. no help whatsoever.. and you have a patient.. Do you transport them both? Its one of my biggest questions ive had
Depends on the situation, but realistically 90% of the time you're probably going to want to wait on scene. Call for 2 more ambulances, do whatever you can on scene for both patients, wait for other crews to come pick up your partner and the patient. This could theoretically change if you were in an extremely rural area, if one or both of the patients had some time-critical problem, etc.
 

jhall98

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Guy with SOB coughing up blood, partner just went into cardiac arrest for no apparent reason... My first thought is that there is some sort of airborne chemical or something, and I need to get out right now. Screw the patient, I'm dragging my partner's body out of the area if possible (and certainly not going back in for the patient...), calling for additional resources and notifying of potential hazmat situation, then CPR/defib on my partner.



I don't feel so good about CPAP given "chest rise and fall diminished on left side of chest" and "c/c is coughing up blood". If he's got a pneumothorax, CPAP is going to finish him off pretty quickly. Also if there is a lot of blood in the mouth/oropharynx you could cause some problems.
wow nice one
Ok guys, but what if your radio battery was dead and the oxygen cylander had a leak and was empty too. Then what?!?!?
and your ambulance battery is dead and no gas in it. tires are flat and your defib is broken.
 
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