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View Full Version : Got an assist this week


Sdiver
02-15-2004, 18:31
So this happened Monday, this past week, (9Feb04), at about 1020 hours, here in Seattle. It was a foggy, drizzling, slick morning.

Was driving down a main road in the northern part of D-town, when I saw a group of people standing around, what appered to be someone lying down. I changed lanes and slowed down enough to see that someone was indeed lying on the gound. I asked one of the people, who was directing traffic around the scene if any medical help was needed. In which he responded, that medical help was needed.

After parking my truck and grabbing my Med-bag, I approched the scene and found an elderly woman (77 y/o) had been hit by a pick-up truck. I first asked if anyone had called 911/EMS, which someone responded "Yes", (Sirens could be heard wailing in the distance, but I didn't want to assume that those where coming to this scene), I than asked if anyone else was medicaly trained here. There was no one.

I then introduced myself to the pt. and told here that I was EMT trained and a Medic First Aid Instructor.

Inital observations were:
Elderly woman, lying on her back. Bystanders had her lying on jackets/coats with a heavy jacket covering her. She had bruising and the start of a good sized "mouse" over her left eye, on the eye-brow. Alert and responsive.

Knowing that I was the only Medicaly trained person at the scene, untill EMS showed up, my first instinct was head/neck trama, so I moved into position, above her head, and placed my hands on either side of her head to keep her from doing any other damage. While I was here I asked her what had happened. She told me that she was starting to cross the street when a pickup truck came from around the cornor and struck her on the right side and she fell over and hit her head on the ground. (While she was talking, I noticed that her pupils were equal and appered responsive). The driver of the pickup truck was behind me, and I asked him if he could tell me about how fast he was going, to which he replied, that he had started out from a stop and was going only about a couple of miles an hour. I didn't question him any further, seeing that would be best to leave for the PD.

I then asked the pt. some standard questions....Do you remember blacking out at all? (No) Do you know what city you're in? (She got it right) Do you know what day of the week it is? (She got it right) Do you know who the President of the U.S. is? ( I knew she was okay, after she told me that it was G.W., I kinda said under my breath, "Yep that's right...and he's doing a pretty good job too." Where then she looked at me and said, "I think so too.", then winked.) I then decided to curtail any other questions, seeing that they would be asked again once EMS showed up, to which they did about 30-40 seconds later.

The Paramedics approched, asked what happened. I said "Morning fellas, I'm Shawn, I'm EMT trained and a MFA Inst. This is xxxxxx and was apperently hit by a vehicle." He then proceded to question the pt. and do a quick survey. While he was doing this, I saw that she was able to move her arms and squeeze the Para's hands and push her feet against his hand. When he got to her R hip, she did react a little, but said she's always had a bad hip. While one Paramedic was doing the survey, the other was getting her vitals. After Para #1 completed his survey he got out a c-collar and applyed it to the pt., at this time another EMS/ambulance arrived and brought over a backboard. (Mind you...I'm still holding onto the pts. head...I haven't been relived yet.)

The other paramedics came over with the backboard and got it ready with rolled towels, sandbags, straps, ect. They then got into position, 3 on the pt., the other on the board. The 1st Paramedic looked at me and said, "Shawn, call the roll."

Needless to say that I was a little surprised. But just briefly. I then collected myself and said, "Okay...on roll." and with a nice steady cadence, "Ready.....1.....2.....3.....Roll...." They then proceeded to strap her down and towel and sandbag her head. After which I steped back at let them proceed. After they got her on the streacher, I asked if they needed me anymore? They said "No they didn't," and "Thanks for the Help." I walked over to the LEO's that had arrived and see if they needed any info from me? Seeing that I didn't wittness anything, they told me I was Good to go. So off I went.

As with any type of "action" like that I replay the scene over and over in my head. As I'm sure most of you do. (Wether it be Medical, Combat, Training, ect.) What did I do right? What did I do wrong? What more could I have done?

This is what I've come up with so far......
1) Since I was the only medically trained person there, my first concern was ABC's. Seeing that her Airway was okay and she was Breathing fine and that I didn't see any apparent bleeding, (although I didn't remove the coat that was over her....I'll address this next), I then moved into the Head position for the possible Head/Neck/Back trama prevention.

2) The reason why I didn't remove the coat that was over her was because A) I was the only med.trained person there, and was worried about the head trama and wanted to steady the head. But I could have told someone there what to do...but I didn't want to take that chance of them Freaking out/Not knowing what to do/Just having a bad day in general. B) Had I removed the coat w/o having any type of head stabilization there I could have caused more damage to her. She could have had an arm in an inside pocket, or sleeve and with me moving it, causing her arm/body/head to move.

3) I didn't want to do a full survey, seeing that the EMS was on route and would do it anyway and had more equipment and training than I have. I also didn't want to bombard the pt. with the same questions, that I knew they would ask.


So.....NDD, Eagle, Doc T, etal....I'm asking for your opinions. Do you see anything I did wrong? What could I have done different? What could I have done better? That is one of the best ways to learn. Getting someone eles's opinion.

rakkasan187
02-15-2004, 21:46
Sounds like you did fine. It's OK to direct a bystander to assume C-spine if you need to do more assessment/treatment. Just make sure you explain what's going on to your help and your pt.

rak

Surgicalcric
02-15-2004, 22:06
Sdiver:

I concur with Rakassan187. Other than directing someone else to secure C-spine looks like you did fine.

JD