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Not unless those fluids happen to be whole blood. But his airway definitely needs managed, looks like he isn’t breathing on his own.

Why didn’t you get her in the ambulance asap? She’s gonna need a CT.

Needs a CT scan and blood work. EMT need to transport her immediately.

👎

JT.

Yeppers.....get that bp up to about 90.

So what was causing the pain?

Dry, warm, stimulate. 160bpm hr is desirable. The compression ratio for a neonate (

Norepinephrine.

1st, circumoral burns and burns around the nairs paired with stridor are 100% indications for intubation. I guess if nobody is qualified for that a nrb is fine but at least do a neb treatment or at the very least ensure your nRB bag is inflated.

Thanks

I concur

It's actually only effective in one very rare circumstance.

Appendicitis

Sounds like the gall bladder pain I had before I found out I had gall stones

Appendicitis, not a drug but I sure do remember that pain 🥺

This was made for the professional not the patient.. great for teaching, not reassuring for ppl struggling

Thanks for this

Had an unusual head trauma recently. Construction worker accidentally fired a framing nail into his head. GCS 12. Pt is conscious, non verbal, vomiting. Blood and Csf weeping from a small entry wound.

Needs to poop.

Just a question I had, wouldn't it be pretty hard to tell whether or not a patient has a herniation or a hemorrhage? Seems like the signs and symptoms are pretty similar and you wouldn't get a clear result until a CT scan is performed, no? Or is there a more defining factor between a herniated and hemorrhaged head injury? I was always taught to not hyperoxygenate head injuries. Was just curious about your input

For second I thought she was going to fart at the end and be ok

Thanks

So you have cushings triad reflecting ICP which given the scenario likely indicates a left sided intracerebral hemorrhage occuring secondary to trauma. Yes intubate. As for what you can do for that id get the blood pressure down just a bit but nothing below 160-140 SBP.

With a more thorough pain assessment you can narrow things down. By assessing antecedants to the pain, quality of pain and doing a CVA tenderness check you can rule out galstones, kidney isses, and more.

Svt, at high enough pacing the p waves can disappear.

Appendix

The kids on the phone sitting on the couch....

Triple A possibly.

A wide range of ddx: perforated ulcer intestinal obstruction Aortic dissection MI we needs past medical, surgical & gynecological history to narrow the ddx.

Avoid excessive direct pressure on the wound, cover with a gloved hand, apply an occlusive dressing to protect from air embolism. Tachycardia with hypotension, lowered level of consciousness and pale skin indicates shock. Administer high flow oxygen. Prevent heat loss, keep patient warm. Start large bore IVs (16/18.) A C-Collar may block view of the bleed, if no distracting injuries are present and no cervical neck pain is present I'd avoid the C-collar. Helmet should be carefully removed if it gets in the way of airway management. Piggyback a 100ml bag with TXA infusion over a 1000ml bag of NS or LR and administer at a rate of 1g/10 minutes. I'd apply at least a 4 lead EKG since air embolism into the jugular vein can cause right ventricular failure. I'd have intubation equipment and Pads ready.

Top priority is to secure the airway with an endotracheal tube, using propofol as an induction agent, since this agonizes GABA, the primary inhibitory neurotransmitter in the brain, it will reduce cerebral metabolic rate and intracranial pressure. Once the tube is in, ventilate him with tidal volumes of 6mL/kg Ideal Body Weight, with a volume control setting, at a rate between 12 and 16 to maintain normocapnea and normoxia. Then administer either hypertonic saline or mannitol to reduce cerebral edema, which will then reduce intracranial pressure. Elevate head with reverse trendelenberg to promote cerebral venous drainage, and keep ETT ties and C-collar loose to prevent jugular veinous obstruction, which inhibits cerebral venous drainage. Continue to manage medically and transport to definitive care.

i don't know bruh im just a civilian 😭

Most obvious " head trauma". Basic assessment with trauma. Secure airway, intubate, IV, call for a chopper if available and if quicker. Of course spinal precautions. Keep monitoring while enroute to the trauma center.

Cushings triad/reflex. TBI with ICP. -IV diuretic. -Intubate and hyperventilate with high O2. -Full spinal immobilisation. -Reverse trendelenberg 40°. Super high risk of stroke and cardiac arrest, I'd be looking to airlift if possible.

39.1 degrees is not normal temp, but not important. give oxygen try to get o2sp to 90%. risk for 30 minute transport is a stroke

Rub some dirt in it?

I have high concerns for concussion and internal bleeding.

Gettem some ibuprofen and like a melatonin or something i dont know i work in marketing

No solution mentioned thank you

SMR, Take care of any life threats, Full dcap. While maintaining c -spine, and hyperventilating the patient on high flow oxygen via bvm. Patient is showing signs of ICP. Maybe due to cerebral hemorrhage. Once we immobilize the patient on a long board and start transporting to a level 1 trauma. Depending on protocols. I would intubate. I would also start an IV.

EMT Answer: they exibiting signs of Cushing's Reflex. I'm calling for ALS. In the mean time I'm going to secure the airway with 2 NPAs and begin ventilating for the patient with high flow O2 and try and maintain at 94-98%, take spine motion restriction precautions, then have the rest of my team doing a thorough head-to-toe and I would apply a pelvic binder due to MOI. In my state EMTs can start IVs w/ PMD approval so I would gain large-bore IV access in both arms (preferably AC) for medics prior to their arrival.

Those vitals kind of jamming

While prone a quick spinal exam, looking for step offs. Cervical precautions. Cervical collar. Backboard to supine position. Establish venous access, keep line open, no bolus. Intubation. 15L/min. Trauma assessment. Thoracic look for failed ribs. Abdomine look for distention. Pelvis, check for displacement, pelivs sling if needed. Extremities check for major bleeding and address. Test reflex at extremities (he may be Glasgow 3 but this will test the connection to the spinal cord. If reflex response repeats (clonus) possible spinal cord injury. Load and go. Prepare for code 3 to Level I trauma center. I'm an A-EMT so I don't know all the drugs.

?? TBI and patient at risk of coning. Then into traumatic cardiac arrest. Adminster 2g of Tranexemic acid IV. Run hypertonic saline Iv. Head up 30 degrees and assisted ventilations to support respiratory rate and blow of CO2. If available a pre-hospital emergency anaesthesia and then rapid blue light transfer to trauma unit with pre-alert.

Based on V/S & PERRL assessment, and the laceration to the occipital region, I'm going to assume Neurogenic Shock Intubation & C-Spine Precautions And possible helicopter ride due to 30 min transport Personally, if it was 15 or even 20 minutes I'd be fine with it, but 30? Nah it's air lift time.