Evidenced Based Emergency Care
Last week at the start of the Caps first game the opposing goalie passed out on the ice with no one around.
It took over 5 minutes before medics moved the man. 5 MINUTES!!! Why did it take 5 minutes?!! From where I sat as an armchair medic it looked as if much of the delay was getting a board and a neck brace under the man.
Here's my gripe. The top 4 rule outs for someone toppling over for no good reason. Heart Attack, Stroke, Low Blood Pressure, Low Blood Sugar. In my expereience low blood sugar and low blood pressure aren't usually instantaneous. The person usually has a 5-10second warning time before they drop and often will try to let someone know. Low blood sugar is also so easily prevented that it just seemed silly for a proathlete to drop from it 3 minutes into a game.
Self care aside even if Heart Attack and Stroke are low on the list they are both on the list. Both are serious potentially fatal conditions that require access to hospital care within 30 minutes for the best chance of recovery. Take 5 minutes out of 30 to put someone on a body board just in case they broke their neck.... Not a good plan in my mind. We need well trained/conditoned medics but we also need thinking medics.
So this morning's Wash. Post front page article about Medvacing in Afghanistan brought much happiness to me.
This is the quote that makes me smile:
Gone from their repertoire are difficult ot time-consuming manuevers such as routinely hanging bags of IV fluids. On the ground, medics no longer carry stethescopes or blood pressure cuffs. They are trained instead to evaluate a patient's status by observation and pulse, to tolerate abnormal vital signs such as low blood pressure, to let the patient postion himself if he's having trouble breathing - and above all to have a heightened awareness that too much medicine can endager the mission and still not save the patient.
The helicopter spent 3 minutes on the ground. 3 MINUTES to unload a medic and reload him and a patient. At the 5 minute mark at the Caps game the stretcher was just getting to the patient and they hadn't even got him moved yet. Hopefully soon in the very near future more EMTs can adopt the battlefield tactic. If their neck isn't broken (and if they weren't hit by a traumatic force why on earth would it be?) and they're not bleeding get them up, get them moving. You can do all the other crap on the fly in the ambulance. We've eliminated the R from CPR because someone finally realized it was crap. Could we please start looking into training for when a bodyboard/neck board is truly appropriate and when its not.
Oh and a lot of people would probably appreciate it if you wouldn't cut their clothes off when by the time you reach them they are conscious and offering to undress themselves. Just because you love your sharp scissors doesn't mean you did someone a favor by destroying their only winter jacket after they slipped on the ice.
It took over 5 minutes before medics moved the man. 5 MINUTES!!! Why did it take 5 minutes?!! From where I sat as an armchair medic it looked as if much of the delay was getting a board and a neck brace under the man.
Here's my gripe. The top 4 rule outs for someone toppling over for no good reason. Heart Attack, Stroke, Low Blood Pressure, Low Blood Sugar. In my expereience low blood sugar and low blood pressure aren't usually instantaneous. The person usually has a 5-10second warning time before they drop and often will try to let someone know. Low blood sugar is also so easily prevented that it just seemed silly for a proathlete to drop from it 3 minutes into a game.
Self care aside even if Heart Attack and Stroke are low on the list they are both on the list. Both are serious potentially fatal conditions that require access to hospital care within 30 minutes for the best chance of recovery. Take 5 minutes out of 30 to put someone on a body board just in case they broke their neck.... Not a good plan in my mind. We need well trained/conditoned medics but we also need thinking medics.
So this morning's Wash. Post front page article about Medvacing in Afghanistan brought much happiness to me.
This is the quote that makes me smile:
Gone from their repertoire are difficult ot time-consuming manuevers such as routinely hanging bags of IV fluids. On the ground, medics no longer carry stethescopes or blood pressure cuffs. They are trained instead to evaluate a patient's status by observation and pulse, to tolerate abnormal vital signs such as low blood pressure, to let the patient postion himself if he's having trouble breathing - and above all to have a heightened awareness that too much medicine can endager the mission and still not save the patient.
The helicopter spent 3 minutes on the ground. 3 MINUTES to unload a medic and reload him and a patient. At the 5 minute mark at the Caps game the stretcher was just getting to the patient and they hadn't even got him moved yet. Hopefully soon in the very near future more EMTs can adopt the battlefield tactic. If their neck isn't broken (and if they weren't hit by a traumatic force why on earth would it be?) and they're not bleeding get them up, get them moving. You can do all the other crap on the fly in the ambulance. We've eliminated the R from CPR because someone finally realized it was crap. Could we please start looking into training for when a bodyboard/neck board is truly appropriate and when its not.
Oh and a lot of people would probably appreciate it if you wouldn't cut their clothes off when by the time you reach them they are conscious and offering to undress themselves. Just because you love your sharp scissors doesn't mean you did someone a favor by destroying their only winter jacket after they slipped on the ice.