Ask A Medic

Georgia says that if you run lights you are required to run siren.

 

Got a student today. First 2 calls out of the chute. 9 Delta that went bravo. And 26 D that went 9 Bravo.

Damn...

 

??? im outa the look

 

9 - Cardiac issues

26 - general malaise

 

question. me and my partner got into an discussion over a snake bite. Say patient is bitten by a rattlesnake in the ankle. what is the best course of action?

 

I carry a CAT tourniquit in my FAK. How do the EMS folks here feel about them. They are easy to apply and don't take up much room.

 

our protocol is to transport with supportive care. not really a whole lot that you can do. most of the hospitals all have anti venom here in fl so

 

Throw a iv type tourniquet to help reduce venous return, and transport. In the ed a lot of care is supportive up here in pa

 

Thats what I said.

 

I assume you are military considering most civilians don't carry an ifak, let alone know what a CAT is.

They are very good at their job when applied correctly, which is very very tight, and if someone has a traumatic amputation, that truly is a lifesaver. I personally know several guys who are alive today because of them.

I will let the guys who still run answer for sure, but I doubt they are on many civilian ems vehicles, and I never carried one. They are designed to be applied within momentss of the injury and one handed if needed. I had a different style conus.

I assume everyone still get cls trained? Take that seriously, it can very likley save you or you buddy one day. Medics are too far and few between and you guys are too important.

 

tourniquets are great if you are a long way from definitive care in order to save a life, and you need a last resort to stop massive blood loss. But they can cause further nerve damage and starve other tissues of blood and cause further damage.

In EMS we are relatively close to definitive care.

In my system we can be to the lvl one trauma center in 5-10 minutes.

 

Limb lower than heart. If you can bring the dead animal or get a picture of it safely do so. Keep pt calm. Patch the receiving hospital and call poison control. Diesel bolus.

We just got them. They're awesome, but you have to know the do's and don't for using it. Otherwise you'll kill the the pt. The thing with it is that once applied you can not take it off. If you do, you'll stop their heart with all the lactic acid and potassium build up.

http://www.remoteemergencycare.com/documents/tourniquets-gn.pdf

It's more for Lymphatic return than venous if memory serves me correctly.

 

Supportive care.. x2

Generally an average healthy adult male wouldn't immediately be critical after a bite, so supportive care is key; however, after a recent incident I heard about, it came to mind that most of the time people are bitten, in my area at least, they aren't going to be within 5-10 minutes of a hospital, they're going to be in a difficult to access/rural area. This could significantly increase the severity the pt's presentation before arrival at the hospital...

I live in a very suburban area (Bay Area) but there are also some very remote areas. Recently a late 20's male had to be life flighted out of a regional park after being bitten...

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I've heard the patient made a full recovery shortly after. I'm sure the response was a mess. The closest station is about 25 minutes out (for just fire, ambulance could've been even further out), minimum, because the road getting to the location is very tight. Then the closest basic ED is about 30 minutes by ground, next closest (L1 trauma center) is about 45, and I believe that's where they flew him.

 

we r very rural here and a 20 minute response is not unheard of for us...

 

Do you utilize a lot of air transports?

 

My county has them (CAT's) on every ambulance.


Edit: I've never seen one used though.

 

Yup it doesn't help that our hospital is the equivalency of a vet so stroke alerts get flown and legit stemis under 50 we will fly if we r far. All trauma goes for a choppa ride

 

Why does a double seem like an okay idea at hour 4 of the first half, but at the end I am hating my life. I'm a walking Zombie. Up 23 hours so far and no nap.

 

How do insurance companies see that policy? Cause choppers ain't cheap. Interesting though since if you are rural you really don't have a choice

 

I have a HUGE interview monday with a local 911 Agency in my home county.

Anyone have any interview questions I can ponder to help get me prepared?

Its been a while since I interviewed.