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Refresh my memory- trauma in field

Discussion in 'Clinical Rotations' started by closertofine, Apr 21, 2007.

  1. closertofine

    closertofine Emerging from hibernation

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    I just had the unsettling experience of being the first medical-ish person on the scene of a car accident. (This is the first time that's ever happened to me...hence unsettling...or I guess it may always be unsettling). I just happened to be passing by and so didn't have all those great things you have during some simulations, like a BP cuff or even a 4 by 4...

    Fortunately she was breathing and talking, though very panicked and visibly injured, so I did what I could to calm her down and assess the basics and keep her still until the EMS got there...

    But could someone refresh my memory in terms of what to do in this kind of situation when your brain is not the clearest either? I know I kind of know this, and I'm getting it reviewed again soon...but I was kind of freaked out at the time and couldn't recall any simple list of things besides ABCD's, etc...

    Also, do you guys carry some kind of med student first aid kit in your car? That could have been helpful...
     
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  3. Tired

    Tired Fading away

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    Someone correct me if I'm wrong, but here's my understanding:

    If you're in field and not able (either due to lack of equipment or lack of training), you treat based solely on BLS and basic first aid. Call 911. Is the situation safe? Do not move the patient unless a life-threatening situation is present. Worry about a potential cervical spine injury. Is the patient breathing? Is there a pulse? Do you need to initiate CPR? Do you need to stop active bleeding?

    And that's pretty much it. You're no different than any other random civilian with a CPR card.
     
  4. closertofine

    closertofine Emerging from hibernation

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    OK, whew, that's what I did...911 had already been called...I just kept her in the car and got her to stay still (she was freaking out and trying to get her purse) and held her head in neutral, though she didn't complain of neck pain...and checked pulses and checked for bleeding...and asked her where she hurt, etc...
     
  5. Tired

    Tired Fading away

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    Sounds to my uneducated mind like you did the right thing. I'd be more worried if you had told us that you attempted to reduce an open femur in the car, performed bilateral prophylactic needle thoracostomies, then inserted a crude ET tube you had fasioned from tree bark.
     
  6. closertofine

    closertofine Emerging from hibernation

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    :laugh: The craziest moment for me was when I came up to the car, there was a man standing there holding her hand, and her head was back and her eyes were closed...I told him I was a med student, and he said, "you take it from here...I'm just a priest!" I was like, "oh, crap!" :oops:
     
  7. Bertelman

    Bertelman Maverick!

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    ...and that's your first mistake. :laugh:

    Seriously, I don't even like telling my kid's pediatrician I'm graduating med school. Next thing I know, he is prefacing every statement with, "but you know what I'm talking about, right?". No, no I don't.
     
  8. AmoryBlaine

    AmoryBlaine the last tycoon

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    1. Make sure the car isn't on fire.
    2. If car is on fire consider moving victim.
    3. ABC.
    4. As little as possible until EMS shows up.
    5. Give EMS a 15 second update on what you have seen.
    6. Get out of their way.


    The only thing I have in my car is gloves. Actually I have gloves all over my life right now. I had a girl go down with a sz in front of me and ended up swabbing gobs of saliva out of her mouth with my bare hands to keep her airway open. Gloves are key, I even have them in my man-bag.
     
  9. Tired

    Tired Fading away

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    So how many fingers do you have left now?
     
  10. WestcoastMedicine

    WestcoastMedicine Senior Member

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    C-Spine immobilization while waiting for BLS/ALS unit to arrive
     
  11. AmoryBlaine

    AmoryBlaine the last tycoon

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    All ten. I don't go past the teeth baby.

    Good question though.
     
  12. dentate_gyrus

    dentate_gyrus Member

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    fixed it for you.
     
  13. AmoryBlaine

    AmoryBlaine the last tycoon

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    Excellent, thank you.
     

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