Trauma calls…

changing gloves again, again, and again…..

image

and then you suddenly need the next size up because your hands are getting sweaty…. 

image

but you’re not in the back of the truck yet….

On July 24th 2010 a BBC camera crew arrived at Yorkshire Air Ambulance HQ to film the team as part of the Helicopter Heroes series. 

Shortly before 7am, emergency medical dispatcher, Chris Solomons, arrived at work feeling unwell. 

Chris’s colleagues assessed him and it quickly became apparent he was suffering from a massive heart attack. 

Within minutes Chris had gone into cardiac arrest and his colleagues and a cameraman immediately began the battle to save his life - using CPR and an AED. 

Meanwhile, the cameras stayed rolling and captured this remarkable footage.

With thanks to the BBC and Chris Solomons.
Read Chris’s full story here (x)

External Jugular Vein Cannulation 
Although external jugular vein cannulation is considered a peripheral IV line, it should not be the first choice for an IV. The route to central circulation is not as direct as the antecubital vein, it is difficult to fully stabilize, and extravasation of fluids into the tissues in this area is a more serious complication than at other peripheral sites. Place the patient supine in a head down position to distend the external jugular vein. The external jugular vein begins near the angle of the mandible and extends across the sternocleidomastoid muscles. Ensure you palpate the vein to ensure there is no pulse prior to cannulating. To help prevent infection cleanse the area with an alcohol swab or other approved product in a circular motion starting from the intended puncture site and moving out. Align the cannula in the direction of the vein with the point aimed at the ipsilateral shoulder. If possible, occlude the vein by lightly pressing a finger on the vein just above the clavicle. Puncture the vein midway between the angle of the jaw and midclavicular line and watch for flashback in the catheter hub 1. Once flashback has been obtained, advance another 2 mm and continue to advance the catheter while withdrawing the needle. Apply pressure over the catheter prior to completely removing the needle or bleeding will occur. While holding the catheter in place, connect the tubing to the hub and open the roller clamp to check for flow. Secure the catheter and tubing in place.
———————————————————-
Have any of you guys ever dared to start one of these in the field?

External Jugular Vein Cannulation 

Although external jugular vein cannulation is considered a peripheral IV line, it should not be the first choice for an IV. The route to central circulation is not as direct as the antecubital vein, it is difficult to fully stabilize, and extravasation of fluids into the tissues in this area is a more serious complication than at other peripheral sites. Place the patient supine in a head down position to distend the external jugular vein. The external jugular vein begins near the angle of the mandible and extends across the sternocleidomastoid muscles. Ensure you palpate the vein to ensure there is no pulse prior to cannulating. To help prevent infection cleanse the area with an alcohol swab or other approved product in a circular motion starting from the intended puncture site and moving out. Align the cannula in the direction of the vein with the point aimed at the ipsilateral shoulder. If possible, occlude the vein by lightly pressing a finger on the vein just above the clavicle. Puncture the vein midway between the angle of the jaw and midclavicular line and watch for flashback in the catheter hub 1. Once flashback has been obtained, advance another 2 mm and continue to advance the catheter while withdrawing the needle. Apply pressure over the catheter prior to completely removing the needle or bleeding will occur. While holding the catheter in place, connect the tubing to the hub and open the roller clamp to check for flow. Secure the catheter and tubing in place.

———————————————————-

Have any of you guys ever dared to start one of these in the field?

Intoxicated Frosh Week Patients

image

image

gif source (x)

New to EMS?

The look your partner gives you right after a weird patient turns around

image

Radio Ambulance (Maruri Grey) (by Luis CAmpoverde)

_______________________________________________________

Do you guys think this warning system would work in your city?

Call I got the other day: 
Pt : 52y/o, M, 200lb. No prior Hx. Hunched over stirring wheel of vehicle, barely able to unlock his door for us.  Put on stretcher and into the bus. Pt. Lethargic, diaphoretic, grey skin, able to maintain good BP, no prior history of heart disease. First 12 lead ECG unremarkable (first ECG picture). Treated: NRM 15L/min O2,  ASA PO, Nitro-Spray SL and Morphine IV.  Four minutes into transport repeated 12 lead ECG and were to do a STEMI diversion to the local Heart Institute.  Repeated 12 lead ECG in the elevator on our way to the Cath lab (second ECG pictured). Even got some show and tell pictures of pt’s  before and after. Pt’s LAD was blocked 100% so they inserted a stent.
Total time between 911 call and stent insertion finished = 54 minutes! You have to love working near top notch facilities.

Call I got the other day:

Pt : 52y/o, M, 200lb. No prior Hx. Hunched over stirring wheel of vehicle, barely able to unlock his door for us.  Put on stretcher and into the bus. Pt. Lethargic, diaphoretic, grey skin, able to maintain good BP, no prior history of heart disease. First 12 lead ECG unremarkable (first ECG picture). Treated: NRM 15L/min O2,  ASA PO, Nitro-Spray SL and Morphine IV.  Four minutes into transport repeated 12 lead ECG and were to do a STEMI diversion to the local Heart Institute.  Repeated 12 lead ECG in the elevator on our way to the Cath lab (second ECG pictured). Even got some show and tell pictures of pt’s  before and after. Pt’s LAD was blocked 100% so they inserted a stent.

Total time between 911 call and stent insertion finished = 54 minutes! You have to love working near top notch facilities.

An EMS Christmas Story

Twas the night before Christmas and all through our town,
Ambulances sat quietly-call volume was down.
Dispatchers and medics, without any calls,
All sttled all cozily within station walls.
The city grew silent as the night grew deep;
My partner and I settled in for some sleep.
But no sooner dreaming in our beds were we,
When dispatch awoke us, crying, “Hurry! Code 3!”
The call had come in for an MVA;
Some nutcase claimed he’d hit Santa’s sleigh!
“Head trauma,” we thought, as we gathered our gear,
“Or maybe a drunken driver – it’s that time of year.”
As we raced to the scene with our sirens and lights,
We hoped for the best, tonight of all nights.
We had no idea we were in for a surprise
And, on our arrival, couldn’t believe our own eyes.
I said to my partner, “This must be a trick!
That man in the ditch just can’t be St. Nick!”
A smashed-up sleigh! Toys thrown far and near!
And off to the side, a group of reindeer!
The driver of the car, with a bump on his head
Was crying and told us he wished he was dead.
“Oh, why did I have that one extra beer?
Now I’ve killed Santa – no Christmas this year!”
By now we’d decided that this was too strange,
So we tried to call backup, but were out of range.
“No radio contact,” to my partner I said,
“I’ll check that one while you dress this one’s head.”
I approached the man in the ditch with great care.
He was dressed so oddly – he gave me a scare.
He wore a red suit and a strange kind of hat.
I thought to myself, “Who dresses like that?”
Then he opened his eyes and said, “Do not fear.
Just please help me up – I must catch my reindeer.”
I said, “The reindeer are fine, but stay where you are.
You’ve taken a pretty hard hit from that car.”
I didn’t want to leave him, so I let out a holler:
“We’re gonna need backboard, head blocks and collar!”
As we worked, the man creid, “No! Please don’t strap me down.
I have toys to deliver all over town!
All of the children tonight are depending on me
To get their presents under the Christmas tree.”
“I’m sorry,” I told him, as I shook my head sadly,
“You’re going to the hospital – you’ve been hurt too badly.”
He looked up at me and wiped away a tear
And told me, “The you must bring the Christmas presents this year!”
“Visit eery child’s home in this town?” asked I.
“Sir, you must think I can make an ambulance fly!”
I thought I had made a serious blunder,
For his eyes grew steely, and hsi voice was like thunder.
“Now Dasher, now Dancer, now Prancer and Vixen,
Come Comet and Cupid and Donner and Blitzen!
Hitch onto that truck and take to the sky
For tonight, indeed, an ambulance will fly!”
I just shook my head as we loaded him in,
Then climbed in the cab and I just had to grin.
There were the reindeer, all in a row,
In front of the truck as if ready to go.
“That’s cute,” I thought. “I’ll just go around.”
But then they took off and our wheels left the ground!
Away we went, up over the trees,
Sailing along as light as a breeze.
We touched down on rooftops, delivering toys,
Dropping gifts for good little girls and boys.
We stopped briefly in the hospital’s ambulance bay
And wheeled him to the ED – and hoped he’d stay.
“We’ll call in report later,” we said on our way.
“This man’s turned our ambulance into a sleigh!”
Then off we flew, all through the night,
Delivering toys til the dawn’s first light.
Finally, at our station, we headed down,
Both of us happy to be on the ground.
Dispatch was mad, but the more we explained,
The less they believed us and the more they looked pained.
So we sat in our quarters – boy, were we in trouble!
We turned on teh news and perked up on the double.
As the TV crews interviewed people around town,
It seems that some very strange things had gone down.
Tire tracks were found on a rooftop or two
And children said, “This year, Santa wore blue!”
I grinned at my partner and said, “It’s no mystery!
This Christmas we will go down in EMS history!”