Quote:
Originally Posted by SRT31B
Just like as an MP we have levels of force that must be followed, as a civilian EMS employee you have SOP's that apply as well. You respond to a situation a certain way because thats what local protocol/medical director says to do. A lot of that comes down to liability in the civilian world. It's a CYA type thing. Knowing when and where those protocols apply though, and when you can "bypass" something is the important thing.
If a jack hole runs at me with a gun, I don't have to try and use IPC or USD skills on him first, I am allowed to go straight to deadly force and cap the guy. If you respond to an MVA and a guy got his arm partially amputated and has a severe arterial bleed, jump straight to the tourniquet first.
Its all about knowing WHEN and WHY to jump to the next level. As long as there is a justifiable reason for doing so, and you don't exceed the scope of your practice, then you're golden. Theres a common sense factor that comes into play. Not everyone can figure it out on their own though if its not in black and white.
If you have a real concern about something, check your local protocols and ask your medical director as he's the one thats paid to make all those decisions.
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I'm not an MP, and I don't play one on TV...but by gum this is an
OUTSTANDING answer.
If this nutshell could be any smaller-I could only attempt to sum it up by saying the situation you are in will dictate your decision. You, as the para-professional, will have to use your training to make a decision. The what-if's are endless.
SRT31B's answer is still better though
For your other concerns...a TQ is a bold step in any situation. Place it where it works, and distal as appropriate, so as to minimize the potential tissue loss if the microvasculature does become permanently damaged. Seeping is still OK with a TQ in place-remember you are turning off the faucet completely-
While it is true that TQ's can stay in place for upto 8 hours in a surgical environment---there are other physiologic aspects within the body that are not coming into play in the OR that are certianly kicking in on the battlefield or in a trauma situation.
Once again-I refer back to SRT31B's most excellent post...follow your local protocols where applicable, and when they are not...rely on your training. You will never be faulted for doing "as trained" if done in good faith...but the second you deviate from that training "Because I asked these guys on the internet and they said do this"...then you are screwed.
Eagle
Eagle