Re: I had an interesting encounter last night........

"Ryan, KC8PMX" <[EMAIL PROTECTED]> wrote in message
news:[EMAIL PROTECTED]
>
> "mark" <[EMAIL PROTECTED]> wrote in message
> news:[EMAIL PROTECTED]
> > I had an interesting encounter last night........
> >
> > A 21 y/o f was hit by a car while running accross street.  A quick
> > secondary revealed that she had deformities on both legs.  EMT (yours
> > truely) r/o tib-fib fractures on both legs.
> >
> > Pittsburgh Paramedic showed up with 5 paramedics for this call.  Patient
> > had low B.P., very quickly they applied mast pants.  Now here is the
> > interesting part, they did not remove her pants.  From what I learned in
> > EMT class, aren't you suppost to remove all the clothing item on the
> > lower ext. before applying MAST??  Another observation I mad:  I thought
> > C-collars is the first thing to put on during the secondary, however,
> > they did not put it on her untill she was about to be placed on a long
> > board and none of them provided manual head immobilization prior to
that.
>
>
> As far as the MAST/PASG pants...... I would think that if the situation
> warranting the need for the pants might overrule the need for the
extensive
> physical examination of the lower extremities by virtue of clothing
removal.
> I could be wrong on this, but just guessing from what data was provided in
> the scenario.
>
> Secondly, after ABC's and life-threatening injuries are assured/managed on
> primary/initial survey, I was taught at least then to assure
immobilization
> of C-spine by manual method (holding C-spine) by self or partner(s) if
any.
> C-collar being applied as soon as physically possible.  The logic the
> instructor gave was pretty much this, do you want a person with a
protected
> c-spine but they have bled out and dead or do you want a person that
> life-threatening injuries are managed first, then immobilization of
C-spine?
>
> Hope I got my point across clearly.... if not.... let me know.

It's the old "life over limb" cliche.  Good point Ryan.  I have been on
trauma scenes where the lead medic is so focused on immobilization that they
forget about the downward-spiraling vitals.  In fact, I'm tasked with
developing five scenarios for an officer assessement center.  I think I'll
put something in about that.  Limited resources, high possibility of spinal
cord injury, diminishing pulses/bp, severe arterial bleeding, what do you
do?
-- 
Gotta Go...It's Hot In Here,
Lt. William Lyster