The Three Collision Rule
I imagine it was probably my first Prehospital Trauma Life Support class back in 1990 that I first heard of the three collision rule. Since then, it has remained a useful tool in examining the mechanism of injury after auto accidents. If you haven’t heard of it, please allow me to elaborate.
The three collision rule states that, in any auto accident, there are three collisions that occur and the keen EMT needs to be aware of all three. The next time you walk up to a vehicle accident, instead of imagining two large objects colliding with each other, imagine three separate collisions occurring with each respective vehic...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Lessons I Learned From My First Cardiac Arrest
It strange to think that it’s been almost 20 years since the first time I did CPR. I still remember it so vividly. How the time flies.
I was fortunate to have good mentors and teachers in my early days in EMS. One of them was Phil Rigardo. As an EMT student, Phil had invited me to come do a few ride-along’s with him. I owe a lot to Phil. He was one of the first major influences I had in EMS and he framed the job in a fun and exciting way. I’ve managed to carry that initial frame (EMS is fun) for most of my career.
I had been riding with Phil for a few shifts when we got dispatched to a cardiac arrest....
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Get Anyone To Go With You To The Hospital
I’m going to share with you a very powerful technique to convince just about anyone to go with you to the hospital, and I’m going to ask a favor of you. Please only use this technique in the patient’s best interest. This isn’t a technique to drag out when your service pressures you to increase transports or you’re not in the mood to call in for a proper refusal. This is a technique for when you really honestly believe that the patient needs to go, but they refuse.
Steve
It’s an interesting contradiction in prehospital medicine. The people who don’t really need an ambulance insist on transp...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
The Art of Using Trauma Shears
I got a request recently from a maker of trauma shears to give their product a test drive and see what I think. I’m more than happy to give their shears a few turns around the block and kick the tires a bit. Who knows, maybe they’ll be really good. Maybe they’ll be my new favorite set.
All the shears I’ve ever owned have come and gone. I don’t have a particular set that I’m really attached to right now. I’ve had some great sets of shears over the years. I think my longest running favorite pair lasted around five years. I don’t remember the brand now, but they were good. Black handle with a bit of cloth t...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Patients Don ’t Buy Backboards
I have a Labrador named Eddie. He eats only Eukanuba dog food. That’s because we buy it for him. If we bought him a different brand, I’m sure he would eat that as well. He might need to get a little hungry before he agreed to the switch, but my gut tells me that he would eventually concede.
Knowing my dog, probably sooner than later.
I want to quote from the Eukanuba web site:
Satisfy your dog’s taste buds with the succulent flavors of beef and rice. Your dog is sure to enjoy every bite with real beef as a key ingredient.
Reading this, one thing is clear. Dogs don’t by dog food. This product was ...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
The S.O.A.P. Reporting Break Through
The objective portion of the report is the time when you state your case and tell everyone the stuff you found during your assessment. It’s time to become the CSI investigator and talk about your investigation and you findings.
This will tend to be almost entirely objective information, however, don’t be scared to throw in the occasional subjective tidbit if it helps to paint your picture. “She thinks this bruise may be old.” or “His ankles are always a bit swollen but not this much.” If a subjective addition adds to the picture, include it.
When telling my objective story I tend to start with the le...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
The Ultimate EMT Guide to Vital Signs (Part 1): Pulse
There are few things that EMT’s should claim as their domain. There are certain skills that the EMT provider should simple dominate. Vital signs are one such skill. No medical provider anywhere should be able to hold a candle to the EMT when vitals signs are the name of the game.
Vital signs are, to the EMT, what sharp shooting is to the sniper; what the fast ball is to the closing pitcher; what swordsmanship is to Zorro. It’s the EMT bread-and-butter skill. And yet…so many EMTs fumble through vital signs like it’s amateur hour. No more. Over the next few weeks we’re going to break down vital signs here at The...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
15 Things to Know Before Your Next Obstetrical Call
There’s something about the patient in labor that makes my palms sweat. I’m not alone. Most of us EMS folks get a little anxious at the idea of delivering a baby. Obstetrical calls can go very right and they can go very wrong. The stakes are high.
Here are a few things to consider before you run your next obstetrical call.
At full term, pregnant females have a heart rate 10-15 beats per minute faster than when they were prepartum. (Psst…Before they were pregnant.) They also have 25%-30% higher stroke volume and 30%-50% higher cardiac output.
Pregnant females will tolerate significant blood loss before they ...
Source: The EMT Spot - November 15, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Responding to Hypothermia
In our last post we looked at some of the causes of hypothermia, both typical and atypical. Then we talked a bit about the recognition of the hypothermia progression and what patients might look, feel and act like as they progress through their hypothermic condition.
Now let’s look at some of the guidelines for treating our hypothermia victims.
On the surface, treating hypothermia might seem deceptively simple. The treatment of mild hypothermia often is simple. Bring them in, stop the cooling and rewarm them. But as we progress into moderate and severe hypothermia, things get more complicated. Here are 12 gui...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Understanding Combative Head Injuries
Big biker dude strained against the double layers on tape across his forehead and it occurred to me that the act of c-spine seemed pointless if the patient insisted on fighting violently against the tape and straps. Three firefighters were still holding big biker dude (BBD) down and the firefighter closest to his head was yelling, “calm down. … CALM DOWN!” This wasn’t working, but I understood. Sometimes the urge is irrisistible. For his part, big biker yelled back in disorganized consonants and vowels, “uaaaaghhh”.
BBD had laid his Harley down just before an inte...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
7 Signs That Say “Do Not Resuscitate”
It is a moment in time that you will certainly face at some point in your EMS career. Most of us will face this decision many times over throughout our tenure. Should I attempt resuscitation?
The question may be complicated by family, friends or bystanders who have, in good faith, started CPR prior to your arrival and fully anticipate that you will continue. Or perhaps other members of emergency services arrived before you and declared the patient not workable. They may advise you of their findings, without much further detail. “This guys dead.”
Often, responders who aren’t responsible for documentin...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
EMS Response To Sexual Assault
The EMT Spot would like to welcome Jimmy Futrelle to our guest post roster. Jimmy s a Paramedic hailing from Scurry County Texas. Jimmy has been responding on calls long enough to remember the Lifepack 5 and using D50 as a diagnostic tool.
His unique background working for private and public EMS as well as for local law enforcement makes him uniquely qualified to teach on the subject of sexual assault.
This detailed guide to responding to these challenging calls is well worth reading. I sincerely thank him for this contribution.
Contents
Responding To Sexual AssaultIntro...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
What Is Nystagmus?
This study has never been duplicated.
Note the estimated angle of nystagmus onset
Yup, my patient has nystagmus. What does that mean?
Big picture … it means that there’s something abnormal about the patient’s nervous system. There are a few major reasons to consider.
Drugs and alcohol
Yes, that old roadside sobriety test is a useful indicator of alcohol intoxication. People begin having nystagmus with blood alcohol levels as low as .04%. But alcohol isn’t the only drug that can cause nystagmus. Other central nervous system depressants like barbiturates, Lithium and benzodiazepines ...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Rapid Diagnosis: Vomiting Blood
The dispatcher reports that the patient is vomiting blood. Hemataemesis if you want to be technical about it. It could be a whole bunch of things right? … Well yes it could. Before you e-mail me to say that you can’t believe I missed Bolivian Hemorrhagic Fever, here’s one web site that lists 113 possibilities.
But if you want to play the numbers, it’s going to be one of four things. And if you want to play “stump your partner” you can narrow it down quite a bit based on your patients age and disposition.
There are four things that tend to cause a person to vomit blood. Before you click on the little ...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
5 Big Trauma Scene Mistakes You Can Avoid
We all have our good calls and our bad calls. Don’t we? Sometimes things just flow. Sometimes the patient, the bystanders, the crew members, everyone just clicks. And it’s beautiful. It’s like that perfect drive off the tee box that keeps you coming back for another round. The three point jumper that makes you wonder if you should have tried to play college ball.
Unfortunately (perhaps) it is the rare scene that runs flawlessly. More often than not we look back on our calls and think about the things we could have, and should have done better. Of course, that’s how it should be. Without those moments we don’t ...
Source: The EMT Spot - November 14, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
