medical scenarios

What would you do?
northernmedic
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Postby northernmedic » Mon Jul 10, 2006 7:11 pm

Ahh the drive by good samaritan. It will be the death of the 911 system in vancouver. Did a call the other day for a home less guy sleeping. Multiple people frantically calling 911 reporting an unconscious man on the sidewalk. Discussion goes something like this....

West side princess: You have to HELP this man!

Me: he sleeping just leave him alone.

WSP: DO SOMETHING!

Me: Ma'am this is an ALS unit you don't get to go in the back unless you're actually really sick.

WSP: WHAT?

My crusty old school partner: Why don't you take him back to your house and feed him a hot meal then you silly woman?

We cleared, and cancelled everyone else. So far no complaint....Some people just need to see the error of their ways

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CanuckEMT
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Postby CanuckEMT » Tue Jul 11, 2006 1:43 pm

I do like the idea of the scenarios. Put my vote in to continue with 'em.

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North_of_60
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Postby North_of_60 » Tue Jul 11, 2006 4:01 pm

firefighter26 wrote: Scenario #2
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You are dispatched to the a little league ball park not to far from the station. Arriving on scene you notice a crowd forming in the outfield.

As you approach the crowd you notice a young female ball player laying 3/4 prone. Bystanders have placed a jacket under her head and are trying to comfort her.

The female PT is unresponsive and you notice that her skin is warm and flushed and some blueness is started to form around her mouth.

Go!
Apart from scene safety etc., I think that my first action would be to ask what happened. This is going to be the biggest indication if it is Trauma or Medical. It may be that she was hit in the head with a ball and has a brain injury. However, if it is medical, I would agree with DH and say that Anaphalaxis would be my first guess.
Remember that a history is a huge clue in what you are going to treat for and the events leading up to an incident are part of that history. Rule of Thumb:
Trauma Cases - 25% verbal history, 75% assessment
Medical Cases - 75% verbal history, 25% assessment

Keep up with your medical training and try out different senarios.
FF26 - Great First Responder Senarios, keep them comming.

Stay Safe,

North of 60
They drop the ball....We get the call

DFCSmash - "THAT, North_of_60, is the best damned response yet to this thread."

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iamvff
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Postby iamvff » Tue Jul 11, 2006 4:03 pm

North_of_60 wrote:However, if it is medical, I would agree with DH and say that Anaphalaxis would be my first guess.
Prolly a peanut allergy! :p


iamvff
"You can lead a horse to water but you cannot make it drink...BUT...if you hold it's head under long enough, it has to take a gulp sooner or later!" iamvff - 2010

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dentedhead
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Postby dentedhead » Tue Jul 11, 2006 4:06 pm

iamvff wrote:Prolly a peanut allergy! :p


iamvff

Nuttin better than baseball and peanuts ;)

Dentedhead
Thousand a week for hide and seek on call when Im paid to be.

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firefighter26
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Postby firefighter26 » Tue Jul 11, 2006 6:12 pm

Ok, time for Scenario No. 4.....

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You've been toned out for an unknown collapse to a residential area in your district. A distraught mother meets you on the road and motions you to the back yard. She points to a tree fort approximately 8 feet off the ground. She says that her boy and his friend, both 12 years old, are passed out in the tree fort.

Using a ladder off the engine you climb up and find two 12 year old males, but unresponsive to verbal. Skin on both PTs is pale cool and clamy. One boy shows evidence of having thrown up a few times. You also notice an empty container of industrial strength cleaner and some soaked rags near the boys.

EHS is delayed. ETA 20 minutes.


Looking for:
- Assessments (how do you think they would present themselves)
- Treatements (your actions)
------------------------------------
"No one ever called the fire department for doing something smart"
- Unknown

"If you don't like what you see, Why don't you fight it?
If you know there's something wrong, Why don't you right it?"
- Trooper

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Scuba
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Postby Scuba » Tue Jul 11, 2006 8:30 pm

firefighter26 wrote:
Using a ladder off the engine you climb up and find two 12 year old males, but unresponsive to verbal. Skin on both PTs is pale cool and clamy. One boy shows evidence of having thrown up a few times. You also notice an empty container of industrial strength cleaner and some soaked rags near the boys.

EHS is delayed. ETA 20 minutes.


Looking for:
- Assessments (how do you think they would present themselves)
- Treatements (your actions)
------------------------------------
  • ASAP remove to fresh air (for both your safety and theirs)
  • ABC's
  • Contact Poision control and/or the manfacturer of the cleaner you''ll have response procedures within seconds.
  • I'd refrain from 02 till you find out what it is, and where it is...if they were doing something stupid like trying to huff the stuff there might be residue left on their faces that you could just be reintroducing into their system.
  • ummm yeah....that's about the limits of my abilities.


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dentedhead
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Postby dentedhead » Tue Jul 11, 2006 9:19 pm

Remove from area using any precautions necessary.

A-B-Cs with close attention paid to the airway of the kid who vomitted suction if needed.

check the oral area for any signs of burning or discolouration that would indicate ingestion vs sniffing,the breath would also provide evidence of this.Insert nasal or oral airway if required

O2 via NRB@ 12L/min, supplement respirations with BVM if required.Place pt semiprone/recovery position vitals Q5

insure that if the liquid was that toxic that it be sealed for transport to the hospital with EMS.Either capped, bagged or both.

Try to illicit some type of Hx from the mother regarding how long the kids had been in the fort, tactfully try and find out if this was typical behaviour or an accidental poisoning,maybe they were just cleaning the fort and were overcome......could happen

wait for EMS and report findings........if they will listen, otherwise return to quarters and finish lunch.

Dentedhead
Thousand a week for hide and seek on call when Im paid to be.

PEMS17
Posts: 551
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Postby PEMS17 » Tue Jul 11, 2006 9:25 pm

dentedhead wrote:Remove from area using any precautions necessary.

A-B-Cs with close attention paid to the airway of the kid who vomitted suction if needed.

check the oral area for any signs of burning or discolouration that would indicate ingestion vs sniffing,the breath would also provide evidence of this.Insert nasal or oral airway if required

O2 via NRB@ 12L/min, supplement respirations with BVM if required.Place pt semiprone/recovery position vitals Q5

insure that if the liquid was that toxic that it be sealed for transport to the hospital with EMS.Either capped, bagged or both.

Try to illicit some type of Hx from the mother regarding how long the kids had been in the fort, tactfully try and find out if this was typical behaviour or an accidental poisoning,maybe they were just cleaning the fort and were overcome......could happen

wait for EMS and report findings........if they will listen, otherwise return to quarters and finish lunch.

Dentedhead
Agree completely with your stellar care with one exception. We have an unwritten (should be written) rule, chemicals stay at the scene. We ahd an incident in the region where the family brought in the chem and ended up contaminatating the ER until it could be decon'd. I would simply write it down and leave it be in a sealed container and bag it. Have it collected by environmental or hazmat guys.

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dentedhead
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Postby dentedhead » Tue Jul 11, 2006 9:37 pm

PEMS17 wrote:Agree completely with your stellar care with one exception. We have an unwritten (should be written) rule, chemicals stay at the scene. We ahd an incident in the region where the family brought in the chem and ended up contaminatating the ER until it could be decon'd. I would simply write it down and leave it be in a sealed container and bag it. Have it collected by environmental or hazmat guys.

Excellent policy.Its true enough that most chemicals have MSDS #s and 1-800 #s plus the name so the ER can call canutec/poison control.

Dentedhead
Thousand a week for hide and seek on call when Im paid to be.


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