December 9th, 2024 By: Fire Chief Ben McKenna
The Scenario
This year our trauma scenario took place in a hunting camp in the middle of the woods. Two 17-year-old teenagers were riding around the woods on a four-wheeler. While driving, the female was thrown off the four-wheeler and experienced severe trauma to her lungs and spine. She was knocked unconscious immediately after the incident. Once the EMS team arrived, they determined that she had labored breathing, a weak pulse, and was unresponsive. She also had a dilated left pupil, low blood pressure, and a quickened heart rate of 120 bpm. The patient had diminished left lung sounds and a physical deformity atop her left lung. Due to this, they began to bag the patient's lungs. This allowed them to control the lungs' function manually. While also using a needle decompression to remove excess blood or air from the lung cavity.
The EMS team's main goal is to quickly and efficiently assess the patient and transport them to the hospital. The initial treatment is focused on the airway obstruction and blood circulation. Since the EMS team cannot perform in-depth treatment on patients, it is important for them to quickly transport them and accurately prepare the patient for incoming treatment. The EMS team is trained to attempt to spend no less than ten minutes on the scene with the patient. They aim to stabilize the patient's blood pressure to 90 systolic, this is done by an IV into the patient. They measure the amount of CCs introduced into the patient through the IV by a weight-to-medication ratio. While stabilizing blood pressure, they will also investigate CO2 and O2 levels, the derived O2 level is from 93-94%. This will in turn confirm the functionality of the respiratory bag. One should administer one breath every five minutes for a successful respiratory bagging. If they administer more than this, it is possible to hyperventilate the patient. To stabilize and control her airway, it is common for the EMS team to intubate the patient. While they have control of the situation, they will inspect for other minor injuries and other medical issues.
While in transit to a trauma center, the EMS team may call the Alabama Trauma System who will direct them and inform the nearest trauma center of the incoming. This allows for a smoother transition of incoming patients. They will inform the Alabama Trauma System of the patient state and injuries, then it will be the Alabama Trauma System’s job to pass on this information to the desired trauma center.
The Patient
Our patient was a seventeen-year-old female, who was played by our lovely mannequin Pat. She was ejected from a moving four-wheeler and experienced extreme trauma to her head and spine. She has a deflated lung, low blood pressure, high heart rate, dilated left pupil, diminished breathing sounds, and low O2 levels.
When informing the trauma center that the patient will be transported to, the EMS team will provide them with specific information about the patient. For example, our patient was a seventeen-year-old female who had been injured in an ATV accident. She was unconscious with labored breathing when we arrived on the scene. She had low blood pressure and a high heart rate. At this time she is intubated and we needle decompressed her left chest. We have inserted an IV and her vital signs have improved slightly. She still has not regained consciousness. Injuries that were found on scene when we log rolled her, were crepitus to the lumbar thoracic region of her spine and injuries to the left chest. They will then give a time estimate for arrival at the desired facility.
What I Enjoyed
I enjoyed learning more about the transportation of patients to trauma centers. Hearing the specific terminology used to communicate on scene and in transit was very interesting to me. Fire Chief Ben McKenna also included a short summary of his job and requirements as a firefighter. This was especially interesting to me since I had never really considered a career in the fire department. I loved learning more about the EMS program and thier experience since my sister is a certified EMS. I cannot wait for tomorrow's guest speaker and the rest of my last-ever training week!
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